ABSTRACT
Objective: To investigate the prevalence and associated risk of cardiovascular event of resistant hypertension in treated outpatients. Methods: This study was a nationwide multi-center prospective cohort study. The participants were treated outpatients enrolled in the China Nationwide Ambulatory and Home Blood Pressure Registry study of 42 hospitals in 19 provinces across the country from August 2009 to October 2017. Apparent resistant hypertension was defined as uncontrolled office blood pressure (≥140/90 mmHg, 1 mmHg=0.133 kPa) in spite of the use of three antihypertensive drugs or controlled office blood pressure (<140/90 mmHg) with four antihypertensive drugs or more. Subjects diagnosed with uncontrolled office blood pressure were further subdivided as pseudo-resistant hypertension and true resistant hypertension based on 24 h ambulatory blood pressure monitoring. The primary endpoint was fatal and non-fatal cardiovascular and cerebrovascular events, which was a composite endpoint consisting of cardiovascular and cerebrovascular death, ischemic and hemorrhagic stroke, myocardial infarction, coronary artery revascularization, unstable angina, heart failure, and coronary artery stenosis≥50% confirmed by coronary angiography. Secondary outcomes included fatal and non-fatal stroke or cardiac events. Patients with controlled office blood pressure after taking only 1 or 2 antihypertensive drugs were included as control. Kaplan-Meier survival curves, log-rank test, and Cox proportional risk model were used to evaluate the risk of apparent refractory hypertension in relation to cardiovascular and cerebrovascular prognosis. Results: A total of 2 782 treated hypertensive patients, aged (58.1±12.3) years were enrolled, including 1 403 (50.4%) men. The prevalence of apparent and true resistant hypertension was 15.1% (420/2 782) and 10.5% (293/2 782), respectively. Among patients with apparent resistant hypertension, during a median of 5 years follow-up, the cumulative incidence rate was 28.2, 11.2 and 19.1 per 1 000 person-years for fatal and non-fatal cardiovascular events (n=58), stroke (n=24) and cardiac events (n=40), respectively. The Kaplan-Meier curve and log-rank test showed that those patients with true resistant hypertension, had the highest cumulative incidence rate of fatal and non-fatal cardiovascular events, stroke, and cardiac events. Multivariable Cox regression analyses showed that true resistant hypertension was associated with a significantly higher risk of fatal and non-fatal cardiovascular events (HR=1.73, 95%CI 1.17-2.56, P=0.006) and stroke (HR=2.81, 95%CI 1.53-5.17, P=0.001). Conclusion: Resistant hypertension, especially true resistant hypertension, is associated with a higher risk of fatal and non-fatal cardiac and cerebrovascular events.
Subject(s)
Antihypertensive Agents , Hypertension , Outpatients , Humans , Hypertension/epidemiology , Hypertension/complications , Prospective Studies , Antihypertensive Agents/therapeutic use , Prognosis , Risk Factors , Blood Pressure , Stroke/epidemiology , Stroke/etiology , Cardiovascular Diseases/epidemiology , China/epidemiology , Male , Female , Middle Aged , PrevalenceABSTRACT
Objective: To explore the genotype-phenotype relationship of Wilson's disease (WD) and further study the mutation spectrum in the ATP7B gene. Methods: The clinical data and genetic test results of 115 cases with WD diagnosed in the First Affiliated Hospital of Zhengzhou University from 2015 to 2022 were retrospectively analyzed. The rank sum test was used for quantitative data comparison, and χ(2) test was used for count data comparison. Multivariate logistic regression was used to analyze the relationship between patients' genotype and phenotype. Results: The onset of liver manifestations (hepatic type) accounted for 60.9%, neurological symptoms (cerebral type) for 13.0%, and mixed hepato-cerebral symptoms for 26.1%. Presymptomatic individuals (hepatic types) accounted for 62.9%. Next-generation sequencing- diagnosed WD cases accounted for 87.8%. Combined