Optical limiting using Laguerre-Gaussian beams

We demonstrate optical limiting using the self-lensing effect of a higher-order Laguerre-Gaussian beam in a thin dye-doped polymer sample, which we find is consistent with our model using Gaussian decomposition. The peak phase shift in the sample required for limiting is smaller than for a fundamental Gaussian beam with the added flexibility that the nonlinear medium can be placed either in front of or behind the beam focus.Comment: 3 pages, 4 figure

TIDE: adjuvant tislelizumab plus donafenib combined with transarterial chemoembolization for high-risk hepatocellular carcinoma after surgery: protocol for a prospective, single-arm, phase II trial

BackgroundThe high recurrence rate of hepatocellular carcinoma (HCC) after surgery negatively affects the prognosis of patients. There is currently no widely accepted adjuvant therapy strategy for patients with HCC. A clinical study of effective adjuvant therapy is still needed.MethodsIn this prospective, single-arm, phase II clinical trial, an adjuvant regimen of donafenib plus tislelizumab combined with transarterial chemoembolization (TACE) will be used to treat enrolled HCC patients after surgery. Briefly, patients newly diagnosed with HCC by pathological examination who underwent curative resection and had a single tumor more than 5 cm in diameter with microvascular invasion as detected by pathological examination are eligible. The primary endpoint of the study is the recurrence-free survival (RFS) rate at 3 years, and secondary endpoints are the overall survival (OS) rate and the incidence of adverse events (AEs). The planned sample size, 32 patients, was calculated to permit the accumulation of sufficient RFS events in 3 years to achieve 90% power for the RFS primary endpoint.DiscussionVascular endothelial growth factor (VEGF) and programmed cell death protein 1 (PD-1)/programmed cell death ligand 1 (PD-L1) pathways regulate the relevant immunosuppressive mechanisms of HCC recurrence. Our trial will evaluate the clinical benefit of adding donafenib plus tislelizumab to TACE in patients with early-stage HCC and a high risk of recurrence.Clinical trial registrationwww.chictr.org.cn, identifier ChiCTR2200063003

Analysis of Vegetation Vulnerability Dynamics and Driving Forces to Multiple Drought Stresses in a Changing Environment

Quantifying changes in the vulnerability of vegetation to various drought stresses in different seasons is important for rational and effective ecological conservation and restoration. However, the vulnerability of vegetation and its dynamics in a changing environment are still unknown, and quantitative attribution analysis of vulnerability changes has been rarely studied. To this end, this study explored the changes of vegetation vulnerability characteristics under various drought stresses in Xinjiang and conducted quantitative attribution analysis using the random forest method. In addition, the effects of ecological water transport and increased irrigation areas on vegetation vulnerability dynamics were examined. The standardized precipitation index (SPI), standardized precipitation-evapotranspiration index (SPEI), and standardized soil moisture index (SSMI) represent atmospheric water supply stress, water and heat supply stress, and soil water supply stress, respectively. The results showed that: (1) different vegetation types responded differently to water stress, with grasslands being more sensitive than forests and croplands in summer; (2) increased vegetation vulnerability under drought stresses dominated in Xinjiang after 2003, with vegetation growth and near-surface temperature being the main drivers, while increased soil moisture in the root zone was the main driver of decreased vegetation vulnerability; (3) vulnerability of cropland to SPI/SPEI/SSMI-related water stress increased due to the rapid expansion of irrigation areas, which led to increasing water demand in autumn that was difficult to meet; and (4) after ecological water transport of the Tarim River Basin, the vulnerability of its downstream vegetation to drought was reduced

