Biliary Neuroendocrine Neoplasms: Clinical Profiles, Management, and Analysis of Prognostic Factors

Biliary neuroendocrine neoplasms (NENs) represent <1% of all NENs. The aim of this retrospective study is to present the clinical characteristics, management and prognosis profiles of 28 biliary NEN patients from a large tertiary center, and identify factors related to prognosis. Nine tumors originated from the gallbladder, two from the extrahepatic bile duct and 17 from the ampulla of Vater. One patient was classified as neuroendocrine tumor (NET) Grade 1, three patients were classified as NET Grade 2, 18 were graded neuroendocrine carcinoma (NEC) Grade 3 and six were classified as mixed adenoneuroendocrine carcinoma (MANEC). The overall survival rate and disease-free survival rate did not have statistically significant differences between tumors of different locations or different grading. Recurrence of disease correlated with poor prognosis (p < 0.001). Lymphovascular invasion and invasion beyond the submucosa were related to higher risk of local lymph node metastases. Multivariate analysis identified patient age (p = 0.021) and R0 resection margin (p = 0.027) as independent prognostic factors associated with overall survival. Our study included relatively large numbers of biliary tract NENs with intact follow-up information. Patients with biliary neuroendocrine tumors showed different clinical outcomes according to tumor locations and tumor grades. Achieving R0 resection is important for better prognosis

THE ADAPTABLE AMPHIBIOUS WHEEL-LEGGED ROBOT

A new category of the large diameter adaptable amphibious wheel-legged robot is proposed in this paper. The proposed mechanism can achieve a greater ability to climb obstacles. The D-H coordinate system is used for kinematics analysis, and the constructed kinematics model is used to solve these joint variables for redundant robot. According to the control strategy which is based on foot trajectory and gait planning, the foot trajectory of the amphibious robot is planned, which is also optimized to meet the operation performance in the special environment, as well as the planning of the walk gait. Then the control system is distributed in closed space. Then related simulation is used to verify the usefulness of the planned foot trajectory and walk gait in the entire running cycle, and related circuit is designed to solve the commutation problem of Arduino and AX-12 servo. Finally, the foot trajectory of the single robot leg is captured by the three-dimensional motion capture system to verify the rationality of the foot trajectory and walk gait.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

Research on Computational Intelligence in Medical Resource Allocation Based on Mass Customization

In this era characterized by rapid improvements in the quality of living, people are eager to seek better medical services. However, the medical resource shortage threatens people's daily lives and has become an important factor causing dissatisfaction. Furthermore, as a sub-branch of artificial intelligence, computational intelligence is widely used to solve real-world problems like resource allocation. This paper proposes a medical resource allocation model based on mass customization, considering parameters such as doctors' professional level, patient preferences, and the medical station distribution. This model aims at optimizing and balancing the uneven distribution of medical resources by taking into account the patient requirements and medical costs. Moreover, a genetic algorithm is applied to improve the computational efficiency of the proposed method. The results show that the medical resource allocation model based on mass customization can lead to a higher profit. Suggestions are also discussed for sustainable development in medical service based on mass customization

Comparative thermal comfort study in educational buildings in autumn and winter seasons

10.1080/23744731.2019.1614426Science and Technology for the Built Environment262185-19

PsAF5 functions as an essential adapter for PsPHB2-mediated mitophagy under ROS stress in Phytophthora sojae

Abstract Host-derived reactive oxygen species (ROS) are an important defense means to protect against pathogens. Although mitochondria are the main intracellular targets of ROS, how pathogens regulate mitochondrial physiology in response to oxidative stress remains elusive. Prohibitin 2 (PHB2) is an inner mitochondrial membrane (IMM) protein, recognized as a mitophagy receptor in animals and fungi. Here, we find that an ANK and FYVE domain-containing protein PsAF5, is an adapter of PsPHB2, interacting with PsATG8 under ROS stress. Unlike animal PHB2 that can recruit ATG8 directly to mitochondria, PsPHB2 in Phytophthora sojae cannot recruit PsATG8 to stressed mitochondria without PsAF5. PsAF5 deletion impairs mitophagy under ROS stress and increases the pathogen’s sensitivity to H2O2, resulting in the attenuation of P. sojae virulence. This discovery of a PsPHB2-PsATG8 adapter (PsAF5) in plant-pathogenic oomycetes reveals that mitophagy induction by IMM proteins is conserved in eukaryotes, but with differences in the details of ATG8 recruitment

The Prognostic Value of the CA19-9/TBIL Ratio in Patients with Biliary Tract Cancers (BTCs): A Retrospective Study

Background. Incidence of biliary tract cancers (BTCs) in China is high, and surgery is the only curative option. Preoperative CA19-9 has been identified as a predictor for survival in patients with resectable BTCs, but more potential predictors need to be studied. This retrospective study aimed to establish the prognostic significance of CA19-9/TBIL ratio (CTR) in patients with BTCs. Methods. A retrospective analysis was performed in patients who were diagnosed with BTCs and received surgical resection between 2013 and 2018 at PUMCH. Demographic and clinical parameters were collected. Preoperative CA19-9 and CTR were classified as elevated (>58.6 and >0.83) according to the receiver operating characteristic (ROC) analysis. Demographic and clinical parameters were compared between the groups using Student’s t-test, chi-square, or Fisher’s exact test. Survival analysis was performed by the Kaplan–Meier methods, and the relationship between variables and survival was assessed by the log-rank test. Cox regression analysis was conducted to identify potential risk factors for overall survival. Results. In total, 109 participants were involved in the final analysis. The overall survival rate was 18.0% at 5 years, with a median survival duration of 1.58 years. The Kaplan–Meier analysis indicated that higher CTR was associated with shorter OS (15 vs. 50, p<0.01). Univariate survival analysis identified TNM staging, CA19-9, and CTR as statistically significant prognostic factors. In a multiple Cox analysis, only CTR was proved as a significantly independent prognostic factor. Conclusion. CTR acts as an independent prognostic predictor for patients with biliary tract cancer