multiplex ligation-dependent probe amplification assay-diagnosed WD cases accounted for 89.6%. A single case with a detected pathogenic locus accounted for 10.4%. The diagnostic rate of WD by genetic testing combined with clinical data was 100%. A total of 76 ATP7B mutations were detected, and the top three mutation frequencies were c.2333G>T (p.Arg778Leu) (30.7%), c.2975C>T (p.Pro992Leu) (7.3%), and c.2621C>T (p.Ala874Val) (6.4%). The mutations were mainly distributed in exons 8, 11-13, and 15-18, accounting for more than 90% of the total mutations. Eight new mutations were found, including c.3724G>A (p.Glu1242Lys), c.3703G>C (p.Gly1235Arg), c.3593T>C (p.Val1198Ala), c.2494A>C (p.Lys832Gln), c.1517T>A (p.Ile506Lys), c.484G>T (p.Glu162Ter), c.1870-49A>G, and the missing of exons 10-21. Liver histopathology showed cellular edema, degeneration, inflammation, and necrosis, as well as a 42.8% copper staining positive rate. Genotype-phenotype analysis showed that the p.Arg778Leu mutation had higher alanine aminotransferase (ALT) levels than those carrying other mutations (P=0.024), while the homozygous mutation of p.Arg778Leu was associated with cerebral-type patients (P=0.027). Conclusion: Genetic testing plays an important role in the diagnosis of WD. p.Arg778Leu is the first high-frequency mutation in the Chinese population, and patients carrying it have higher ALT levels. The p.Arg778Leu homozygous mutation is prone to causing cerebral-type WD. This study expands the ATP7B gene mutation spectrum.
Subject(s)
Copper-Transporting ATPases , Genotype , Hepatolenticular Degeneration , Mutation , Phenotype , Humans , Hepatolenticular Degeneration/genetics , Hepatolenticular Degeneration/diagnosis , Copper-Transporting ATPases/genetics , Retrospective Studies , Female , Male , Cation Transport Proteins/genetics , Genetic Association Studies , Adult , Adenosine Triphosphatases/genetics , Young Adult , Adolescent , Child , Genetic Testing , Middle Aged , High-Throughput Nucleotide SequencingABSTRACT
Objective: To understand the infection status, epidemiological characteristics and drug resistance of Diarrheagenic Escherichia coli (DEC) in Shanghai and provide evidence for the disease surveillance. Methods: The epidemiological data of diarrhea cases in Shanghai from 2016 to 2022 were collected from Shanghai Diarrhea Comprehensive Surveillance System, and stool samples were collected from the cases for DEC detection. The drug resistance data was obtained from Chinese Pathogen Identification Network. Statistical analysis was conducted by using χ2 and fisher test. Results: In 24 883 diarrhea cases detected during 2016-2022, the DEC positive rate was 9.13% (2 271/24 883), the single DEC positive rate was 8.83% (2 197/24 883) and the mixed DEC positive rate was 0.30% (74/24 883). The main type of DEC was Enterotoxigenic Escherichia coli (ETEC) [4.33% (1 077/24 883)]. The DEC positive rate was highest in people aged ≤5 years 18.48% (22/119). The annual peak of DEC positive rate was observed during July - September [5.91% (1 470/24 883)]. The DEC positive rate were 9.47% (554/5 847) and 9.02% (1 717/19 036) in urban area and in suburbs, respectively, Enteroaggregative Escherichia coli (EAEC) [3.98% (233/5 847)] and ETEC [4.56% (868/19 036)] were mainly detected. From 2016 to 2019, the DEC positive rate was 9.42% (1 821/19 330), while it was 8.10% (450/5 553) from 2020 to 2022, the main DEC types were ETEC (4.87%, 941/19 330) and EAEC (4.70%, 261/5 553). The multi-drug resistance rate was 40.21% (618/1 537). The top three antibiotics with high drug resistance rates were ampicillin [64.74% (995/1 537)], nalidixic acid [58.49% (899/1 537)] and tetracycline [45.09% (693/1 537)]. Conclusions: Compared with 2016- 2019, a decrease in DEC detection rate was observed during 2020-2022, and the main type of DEC detected shifted from ETEC to EAEC. The prevalence of multi-drug resistance was severe. Therefore, it is necessary to further strengthen the surveillance for DEC drug resistance and standardize the use of clinical antibiotics.
