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The negative regulation effect of tumor microenvironment (TME) greatly compromised the efficacy of various cancer treatments, especially cancer immunotherapy. As a result, it is generally recognized that remodeling of TME along with the treatment is a promising way to realize satisfactory cancer therapy. Here, in our study, a drug delivery system (DDS) composed cancer cell membrane (CCM) vehicle loaded mitoxantrone (Mit) and sorafenib (Sfn) was proposed with the aim to combine TME regulation and chemotherapy-induced immunotherapy in one platform. Our results confirmed that after treating with this DDS, the Mit induced immunogenic cell death (ICD) could be augmented by Sfn-based TME regulation to realize effective cancer immunotherapy. The Sfn was shown to downregulate of the regulatory T cells (Treg) level while activating the effector T cells of TME. The synergetic TME regulation along with cancer immunotherapy might be a promising way for advanced cancer treatment.
The aim of this study was to explore the effects and mechanisms of different starvation treatments on the compensatory growth of Acipenser dabryanus. 120 fish (60.532 ± 0.284 g) were randomly assigned to 4 groups (fasting 0, 3, 7or 14 days and then refed for 14 days). During fasting, MBW decreased significantly with prolonged starvation. The whole body and muscle composition, serum biochemical indexes, visceral indexes and digestive enzyme activities had been effected with varying degrees of changes The GH level in serum was significantly increased in 14D; however, IGF-1 showed the opposite trend. The npy mRNA level in brain was significantly improved in 7D, pyy mRNA level in intestine was significantly decreased during fasting. After refeeding, the FBW, PWG, SGR, FI, FE and PER showed no difference between 0D and 3D. The changes of whole body and muscle composition, serum biochemical indexes, visceral indexes and digestive enzyme activities had taken place in varying degrees. GH levels in 3D and 7D were significantly higher than those in the 0D, the IGF-1 content decreased significantly during refeeding. There was no significant difference in npy and pyy mRNA levels. These results indicated that short-term fasting followed by refeeding resulted in full compensation and the physiological and biochemical effects on A. dabryanus were the lowest after three days of starvation and 14 days of refeeding. Additionally, compensation in A. dabryanus may be mediated by appetite genes and growth hormones, and the degree of compensation is also affected by the duration of starvation.
The single initial Global Positioning System (GPS) has been expanded into multiple global and regional navigation satellite systems (multi-GNSS/RNSS) as the Global Navigation Satellite System (GLONASS) is restored and the BeiDou Navigation Satellite System (BDS), Galileo Satellite Navigation System (Galileo) and Quasi-Zenith Satellite System (QZSS) evolve. Using the differences among these five systems, the paper constructs a consolidated multi-GNSS/RNSS precise point positioning (PPP) observation model. A large number of datasets from Multi-GNSS Experiment (MGEX) stations are employed to evaluate the PPP performance of multi-GNSS/RNSS. The paper draws three main conclusions based on the experimental results. (1) The combined GPS/GLONASS/Galileo/BDS/QZSS presents the PPP with the shortest mean convergence time of 11·5 min, followed by that of GPS/GLONASS/Galileo/BDS (12·4 min). (2) The combined GPS/GLONASS/BDS/Galileo/QZSS shows the optimal PPP performance when the cut-off elevation angle is basically the same because of the rich observation data due to a large number of satellites. To be specific, for combined GPS/GLONASS/BDS/Galileo/QZSS, the PPP convergence percentage is 80·9% higher relative to other combined systems under 35° cut-off elevation angle, and the percentages of the root mean square values of PPP within 0–5 cm are enhanced by 80·5%, 81·5% and 87·3% in the North, East and Up directions relative to GPS alone at 35° cut-off elevation angle. (3) GPS alone fails to conduct continuous positioning due to the insufficiency of visible satellites at 40° cut-off elevation angle, while the kinematic PPP of multi-GNSS/RNSS remains capable of obtaining positioning solutions with relatively high accuracy, especially in the horizontal direction.
To examine the association between physician–patient treatments shared decision making (SDM), patient satisfaction, and adoption of a new health technology.
