On-chip topological beamformer for multi-link terahertz 6G to XG wireless.

Terahertz (THz) wireless communication holds immense potential to revolutionize future 6G to XG networks with high capacity, low latency and extensive connectivity. Efficient THz beamformers are essential for energy-efficient connections, compensating path loss, optimizing resource usage and enhancing spectral efficiency. However, current beamformers face several challenges, including notable loss, limited bandwidth, constrained spatial coverage and poor integration with on-chip THz circuits. Here we present an on-chip broadband THz topological beamformer using valley vortices for waveguiding, splitting and perfect isolation in waveguide phased arrays, featuring 184 densely packed valley-locked waveguides, 54 power splitters and 136 sharp bends. Leveraging neural-network-assisted inverse design, the beamformer achieves complete 360° azimuthal beamforming with gains of up to 20 dBi, radiating THz signals into free space with customizable user-defined beams. Photoexciting the all-silicon beamformer enables reconfigurable control of THz beams. The low-loss and broadband beamformer enables a 72-Gbps chip-to-chip wireless link over 300 mm and eight simultaneous 40-Gbps wireless links. Using four of these links, we demonstrate point-to-4-point real-time HD video streaming. Our work provides a complementary metal-oxide-semiconductor-compatible THz topological photonic integrated circuit for efficient large-scale beamforming, enabling massive single-input multiple-output and multiple-input and multiple-output systems for terabit-per-second 6G to XG wireless communications.

Correction: Systemic Delivery of MicroRNA-101 Potently Inhibits Hepatocellular Carcinoma In Vivo by Repressing Multiple Targets.

[This corrects the article DOI: 10.1371/journal.pgen.1004873.].

Identification and Fungicide Screening of Fungal Species Associated with Walnut Anthracnose in Shaanxi and Liaoning Provinces, China.

Walnut is cultivated around the world for its precious woody nut and edible oil. Recently, walnut infected by Colletotrichum spp. resulted in a great yield and quality loss. In August and September 2014, walnut fruits with anthracnose were sampled from two commercial orchards in Shaanxi and Liaoning provinces, and five representative isolates were used in this study. To identify the pathogen properly, four genes per region (internal transcribed spacer, glyceraldehyde-3-phosphate dehydrogenase, actin, and chitin synthase) were sequenced and used in phylogenetic studies. Based on multilocus phylogenetic analysis, five isolates clustered with Colletotrichum fioriniae, including its ex-type, with 100% bootstrap support. The results of multilocus phylogenetic analyses, morphology, and pathogenicity confirmed that C. fioriniae was one of the walnut anthracnose pathogens in China. All 13 fungicides tested inhibited mycelial growth and spore germination. Flusilazole, fluazinam, prochloraz, and pyraclostrobin showed the strongest suppressive effects on the mycelial growth than the others, the average EC50 values ranged from 0.09 to 0.40 µg/ml, and there was not any significant difference (P < 0.05). Pyraclostrobin, thiram, and azoxystrobin were the most effective fungicides on spore germination (P < 0.05), and the EC50 values ranged from 0.01 to 0.44 µg/ml. Pyraclostrobin, azoxystrobin, fluazinam, flusilazole, mancozeb, thiram, and prochloraz exhibited a good control effect on walnut anthracnose caused by C. fioriniae, and preventive activities were greater than curative activities. Pyraclostrobin at 250 a.i. µg/ml and fluazinam at 500 a.i. µg/ml provided the highest preventive and curative efficacy, and the values ranged from 81.3 to 82.2% and from 72.9 to 73.6%, respectively. As a consequence, mancozeb and thiram could be used at the preinfection stage, and pyraclostrobin, azoxystrobin, flusilazole, fluazinam, and prochloraz could be used at the early stage for effective prevention and control of walnut anthracnose caused by C. fioriniae. The results will provide more significant instructions for controlling the disease effectively in northern China.

Interfacial topological photonics: broadband silicon waveguides for THz 6G communication and beyond.