Subject(s)
Diarrhea , Enterotoxigenic Escherichia coli , Escherichia coli Infections , Humans , Diarrhea/microbiology , Diarrhea/epidemiology , Escherichia coli Infections/epidemiology , Escherichia coli Infections/microbiology , China/epidemiology , Enterotoxigenic Escherichia coli/drug effects , Enterotoxigenic Escherichia coli/isolation & purification , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Feces/microbiology , Escherichia coli/drug effects , Escherichia coli/isolation & purification , Drug Resistance, Bacterial , Child, Preschool , Child , Infant , Adolescent , AdultABSTRACT
At present, stock linear distractors are used for internal maxillary distraction osteogenesis. However, the authors' research group has demonstrated, through an in silico analysis, that linear distraction leads to bone deformities and malocclusion, whereas helical distraction can yield ideal outcomes. A system for designing and manufacturing custom helical distractors has recently been developed, and the feasibility of these appliances now needs to be assessed. This study was, therefore, conducted to gain an initial insight into their feasibility. The study had two goals. First, it aimed to demonstrate, in an in vitro model, that the novel system of custom helical distraction can produce appropriate clinical outcomes. The second aim was to compare the performance of custom helical distractors with that of stock devices and hybrid devices (i.e., linear appliances that feature patient-specific footplates). Interpreting the results as trends, this study showed that the system of custom helical distraction resulted in in vitro outcomes that were superior to those obtained with stock and hybrid devices.
Subject(s)
Feasibility Studies , Maxilla , Osteogenesis, Distraction , Humans , Osteogenesis, Distraction/instrumentation , Osteogenesis, Distraction/methods , Maxilla/surgery , In Vitro Techniques , Equipment DesignABSTRACT
The list of occupational diseases reflecting the latest advances in the identification and recognition of occupational diseases, and providing guidance on the protection of workers' health rights and interests and the prevention, recording, notification and compensation of related occupational diseases. Diagnostic criteria for occupational diseases are an important basis for making diagnoses attributable to occupational diseases, and provide a theoretical basis for health monitoring of occupational groups and occupational hygiene supervision. This thesis starts with the definition of the occupational disease elaborates in detail the development history of list of occupational diseases in International Labour Organization (ILO) , compares the list of occupational diseases in China (2013 version) with the list of occupational diseases in international (2010 version) , and then introduces in detail the latest diagnostic standards of the major occupational diseases. And finally, it puts forward relevant suggestions on the list and diagnostic level of China's occupational diseases, so as to provide certain insights for the further improvement of the list and diagnostic standards of occupational diseases.
Subject(s)
Occupational Diseases , Humans , Occupational Diseases/diagnosis , China , Occupational HealthABSTRACT
Objective: To investigate the clinical and genetic characteristics of children with 45, X/46, XY mosaicism. Methods: The retrospective study included 20 children diagnosed with 45, X/46, XY and 45, X/46, X,+mar mosaicism in the First Affiliated Hospital of Zhengzhou University from 2018 to 2022. The clinical features, gonadal pathology, treatment and follow-up were summarized. Genetic tests were performed by SRY gene test, azoospermia factor region (AZF) deletion test, copy number variation-sequencing (CNV-seq). Age at first diagnosis was compared between boys and girls using independent sample t-test. Results: The 20 patients included 3 boys and 17 girls, and the age at first diagnosis were (7.6±5.5) years, it is (2.1±1.9) years in boys, (8.7±5.4) years in girls, significantly younger for boys (t=-3.86, P=0.004). The chief complaint was external genitalia malformation for boys, and short stature (13 cases) and dysplastic external genital for girls (4 cases). Five girls presented with features of Turner syndrome. The gonadal phenotypes included mixed gonadal dysplasia (MGD, 6 cases), complete gonadal dysplasia (CGD, 10 cases), unilateral ovotestis (2 cases), possible ovaries (1 case) and undetermined gonad (1 case). One female with dysplastic genital was reassigned to male, and the gender of the remaining cases remained unchanged. Seven females were treated with recombinant human growth hormone. The height increased by (17±7) cm during the (2.9±1.2) years follow-up. No gonadal malignancy was observed. The karyotype was 45, X/46, XY in 16 cases, and 45, X/46, X,+mar in 4 cases. All of the 4 marker chromosomes were derived from Y chromosome confirmed by CNV-seq. SRY gene was detected in all 20 patients genome, and AZF deletion was found in 7 girls. Conclusions: 45, X/46, XY mosaicism presented with dysplastic external genital or female with remarkable short stature. Gonadal phenotypes included MGD, CGD and ovotestis. AZF microdeletions were found in the majority of female cases.
