Two-sample Mendelian randomization analysis reveals causal relationships between blood lipids and venous thromboembolism.

Venous Thromboembolism (VTE) is a complex disease that can be classified into two subtypes: Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE). Previous observational studies have shown associations between lipids and VTE, but causality remains unclear. Hence, by utilizing 241 lipid-related traits as exposures and data from the FinnGen consortium on VTE, DVT, and PE as outcomes, we conducted two-sample Mendelian randomization (MR) analysis to investigate causal relationships between lipids and VTE, DVT and PE. The MR results identified that fatty acid (FA) unsaturation traits (Ratio of bis-allylic bonds to double bonds in lipids, and Ratio of bis-allylic bonds to total fatty acids in lipids) were associated with VTE (OR [95% CI]: 1.21 [1.15-1.27]; 1.21 [1.13-1.30]), DVT (OR [95%CI]: 1.24 [1.16-1.33]; 1.26 [1.16-1.36]) and PE (OR [95%CI]: 1.18 [1.08-1.29]; 1.18 [1.09-1.27]). Phosphatidylcholines exhibit potential causal effects on VTE and PE. Phosphatidylcholine acyl-alkyl C40:4 (PC ae C40:4) was negatively associated with VTE (OR [95% CI]: 0.79 [0.73-0.86]), while phosphatidylcholine diacyl C42:6 (PC aa C42:6) and phosphatidylcholine acyl-alkyl C36:4 (PC ae C36:4) were positively associated with PE (OR [95%CI]: 1.44 [1.20-1.72]; 1.22 [1.10-1.35]). Additionally, we found that medium LDL had a protective effect on VTE. Our study indicates that higher FA unsaturation may increase the risk of VTE, DVT, and PE. Different types of phosphatidylcholine have either promotive or inhibitory effects on VTE and PE, contributing to a better understanding of the risk factors for VTE.

Pulse energy exchange of vector solitons in a fiber laser.

The energy exchange between orthogonal polarization components is crucial for the build-up of vector solitons (VSs). Unlike previous observations of energy exchange in the frequency domain, our experiments analyzed pulse energy flows in the time domain. We provide evidence to demonstrate the influence of the four-wave mixing (FWM) and cross-phase modulation (XPM) effect on VSs build-up in passive mode-locked fiber lasers through a perspective of pulse energy exchange. The results indicate that the energy exchange of PRVS caused by FWM and XPM is stronger than that of PLVS. The liner energy exchange caused by the birefringence of fiber and PC influences the period of energy exchange. After stabilization, the intra-cavity energy evolution period is one roundtrip for PLVS while serval roundtrips for PRVS. In the future, we can achieve PLVS by adjusting the linear energy exchange through cavity birefringence, thereby meeting the industrial demand for stable and uniform pulse trains.

Global burden and trends of three common road injuries from 1990 to 2019 and the implications for prevention and intervention.

BACKGROUND: Analysis on the burden of specific types of road injuries (RIs) in the previous Global burden of disease (GBD) studies is lacking. The present work aimed to analyze the burden of three common RIs using the updated data of the GBD 2019, which would inform policy-making. METHODS: Data on cyclist road injuries (CRIs), motorcyclist road injuries (MRIs), and motor vehicle road injuries (MVRIs) were extracted from the GBD 2019. Trends of age-standardized rate (ASR) were predicted using estimated annual percentage change (EAPC) from 1990 to 2019. RESULTS: Over the past three decades, the global incident ASRs of CRIs and MRIs presented increasing trends, but that of MVRIs declined slightly. However, trends of death and disability adjusted life years (DALYs) caused by three common RIs decreased in most regions and countries. Particularly, trends in ASRs of years of life lost (YLLs) cuased by RIs decreased more pronouncedly than that of years of life lived with disability (YLDs). The burden of three common RIs showed significant social and demographic characteristics. Low-middle and middle socio-demographic index (SDI) areas had a heavy burden of RIs, particularly CRIs and MRIs. However, the high SDI area undertook a relatively low burden, and presented more pronounced downward trends in death and DALYs. CONCLUSIONS: The burden and changing trends of three common RIs were geographically heterogeneous. The findings highlighted that increasing incident trends of RIs needed more cost-effective measures of prevention and intervention.

