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This study aimed to investigate the association between long-term survival and different management of major aortopulmonary collateral arteries in patients with pulmonary atresia, ventricular septal defect, and major aortopulmonary collateral arteries.
From November, 2009 to October, 2018, a total of 98 consecutive patients with pulmonary atresia, ventricular septal defect, major aortopulmonary collateral arteries, and hypoplastic pulmonary arteries treated with modified Blalock–Taussig shunt or right ventricle–pulmonary artery connection were included. Fifty-five patients who received occlusion or ligation of major aortopulmonary collateral arteries during or after palliative procedure were occlusion group, and the other 43 patients were no occlusion group. The early and late outcomes were compared.
The mean duration of follow-up was 30.9 months in no occlusion group and 49.8 months in the occlusion group (p < 0.001). Multivariate analysis showed that only no occlusion of major aortopulmonary collateral arteries was predictive of total mortality (Hazard Ratio: 4.42, 95% CI: 1.27 to 15.42, p = 0.02). The Kaplan–Meier survival curves confirmed that patients without occlusion of major aortopulmonary collateral arteries demonstrated worse survival as compared with the occlusion group (p = 0.013). The Kaplan–Meier survival curves of patients who underwent different palliative procedures showed no differences.
For patients with pulmonary atresia, ventricular septal defect and major aortopulmonary collateral arteries when a primary repair is not feasible, those without occlusion of major aortopulmonary collateral arteries have a higher risk of death following an initial palliative procedure compared with patients who underwent occlusion of major aortopulmonary collateral arteries. The occlusion of major aortopulmonary collateral arteries is not associated with a higher rate of complete repair or better improvement of pulmonary artery growth.
The FNDC5 gene encodes the fibronectin type III domain-containing protein 5 that is a membrane protein mainly expressed in skeletal muscle and the FNDC5 rs3480 polymorphism may be associated with liver disease severity in nonalcoholic fatty liver disease (NAFLD). We investigated the influence of the FNDC5 rs3480 polymorphism on the relationship between sarcopenia and the histological severity of NAFLD.
370 adult individuals with biopsy-proven NAFLD were studied. Appendicular skeletal muscle mass was measured by bioelectrical impedance. The association between the key exposure sarcopenia, and the outcome liver histological severity, was investigated by binary logistic regression. Stratified analyses were undertaken to examine the impact of FNDC5 rs3480 polymorphism on the association between sarcopenia and the severity of NAFLD histology.
Patients with sarcopenia had more severe histological grades of steatosis and a higher prevalence of significant fibrosis and definite NASH than those without sarcopenia. There was a significant association between sarcopenia and significant fibrosis (adjusted odds ratio 2.79, 95%CI 1.31-5.95, p=0.008), independent of established risk factors and potential confounders. Among patients with sarcopenia, significant fibrosis occurred more frequently in the rs3480 AA genotype carriers than in those carrying the FNDC5 rs3480 G genotype (43.8% vs. 17.2%, p=0.031). In the association between sarcopenia and liver fibrosis, there was a significant interaction between the FNDC5 genotype and sarcopenia status (p-value for interaction=0.006).
Sarcopenia is independently associated with significant liver fibrosis, and the FNDC5 rs3480 G variant influences the association between sarcopenia and liver fibrosis in patients with biopsy-proven NAFLD.
A recently developed pneumonia caused by SARS-CoV-2 has quickly spread across the world. Unfortunately, a simplified risk score that could easily be used in primary care or general practice settings has not been developed. The objective of this study is to identify a simplified risk score that could easily be used to quickly triage severe COVID-19 patients. All severe and critical adult patients with laboratory-confirmed COVID-19 on the West campus of Union Hospital, Wuhan, China, from 28 January 2020 to 29 February 2020 were included in this study. Clinical data and laboratory results were obtained. CURB-65 pneumonia score was calculated. Univariate logistic regressions were applied to explore risk factors associated with in-hospital death. We used the receiver operating characteristic curve and multivariate COX-PH model to analyse risk factors for in-hospital death. A total of 74 patients (31 died, 43 survived) were finally included in the study. We observed that compared with survivors, non-survivors were older and illustrated higher respiratory rate, neutrophil-to-lymphocyte ratio, D-dimer and lactate dehydrogenase (LDH), but lower SpO2 as well as impaired liver function, especially synthesis function. CURB-65 showed good performance for predicting in-hospital death (area under curve 0.81, 95% confidence interval (CI) 0.71–0.91). CURB-65 ⩾ 2 may serve as a cut-off value for prediction of in-hospital death in severe patients with COVID-19 (sensitivity 68%, specificity 81%, F1 score 0.7). CURB-65 (hazard ratio (HR) 1.61; 95% CI 1.05–2.46), LDH (HR 1.003; 95% CI 1.001–1.004) and albumin (HR 0.9; 95% CI 0.81–1) were risk factors for in-hospital death in severe patients with COVID-19. Our study indicates CURB-65 may serve as a useful prognostic marker in COVID-19 patients, which could be used to quickly triage severe patients in primary care or general practice settings.