Subject(s)
Gonadal Dysgenesis, Mixed , Turner Syndrome , Child , Humans , Male , Female , Child, Preschool , Adolescent , Mosaicism , Gonadal Dysgenesis, Mixed/genetics , Retrospective Studies , DNA Copy Number Variations , Turner Syndrome/genetics , Y ChromosomeABSTRACT
Objective: To explore the latest clinical characteristics and development trends of posterior malleolus fracture. Methods: Clinical information of inpatients with posterior malleolus fracture in Shanghai Tongji Hospital and Karamay Central Hospital from January 2014 to December 2022 were reviewed and collected. The imaging data of patients were acquired using the Picture Archiving and Communication Systems. A statistical analysis was performed as to gender, current age, year of admission, injury mechanism, fracture type, and posterior malleolus fracture classification. Moreover, a comparative analysis was conducted on the injury mechanisms and morphological differences of posterior malleolus fracture at different periods, regions, and age groups. Results: A total of 472 patients (210 patients from Shanghai Tongji Hospital and 262 patients from Karamay Central Hospital) with posterior malleolus fracture with a mean age of (48.7±15.6) years were included in this study. The peak of posterior malleolus fracture occurs in the age group of 50-59 years. The injury mechanisms mainly involve low-energy fall and sprain (411 cases, 87.1%), followed by traffic accidents (52 cases, 11.0%), and fall injury from height (9 cases, 1.9%). The number of cases according to different fracture types showed the following descending order: trimalleolar fracture-supination extorsion (335 cases, 71.0%), bimalleolar fracture (60 cases, 12.7%), trimalleolar fracture-pronation extorsion (43 cases, 9.1%), posterior malleolus+tibial shaft fracture (19 cases, 4.0%), simple posterior malleolus fracture (15 cases, 3.2%). The numbers of cases corresponding to the Haraguchi â , â ¡ and â ¢ type of posterior malleolus fractures was 369 (78.2%), 49 (10.4%), and 54 (11.4%), respectively. The Tongji â ¡A type represented the highest number of cases (249 cases, 52.8%), followed by the â ¡B type (120 cases, 25.4%), â type (54 cases, 11.4%), â ¢B type (36 cases, 7.6%), and â ¢A type (13 cases, 2.8%). However, no obvious statistical difference was observed in the injury mechanism, Haraguchi classification, and Tongji classification of posterior malleolus fractures among different years and regions from the year of 2014 to 2022 (all P>0.05). Conclusions: The injury mechanism of posterior malleolus fracture mainly involves low-energy fall and sprain cases. The trimalleolar fracture-supination extorsion, Haraguchi â type and Tongji â ¡A type of posterior malleolus fracture are predilection fracture types, and all present an obvious incidence peak in the age group of 50-59 years. There has been no significant change in the development trend of clinical characteristics of posterior malleolus fractures in recent years.