Nanostructured Co3O4 for achieving high-performance supercapacitor

Supercapacitors with cobalt oxide (Co3O4) electrode are a kind of strong candidates for achieving high capacity storage energy devices. However, the reported capacitances lower than the theoretical values are undesirable. In this study, a high-performance supercapacitor by using the Co3O4 electrode with a porous nanostructure is enabled by the calcination treatment of metal organic framework ZIF-67. Of note, the resulting Co3O4 electrodes shows high specific capacitance of 1015 F/g under a current density of 1 A/ g. Additionally, it exhibits energy density of 36.6 Wh/kg at a power density of 189.5 W/kg and maintains capacitance retention of 78.2% after 5000 cycles at 8 A/g. The strategy proposed here provides a good way to synthesize nanostructured Co3O4, a candidate for constructing high-capacitance energy storage devices. (c) 2020 Elsevier B.V. All rights reserved

Construction of hierarchical structure of Co3O4 electrode based on electrospinning technique for supercapacitor

The design and synthesis of hierarchical micro-nano structures of transition metal oxides have played an essential role in the supercapacitor field. In this work, in situ three-dimensional construction of nanoporous cobalt oxide (Co3O4) has been derived from the metal-organic framework (MOF) distributed evenly in electrospun polyacrylonitrile nanofibers. Due to large specific surface area and network architectures, the as-synthesized Co3O4 electrode notably presents a high specific capacitance of 970 F/g at a current density of 1 A/g. Besides, the as-obtained electrode exhibits a high energy density of 54.6 Wh/ kg at a power density of 360.6 W/kg and maintains a capacitance retention of 77.5% after 5000 cycles at 6 A/g. Therefore, this method paves a way to produce the nanoporous MOF-derived Co3O4 network architecture as advanced electrodes materials, which shows an application potential for the energy storage industry. (C) 2020 Elsevier B.V. All rights reserved

Restoring Wnt signaling in a hormone-simulated postpartum depression model remediated imbalanced neurotransmission and depressive-like behaviors

Abstract Background Postpartum depression (PPD) is a prevalent mental disorder that negatively impacts mothers and infants. The mechanisms of vulnerability to affective illness in the postpartum period remain largely unknown. Drastic fluctuations in reproductive hormones during the perinatal period generally account for triggering PPD. However, the molecular mechanism underlying the PPD-like behaviors induced by the fluctuations in hormones has rarely been reported. Methods We utilized hormones-simulated pseudopregnancy (HSP) and hormones-simulated postpartum period (HSPP) rat models to determine how drastic fluctuations in hormone levels affect adult neurotransmission and contribute to depressive-like behaviors. The electrophysiological response of CA1 pyramidal neurons was evaluated by whole-cell patch clamping to identify the hormone-induced modulations of neurotransmission. The statistical significance of differences was assessed with One-way ANOVA and t-test (p < 0.05 was considered significant). Results Reproductive hormones withdrawal induced depressive-like behaviors and disturbed the balance of excitatory and inhibitory transmission in the pyramidal neurons in the hippocampus. Molecular analyses revealed that the blunted Wnt signaling might be responsible for the deficits of synaptic transmission and behaviors. Activation of Wnt signaling increased excitatory and inhibitory synaptic transmission in the hippocampus. Reactivation of Wnt signaling alleviated the anhedonic behaviors and abnormal synaptic transmission. Conclusions Restoring Wnt signaling in the hormones-simulated postpartum period rat models remediated depression-related anhedonia symptoms and rebalanced the excitation/inhibition ratio by collectively enhancing the plasticity of GABAergic and glutamatergic synapses. The investigations carried out in this research might provide an alternative and prospective treatment strategy for PPD

Pancreatic stromal Gremlin 1 expression during pancreatic tumorigenesis

© 2020 Chronic pancreatitis (CP) is a major risk factor of pancreatic ductal adenocarcinoma (PDAC). How CP promotes pancreatic oncogenesis remains unclear. A characteristic feature of PDAC is its prominent desmoplasia in the tumor microenvironment, composed of activated fibroblasts and macrophages. Macrophages can be characterized as M1 or M2, with tumor-inhibiting or -promoting functions, respectively. We reported that Gremlin 1 (GREM1), a key pro-fibrogenic factor, is upregulated in the stroma of CP. The current study aimed to investigate the expression of GREM1 and correlation between GREM1 and macrophages within the pancreas during chronic inflammation and the development of PDAC. By mRNA in situ hybridization, we detected GREM1 mRNA expression within α-smooth muscle actin (SMA)-positive fibroblasts of the pancreatic stroma. These designated FibroblastsGrem1+ marginally increased from CP to pancreatic intraepithelial neoplasia (PanIN) and PDAC. Within PDAC, FibroblastsGrem1+ increased with higher pathological tumor stages and in a majority of PDAC subtypes screened. Additionally, FibroblastsGrem1+ positively correlated with total macrophages (MacCD68+) and M2 macrophages (M2CD163+) in PDAC. To begin exploring potential molecular links between FibroblastsGrem1+ and macrophages in PDAC, we examined the expression of macrophage migration inhibitory factor (MIF), an endogenous counteracting molecule of GREM1 and an M1 macrophage promoting factor. By IHC staining of MIF, we found MIF to be expressed by tumor cells, positively correlated with GREM1; by IHC co-staining, we found MIF to be negatively correlated with M2CD163+ expression. Our findings suggest that GREM1 expression by activated fibroblasts may promote PDAC development, and GREM1/MIF may play an important role in macrophage phenotype