Topological photonics has expanded our understanding of electromagnetic wave propagation and unraveled new methods of electromagnetic wave shaping. Among the various topological photonic systems, valley photonic crystal (VPC) is a highly versatile platform for constructing interfaces that supports unidirectional edge state to enable the robust topological transport of light. Although silicon VPC waveguides has demonstrated the lossless propagation of terahertz (THz) waves through multiple sharp bends, existing designs are mostly based on the standard zigzag-interface. Here, we explore interfacial topological photonics by designing a composite interface junction for an air-slot-like VPC waveguide with a 60° bend and an unchanging bearded-interface to allow the topologically protected propagation of THz waves over a 20% relative bandwidth. We employ particle swarm optimization to design the geometry of a bearded-interface silicon VPC waveguide to achieve a 42% relative bandgap and a topological edge state spanning a usable 25% relative bandwidth. Our work illustrates the prospects and challenges of interfacial topological photonics in the design of broadband silicon topological waveguides for potential applications across the electromagnetic spectrum, including the on-chip THz sixth-generation (6G) communication.

Self-adaptive deep reinforcement learning for THz beamforming with silicon metasurfaces in 6G communications.

Exponential growth in data rate demands has driven efforts to develop novel beamforming techniques for realizing massive multiple-input and multiple-output (MIMO) systems in sixth-generation (6G) terabits per second wireless communications. Existing beamforming techniques rely on conventional optimization algorithms that are too computationally expensive for real-time applications and require complex digital processing yet to be achieved for phased array antennas at terahertz frequencies. Here, we develop an intelligent and self-adaptive beamforming scheme enabled by deep reinforcement learning, which can predict the spatial phase profiles required to produce arbitrary desired radiation patterns in real-time. Our deep learning model adaptively trains an artificial neural network in real-time by comparing the input and predicted intensity patterns via automatic differentiation of the phase-to-intensity function. As a proof of concept, we experimentally demonstrate two-dimensional beamforming by spatially modulating broadband terahertz waves using silicon metasurfaces designed with the aid of the deep learning model. Our work offers an efficient and robust deep learning model for real-time self-adaptive beamforming to enable multi-user massive MIMO systems for 6G terahertz wireless communications, as well as intelligent metasurfaces for other terahertz applications in imaging and sensing.

First report of Colletotrichum fioriniae causing leaf spot on Schima superba in the world.

Schima superba Gardn. et Champ. is a subtropical evergreen tree species naturally distributed mainly in China, Japan, and Vietnam. It is primarily planted for its timber and urban landscaping in China (Ni, 1996). In September 2018, leaves necrotic spots were observed on S. superba in Jiangxi Forest Breeding Center (28°57'19.52" N, 115°39'21.32" E), Jiangxi Province, China. The disease incidence was about 30%. Initially, spots were circular to semicircular, grayish-brown in the center with dark brown margin, then expanded and eventually collapsed into sunken necrotic lesions. To identify the agent, diseased leaves were collected randomly. Pieces (5 × 5 mm) from the lesion borders were surfaced sterilized in 70% ethanol (30 s), 3% NaOCl (60 s), and rinsed 3 times in sterile water. These pieces were put on potato dextrose agar (PDA) and cultured at 25 °C. Pure cultures were obtained by monosporic isolation, and 3 isolates (MH-1, MH-2, MH-3) were used for morphological studies and phylogenetic analyses. On PDA, colonies were initially white, cottony, then became pinkish to deep-pink at the center and pink on the reverse. Conidia were fusiform with acute ends, smooth-walled, hyaline, 13.7-18.5 × 4.6-6.1 µm (16.4 ± 1.3× 5.3 ± 0.6 µm, n = 100). Conidiophores were colorless to pale brown, smooth, septate. Conidiogenous cells were colorless to pale brown, smooth, cylindrical to ampulliform. The morphological characteristics fit the descriptions of Colletotrichum acutatum J. H. Simmonds sensu lato (Damm et al., 2012). For accurate identification, genomic DNA of 3 isolates was extracted, and the internal transcribed spacer (ITS), actin (ACT), glyceraldehyde-3-phosphate dehydrogenase (GAPDH), beta-tubulin 2 (TUB2), and chitin synthase (CHS-1) were amplified and sequenced using the corresponding primers (Weir et al., 2012). The sequences were deposited in GenBank (ITS: MZ325946, MZ325947, MW584318; ACT: MZ399375, MZ419566, MW661171; CHS-1: MZ399376, MZ419567, MW661172; MZ399377, GAPDH: MZ419568, MW661173; TUB2: MZ399378, MZ419569, MW661174). Five loci were concatenated, and the aligned sequences (1528bp) were 99.89% homologous to ex-type C. fioriniae (Marcelino & Gouli) R. G. Shivas & Y. P. Tan CBS128517. Phylogenetic analysis using the maximum likelihood showed that 3 isolates were clustered in C. fioriniae clade with 100% bootstrap support. Based on the multi-locus phylogeny and morphology, 3 isolates were identified as C. fioriniae. Pathogenicity tests were performed on 36 seedlings of S. superba (2-year-old). The leaves were wounded slightly and inoculated with a drop of spore suspension (106 conidia/mL). The sterile water was used as controls. All the tested leaves were covered with black plastic bags to keep them moist for 2 days. All seedlings were placed in the greenhouse (25 °C, 12 h light/dark) for 10 days, and all inoculated leaves had typical symptoms. The controls were asymptomatic. The same fungus was reisolated from the lesions, fulfilling Koch's postulates. Colletotrichum fioriniae was described as a new species from the C. acutatum s. l. (Shivas et al., 2009), and it was an important plant pathogen, such as Pyrus spp. (Pavlovic et al., 2019), Morus alba L. (Xue et al., 2019), and so on. This is the first report of the newly emerging disease of S. superba caused by C. fioriniae in the world, and its potential threat should be evaluated in the future. This study provided crucial information for epidemiologic studies and appropriate control strategies.