Global, regional, and national burden of asbestosis from 1990 to 2019 and the implications for prevention and control.

BACKGROUND: Asbestosis is a common pneumoconiosis caused by long-term asbestos exposure. Analysis of the burden of asbestosis would help in creating informed public health strategies. METHODS: Data on asbestosis were analyzed using the Global Burden of Disease study 2019. The estimated annual percentage change (EAPC) was calculated to demonstrate temporal trends in the age-standardized rate (ASR) of asbestosis from 1990 to 2019. RESULTS: Globally, 36,339 incident cases of asbestosis, led to 3572 deaths and 71,225 disability adjusted life years (DALYs) in 2019. During 1990-2019, the overall ASRs of incidence and DALYs declined by an annual average of 0.29 % and 0.27 %, with the respective EAPCs being -0.29 (95 % confidence interval [CI]: -0.43, -0.14) and -0.27 (95%CI: -0.53, -0.01). The ASRs of mortality increased with EAPC of 0.65 (95%CI: 0.34, 0.96). Trends in incidence and prevalence rose in females, but declined in males. The asbestosis burden was heterogeneous across regions and countries. The heaviest burden of asbestosis was observed in the United States, India, and China. Trends in ASRs of asbestosis varied across countries/territories. Pronounced increasing trends in incidence and prevalence occurred in Georgia, Iran, and Croatia. CONCLUSIONS: Decreasing incident trend of asbestosis was observed globally over the past three decades. However, the ongoing asbestosis burden highlighted that asbestosis remained a challenge to public health, and cost-effective measures were required to reduce the asbestosis burden.

High-efficiency mode-locked erbium-doped ZBLAN fiber laser around 2.8 µm by directly depositing Bi2S3 particles onto a cavity mirror.

Mid-infrared (MIR) pulsed lasers near a 3 µm waveband show great potential for the high absorption of water molecules and many important gas molecules. A passively Q-switched mode-locked (QSML) E r 3+-doped fluoride fiber laser with a low laser threshold and high slope efficiency around a 2.8 µm waveband is reported. The improvement is achieved by depositing bismuth sulfide (B i 2 S 3) particles onto the cavity mirror directly as a saturable absorber and using the cleaved end of the fluoride fiber as output directly. -QSML pulses begin to appear with the pump power of 280 mW. The repetition rate of the QSML pulses reaches a maximum of 33.59 kHz with the pump power of 540 mW. When the pump power is further increased, the output of the fiber laser switches from the QSML to the continuous-wave mode-locked operation with the repetition rate of 28.64 MHz and the slope efficiency of 12.2%. The results indicate that B i 2 S 3 is a promising modulator for the pulsed lasers near a 3 µm waveband, which paves the way for further development of various applications in MIR wavebands, including material processing, MIR frequency combs, and modern healthcare.

Case report: Successful outcome of a young patient with rhabdomyolysis and shock caused by diquat poisoning.

The widespread use of diquat as a substitute for paraquat has led to an increase in poisoning deaths. A successful case of diquat poisoning complicated with rhabdomyolysis and shock was lacking. A 13-year-old previously healthy girl ingested 40 ml of diquat solution in a suicide attempt. The concentration of diquat in serum was 436.2 ug/L at 10 h after poisoning. The clinical course was characterized by progressive multi-organ dysfunction, particularly rhabdomyolysis and shock. The main treatments included intensive hemoperfusion combined with continuous renal replacement therapy (CRRT), drainage, and activated carbon adsorption. Meanwhile, accurate dilatation under the model of pulse indicator continuous cardiac output (PICCO) was essential for the successful treatment of shock. The serum concentration of diquat declined to 20 ug/L after 96 h of treatments. The patient was discharged from the hospital after 3 weeks of treatment without obvious symptoms. So far, this was the first successful case of diquat poisoning complicated with rhabdomyolysis and shock, which would enrich the experience of diquat poisoning treatment.

Origins of black carbon from anthropogenic emissions and open biomass burning transported to Xishuangbanna, Southwest China.

