Introduction
This study aimed to investigate whether maternal blood lipid levels during early pregnancy are associated with the occurrence of congenital heart disease (CHD) in their offspring.
...Material and methods
In this single‐center case–control study, mothers of offspring with CHD (n = 230) and without CHD (n = 381) were included. Maternal lipid levels were determined on fasting blood samples taken in the first trimester. Relevant demographic and clinical data were extracted from the medical records. Maternal lipid profile was compared between the two groups, and regression analysis was performed to evaluate the association between lipid profile and CHD risk in offspring.
Results
Compared with the control group, levels of triglyceride, apolipoprotein‐A1, and apolipoprotein‐B in early pregnancy were significantly higher in the CHD group. Multivariate analyses showed that triglyceride (odds ratio OR 2.46, 95% CI 1.62–3.73, p < 0.01), total/high‐density lipoprotein cholesterol (OR 2.10, 95% CI 1.07–4.13, p = 0.03), and apolipoprotein‐A1 (OR 2.73, 95% CI 1.16–6.40, p = 0.02) were positively associated with CHD risk in offspring.
Conclusions
Elevated maternal lipid profile was associated with increased risk of CHD in offspring.
The consensus recommendations in 2018 from The Chinese Society of Hematology (CSH) on indications, conditioning regimens and donor selection for allogeneic hematopoietic stem cell transplantation ...(allo-HSCT) facilitated the standardization of clinical practices of allo-HSCT in China and progressive integration with the world. There have been new developments since the initial publication. To integrate recent developments and further improve the consensus, a panel of experts from the CSH recently updated the consensus recommendations, which are summarized as follows: (1) there is a new algorithm for selecting appropriate donors for allo-HSCT candidates. Haploidentical donors (HIDs) are the preferred donor choice over matched sibling donors (MSDs) for patients with high-risk leukemia or elderly patients with young offspring donors in experienced centers. This replaces the previous algorithm for donor selection, which favored MSDs over HIDs. (2) Patients with refractory/relapsed lymphoblastic malignancies are now encouraged to undergo salvage treatment with novel immunotherapies prior to HSCT. (3) The consensus has been updated to reflect additional evidence for the application of allo-HSCT in specific groups of patients with hematological malignancies (intermediate-risk acute myeloid leukemia (AML), favorable-risk AML with positive minimal residual disease, and standard-risk acute lymphoblastic leukemia). (4) The consensus has been updated to reflect additional evidence for the application of HSCT in patients with nonmalignant diseases, such as severe aplastic anemia and inherited diseases. (5) The consensus has been updated to reflect additional evidence for the administration of anti-thymocyte globulin, granulocyte colony-stimulating factors and post-transplantation cyclophosphamide in HID-HSCT.
The region-based convolutional networks have shown their remarkable ability for object detection in optical remote sensing images. However, the standard CNNs are inherently limited to model geometric ...transformations due to the fixed geometric structures in its building modules. To address this, we introduce a new module named deformable convolution that is integrated into the prevailing Faster R-CNN. By adding 2D offsets to the regular sampling grid in the standard convolution, it learns the augmenting spatial sampling locations in the modules from target tasks without additional supervision. In our work, a deformable Faster R-CNN is constructed by substituting the standard convolution layer with a deformable convolution layer in the last network stage. Besides, top-down and skip connections are adopted to produce a single high-level feature map of a fine resolution, on which the predictions are to be made. To make the model robust to occlusion, a simple yet effective data augmentation technique is proposed for training the convolutional neural network. Experimental results show that our deformable Faster R-CNN improves the mean average precision by a large margin on the SORSI and HRRS dataset.