A cross-sectional study was conducted from July 2016 to October 2016 in Fujian Province and Shanghai, in Eastern China. A total of 542 physicians and 619 patients in eleven hospitals were surveyed. Patients and their treating physicians completed self-reported questionnaires on patient–physician SDM, satisfaction with treatment decision making and adoption of a new health technology. Correlation analysis, multivariate logistic regression and multivariate linear regression were performed.
The majority (68.20 percent) of patients preferred SDM. Involvement of patients in SDM was positively associated with their satisfaction with treatment decision making (p < .001) and adoption of a new health technology (p < .05). Better concordance between their preference and actual SDM was positively associated with patients' adoption behavior (p < .05), but no statistically significant association was found between concordance and satisfaction.
SDM was the most important predictor of patients' satisfaction with decision making and adoption of a new health technology. Therefore, better communication between physicians and patients is recommended to improve their SDM, increase patient satisfaction and to assist with the adoption of new technologies. Training healthcare provider and teaching communication skills in working with patients in the initial stage of technology diffusion is required.
Unmanned aerial vehicle (UAV) was introduced for nondeterministic traffic monitoring, and a real-time UAV cruise route planning approach was proposed for road segment surveillance. First, critical road segments are defined so as to identify the visiting and unvisited road segments. Then, a UAV cruise route optimization model is established. Next, a decomposition-based multi-objective evolutionary algorithm (DMEA) is proposed. Furthermore, a case study with two scenarios and algorithm sensitivity analysis are conducted. The analysis result shows that DMEA outperforms other two commonly used algorithms in terms of calculation time and solution quality. Finally, conclusions and recommendations on UAV-based traffic monitoring are presented.
We aimed to describe the clinical features in coronavirus disease 2019 (COVID-19) cases. We studied 134 critically ill COVID-19 cases from 30 December 2019 to 20 February 2020 in an intensive care unit (ICU) at Wuhan Jinyintan Hospital. Demographics, underlying diseases, therapy strategies and test results were collected and analysed from patients on admission, admission to the ICU and 48 h before death. The non-survivors were older (65.46 (s.d. 9.74) vs. 46.45 (s.d. 11.09)) and were more likely to have underlying diseases. The blood group distribution of the COVID-19 cases differed from that of the Han population in Wuhan, with type A being 43.85%; type B, 26.92%; type AB, 10% and type O, 19.23%. Non-survivors tend to develop more severe lymphopaenia, with higher C-reactive protein, interleukin-6, procalcitonin, D-dimer levels and gradually increased with time. The clinical manifestations were non-specific. Compared with survivors, non-survivors more likely to have organ function injury, and to receive mechanical ventilation, either invasively or noninvasively. Multiple organ failure and secondary bacterial infection in the later period is worthy of attention.
Predictors of compliance with aspirin in children following cardiac catheterisation have not been identified. The aim of this study is to identify the caregivers’ knowledge, compliance with aspirin medication, and predictors of compliance with aspirin in children with Congenital Heart Disease (CHD) post-percutaneous transcatheter occlusion.
A cross-sectional explorative design was adopted using a self-administered questionnaire and conducted between May 2017 and May 2018. Recruited were 220 caregivers of children with CHD post-percutaneous transcatheter occlusion. Questionnaires included child and caregivers’ characteristics, a self-designed and tested knowledge about aspirin scale (scoring scale 0–2), and the 8-item Morisky Medication Adherence Scale (scoring scale 0–8). Data were analysed using multivariate binary logistic regression analysis to identify predictors of compliance with aspirin.
Of the 220 eligible children and caregivers, 210 (95.5%) responded and 209 surveys were included in the analysis. The mean score of knowledge was 7.25 (standard deviation 2.27). The mean score of compliance was 5.65 (standard deviation 1.36). Child’s age, length of aspirin use, health insurance policies, relationship to child, monthly income, and knowledge about aspirin of caregivers were independent predictors of compliance with aspirin (p < 0.05).