Black carbon (BC) has importance regarding aerosol composition, radiative balance, and human exposure. This study adopted a backward-trajectory approach to quantify the origins of BC from anthropogenic emissions (BCAn) and open biomass burning (BCBB) transported to Xishuangbanna in 2017. Haze months, between haze and clean months, and clean months in Xishuangbanna were defined according to daily PM2.5 concentrations of >75, 35-75, and <35 µg/m3, respectively. Results showed that the transport efficiency density (TED) of BC transported to Xishuangbanna was controlled by the prevailing winds in different seasons. The yearly contributions to the effective emission intensity of BCAn and BCBB transported to Xishuangbanna were 52% and 48%, respectively. However, when haze occurred in Xishuangbanna, the average BCAn and BCBB contributions were 23% and 77%, respectively. This suggests that open biomass burning (BB) becomes the dominant source in haze months. Myanmar, India, and Laos were the dominant source regions of BC transported to Xishuangbanna during haze months, accounting for 59%, 18%, and 13% of the total, respectively. Furthermore, India was identified as the most important source regions of BCAn transported to Xishuangbanna in haze months, accounting for 14%. The two countries making the greatest contributions to BCBB transported to Xishuangbanna were Myanmar and Laos in haze months, accounting for 55% and 13%, respectively. BC emissions from Xishuangbanna had minimal effects on the results of the present study. It is suggested that open BB in Myanmar and Laos, and anthropogenic emissions in India were responsible for poor air quality in Xishuangbanna.

Global burden and trends of firearm violence in 204 countries/territories from 1990 to 2019.

Background: Gaps remained in the updated information of the firearm violence (FV) burden from a global landscape. Understanding the global burden of FV could contribute to decision-making. Methods: Data on the FV burden, including physical violence by firearm (PVF), self-harm by firearm (SHF), and unintentional firearm injuries (UFI), were extracted from the Global Burden of Disease 2019. The temporal trends of age-standardized rate (ASR) were estimated using estimated annual percentage change (EAPC). Results: In 2019, PVF, SHF, and UFI reported 710.64 × 103, 335.25 × 103, and 2,133.88 × 103, respectively, incident cases worldwide. Their ASR (/100,000 people-years) were 9.31, 4.05, and 28.07. During 1990-2019, the overall incident ASRs of PVF presented an increasing trend (EAPC = 0.61, 95% confidence interval [CI]: 0.48 to 0.75). Notably, pronounced increasing trends were observed in Tropical Latin America, and North Africa and Middle East. However, incident trends of SHF and UFI declined globally, with the respective EAPCs being -0.68 (95% CI: -0.83 to -0.54) and -0.98 (95% CI: -1.19 to -0.77). In 2019, the ASR of death due to PVF, SHF, and UFI were 2.23, 0.65, and 0.26, and that of DALYs were 127.56, 28.10, and 17.64, respectively. Decreasing trends in the ASRs of FV were observed in most regions and countries worldwide over the past three decades, particularly that of PVF in Estonia. Conclusion: The FV burden was heterogeneous across regions and countries, which was deeply subjected to socioeconomic factors. The findings highlighted that specific prevention strategies and interventions were required, particularly in the high prevalent settings.

Global Trends in Death, Years of Life Lost, and Years Lived With Disability Caused by Breast Cancer Attributable to Secondhand Smoke From 1990 to 2019.