Treatment of Syndromic Craniosynostosis by Anterior and Posterior Vault Distraction Osteogenesis (A-PVDO).

OBJECTIVE: To explore the feasibility and therapeutic effect of anterior and posterior vault distraction osteogenesis (A-PVDO) in the treatment of infantile syndromic craniosynostosis. METHODS: Between January 2017 and December 2019, 7 children with syndromic craniosynostosis underwent osteotomy with Piezo-surgery at our hospital. The first step was to harvest the frontal bone flap and the orbitofrontal bone flap. The second step was to separate the scalp and expose the posterior occipital. Osteotomy was performed on the occipital tubercle. Thereafter, 2 distractors were horizontally installed on the upper edge of the anterior cranial orbit, 2 distractors of 3 cm were installed on the posterior cranial bone. Meanwhile, lambdoidal sutures were fixed by titanium plates. Bone distraction was initiated on postoperative day 5 at the rate of 0.4 to 0.6 mm/day, twice per-day, for a total of 10 to 15 days. After 6 months, the distractors and the titanium plates were removed by secondary surgery. RESULTS: The intracranial volume and posterior cranial morphology were recorded during the follow-up of 6 to 14 months (average = 12 months). The posterior craniums of 7 cases with lambdoidal sutures fixation were completely extended. The anterior cranial morphology was normal. All the cranial deformities were significantly improved. There were no severe complications, such as death, cranial necrosis, and intracranial infection. CONCLUSIONS: A-PVDO is an ideal method for the treatment of severe syndromic craniosynostosis, which can achieve more natural appearance than anterior vault distraction osteogenesis or posterior vault distraction osteogenesis. Moreover, A-PVDO causes no severe complications and is suitable for the treatment of severe syndromic craniosynostosis.

The web-based multiplex PCR primer design software Ultiplex and the associated experimental workflow: up to 100- plex multiplicity.

BACKGROUND: A large number of variants have been employed in various medical applications, such as providing medication instructions, disease susceptibility testing, paternity testing, and tumour diagnosis. A high multiplicity PCR will outperform other technologies because of its lower cost, reaction time and sample consumption. To conduct a multiplex PCR with higher than 100 plex multiplicity, primers need to be carefully designed to avoid the formation of secondary structures and nonspecific amplification between primers, templates and products. Thus, a user-friendly, highly automated and highly user-defined web-based multiplex PCR primer design software is needed to minimize the work of primer design and experimental verification. RESULTS: Ultiplex was developed as a free online multiplex primer design tool with a user-friendly web-based interface ( http://ultiplex.igenebook.cn ). To evaluate the performance of Ultiplex, 294 out of 295 (99.7%) target primers were successfully designed. A total of 275 targets produced qualified primers after primer filtration, and 271 of those targets were successfully clustered into one compatible PCR group and could be covered by 108 primers. The designed primer group stably detected the rs28934573(C > T) mutation at lower than a 0.25% mutation rate in a series of samples with different ratios of HCT-15 and HaCaT cell line DNA. CONCLUSION: Ultiplex is a web-based multiplex PCR primer tool that has several functions, including batch design and compatibility checking for the exclusion of mutual secondary structures and mutual false alignments across the whole genome. It offers flexible arguments for users to define their own references, primer Tm values, product lengths, plex numbers and tag oligos. With its user-friendly reports and web-based interface, Ultiplex will provide assistance for biological applications and research involving genomic variants.