Subject(s)
Ankle Fractures , Ankle Injuries , Sprains and Strains , Adult , Humans , Middle Aged , Fracture Fixation, Internal , China/epidemiology , Retrospective Studies , Treatment OutcomeABSTRACT
Helical mandibular distraction is theoretically better than linear or circular distraction. However, it is not known whether this more complex treatment will result in unquestionably better outcomes. Therefore, the best attainable outcomes of mandibular distraction osteogenesis were evaluated in silico, given the constraints of linear, circular, and helical motion. This cross-sectional kinematic study included 30 patients with mandibular hypoplasia who had been treated with distraction, or to whom this treatment had been recommended. Demographic information and the computed tomography (CT) scans showing the baseline deformity were collected. The CT scans of each patient were segmented and three-dimensional models of the face created. Then, the ideal distraction outcomes were simulated. Next, the most favorable helical, circular, and linear distraction movements were calculated. Finally, errors were measured: misalignment of key mandibular landmarks, misalignment of the occlusion, and changes in intercondylar distance. Helical distraction produced trivial errors. In contrast, circular and linear distractions resulted in errors that were statistically and clinically significant. Helical distraction also preserved the planned intercondylar distance, while circular and linear distractions led to unwanted changes in the intercondylar distance. It is now evident that helical distraction offers a new strategy to improve the outcomes of mandibular distraction osteogenesis.
Subject(s)
Micrognathism , Osteogenesis, Distraction , Humans , Osteogenesis, Distraction/methods , Cross-Sectional Studies , Facial Asymmetry , Mandible/diagnostic imaging , Mandible/surgery , Mandible/abnormalitiesABSTRACT
This corrects the article DOI: 10.1103/PhysRevLett.130.031802.
ABSTRACT
OBJECTIVE: The aim of this study was to explore the effects of computer-aided cognitive rehabilitation (CACR) combined with virtual reality (VR) technology on event-related potential P300 and cognitive function in patients with cognitive impairment after stroke. PATIENTS AND METHODS: Clinical data from 94 patients with post-stroke cognitive impairment, admitted to our hospital from January 2020 to March 2023, were retrospectively analyzed. Of them, 45 patients received routine rehabilitation training (Control group), and 49 patients received CACR combined with VR technology (Observation group). Cognitive rehabilitation status, event-related potential P300 examination status, biochemical indices levels, and daily living activity scores of the two groups were evaluated and compared. RESULTS: After treatment, cognitive function significantly improved in the Observation group compared to the Control group. The amplitude of P300 in the Observation group was significantly higher, and the latency was significantly lower compared to the Control group. The levels of brain-derived neurotrophic factor (BDNF) in the Observation group were significantly higher (p<0.05), while the levels of cystatin C (Cys-C) and neuron-specific enolase (NSE) were significantly lower than those in the Control group (p<0.05 each). Patients in the Observation group demonstrated a significantly higher ability to perform daily living activities compared to the Control group (p<0.05). CONCLUSIONS: Compared with conventional rehabilitation training, the combination of CACR and VR technology in the treatment of stroke-induced cognitive impairment is more effective in improving patients' cognitive function, regulating BDNF, Cys-C, and NSE levels, and enhancing patients' ability to perform daily living activities.
Subject(s)
Cognitive Dysfunction , Stroke Rehabilitation , Stroke , Virtual Reality , Humans , Brain-Derived Neurotrophic Factor , Retrospective Studies , Cognitive Training , Cognition , Activities of Daily Living , Cognitive Dysfunction/etiology , ComputersABSTRACT
The morphology of dodecane in a nanopore at temperatures typical in exploited or depleted oil reservoirs is investigated using molecular dynamics simulation. The dodecane morphology is found to be determined by interactions between interfacial crystallization and surface wetting of the simplified oil, while "evaporation" only plays a minor role. The morphology changes from an isolated, solidified dodecane droplet to a film with orderly lamellae structures remaining within, and finally to a film containing randomly distributed dodecane molecules, as the system temperature increases. In a nanoslit under the impact of water, since water wins against oil in surface wetting on the silica surface due to electrostatic interaction induced hydrogen bonding between water and the silanol group of silica, the spreading of dodecane molecules over the silica surface is impeded by this water confinement mechanism. Meanwhile, interfacial crystallization is enhanced, leading to always an isolated dodecane "droplet," with crystallization weakening as the temperature increases. Since dodecane is immiscible to water, there is no mechanism for dodecane to escape the silica surface, and the competition of surface wetting between water and oil determines the morphology of the crystallized dodecane droplet. For the CO2-dodecane system in a nanoslit, CO2 is an efficient solvent for dodecane at all temperatures. Therefore, interfacial crystallization rapidly disappears. The competition of surface adsorption between CO2 and dodecane is secondary for all cases. The dissolution mechanism is a clear clue for the fact that CO2 is more effective than water flooding in oil recovery for a depleted oil reservoir.