Cortical thickness and surface area in neonates at high risk for schizophrenia

Schizophrenia is a neurodevelopmental disorder associated with subtle abnormal cortical thickness and cortical surface area. However, it is unclear whether these abnormalities exist in neonates associated with genetic risk for schizophrenia. To this end, this preliminary study was conducted to identify possible abnormalities of cortical thickness and surface area in the high-genetic-risk neonates. Structural magnetic resonance images were acquired from offspring of mothers (N = 21) who had schizophrenia (N = 12) or schizoaffective disorder (N = 9), and also matched healthy neonates of mothers who were free of psychiatric illness (N = 26). Neonatal cortical surfaces were reconstructed and parcellated as regions of interest (ROIs), and cortical thickness for each vertex was computed as the shortest distance between the inner and outer surfaces. Comparisons were made for the average cortical thickness and total surface area in each of 68 cortical ROIs. After false discovery rate (FDR) correction, it was found that the female high-genetic-risk neonates had significantly thinner cortical thickness in the right lateral occipital cortex than the female control neonates. Before FDR correction, the high-genetic-risk neonates had significantly thinner cortex in the left transverse temporal gyrus, left banks of superior temporal sulcus, left lingual gyrus, right paracentral cortex, right posterior cingulate cortex, right temporal pole, and right lateral occipital cortex, compared with the control neonates. Before FDR correction, in comparison with control neonates, male high-risk neonates had significantly thicker cortex in the left frontal pole, left cuneus cortex, and left lateral occipital cortex; while female high-risk neonates had significantly thinner cortex in the bilateral paracentral, bilateral lateral occipital, left transverse temporal, left pars opercularis, right cuneus, and right posterior cingulate cortices. The high-risk neonates also had significantly smaller cortical surface area in the right pars triangularis (before FDR correction), compared with control neonates. This preliminary study provides the first evidence that early development of cortical thickness and surface area might be abnormal in the neonates at genetic risk for schizophrenia

Waterproofed Photomultiplier Tube Assemblies for the Daya Bay Reactor Neutrino Experiment

In the Daya Bay Reactor Neutrino Experiment 960 20-cm-diameter waterproof photomultiplier tubes are used to instrument three water pools as Cherenkov detectors for detecting cosmic-ray muons. Of these 960 photomultiplier tubes, 341 are recycled from the MACRO experiment. A systematic program was undertaken to refurbish them as waterproof assemblies. In the context of passing the water leakage check, a success rate better than 97% was achieved. Details of the design, fabrication, testing, operation, and performance of these waterproofed photomultiplier-tube assemblies are presented.Comment: 16 pages, 11 figures. Submitted to Nucl. Instr. Met

Efficacy and safety of Danlou tablets in traditional Chinese medicine for coronary heart disease: a systematic review and meta-analysis

BackgroundDanlou tablets exert auxiliary advantages in treating coronary heart disease (CHD), but a summary of evidence-based proof is lacking. This study aims to systematically evaluate Danlou tablets in treating CHD from two aspects, including efficacy and safety.MethodsBy a thorough retrieval of the four English databases, namely, PubMed, The Cochrane Library, Embase, and Web of Science, and the four Chinese databases, namely, CNKI, Wanfang, VIP database, and China Biomedical Literature Service System, we found all randomized controlled trials (RCTs) related to Danlou tablets in treating CHD. The retrieval time was from the construction of the database to April 2022. We engaged two researchers to screen the studies, extract the required data, and assess the risk of bias. We then used RevMan5.3 and STATA.14 software to conduct a meta-analysis. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the quality of outcome indicators.ResultsSeventeen RCTs involving 1,588 patients were included. The meta-analysis results are displayed as follows: clinical treatment effect [risk ratio (RR) = 1.22, 95% confidence interval (CI): 1.16, 1.28, P < 0.00001], angina pectoris duration [MD = −0.2.15, 95% CI: −2.91, −1.04, P < 0.00001], angina pectoris frequency [standard mean difference (SMD) = −2.48, 95% CI: −3.42, −1.54, P < 0.00001], angina pectoris degree [SMD = −0.96, 95% CI: −1.39, −0.53, P < 0.0001], TC [MD = −0.71, 95% CI: −0.92, −0.51, P < 0.00001], TG [MD = −0.38, 95% CI: −0.53, −0.22, P < 0.00001], low-density lipoprotein cholesterol [MD = −0.64, 95% CI: −0.76, −0.51, P < 0.00001], high-density lipoprotein cholesterol [MD = 0.16, 95% CI: 0.11, 0.21, P < 0.00001], and adverse events [RR = 0.46, 95% CI: 0.24, 0.88, P = 0.02].ConclusionThe current evidence suggests that the combination of Danlou tablets and Western medicine can enhance the efficacy of CHD and does not increase adverse events. However, because of the limited number and quality of the included studies, the results of our study should be treated with caution. Further large-scale RCTs are necessary to verify the benefits of this approach

Timing of surgery and risk of postoperative thrombotic complications after recovery from Covid-19 in breast cancer patients