Comparison of functional and oncological outcomes of innovative "three-port" and traditional "four-port" laparoscopic radical prostatectomy in patients with prostate cancer.

BACKGROUND: To compare the functional and oncological outcomes between innovative "three-port" and traditional "four-port" laparoscopic radical prostatectomy (LRP) in patients with prostate cancer (PCa). METHODS: We retrospectively collected the data of PCa patients treated at our institutions from June 2012 to May 2016. According to the inclusion criteria, a total of 234 patients were included in the study, including 112 in group A (four-port) and 122 in group B (three-port). The perioperatively surgical characteristics, functional and oncological outcomes were compared between groups. RESULTS: There were no statistical differences in the baseline parameters between these two groups. Compared with group A, the operative time (OT) and estimated blood loss (EBL) were significantly less in group B. On follow-up, the rate of positive surgical margin (PSM), prostate specific antigen (PSA) biochemical recurrence and continence after LRP did not show any statistically significant difference between the groups. An identical conclusion was also received in comparison of overall survival (OS) and biochemical recurrence-free survival (BRFS) between both groups. CONCLUSIONS: Innovative "three-port" LRP can significantly shorten the OT and reduce the EBL compared with the traditional "four-port" LRP. Meanwhile, it does not increase the rate of PSM and PSA biochemical recurrence. "Three-port" LRP could be popularized in the future in view of its superior surgical technique, considerably better functional outcomes and remarkable oncological control.

Deep Learning in Biomedical Optics.

This article reviews deep learning applications in biomedical optics with a particular emphasis on image formation. The review is organized by imaging domains within biomedical optics and includes microscopy, fluorescence lifetime imaging, in vivo microscopy, widefield endoscopy, optical coherence tomography, photoacoustic imaging, diffuse tomography, and functional optical brain imaging. For each of these domains, we summarize how deep learning has been applied and highlight methods by which deep learning can enable new capabilities for optics in medicine. Challenges and opportunities to improve translation and adoption of deep learning in biomedical optics are also summarized. Lasers Surg. Med. © 2021 Wiley Periodicals LLC.

Learning Curve of an Innovative "3-Port" Laparoscopic Radical Prostatectomy: A Single-Center Analysis from 2016 to 2019.

BACKGROUND: "Three-port" laparoscopic radical prostatectomy (LRP) has been applied as a substitution for the conventional 4- to 5-port LRP to treat prostate cancer (PCa) patients in our institution. OBJECTIVE: To evaluate the learning curve of an innovative "3-port" LRP for PCa patients. METHODS: 206 patients who received "3-port" LRP were retrospectively reviewed between January 2016 and December 2019 at our institution. According to the different years of operations performed, all of the patients were divided into group A (No. 1-50), group B (No. 51-107), group C (No. 108-160), and group D (No. 161-206). A learning curve was depicted by analyzing the parameters of operative time (OT), estimated blood loss (EBL), hospitalization, and drainage indwelling days. RESULTS: All groups were comparable with regard to the preoperative characteristics (p > 0.05). The sloping learning curve for the surgeon showed that OT and EBL were strongly correlated with an accumulated experience when compared between group A and the other groups (p < 0.05), denoting that the surgical skill of the "3-port" LRP can be fully mastered after around 50 cases. Although no significant correlation with additional experience was observed in the hospitalization and drainage indwelling days among groups, a tendency towards less hospitalization and drainage indwelling days was still reflected. CONCLUSIONS: Our 4-year analysis based on a single-center experience exhibits that the innovative "3-port" LRP appears to be favorable with decreasing tendency in OT and EBL with experience accumulation. In view of its advantage of perioperative parameters with an evidently improved learning curve, it should be recommended in the clinical practice!

Five New Triene Derivatives from the Fungus Penicillium herquei JX4.