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Objective: To investigate the clinical phenotype and genetic characteristics of disorders of sex development (DSD) caused by Y chromosome copy number variant (CNV). Methods: A retrospective analysis was performed on 3 patients diagnosed with DSD caused by Y chromosome CNV admitted to the First Affiliated Hospital of Zhengzhou University from January, 2018 to September, 2022. Clinical data were collected. Clinical study and genetic test were performed by karyotyping, whole exome sequencing (WES), low coverage whole genome copy number variant sequencing (CNV-seq), fluorescence in situ hybridization (FISH) and gonadal biopsy. Results: The 3 children, aged 12, 9, 9 years, the social gender were all female, presented with short stature, gonadal dysplasia and normal female external genital. No other phenotypic abnormality was found except for case 1 with scoliosis. The karyotype of all cases were identified as 46, XY. No pathogenic vraiants were found by WES. CNV-seq determined that case 1 was 47, XYY,+Y(2.12) and case 2 was 46, XY,+Y(1.6). FISH concluded that the long arm of Y chromosome was broken and recombined near Yq11.2, and then produced a pseudodicentric chromosome idic(Y). The karyotype was reinterpreted as mos 47, X, idic(Y)(q11.23)×2(10)/46, X, idic(Y)(q11.23)(50) in case 1. The karyotype was redefined as 45, XO(6)/46, X, idic(Y)(q11.22)(23)/46, X, del(Y)(q11.22)(1) in case 2. 46, XY, -Y(mos) was found by CNV-seq in case 3, and the karyotype of 45, XO/46, XY was speculated. Conclusions: The clinical manifestations of children with DSD caused by Y chromosome CNV are short stature and gonadal dysgenesis. If there is an increase of Y chromosome CNV detected by CNV-seq, FISH is recommended to classify the structural variation of Y chromosome.
Subject(s)
DNA Copy Number Variations , Turner Syndrome , Humans , Female , In Situ Hybridization, Fluorescence , Retrospective Studies , Chromosomes, Human, YABSTRACT
Objective: To investigate the clinical efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for patients with acute leukemia who are positive for the SET-NUP214 fusion gene (SET-NUP214+AL). Methods: This was a retrospective case series study. Clinical data of 18 patients with SET-NUP214+AL who received allo-HSCT in the First Affiliated Hospital of Soochow University and Soochow Hongci Hematology Hospital from December 2014 to October 2021 were retrospectively analyzed to investigate treatment efficacy and prognosis. The Kaplan-Meier method was used for survival analysis. Results: Of the 18 patients, 12 were male and 6 were female, and the median age was 29 years (range, 13-55 years). There were six cases of mixed phenotype acute leukemia (three cases of myeloid/T, two cases of B/T, one case of myeloid/B/T), nine cases of acute lymphoblastic leukemia (ALL) (one case of B-ALL and eight cases of T-ALL), and three cases of acute myeloid leukemia. All patients received induction chemotherapy after diagnosis, and 17 patients achieved complete remission (CR) after chemotherapy. All patients subsequently received allo-HSCT. Pre-transplantation status: 15 patients were in the first CR, 1 patient was in the second CR, 1 was in partial remission, and 1 patient did not reach CR. All patients were successfully implanted with stem cells. The median time of granulocyte and platelet reconstitution was +12 and +13 days, respectively. With a median follow-up of 23 (4-80) months, 15 patients survived, while 3 patients died. The cause of death was recurrence of SET-NUP214+AL after transplantation. After allo-HSCT, 5 patients relapsed. The estimated 3-year overall survival (OS) and relapse-free survival (RFS) rates were 83.3%±15.2% and 55.4%±20.7%, respectively. Among the 15 patients who achieved CR before transplantation, there was no significant difference in OS and RFS between haploidentical HSCT and matched sibling donor HSCT (all P>0.05). Conclusions: Allo-HSCT can improve the prognosis and long-term survival rate of patients with SET-NUP214+AL. Disease recurrence is the most important factor affecting long-term survival.