Renal fibrosis is common especially in the elderly population. Recently, we found that vitamin D deficiency caused prostatic hyperplasia. This study aimed to investigate whether vitamin D deficiency promotes renal fibrosis and functional impairment. All mice except controls were fed with vitamin D-deficient (VDD) diets, beginning from their early life. The absolute and relative kidney weights on postnatal week 20 were decreased in VDD diet-fed male pups but not in female pups. A mild pathological damage was observed in VDD diet-fed male pups but not in females. Further analysis showed that VDD-induced pathological damage was aggravated, accompanied by renal dysfunction in 40-week-old male pups. An obvious collagen deposition was observed in VDD diet-fed 40-week-old male pups. Moreover, renal α-smooth muscle actin (α-SMA), a marker of epithelial–mesenchymal transition (EMT), and Tgf-β mRNA were up-regulated. The in vitro experiment showed that 1,25-dihydroxyvitamin D3 alleviated transforming growth factor-β1 (TGF-β1)-mediated down-regulation of E-cadherin and inhibited TGF-β1-evoked up-regulation of N-cadherin, vimentin and α-SMA in renal epithelial HK-2 cells. Moreover, 1,25-dihydroxyvitamin D3 suppressed TGF-β1-evoked Smad2/3 phosphorylation in HK-2 cells. These results provide experimental evidence that long-term vitamin D deficiency promotes renal fibrosis and functional impairment, at least partially, through aggravating TGF-β/Smad2/3-mediated EMT in middle-aged male mice.
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.
Findings for the roles of dairy products, Ca and vitamin D on ovarian cancer risk remain controversial. We aimed to assess these associations by using an updated meta-analysis. Five electronic databases (e.g. PubMed and Embase) were searched from inception to 24 December 2019. Pooled relative risks (RR) with 95 % CI were calculated. A total of twenty-nine case–control or cohort studies were included. For comparisons of the highest v. lowest intakes, higher whole milk intake was associated with increased ovarian cancer risk (RR 1·35; 95 % CI 1·15, 1·59), whereas decreased risks were observed for higher intakes of low-fat milk (RR 0·84; 95 % CI 0·73, 0·96), dietary Ca (RR 0·71; 95 % CI 0·60, 0·84) and dietary vitamin D (RR 0·80; 95 % CI 0·67, 0·95). Additionally, for every 100 g/d increment, increased ovarian cancer risks were found for total dairy products (RR 1·03; 95 % CI 1·01, 1·04) and for whole milk (RR 1·07; 95 % CI 1·03, 1·11); however, decreased risks were found for 100 g/d increased intakes of low-fat milk (RR 0·95; 95 % CI 0·91, 0·99), cheese (RR 0·87; 95 % CI 0·76, 0·98), dietary Ca (RR 0·96; 95 % CI 0·95, 0·98), total Ca (RR 0·98; 95 % CI 0·97, 0·99), dietary vitamin D (RR 0·92; 95 % CI 0·87, 0·97) and increased levels of circulating vitamin D (RR 0·84; 95 % CI 0·72, 0·97). These results show that whole milk intake might contribute to a higher ovarian cancer risk, whereas low-fat milk, dietary Ca and dietary vitamin D might reduce the risk.
Terrorist attacks can occur anywhere. As the threat of terrorism develops, the China-Eurasia Expo held in Ürümqi, China is attracting fewer potential visitors. A nationwide survey of 2034 residents from 31 provinces and municipalities in China was conducted to examine the relation between the distance to respondents’ city of residence from Ürümqi and their levels of concern for safety and security concerning the Expo. The two were found to be positively related: the closer the respondents lived to Ürümqi, the less concerned they were with the safety and security of the Expo. This is consistent with the “psychological typhoon eye” effect, which states that people living closer to the center of an unfortunate event (whether natural or man-made hazards) are less concerned with the event’s negative consequences. This effect appears to hold for terrorism. There are implications of this finding for international counter-terrorism practice, tourism, and research.