Background: Secondhand smoke is an important risk factor to breast cancer patients' survival. This article aimed to describe the epidemiological changes of health loss caused by female breast cancer attributable to secondhand smoke from 1990 to 2019. Methods: Data on breast cancer was derived from the Global Burden of Disease study 2019. The epidemiological status and trends were estimated using the number, age-standardized rate (ASR), and estimated annual percentage change (EAPC). Results: In 2019, secondhand smoke-related breast cancer caused 168.33×102 death, 5242.58×102 years of life lost (YLLs), and 334.03×102 years lived with disability (YLDs) globally. The overall ASR of death and YLLs caused by breast cancer attributable to secondhand smoke presented decreasing trends from 1990 to 2019, with the respective EAPCs of -0.78 and -0.87. Meanwhile, decreasing trends occurred in most geographic regions, particularly that of YLLs in high-income North America (EAPC = -3.35). At the national level, most countries/territories had decreasing trends of death and YLLs, particularly Denmark, in which the respective EAPCs were -4.26 and -4.64. However, the ASR of YLDs showed an increasing trend globally (EAPC = 0.32). Meanwhile, increasing trends were observed in most regions and countries, particularly the Solomon Islands and Lesotho, with the respective EAPCs being 6.18 and 4.33. The changing trends were closely associated with sociodemographic development. Conclusions: Trends in secondhand smoke-related death and YLLs caused by breast cancer declined from 1990 to 2019. However, secondhand smoke remains a challenge to the patients' longevity and quality of life. The findings informed strategies should be strengthened the control of secondhand smoking.

Restoration of the gut microbiota is associated with a decreased risk of hepatic encephalopathy after TIPS.

Background & Aims: Hepatic encephalopathy (HE) is a major complication after transjugular intrahepatic portosystemic shunt (TIPS) and is primarily influenced by the gut microbiota. We aimed to evaluate alterations in the microbiota after TIPS and the association between such alterations and HE. Methods: We conducted a prospective longitudinal study of 106 patients with cirrhosis receiving TIPS. Faecal samples were collected before and after TIPS, and the gut microbiota was analysed by 16S ribosomal RNA sequencing. Results: Among all patients, 33 developed HE (HE+ group) within 6 months after TIPS and 73 did not (HE- group), and 18 died during follow-up. After TIPS, the autochthonous taxa increased, whereas the potential pathogenic taxa decreased in the HE- group, and the autochthonous taxon Lachnospiraceae decreased in the HE+ group. Furthermore, synergism among harmful bacteria was observed in all patients, which was weakened in the HE- group (p <0.001) but enhanced in the HE+ group (p <0.01) after TIPS. Variations of 5 autochthonous taxa, namely, Coprococcus, Ruminococcus, Blautia, Ruminococcaceae_uncultured, and Roseburia, were negatively correlated with the severity of HE. Notably, increased abundances of Coprococcus and Ruminococcus were protective factors against HE, and the incidences of HE in patients with improved, stable, and deteriorated microbiota after TIPS were 13.3, 25.9, and 68.2%, respectively. Higher total bilirubin level, Child-Pugh score, model for end-stage liver disease score, Granulicatella, and Alistipes and lower Subdoligranulum before TIPS were the independent risk factors for death. Conclusions: Alterations in gut dysbiosis were negatively related to the occurrence and severity of post-TIPS HE, and the pre-TIPS microbiota were associated with death, suggesting the gut microbiota could be a promising potential biological target for screening suitable patients receiving TIPS and prevention and treatment of post-TIPS HE. Lay summary: Alterations in the gut microbiota after transjugular intrahepatic portosystemic shunt (TIPS) and the relationship between such alterations and post-TIPS hepatic encephalopathy (HE) remain unclear. We therefore performed this study and found that after TIPS, restoration of the gut microbiota, mainly characterised by expansion of autochthonous taxa, depletion of harmful taxa, and weakening of synergism among harmful bacteria, was inversely related to the occurrence and severity of post-TIPS HE.

Global Trends in the Incidence, Prevalence, and Years Lived With Disability of Parkinson's Disease in 204 Countries/Territories From 1990 to 2019.