Subject(s)
Hematopoietic Stem Cell Transplantation , Leukemia, Myeloid, Acute , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Male , Female , Humans , Retrospective Studies , Hematopoietic Stem Cell Transplantation/methods , Leukemia, Myeloid, Acute/therapy , Survival Analysis , Remission Induction , Acute Disease , Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy , Recurrence , Nuclear Pore Complex ProteinsABSTRACT
We report a search for cosmic-ray boosted dark matter with protons using the 0.37 megaton×years data collected at Super-Kamiokande experiment during the 1996-2018 period (SKI-IV phase). We searched for an excess of proton recoils above the atmospheric neutrino background from the vicinity of the Galactic Center. No such excess is observed, and limits are calculated for two reference models of dark matter with either a constant interaction cross section or through a scalar mediator. This is the first experimental search for boosted dark matter with hadrons using directional information. The results present the most stringent limits on cosmic-ray boosted dark matter and exclude the dark matter-nucleon elastic scattering cross section between 10^{-33}cm^{2} and 10^{-27}cm^{2} for dark matter mass from 1 MeV/c^{2} to 300 MeV/c^{2}.
ABSTRACT
This in silico kinematic study was performed to evaluate the best attainable outcomes of maxillary distraction osteogenesis given the constraints of linear and helical motion. The study sample included the retrospective records of 30 patients with maxillary retrusion who had been treated with distraction or had been recommended this treatment. The primary outcomes were the errors of linear and helical distraction. The study measured two types of error: misalignment of key upper jaw landmarks and misalignment of the occlusion. Concerning the misalignment of key landmarks, the median misalignments resulting from helical distraction were minimal; the interquartile ranges were also minimal. The median misalignments and interquartile ranges that resulted from linear distraction were significantly larger. Regarding the occlusal misalignments, helical distraction produced minor occlusal misalignments, while linear distraction produced significantly larger errors. The results of this study confirmed that helical motion is the ideal motion for LeFort I distraction.
Subject(s)
Cleft Lip , Cleft Palate , Osteogenesis, Distraction , Humans , Osteogenesis, Distraction/methods , Retrospective Studies , Osteotomy, Le Fort/methods , Maxilla/surgery , Cephalometry , Treatment OutcomeABSTRACT
AIM: To reveal the prognostic value of the postoperative and dynamic albumin-to-alkaline phosphatase ratio (AAPR) in hepatocellular carcinoma (HCC) patients undergoing trans-catheter chemoembolisation (TACE). MATERIALS AND METHODS: In total, 545 HCC patients undergoing initial TACE were enrolled into the study. The receiver operating characteristic (ROC) curve was plotted to determine the best cut-off for AAPR. Univariate and multivariate Cox regression analyses were used to confirm the independent prognostic effect of AAPR on overall survival (OS). The predictive performance of AAPR was assessed by ROC curves, concordance index (C-index), and Akaike information criterion (AIC), and was compared to existing liver function assessment systems. RESULTS: The optimal cut-off value for the AAPR was 0.26. Elevated AAPR (>0.26) was associated with a low risk of death after adjustment whether before (HR: 0.53; 95% CI: 0.4-0.69) or after (HR: 0.64; 95% CI: 0.43-0.95) TACE treatment. The combined pre- and postoperative AAPR showed much better performance in ROC curve (1-, 3-, and 5-year AUCs: 0.69, 0.71, 0.69), C-index (0.65; 95% CI: 0.59-0.72) and AIC analyses than pre-AAPR and post-AAPR alone or liver function assessment systems. CONCLUSION: This study demonstrated both preoperative and postoperative AAPR were independent prognostic factors for HCC patients undergoing TACE. In addition, the combined pre- and post-AAPR showed better predictive performance than pre-AAPR and post-AAPR alone or liver function assessment systems.