Five undescribed triene derivatives, pinophols B-F (2-6), together with one known compound, pinophol A (1), were obtained from the mangrove endophytic fungus Penicillium herquei JX4. The structures of compounds 1-6 were elucidated using IR, HR-ESI-MS, and NMR methods. The absolute configurations of compounds 1-6 were confirmed by comparing their experimental or calculated ECD spectra. Pinophols C and D (3 and 4) showed inhibitory activities against LPS-induced NO production.

Schizophrenia Detection Using Machine Learning Approach from Social Media Content.

Schizophrenia is a severe mental disorder that ranks among the leading causes of disability worldwide. However, many cases of schizophrenia remain untreated due to failure to diagnose, self-denial, and social stigma. With the advent of social media, individuals suffering from schizophrenia share their mental health problems and seek support and treatment options. Machine learning approaches are increasingly used for detecting schizophrenia from social media posts. This study aims to determine whether machine learning could be effectively used to detect signs of schizophrenia in social media users by analyzing their social media texts. To this end, we collected posts from the social media platform Reddit focusing on schizophrenia, along with non-mental health related posts (fitness, jokes, meditation, parenting, relationships, and teaching) for the control group. We extracted linguistic features and content topics from the posts. Using supervised machine learning, we classified posts belonging to schizophrenia and interpreted important features to identify linguistic markers of schizophrenia. We applied unsupervised clustering to the features to uncover a coherent semantic representation of words in schizophrenia. We identified significant differences in linguistic features and topics including increased use of third person plural pronouns and negative emotion words and symptom-related topics. We distinguished schizophrenic from control posts with an accuracy of 96%. Finally, we found that coherent semantic groups of words were the key to detecting schizophrenia. Our findings suggest that machine learning approaches could help us understand the linguistic characteristics of schizophrenia and identify schizophrenia or otherwise at-risk individuals using social media texts.

[Systematic review and sequential analysis of Xuebijing Injection in treatment of systemic inflammatory response syndrome].

To systematically review the efficacy of Xuebijing Injection combined with western medicine in the treatment of systemic inflammatory response syndrome(SIRS). In this study, CBM, CNKI, Wanfang, VIP, PubMed and EMbase databases were retrieved for clinical randomized controlled trials on the effect of Xuebijing Injection combined with western medicine in the treatment of SIRS from the establishment of the database to July 31, 2020. After screening, Meta-analysis was conducted by RevMan 5.3 software, trial sequential analysis was conducted by TSA 0.9.5.10 beta software, and the evidence quality level was evaluated by GRADEprofiler 3.6.1 software. Meta-analysis showed that Xuebijing Injection combined with western medicine could reduce white blood cell count(MD=-2.32, 95%CI[-2.44,-2.21], P<0.000 01), C-reactive protein count(MD=-22.70, 95%CI[-29.61,-15.79], P<0.000 01), APACHE Ⅱ score(MD=-2.15, 95%CI[-2.43,-1.87], P<0.000 01), tumor necrosis factor alpha count(SMD=-1.23, 95%CI[-1.48,-0.99], P<0.000 01) and interleukin-6 count(SMD=-0.92, 95%CI[-1.15,-0.69], P<0.000 01), improve treatment efficiency(RR=1.39, 95%CI[1.23, 1.56], P<0.000 01), reduce incidence of multiple organ dysfunction(RR=0.47, 95%CI[0.35, 0.64], P<0.000 01) and mortality(RR=0.22, 95%CI[0.13, 0.37], P<0.000 01), which were better than western medicine treatment alone. Trial sequential analysis showed that in terms of reducing the incidence of multiple organ dysfunction and C-reactive protein count, the cumulative Z value passed through the traditional threshold, TSA threshold and expected information value, and reached the required number of cases. GRADE evaluation showed that the level of evidence was low or very low. According to the findings, Xuebijing Injection combined with western medicine is effective in treating SIRS. However, as the low quality of the included studies may affect the reliability of the conclusion, more high-quality studies shall be included for further verification in the future, so as to provide better suggestions for clinical medication.

LED array reflectance microscopy for scattering-based multi-contrast imaging.