Background: Parkinson's disease (PD) is an increasing challenge to public health. Tracking the temporal trends of PD burden would inform health strategies. Methods: Data of PD burden was obtained from the Global Burden of Disease 2019. Trends in the incidence, prevalence, and years lived with disability (YLDs) of PD were estimated using the annual percentage change (EAPC) and age-standardized rate (ASR) from 1990 to 2019. The EAPCs were calculated with ASR through a linear regression model. Results: The overall ASR of the incidence, prevalence, and YLDs of PD increased from 1990 to 2019, and their EAPCs were 0.61 (95% confidence interval [CI]: 0.58-0.65), 0.52 (95% CI: 0.43-0.61), and 0.53 (95% CI: 0.44-0.62). The largest number of PD patients was seen in the groups aged more than 65 years, and the percentage rapidly increased in the population aged more than 80 years. Upward trends in the ASR of PD were observed in most settings over the past 30 years. Incident trends of ASR increased pronouncedly in the United States of America and Norway, in which the respective EAPCs were 2.87 (95% CI: 2.35-3.38) and 2.14 (95% CI: 2.00-2.29). Additionally, the largest increasing trends for prevalence and YLDs were seen in Norway, with the respective EAPCs of 2.63 (95% CI: 2.43-2.83) and 2.61 (95% CI: 2.41-2.80). However, decreasing trends in PD appeared in about 30 countries, particularly Italy and the Republic of Moldova. Conclusions: Increasing trends in the burden of PD were observed globally, and in most regions and countries from 1990 to 2019. Our findings suggested that the control and management of PD should be strengthened, especially when considering the aging tendency of the population.

Causal Associations Between Blood Lipids and COVID-19 Risk: A Two-Sample Mendelian Randomization Study.

[Figure: see text].

A Novel Location Source Optimization Algorithm for Low Anchor Node Density Wireless Sensor Networks.

Location information is one of the basic elements of the Internet of Things (IoT), which is also an important research direction in the application of wireless sensor networks (WSNs). Aiming at addressing the TOA positioning problem in the low anchor node density deployment environment, the traditional cooperative localization method will reduce the positioning accuracy due to excessive redundant information. In this regard, this paper proposes a location source optimization algorithm based on fuzzy comprehensive evaluation. First, each node calculates its own time-position distribute conditional posterior Cramer-Rao lower bound (DCPCRLB) and transfers it to neighbor nodes. Then collect the DCPCRLB, distance measurement, azimuth angle and other information from neighboring nodes to form a fuzzy evaluation factor set and determine the final preferred location source after fuzzy change. The simulation results show that the method proposed in this paper has better positioning accuracy about 33.9% with the compared method in low anchor node density scenarios when the computational complexity is comparable.

Long-term survival prediction for transjugular intrahepatic portosystemic shunt in severe cirrhotic ascites: assessment of ten prognostic models.

OBJECTIVES: Patients with severe cirrhotic ascites have poor prognosis, yet individual patient survival varies greatly. Therefore, suitable prognostic models can be helpful in clinical decision making. The aim of this study was to evaluate and compare the performance of 10 scores in predicting transplant-free survival (TFS) after transjugular intrahepatic portosystemic shunt (TIPS) in severe cirrhotic ascites. METHODS: Two hundred eighty consecutive cirrhotic patients with severe ascites undergoing TIPS between March 2006 and December 2017 were retrospectively screened and included from nine tertiary Chinese centers, consisting of 123 patients with refractory ascites and 157 with recurrent ascites. Discriminatory ability of these models was further assessed in the whole cohort and subgroups. RESULTS: TFS rates of all 280 patients were 75.4, 65.7, and 53.6% at 6-month, 1-year, and 2-year follow-up, respectively. Compared with other prognostic systems, the integrated model for end-stage liver disease (iMELD, incorporating serum sodium and age) showed optimal performance in predicting 6-month, 1-year, and 2-year TFS. Cutoffs were determined according to c-index and were used to stratify patients into three strata presenting significantly different TFS for short-term and long-term: iMELD < 32, ≥32 but <38 and ≥38 (log-rank P < 0.001). CONCLUSIONS: The iMELD score proved to be the best prognostic model in predicting TFS in patients with severe cirrhotic ascites receiving TIPS. Meanwhile, the model could stratify patients in three strata to help guiding clinical practice.

Using Deep Learning to Detect Defects in Manufacturing: A Comprehensive Survey and Current Challenges.

The detection of product defects is essential in quality control in manufacturing. This study surveys stateoftheart deep-learning methods in defect detection. First, we classify the defects of products, such as electronic components, pipes, welded parts, and textile materials, into categories. Second, recent mainstream techniques and deep-learning methods for defects are reviewed with their characteristics, strengths, and shortcomings described. Third, we summarize and analyze the application of ultrasonic testing, filtering, deep learning, machine vision, and other technologies used for defect detection, by focusing on three aspects, namely method and experimental results. To further understand the difficulties in the field of defect detection, we investigate the functions and characteristics of existing equipment used for defect detection. The core ideas and codes of studies related to high precision, high positioning, rapid detection, small object, complex background, occluded object detection and object association, are summarized. Lastly, we outline the current achievements and limitations of the existing methods, along with the current research challenges, to assist the research community on defect detection in setting a further agenda for future studies.