Background and purpose: The incidence of deep venous thrombosis (DVT) for patients with breast cancer after surgery is 2.00%-6.40%. The purpose of this study was to evaluate the correlation between postoperative DVT complications and surgical timing in breast cancer patients with coronavirus disease 2019 (COVID-19) infection, in order to guide clinical decision-making. Methods: From December 20, 2022 to March 20, 2023, 317 patients with breast cancer diagnosed with COVID-19 and with signs and symptoms of infection turning negative in Shandong Institute of Cancer Prevention and Treatment (Shandong Cancer Hospital), Shandong First Medical University (Shandong Academy of Medical Sciences) were enrolled. The control group included 329 patients with breast cancer who underwent surgery between May 1, 2019 and September 30, 2019 in the same hospital. Patients were grouped according to the interval between the date of COVID-19 infection and the date of surgery, and the interval time and postoperative DVT occurrence were analyzed. Results: Among 317 patients with breast cancer who underwent surgery after COVID-19 infection, 17 (5.36%), 29 (9.15%), 31 (9.78%), 50 (15.78%) and 190 (59.90%) underwent surgery after 0-2, 3-4, 5-6, 7-8 and 8 weeks, respectively. The incidence of postoperative DVT was 11.76%, 3.45%, 3.23%, 6.00% and 1.58%, respectively. The incidence of postoperative DVT in 329 patients without COVID-19 infection was 1.21%, and the incidence of postoperative DVT in patients receiving operation within 2 weeks of COVID-19 infection was significantly higher (OR=10.556; 95% CI: 1.095-303.313, P=0.03), the incidence of postoperative DVT in patients undergoing operation 3-8 weeks following COVID-19 infection was 4.55%. Multivariate analysis showed that COVID-19 infection interval was an independent predictor of DVT (OR=2.795; 95% CI: 0.692-11.278, P=0.024). All 10 patients with DVT after breast cancer surgery were recovered without serious complications such as pulmonary embolism, and the follow-up adjuvant anti-tumor therapy was not affected after symptomatic treatment. Conclusion: The incidence of DVT after breast cancer surgery within 8 weeks of COVID-19 infection is significantly higher than that of uninfected patients, especially the incidence of DVT in patients undergoing surgery within 2 weeks of COVID-19 infection is as high as 11.76%. Elective surgery for breast cancer within 2 weeks of COVID-19 infection should be avoided. Although the incidence of DVT in patients undergoing surgery 3 weeks after COVID-19 infection is still slightly high, surgical treatment can be recommended considering the urgency of breast cancer treatment, the good prognosis of DVT and the lack of influence on subsequent adjuvant therapy. However, detailed records of COVID-19 infection history of patients, early prevention and close monitoring should be made, and postoperative DVT should be treated

Modified lumbar foraminoplasty using a power-aided reciprocating burr for percutaneous transforaminal endoscopic lumbar discectomy: A technical note and clinical report

BackgroundOne of the main difficulties in a transforaminal endoscopic lumbar discectomy (TELD), and simultaneously the most critical step, is performing an effective and safe foraminoplasty, which is especially difficult for beginners. To make it safer and faster for beginners to perform, we have used a specially designed power-aided reciprocating burr for TELD and reported the technical details.MethodsFrom Jan. 2019 to Nov. 2022, 432 patients with single-level, symptomatic L4/5 or L5/S1 disc herniation were treated with TELD using a novel power-aided reciprocating burr. The surgical procedure is described in detail. Magnetic resonance imaging (MRI) was performed the following day and 3 months after the operation. The learning curves of surgeons with different seniority levels are displayed. The Visual Analogue Scale (VAS) score and the Oswestry Disability Index (ODI) were used to measure low back pain, leg pain, and lumbar function. All patients were followed up for at least 1 year.ResultsAll patients underwent endoscopic surgery successfully. Among the 432 patients, radicular outer membrane damage was observed in 6 cases, and 1 case had hernia of the nerve tract. Except for this patient with aggravation of postoperative numbness, the postoperative neurological symptoms of all patients were significantly improved. The mean VAS scores for low back pain and leg pain and ODI scores were significantly decreased 6 w post-operatively and were maintained until 12 months post-operatively compared to preoperative scores (P < 0.05). All three doctors involved in the study had substantial experience in traditional open spinal surgery. The more operations all three surgeons completed, the more time spent on intervertebral foraminoplasty decreased (P < 0.05). Among them, doctors without experience in TELD surgery became proficient in this technique after accumulating experience in 13 cases. There was no significant difference in foraminoplasty time among these three surgeons during the same growing period (P > 0.05).ConclusionsCurrent clinical data demonstrated the safety and efficacy of modified TELD using a power-aided reciprocating burr for treating lumbar disc herniation (LDH) and showed that this technique significantly reduces the learning curve for beginners when performing foraminoplasty