Subject(s)
Carcinoma, Hepatocellular , Liver Neoplasms , Humans , Prognosis , Carcinoma, Hepatocellular/therapy , Alkaline Phosphatase , Liver Neoplasms/therapy , Albumins , CathetersABSTRACT
Low temperatures limit the geographic distribution and yield of plants. Hormones play an important role in coordinating the growth and development of plants and their tolerance to low temperatures. However, the mechanisms by which hormones affect plant resistance to extreme cold stress in the natural environment are still unclear. In this study, two winter wheat varieties with different cold resistances, Dn1 and J22, were used to conduct targeted plant hormone metabolome analysis on the tillering nodes of winter wheat at 5 °C, -10 °C and -25 °C using an LC-ESI-MS/MS system. We screened 39 hormones from 88 plant hormone metabolites and constructed a partial regulatory network of auxin, jasmonic acid and cytokinin. GO analysis and enrichment of KEGG pathways in different metabolites showed that the 'plant hormone signal transduction' pathway was the most common. Our study showed that extreme low temperature increased the most levels of auxin, cytokinin and salicylic acid, and decreased levels of jasmonic acid and abscisic acid, and that levels of auxin, jasmonic acid and cytokinin in Dn1 were higher than those in J22. These changes in hormone levels were associated with changes in gene expression in synthesis, catabolism, transport and signal transduction pathways. These results differ from the previous hormone regulation mechanisms, which were mostly obtained at 4 °C. Our results provide a basis for further understanding the molecular mechanisms by which plant endogenous hormones regulate plant freezing stress tolerance.
Subject(s)
Plant Growth Regulators , Triticum , Plant Growth Regulators/metabolism , Freezing , Triticum/metabolism , Cold-Shock Response , Tandem Mass Spectrometry , Cold Temperature , Cytokinins/metabolism , Plants/metabolism , Indoleacetic Acids/metabolism , Hormones/metabolism , Gene Expression Regulation, PlantABSTRACT
The purpose of this ambispective study was to investigate whether deep learning-based automatic segmentation and landmark detection, the SkullEngine, could be used for orthognathic surgical planning. Sixty-one sets of cone beam computed tomography (CBCT) images were automatically inferred for midface, mandible, upper and lower teeth, and 68 landmarks. The experimental group included automatic segmentation and landmarks, while the control group included manual ones that were previously used to plan orthognathic surgery. The qualitative analysis of segmentation showed that all of the automatic results could be used for computer-aided surgical simulation. Among these, 98.4% of midface, 70.5% of mandible, 98.4% of upper teeth, and 93.4% of lower teeth could be directly used without manual revision. The Dice similarity coefficient was 96% and the average symmetric surface distance was 0.1 mm for all four structures. With SkullEngine, it took 4 minutes to complete the automatic segmentation and an additional 10 minutes for a manual touchup. The results also showed the overall mean difference between the two groups was 2.3 mm for the midface and 2.4 mm for the mandible. In summary, the authors believe that automatic segmentation using SkullEngine is ready for daily practice. However, the accuracy of automatic landmark digitization needs to be improved.
Subject(s)
Deep Learning , Orthognathic Surgery , Spiral Cone-Beam Computed Tomography , Humans , Feasibility Studies , Cone-Beam Computed Tomography/methods , Computers , Image Processing, Computer-Assisted/methodsABSTRACT
In this paper, an Artificial Neural Network (ANN) is used to investigate the influence of rolling parameters such as thickness reduction, inter-strand tension, rolling speed and friction on the rolling force, rolling power, and slip of tandem cold rolling. For this reason, the rolling power was derived for 195 various experiments through a series of observation tests. The network is trained and tested using real data collected from a practical tandem rolling line. The best topology of the ANN is determined by Broyden-Fletcher-Goldfarb-Shanno (BFGS) training algorithm and error, and nine neurons in the hidden layer had the best performance. The average of the training, testing, and validating correlation coefficients data sets are mentioned 0.947, 0.924, and 0.943, respectively. The obtained results show MSE value 4.2 × 10-4 for predicting slip. In addition, the effect of friction and angular velocity condition on the cold rolling critical slip phenomena are investigated. The results show that ANNs can accurately predict the cold rolling parameters considered in this study.