Cooperative Localization and Time Synchronization Based on M-VMP Method.

Localization estimation and clock synchronization are important research directions in the application of wireless sensor networks. Aiming at the problems of low positioning accuracy and slow convergence speed in localization estimation methods based on message passing, this paper proposes a low-complexity distributed cooperative joint estimation method suitable for dynamic networks called multi-Gaussian variational message passing (M-VMP). The proposed method constrains the message to be a multi-Gaussian function superposition form to reduce the information loss in the variational message passing algorithm (VMP). Only the mean, covariance and weight of each message need to be transmitted in the network, which reduces the computational complexity while ensuring the information completeness. The simulation results show that the proposed method is superior to the VMP algorithm in terms of position accuracy and convergence speed and is close to the sum-product algorithm over a wireless network (SPAWN) based on non-parametric belief propagation, but the computational complexity and communication load are significantly reduced.

Long-term results of variceal bleeding management in 302 patients with chronic extrahepatic portal vein obstruction.

BACKGROUND AND AIM: Treatment modalities of variceal bleeding or rebleeding for extrahepatic portal vein obstruction (EHPVO) are limited, and their long-term results and prognostic factors are unclear. This study aimed at assessing the long-term results of EHPVO treated with current recommendations and investigating the influencing factors. METHODS: Between 2009 and 2016, 302 consecutive patients with EHPVO were included. Watch-and-wait policy was applied for those with no (n = 59) or small varices (n = 55), nonselective beta-adrenergic blocker and nonselective beta-adrenergic blocker plus endotherapy were for primary (n = 115) and secondary prophylaxis (n = 87), transjugular intrahepatic portosystemic shunt (TIPS) or combination therapy was for those with recurrent bleeding (n = 92). RESULTS: The median follow up was 58.8 months. The 1-, 3-, and 5-year cumulative rates were 3.6%, 19.2%, 32.3% for small varices development and 4.5%, 30.9%, 53.4% for large varices development. The 1-, 3-, and 5-year cumulative rates were 11.1%, 20.9%, and 34.9% for first variceal bleeding and 16.0%, 26.9%, and 33.6% for variceal rebleeding. For those with recurrent variceal bleeding, only TIPS (n = 37, technical success rate: 90.2%) was associated with a reduced risk of variceal rebleeding (1-, 3-, and 5-year: 5.6%, 11.7%, and 21.9%). The 1-, 3-, and 5-year survival rates were 96.9%, 95.8%, and 91.9%. Prothrombotic factors and anticoagulation did not influence the risk of variceal bleeding, rebleeding, and survival. CONCLUSIONS: By applying the same variceal management as recommended for patients with liver cirrhosis, patients with non-cirrhotic EHPVO showed a similar development of varices and variceal bleeding. This is also true for the beneficial effect of TIPS to prevent rebleeding.

A high-sensitivity MEMS gravimeter with a large dynamic range.

Precise measurement of variations in the local gravitational acceleration is valuable for natural hazard forecasting, prospecting, and geophysical studies. Common issues of the present gravimetry technologies include their high cost, high mass, and large volume, which can potentially be solved by micro-electromechanical-system (MEMS) technology. However, the reported MEMS gravimeter does not have a high sensitivity and a large dynamic range comparable with those of the present commercial gravimeters, lowering its practicability and ruling out worldwide deployment. In this paper, we introduce a more practical MEMS gravimeter that has a higher sensitivity of 8 µGal/√Hz and a larger dynamic range of 8000 mGal by using an advanced suspension design and a customized optical displacement transducer. The proposed MEMS gravimeter has performed the co-site earth tides measurement with a commercial superconducting gravimeter GWR iGrav with the results showing a correlation coefficient of 0.91.