Wire-shaped supercapacitors (WSSCs) hold great promise in portable and wearable electronics. Herein, a novel kind of high-performance coaxial WSSCs has been demonstrated and realized by scrolling porous carbon dodecahedrons/Al foil film electrode on vertical FeOOH nanosheets wrapping carbon fiber tows (FeOOH NSs/CFTs) yarn electrode. Remarkably, ionogel is utilized as solid-state electrolyte and exhibits a high thermal/electrochemical stability, which effectively ensures the great reliability and high operating voltage of coaxial WSSCs. Benefiting from the intriguing configuration, the coaxial WSSCs with superior flexibility act as efficient energy storage devices and exhibit low resistance, high volumetric energy density (3.2 mW h/cm3), and strong durability (82% after 10,000 cycles). Importantly, the coaxial WSSCs can be effectively recharged by harvesting sustainable wind source and repeatedly supply power to the lamp without a decline of electrochemical performance. Considering the facile fabrication technology with an outstanding performance, this work has paved the way for the integration of sustainable energy harvesting and wearable energy storage units.
Schizophrenia is a complex mental disorder with high heritability and polygenic inheritance. Multimodal neuroimaging studies have also indicated that abnormalities of brain structure and function are a plausible neurobiological characterisation of schizophrenia. However, the polygenic effects of schizophrenia on these imaging endophenotypes have not yet been fully elucidated.
To investigate the effects of polygenic risk for schizophrenia on the brain grey matter volume and functional connectivity, which are disrupted in schizophrenia.
Genomic and neuroimaging data from a large sample of Han Chinese patients with schizophrenia (N = 509) and healthy controls (N = 502) were included in this study. We examined grey matter volume and functional connectivity via structural and functional magnetic resonance imaging, respectively. Using the data from a recent meta-analysis of a genome-wide association study that comprised a large number of Chinese people, we calculated a polygenic risk score (PGRS) for each participant.
The imaging genetic analysis revealed that the individual PGRS showed a significantly negative correlation with the hippocampal grey matter volume and hippocampus–medial prefrontal cortex functional connectivity, both of which were lower in the people with schizophrenia than in the controls. We also found that the observed neuroimaging measures showed weak but similar changes in unaffected first-degree relatives of patients with schizophrenia.
These findings suggested that genetically influenced brain grey matter volume and functional connectivity may provide important clues for understanding the pathological mechanisms of schizophrenia and for the early diagnosis of schizophrenia.
Image stitching is important for the perception and manipulation of undersea robots. In spite of a well-developed technique, it is still challenging for undersea images because of their inevitable appearance ambiguity caused by the limited light in the undersea environment, and local disturbance caused by moving objects, ocean current, etc. To get a clean and stable background panorama in the undersea environment, this paper proposes an undersea image-stitching method by introducing graph-based registration and blending procedures. Specifically, in the registration procedure, matching the features in each undersea image pair is formulated and solved by graph matching, to incorporate the structural information between features. In the blending procedure, an energy function on the indirect graph Markov random field is proposed, which takes both image consistency and neighboring consistency into consideration. Coincidentally, both graph matching and energy minimization can be mathematically formulated by integer quadratic programming problems with different constraints; the recently proposed graduated nonconvexity and concavity procedure is used to optimize both problems. Experiments on both synthetic images and real-world undersea images witness the effectiveness of the proposed method.
In this study, a three-phased multiwalled scaffold, composed of carbon nanotube (mwCNT), nanocrystalline hydroxyapatite (nHA), and polycaprolactone (PCL), was fabricated by the solvent evaporation technique. The structure character, mechanical properties, and degradation activity in simulated body fluid (SBF), along with osteoproductive ability in human osteosarcoma cell MG63, were investigated thoroughly. Results showed that the three phases in mwCNT/nHA/PCL composite presented excellent miscibility and stronger interfacial force when the weight content was 1/15/84 (wt%). Simultaneously, the composite had smaller porosity and slower degradation rate, and there was massive crystallized hydroxyapatite formed on the surface after being soaked in SBF. With regard to bioactivity, MG63s on this scaffolds presented good proliferation performance and differentiated into the osteogenic lineage by expressing high levels of ALP. It was concluded that mwCNTs/nHA/PCL composite scaffolds might be beneficial for bone tissue engineering at a relatively low concentration of mwCNTs and nHA.