There are a large number of fouling organisms in the ocean, which easily attach to the surface of ships, oil platforms and breeding facilities, corrode the surface of equipment, accelerate the aging ...of equipment, affect the stability and safety of marine facilities and cause serious economic losses. Antifouling coating is an effective method to prevent marine biological fouling. Traditional organic tin and copper oxide coatings are toxic and will contaminate seawater and destroy marine ecology and have been banned or restricted. Environmentally friendly antifouling coatings have become a research hotspot. Among them, the use of natural biological products with antifouling activity as antifouling agents is an important research direction. In addition, some fouling release coatings without antifoulants, biomimetic coatings, photocatalytic coatings and other novel antifouling coatings have also developed rapidly. On the basis of revealing the mechanism of marine biofouling, this paper reviews the latest research strategies to develop environmentally friendly marine antifouling coatings. The composition, antifouling characteristics, antifouling mechanism and effects of various coatings were analyzed emphatically. Finally, the development prospects and future development directions of marine antifouling coatings are forecasted.
It was found that benzyl chlorides and bromides could directly react with electron‐rich arenes, which provided an example of promoter‐free and additive‐free benzylation of arenes. A variety of benzyl ...chlorides and bromides were treated with benzene rings to give the targeted products in low to high yields. The present conditions tolerated the vinyl group of the substrates. Preliminary mechanistic investigation suggests that the present reactions possibly proceed via an autocatalytic mechanism pathway.
It was found that benzyl chlorides and bromides could directly react with electron‐rich arenes, which provided an example of promoter‐ and additive‐free benzylation of arenes.
To investigate the resilience of non-local medical workers sent to support local medical workers in treating the outbreak of 2019 novel coronavirus disease (COVID-19).
In February 2020, non-local ...medical workers who had been sent to Wuhan as support staff to respond to the COVID-19 outbreak were asked to complete an online survey composed of the Connor Davidson Resilience Scale (CD-RISC), Hospital Anxiety Depression Scale (HADS) and Simplified Coping Style Questionnaire (SCSQ).
Survey responses from 114 non-local medical workers were analyzed. CD-RISC scores were high (67.03 ± 13.22). The resilience level was highest for physicians (73.48 ± 11.49), followed by support staff, including health care assistants, technicians (67.78 ± 12.43) and nurses (64.86 ± 13.46). Respondents differed significantly in the levels of education, training/support provided by the respondent's permanent hospital (where he or she normally works), and in their feelings of being adequately prepared and confident to complete tasks (P < 0.05). Resilience correlated negatively with anxiety (r = -.498, P < 0.01) and depression (r = -.471, P < 0.01) but positively with active coping styles (r = .733, P < 0.01). Multiple regression analysis showed that active coping (β = 1.314, p < 0.05), depression (β = -.806, p < 0.05), anxiety (β = - 1.091, p < 0.05), and training/support provided by the respondent's permanent hospital (β = 3.510, p < 0.05) were significant associated with resilience.
Our data show that active coping, depression, anxiety, and training/support provided by the respondent's permanent hospital are associated with resilience. Managers of medical staff should use these data to develop psychosocial interventions aimed at reinforcing the resilience of medical workers during highly stressful and prolonged medical emergencies, as seen during the COVID-19 outbreak.
High efficiency video coding (HEVC) is the latest video coding standard, and it has the best performance among all the existing standards. HEVC main still picture profile (HEVC-MSP) also achieves top ...performance in image compr-ession. In this paper, we propose a closed-form bit allocation approach to optimize the saliency-guided PSNR (viewed as perceptual distortion) such that the coding efficiency of HEVC-based image compression can be significantly improved from a subjective perspective. Specifically, a bit allocation formulation is established to minimize perceptual distortion with a constraint on bit-rates. Then, this formulation is solved using the proposed recursive Taylor expansion method with a closed-form solution. On the basis of our solution, a bit allocation and re-allocation process is developed in our approach to minimize perceptual distortion, meanwhile accurately controlling bit-rates. In addition, we provide both theoretical and numerical analyses of the computational complexity, verifying the little extra time cost of our approach. The experimental results demonstrate the superior performance of our approach over the state-of-the-art HEVC-MSP, and the BD-rate savings are approximately 40% and 24% for face and generic images, respectively.