Caregivers of children with CHD had an adequate level of knowledge about aspirin. Compliance to aspirin medication reported by caregivers was low. Predictors of medium to high compliance with aspirin were related to the child’s age and socio-economic reasons. Further studies are needed to identify effective strategies to improve knowledge, compliance with medication, and long-term outcomes of children with CHD.
The North Qilian orogenic belt in North China has been defined as a subduction–collision zone between the Alxa Block and the Qilian Block. We present petrography, zircon U–Pb geochronology, major- and trace-element geochemistry, and Sr–Nd–Pb–Hf isotope analysis for the Yushigou diabase from the Longshoushan area, which is located SW of the Alxa Block, aiming to understand its petrogenetic link to subduction processes. The Yushigou diabase belongs to the tholeiite series, and shows enrichment in light rare earth and large-ion lithophile elements, and a depletion in heavy rare earth and high-field-strength elements. Laser ablation – inductively coupled plasma – mass spectrometry U–Pb zircon dating yielded an emplacement age of 414 ± 9 Ma, with an ϵHf(t) value in the range of −10.3 to 1.8. The whole-rock initial 206Pb/204Pb, 207Pb/204Pb and 208Pb/204Pb ratios of the diabase range over 16.811–17.157, 15.331–15.422 and 37.768–37.895, respectively. The (87Sr/86Sr)i ratios vary between 0.7086 and 0.7106, and ϵNd(t) values vary between −14.4 and −13.4, which are significantly higher than the ϵHf(t) value (Nd–Hf decoupling). An interpretation of the elemental and isotopic data suggests that the Yushigou diabase was derived from partial melting of an enriched mantle I (EM-I) -type lithospheric mantle in the spinel–garnet transitional zone. Based on the geochemical features and previous regional geological data, we propose that the Silurian magmatism was most likely triggered by slab break-off after the closure of the North Qilian Ocean, and ancient continental materials from the subduction slab metasomatized the overlying lithospheric mantle during exhumation.
A suite of Jurassic–Cretaceous migmatites was newly identified in the Liaodong Peninsula of the eastern North China Craton (NCC). Anatexis is commonly associated with crustal thickening. However, the newly identified migmatites were formed during strong lithospheric thinning accompanied by voluminous magmatism and intense deformation. Field investigations show that the migmatites are spatially associated with low-angle detachment faults. Numerous leucosomes occur either as isolated lenses or thin layers (dykes), parallel to or cross-cutting the foliation. Peritectic minerals such as titanite and sillimanite are distributed mainly along the boundaries of reactant minerals or are accumulated along the foliation. Most zircons show distinct core–rim structures, and the rims have low Th/U ratios (0.01–0.24). Zircon U–Pb dating results indicate that the protoliths of the migmatites were either the Late Triassic (224–221 Ma) diorites or metasedimentary rocks deposited sometime after c. 1857 Ma. The zircon overgrowth rims record crystallization ages of 173–161 Ma and 125 Ma, which represent the formation time of leucosomes. These ages are consistent with those reported magmatic events in the Liaodong Peninsula and surrounding areas. The leucosomes indicate a strong anatectic event during the Jurassic–Cretaceous period. Partial melting occurred through the breakdown of muscovite and biotite with the presence of water-rich fluid under a thermal anomaly regime. The possible mechanism that caused the 173–161 Ma and 125 Ma anatectic events was intimately related to the regional crustal extension during the lithospheric thinning of the NCC. Meanwhile, the newly generated melts further weakened the rigidity of the crust and enhanced the extension.