Angioplasty with versus without routine stent placement for Budd-Chiari syndrome: a randomised controlled trial.

BACKGROUND: Angioplasty recanalisation is recommended as the first-line interventional procedure for Budd-Chiari syndrome, but subsequent restenosis is common. We aimed to test whether use of routine, non-selective stenting in angioplasty could improve patency and treatment efficacy with adequate safety in Budd-Chiari syndrome. METHODS: We did a randomised controlled trial, for which patients aged 18-75 years with Budd-Chiari syndrome with membranous obstruction or short-length stenosis (≤4 cm), and a Child-Pugh score of less than 13 were considered eligible. Patients were excluded if they had obstruction not amenable to angioplasty, were recommended to be treated with transjugular intrahepatic portosystemic shunt or liver transplantation, or had contraindications for angioplasty. Eligible patients were randomly assigned (1:1) to an angioplasty-only group or an angioplasty plus routine stenting group, with use of a web-based allocation system (Pocock and Simon's minimisation method, stratified by obstruction features and Child-Pugh score). Recanalisation procedures were done within 24 h of randomisation. The statistician and investigators responsible for data collection data and endpoint assessment were masked to group allocation. The primary outcome was the proportion of patients free of restenosis, analysed in the intention-to-treat population. The study is registered on ClinicalTrials.gov (NCT02201485) and is completed. FINDINGS: Between July 28, 2014, and Sept 29, 2017, 88 (59%) of 150 screened patients were enrolled and assigned either the angioplasty-only group (n=45) or the angioplasty plus routine stenting group (n=43). During a median follow-up period of 27 months (IQR 19-41), the angioplasty plus routine stenting group had significantly higher proportion of patients free of restenosis (42 [98%] of 43 patients) than did the angioplasty-only group (27 [60%] of 45 patients; p<0·0001). In the survival analysis, 3-year restenosis-free survival was 96·0% (95% CI 88·6-100·0) in the routine stenting group versus 60·4% (46·4-78·7) in the angioplasty-only group (log-rank p<0·0001). The hazard ratio for restenosis was 0·04 (95% CI 0·01-0·31) in favour of routine stenting, with an absolute risk reduction of 35·6% (95% CI 24·2-55·0). Two (5%) patients in the angioplasty plus routine stenting group and one (2%) patient in the angioplasty-only group died during follow-up. One (2%) patient from the angioplasty plus routine stenting group had puncture site haematoma, which was not related to stenting. No stent fracture or migration occurred. Anticoagulation-related adverse events occurred in five (11%) patients from angioplasty alone group and five (12%) patients from angioplasty plus routine stenting group. INTERPRETATION: Routine stenting with angioplasty is superior to angioplasty alone for preventing restenosis in patients with Budd-Chiari syndrome with short-length stenosis and is safe to use as part of first-line invasive treatment. Further validation is needed in similar settings and other regions in which different characteristics of Budd-Chiari syndrome are more prevalent. FUNDING: National Natural Science Foundation of China, National Key Technology R&D Programme, Optimised Overall Project of Shaanxi Province, Boost Programme of Xijing Hospital.

An Ultra-Wideband THz/IR Metamaterial Absorber Based on Doped Silicon.

Metamaterial-based absorbers have been extensively investigated in the terahertz (THz) range with ever increasing performances. In this paper, we propose an all-dielectric THz absorber based on doped silicon. The unit cell consists of a silicon cross resonator with an internal cross-shaped air cavity. Numerical results suggest that the proposed absorber can operate from THz to far-infrared regimes, having an average power absorption of ∼95% between 0.6 and 10 THz. Experimental results using THz time-domain spectroscopy show a good agreement with simulations. The underlying mechanisms for broadband absorption are attributed to the combined effects of multiple cavities modes formed by silicon resonators and bulk absorption in the doped silicon substrate, as confirmed by simulated field patterns and calculated diffraction efficiency. This ultra-wideband absorption is polarization insensitive and can operate across a wide range of the incident angle. The proposed absorber can be readily integrated into silicon-based photonic platforms and used for sensing, imaging, energy harvesting and wireless communications applications in the THz/IR range.