LED array microscopy is an emerging platform for computational imaging with significant utility for biological imaging. Existing LED array systems often exploit transmission imaging geometries of standard brightfield microscopes that leave the rich backscattered field undetected. This backscattered signal contains high-resolution sample information with superb sensitivity to subtle structural features that make it ideal for biological sensing and detection. Here, we develop an LED array reflectance microscope capturing the sample's backscattered signal. In particular, we demonstrate multimodal brightfield, darkfield, and differential phase contrast imaging on fixed and living biological specimens including Caenorhabditis elegans (C. elegans), zebrafish embryos, and live cell cultures. Video-rate multimodal imaging at 20 Hz records real time features of freely moving C. elegans and the fast beating heart of zebrafish embryos. Our new reflectance mode is a valuable addition to the LED array microscopic toolbox.

A novel "three-port" trocar placement technique for laparoscopic radical prostatectomy.

BACKGROUND: To introduce a novel "three-port" trocar placement technique for laparoscopic radical prostatectomy (LRP) in prostate cancer (PCa) patients. METHODS: We retrospectively reviewed 300 patients with PCa who received surgical treatment between November 2010 and June 2015 at our institution. They were divided into group A, three-port LRP; group B, conventional four-five-port LRP; group C, open RP (ORP); and group D, robotic-assisted RP (RARP). A learning curve was analyzed by dividing patients of group A into the early and late stages. RESULTS: All groups were comparable with regard to the preoperative characteristics except for the relatively smaller prostate volume in group A. The three-port LRP operations were performed successfully with only 8 cases of conversion to the conventional LRP. None of any severe complications or conversion to ORP occurred. In group A, the mean operative time (OT) duration was 113.8 min, the mean estimated blood loss (EBL) was 94.2 ml, the mean drainage days was 4.0 days, the mean hospitalization was 5.1 days, and 27.8% of the prostate specimen margins (PSM) were positive. The differences of OT, EBL, drainage days, hospitalization, and transfusion in group A were statistically significant among the majority of the other groups (p < 0.05). After undergoing the early stages of a learning curve analysis in three-port LRP, the EBL was obviously decreased. CONCLUSIONS: Three-port LRP is a novel technique that exhibits superior intraoperative advantages to the conventional LRP. Due to its less OT, EBL, drainage days, hospitalization, and transfusion with a shorter learning curve, it should be recommended and popularized in the clinical practice.

Differences in perspectives of pediatricians on advance care planning: a cross-sectional survey.

BACKGROUND: The increase in the number of pediatric patients with complex health conditions necessitates the application of advance care planning for children. Earlier, withdrawal of life-sustaining treatment was taboo in the medical society in South Korea due to the history of such practice being punishable by law, and physicians tended to pursue aggressive treatment. With changes in public opinion on end-of-life care, the Korean government enacted a new law that protect human dignity by respecting patients' self-determination and facilitating advance care planning. However, little is known about current state of advance care planning for pediatric patients. The study aimed to assess perceptions regarding advance care planning among South Korean pediatricians and clarify any differences in perception among pediatric subspecialties. METHODS: This study was an observational cross-sectional survey that used a web-based self-report questionnaire. Participants comprised of pediatricians currently caring for children with life-limiting conditions in 2018. RESULTS: Of the 96 respondents, 89 were included in the analysis. In a hypothetical patient scenario, more hemato-oncologists and intensivists than neonatologists and neurologists preferred to provide comfort care than aggressive treatment. While 72.2% of hemato-oncologists reported that they usually or always discuss advance care plans with parents during treatment, more than half of other pediatricians reported that they seldom do so. Furthermore, 65% of respondents said that they never discuss advance care planning with adolescent patients. Moreover, there were no notable differences among subspecialties. The most prevalent answers to factors impeding advance care planning were lack of systemic support after performing advance care planning (82.0%) and uncertain legal responsibilities (70.8%). CONCLUSIONS: The pediatricians differed in their experiences and attitudes toward advance care planning based on their subspecialty. Consequently, institutional support and education should be provided to physicians so that they can include children and families in discussions on prognosis.

Eukaryotic Initiation Factor 5A2 Contributes to the Maintenance of CD133(+) Hepatocellular Carcinoma Cells via the c-Myc/microRNA-29b Axis.