Nutrition therapy is considered an important treatment of burn patients. The aim of the study was to delineate the nutritional support in severe burn patients and to investigate association between nutritional practice and clinical outcomes. Severe burn patients were enrolled (n 100). In 90 % of the cases, the burn injury covered above 70 % of the total body surface area. Mean interval from injury to nutrition start was 2·4 (sd 1·1) d. Sixty-seven patients were initiated with enteral nutrition (EN) with a median time of 1 d from injury to first feed. Twenty-two patients began with parenteral nutrition (PN). During the study, thirty-two patients developed EN intolerance. Patients received an average of about 70 % of prescribed energy and protein. Patients with EN providing <30 % energy had significantly higher 28- d and in-hospital mortality than patients with EN providing more than 30 % of energy. Mortality at 28 d was 11 % and in-hospital mortality was 45 %. Multiple regression analysis demonstrated that EN providing <30 % energy and septic shock were independent risk factors for 28- d prognosis. EN could be initiated early in severe burn patients. Majority patients needed PN supplementation for energy requirement and EN feeding intolerance. Post-pyloric feeding is more efficient than gastric feeding in EN tolerance and energy supplement. It is difficult for severe burn patients to obtain enough feeding, especially in the early stage of the disease. More than 2 weeks of underfeeding is harmful to recovery.
This study presents an optimal design procedure including topology optimization and size–shape optimization methods to maximize mechanical advantage (which is defined as the ratio of output force to input force) of the synthesized compliant mechanism. The formulation of the topology optimization method to design compliant mechanisms with multiple output ports is presented. The topology-optimized result is used as the initial design domain for subsequent size–shape optimization process. The proposed optimal design procedure is used to synthesize an adaptive compliant gripper with high mechanical advantage. The proposed gripper is a monolithic two-finger design and is prototyped using silicon rubber. Experimental studies including mechanical advantage test, object grasping test, and payload test are carried out to evaluate the design. The results show that the proposed adaptive complaint gripper assembly can effectively grasp irregular objects up to 2.7 kg.
Suppression of stimulated Raman scattering (SRS) by means of chirped and tilted fiber Bragg gratings (CTFBGs) has become a key topic. However, research on high-power systems is still lacking due to two problems. Firstly, after the inscription, there are a large number of hydroxyl compounds and hydrogen molecules in CTFBGs that cause significant heating due to their strong infrared absorption. Secondly, CTFBGs can couple Stokes light from the core to the cladding and the coating, which causes serious heating in the coating of the CTFBG. Aimed at overcoming these bottlenecks, a process that combines constant-low-temperature and variable-high-temperature annealing is used to reduce the thermal slope of the CTFBG. Also, a segmented-corrosion cladding power stripping technology is used on the CTFBG to remove the Stokes light which is coupled to the cladding, which solves the problem of overheating in the coating of the CTFBG. Thereby, a CTFBG with both a kilowatt-level power-carrying load and the ability to suppress SRS in a fiber laser has been developed. Further, we establish a kW-level CW oscillator to test the CTFBG. Experimental results demonstrate that the power-carrying load of the CTFBG is close to 1 kW, the thermal slope is lower than
, and the SRS suppression ratio is nearly 23 dB.
The evolution of fatigue performance and surface mechanical properties of AISI 304 stainless steel induced by the electropulsing-assisted ultrasonic surface rolling process (EP-USRP) was systematically investigated by integrating instrumented indentation, scanning electron microscopy with electron backscatter diffraction, and transmission electron microscopy. The results indicate that higher hardness, greater strength, finer ultra-refined grains, and higher residual compressive stress are formed within the strengthened layer compared with the original ultrasonic surface rolling process (USRP). EP-USRP with the optimized experimental parameters can produce a higher average rotating bending fatigue strength for AISI 304 stainless steel than USRP. Anomalously and noteworthily, all fatigue specimens treated by EP-USRP showed an incomplete fracture, revealing a higher reservation of safety in practical engineering applications. The further modified structure strengthening and stress strengthening induced by EP-USRP are likely the primary intrinsic reasons for the observed phenomena. Furthermore, the influence mechanism of EP-USRP was discussed scrupulously.
The hot deformation behavior of Ti–6Al–4V alloy with starting fully lamellar microstructure was investigated by conducting isothermal hot compression tests at the temperature of 700–1000 °C and strain rate of 0.001–10 s−1. The deformation activation energy is calculated to be 342 kJ/mol at temperatures from 750 to 850 °C, whereas the higher apparent activation energy of 610 kJ/mol is obtained at a high temperature regime of 900–1000 °C. The relationship between the dynamic softening behavior and deformation parameters was analyzed by power dissipation efficiency η, which shows an increasing trend as the deformation temperature increases and strain rate decreases, respectively. Processing maps were constructed. The instability flow is dominated by the presence of adiabatic shear bands, and the dynamic softening is mainly caused by a combination effect of dynamic recrystallization and dynamic recovery. Moreover, straining is found to have a positive effect on lowering the phase transformation temperature.