The Wulian complex is located on the northern margin of the Sulu orogenic belt, and was formed by collision between the North China Craton (NCC) to the north and South China Craton (SCC) to the south. It consists of the metasedimentary Wulian Group, gneissic granite and meta-diorite. The U–Pb analyses for the detrital zircons from the Wulian Group exhibit one predominant age population of 2600–2400 Ma with a peak at c. 2.5 Ga and several secondary age populations of > 3000, 3000–2800, 2800–2600, 2200–2000, 1900–1800, 1500–1300 and 1250–950 Ma; some metamorphic zircons have metamorphic ages of c. 2.7, 2.55–2.45, 2.1–2.0 and 1.95–1.80 Ga, which are consistent with magmatic-metamorphic events in the SCC. Additionally, the Wulian Group was intruded by the gneissic granite and meta-diorite at c. 0.76 Ga, attributed to Neoproterozoic syn-rifting bimodal magmatic activity in the SCC and derived from partial melting of Archaean continental crust and depleted mantle, respectively. The Wulian Group therefore has tectonic affinity to the SCC and was mainly sourced from the SCC. The detrital zircons have positive and negative ϵHf(t) values, indicating that their source rocks were derived from reworking of both ancient and juvenile crustal rocks. The major early Precambrian crustal growth took place during c. 3.4–2.5 Ga with a dominant peak at 2.96 Ga and several secondary peaks at 3.27, 2.74 and 2.52 Ga. The two oldest zircons with ages of 3307 and 3347 Ma record the recycling of ancient continental crust (> 3.35 Ga) and crustal growth prior to c. 3.95 Ga in the SCC.
A separately-designable diplexer with multiple transmission zeroes (TZs) using common stub-loaded stepped impedance resonator (SIR) is proposed. The common stub-loaded SIR operating in third harmonic (f3) and fifth harmonic (f5) is used for designing the two diplexer channels. The stub is loaded at the voltage-null point of f3 of the SIR. It can separately control f5 but has no effect on f3 so that the two channels can be separately designed. Meanwhile, the input port is tap-connected to the common stub-loaded SIR, which necessarily produces a TZ between f3 and f5, existing in both channel filtering responses. By properly choosing coupling schemes of the two channels, more TZs are realized at the desired locations. Thanks to the generation of the multiple TZs, both passband selectivity and isolation between the two channels are improved significantly. For demonstration, a diplexer operating at 2.22 and 2.95 GHz is designed, fabricated, and measured. The simulated and measured results are presented, showing good agreement.
Physicians' attitudes and adoption behavior toward the delivery of prenatal tests take vital significance for its influence on their professional practice and patient acceptance. This study aimed to identify how physicians have perceived the diffusion of non-invasive prenatal testing (NIPT) in China.
A cross-sectional study was conducted from July 2016 to October 2016 in Shanghai, and Fujian and Sichuan Provinces in China. Physicians working on prenatal screening completed a self-report questionnaire. Following Roger's diffusion of innovation model, multivariable logistic regressions were performed separately for the following key elements of the theory which influence diffusion: physician-perceived attributes of NIPT, communication channels, the nature of the social system, the extent of change agent (who introduces innovations into a society), promotion efforts, and physicians' benefits from adopting NIPT.
Most specialists had a positive attitude (53.2 percent) toward NIPT, whereas 58.9 percent of physicians had already adopted NIPT in their clinical practice. Physician adoption of NIPT was positively associated with the strength of HTA evidence (p = .03), perceived communication frequency with colleagues (p = .04), adoption by other physicians (p = .07), hospital competition (p = .06), hospital teaching status (p = .02), perceived for-profit genetic testing company's promotion (p < .001), and perceived clinical practice skill improvement (p = .02). However, the adoption behavior toward NIPT may be negatively associated with physician-perceived ethical concerns of NIPT (p = .06).
Obstetricians and gynecologists’ positive perceptions facilitate the adoption of NIPT. Combined with cost-effectiveness analysis of prenatal screening methods, health policy makers can promote the adoption of appropriate, cost-effective prenatal screening in pregnant women.
A bidirectional dielectric resonator (DR) antenna array using back-to-back quasi-Yagi antenna configuration is proposed and implemented for the first time. The DR operating at higher-order TE3δ1 mode is used as a magnetic dipole, applying for the driver of quasi-Yagi antenna. Due to the high-order mode employment, the antenna gain can be enhanced. By partially loading the metallic strip on the side wall of the DR, the gain can be further enhanced. In addition, a simple dual Marchand balun is constructed for feeding the two quasi-Yagi antennas directly for bidirectional radiation. To verify the design concept, a prototype operating at the X-band is fabricated and measured. Good agreement between the simulated and measured results can be observed.