Cancer stem cells (CSCs)/cancer-initiating cells (CICs) are suggested responsible for driving cancer resistance to conventional therapies and for cancer recurrence and/or metastasis. CD133 is served as a key biomarker to identify and characterize this subpopulation of cells in hepatocellular carcinoma (HCC). Our previous study indicated that overexpression of eukaryotic initiation factor 5A2 (EIF5A2) promotes HCC cell metastasis and angiogenesis. In this study, we demonstrated that EIF5A2 might play a crucial role in CSCs regulation and investigated its potential molecular mechanisms. Using quantitative real-time polymerase chain reaction assay, we observed that the expression of EIF5A2 positively correlated with CD133 levels in a cohort of cancerous and noncancerous liver tissues and cells. Next, HCC cells with high expression of EIF5A2 have a strong capacity to form undifferentiated tumor spheres in vitro and show elevated levels of stem cell-related genes, leading to an increased ability to develop tumors when subcutaneously injected into nude mice. Furthermore, differential microRNA expression was profiling between two EIF5A2-depleted HCC cell lines and their control one identified a decreased expression of miR-29b in EIF5A2-depleted cell lines. Further functional studies illustrated that downregulated miR-29b level is responsible for EIF5A2-maintained HCC cell stemness either in vitro or in vivo. Moreover, enforced expression of EIF5A2 in HCC cells largely enhanced the binding of c-Myc on the promoter of miR-29b and downregulation of miR-29b by EIF5A2 was dependent on c-Myc. Our findings, collectively, reveal that EIF5A2 contributes to the maintenance of CD133+ HCC cells via the c-Myc/miR-29b axis. Stem Cells 2018;36:180-191.

Ileostomy for steroid-resistant acute graft-versus-host disease of the gastrointestinal tract.

Steroid-resistant acute graft-versus-host disease (GVHD) of the gastrointestinal tract associates with important morbidity and mortality. While high-dose steroids are the established first-line therapy in GVHD, no second-line therapy is generally accepted. In this analysis of 65 consecutive patients with severe, steroid-resistant, intestinal GVHD (92% stage 4), additional ileostomy surgery significantly reduced overall mortality (hazard ratio 0.54; 95% confidence interval, 0.36-0.81; p = 0.003) compared to conventional GVHD therapy. Median overall survival was 16 months in the ileostomy cohort compared to 4 months in the conventional therapy cohort. In the ileostomy cohort, both infectious- and GVHD-associated mortality were reduced (40% versus 77%). Significantly declined fecal volumes (p = 0.001) after surgery provide evidence of intestinal adaptation following ileostomy. Correlative studies indicated ileostomy-induced immune-modulation with a > 50% decrease of activated T cells (p = 0.04) and an increase in regulatory T cells. The observed alterations of the patients' gut microbiota may also contribute to ileostomy's therapeutic effect. These data show that ileostomy induced significant clinical responses in patients with steroid-resistant GVHD along with a reduction of pro-inflammatory immune cells and changes of the intestinal microbiota. Ileostomy is a treatment option for steroid-resistant acute GVHD of the gastrointestinal tract that needs further validation in a prospective clinical trial.

Dual-Energy and Iterative Metal Artifact Reduction for Reducing Artifacts Due to Metallic Hardware: A Loosening Hip Phantom Study.

OBJECTIVE. The purpose of this study was to compare the value of iterative metal artifact reduction (IMAR) with that of dual-energy CT (DECT) and filtered back projection (FBP) CT protocols for reducing metal artifacts and for facilitating visualization of the acetabular cortex in a loosening hip phantom model. MATERIALS AND METHODS. CT scans were obtained with conventional FBP and dual-source CT for two types of hip phantom. For the quantitative study, attenuation was measured by placement of ROIs in the phantoms around the metallic hardware. The differences between mean attenuation in each ROI and the actual attenuation were compared among the three CT protocols. For the qualitative study, the visibility of the acetabular cortex in the artificial loosening area of the total hip arthroplasty model and in the joint space of the bipolar hemiarthroplasty model was evaluated by measurement of the obscured cortical angle. RESULTS. In the quantitative study, attenuation differences in the bipolar hemiarthroplasty model were markedly decreased with IMAR and DECT compared with FBP (p = 0.006-0.007). In the total hip replacement model, attenuation differences were significantly lower with IMAR than with FBP (p < 0.001). In the qualitative study, visibility of the acetabular cortex was markedly improved with IMAR compared with DECT and FBP (p < 0.001) for both hip models. CONCLUSION. CT with IMAR can reduce the distortion caused by metal artifacts more effectively than FBP and DECT can while preserving visibility of the acetabular cortex in both bipolar hemiarthroplasty and total hip arthroplasty phantoms.