This Research Communication describes the polymorphisms in the coding region of DGAT1 gene in Riverine buffalo, Swamp buffalo and crossbred buffalo, and associations between polymorphisms and milk production performance in Riverine buffalo. Two polymorphisms of DGAT1were identified, located in exon 13 and exon 17, respectively. The distribution of the genotypes of the two SNP loci in different buffalo population varied, especially the polymorphism located in exon 13 which was not found in the Swamp buffalo. Moreover, SNP located in exon 17 was a nonsynonymous switch resulting in the animo acid sequence changed from an arginine (Arg) to a histidine (His) at position 484. Both SNPs were in Hardy–Weinberg equilibrium, and the polymorphism of g.8330T>C in the exon 13 was significantly associated with peak milk yield, total milk yield and protein percentage. The C variant was associated with an increase in milk yield and peak yield but less in protein percentage compared with the T variant. The polymorphisms of g.9046T>C in exon 17 were significantly associated with fat percentage, in that the buffaloes with TT genotype had a significantly higher fat percentage than those with CC genotype. These findings reveal the difference in the genetic evolution of the DGAT1 between Riverine buffalo and Swamp buffalo, and provide evidence that the DGAT1 gene has potential effects for Riverine buffalo milk production traits, which can be used as a candidate gene for marker-assisted selection in buffalo breeding.
Molecular techniques play a critical role in identifying breast cancer patients with overexpressed human epidermal growth factor receptor-2 (HER2). New bright field techniques such as chromogenic in-situ hybridization (CISH) and silver in-situ hybridization (SISH) have emerged to overcome some of the challenges associated with the reference standard, fluorescence in-situ hybridization (FISH). We conducted a literature review and synthesis to characterize the accuracy of HER2 tests, and inform decisions about test selection.
We searched MEDLINE and EMBASE databases using these eligibility criteria: studies evaluating invasive breast cancer samples which examined agreement between CISH or SISH, and FISH, and reported sensitivity, specificity, or concordance. We performed a bivariate meta-analysis of sensitivity and specificity using a generalized linear mixed model in Stata. We used likelihood ratio tests from meta-regression to compare accuracy between HER2 tests.
The search identified 4,475 articles, of which thirty-one were included. A total of thirteen studies (43%) evaluated dual-color SISH, twelve single-color CISH, and six dual-color CISH. The summary estimates for sensitivity and specificity were, respectively, 0.97 (95%CI 0.83–0.99) and 0.99 (95%CI 0.96–1.00) for single-color CISH, 0.98 (95%CI 0.92–0.99) and 0.98 (95%CI 0.91–0.99) for dual-color CISH; 0.92 (95%CI 0.86–0.95), and 0.96 (95%CI 0.91–0.98) for SISH. Significantly higher specificity was reported for single-color CISH than SISH (chi-square 4.12; p = 0.04), while dual-CISH had higher sensitivity than SISH (chi-square: 4.63; p = 0.03). These differences were not maintained when studies with cohorts enriched with equivocal samples were excluded.
The agreement between new bright field tests (SISH and CISH) and FISH is high (>92 percent). Indirect comparison of HER2 tests indicated that overall CISH performance exceeds that of SISH. However, low agreement between SISH and FISH in equivocal cases affects these comparative estimates. The pooled estimates from this meta-analysis can help inform future HER2 test selection decisions.
The Shen-Guang II Upgrade (SG-II-U) laser facility consists of eight high-power nanosecond laser beams and one short-pulse picosecond petawatt laser. It is designed for the study of inertial confinement fusion (ICF), especially for conducting fast ignition (FI) research in China and other basic science experiments. To perform FI successfully with hohlraum targets containing a golden cone, the long-pulse beam and cylindrical hohlraum as well as the short-pulse beam and cone target alignment must satisfy tight specifications (30 and
rms for each case). To explore new ICF ignition targets with six laser entrance holes (LEHs), a rotation sensor was adapted to meet the requirements of a three-dimensional target and correct beam alignment. In this paper, the strategy for aligning the nanosecond beam based on target alignment sensor (TAS) is introduced and improved to meet requirements of the picosecond lasers and the new six LEHs hohlraum targets in the SG-II-U facility. The expected performance of the alignment system is presented, and the alignment error is also discussed.