Intravenous arsenic trioxide plus all-trans retinoic acid (ATRA) without chemotherapy is the standard of care for non-high-risk acute promyelocytic leukaemia (white blood cell count ≤10 × 109 per L), ...resulting in cure in more than 95% of cases. However, a pilot study of treatment with oral arsenic realgar-Indigo naturalis formula (RIF) plus ATRA without chemotherapy, which has a more convenient route of administration than the standard intravenous regimen, showed high efficacy. In this study, we compare an oral RIF plus ATRA treatment regimen with the standard intravenous arsenic trioxide plus ATRA treatment regimen in patients with non-high-risk acute promyelocytic leukaemia.
We did a multicentre, non-inferiority, open-label, randomised, controlled phase 3 trial at 14 centres in China. Patients aged 18–70 years with newly diagnosed (within 7 days) non-high-risk acute promyelocytic leukaemia, and a WHO performance status of 2 or less were eligible. Patients were randomly assigned (2:1) to receive treatment with RIF-ATRA or arsenic trioxide-ATRA as the induction and consolidation therapy. Randomisation was done centrally with permuted blocks and stratification according to trial centre and was implemented through an interactive web response system. RIF (60 mg/kg bodyweight daily in an oral divided dose) or arsenic trioxide (0·15 mg/kg daily in an intravenous dose) and ATRA (25 mg/m2 daily in an oral divided dose) were used until complete remission was achieved. The home-based consolidation therapy was RIF (60 mg/kg daily in an oral divided dose) or intravenous arsenic trioxide (0·15 mg/kg daily in an intravenous dose) in a 4-week on 4-week off regimen for four cycles and ATRA (25 mg/m2 daily in an oral divided dose) in a 2-week on 2-week off regimen for seven cycles. Patients and treating physicians were not masked to treatment allocation. The primary outcome was event-free survival at 2 years. A non-inferiority margin of −10% was used to assess non-inferiority. Primary analyses were done in a modified intention-to-treat population of all patients who received at least one dose of their assigned treatment and the per-protocol population. This study was registered with the Chinese Clinical Trial Registry (ChiCTR-TRC-13004054), and the trial is complete.
Between Feb 13, 2014, and Aug 31, 2015, 109 patients were enrolled and assigned to RIF-ATRA (n=72) or arsenic trioxide-ATRA (n=37). Three patients in the RIF-ATRA and one in the arsenic trioxide-ATRA did not receive their assigned treatment. After a median follow-up of 32 months (IQR 27–36), 67 (97%) of 69 patients in the RIF-ATRA group and 34 (94%) of 36 in the arsenic trioxide-ATRA group had achieved 2-year event-free survival in the modified intention-to-treat population. The percentage difference in event-free survival was 2·7% (95% CI, −5·8 to 11·1). The lower limit of the 95% CI for the difference in event-free survival was greater than the −10% non-inferiority margin, confirming non-inferiority (p=0·0017). Non-inferiority was also confirmed in the per-protocol population. During induction therapy, grade 3–4 hepatic toxic effects (ie, increased liver aspartate aminotransferase or alanine transaminase concentrations) were reported in six (9%) of 69 patients in the RIF-ATRA group versus five (14%) of 36 patients in the arsenic trioxide-ATRA group; grade 3–4 infection was reported in 15 (23%) of 64 versus 15 (42%) of 36 patients. Two patients in the arsenic trioxide-ATRA group died during induction therapy (one from haemorrhage and one from thrombocytopenia).
Oral RIF plus ATRA is not inferior to intravenous arsenic trioxide plus ATRA for the treatment of patients with non-high-risk acute promyelocytic leukaemia. This study suggests that a completely oral, chemotherapy-free model might be an alternative to the standard intravenous treatment for patients with non-high-risk acute promyelocytic leukaemia.
Foundation for innovative research group of the National Natural Science Foundation of China, the Beijing Municipal Science and Technology Commission, the National Key R&D Program of China, and the National Natural Science Foundation of China.
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•Distribution of shear rate on the membrane surface was calculated.•Critical shear radii at different rotating speeds were calculated.•Critical shear rates of the complexes at ...different pH values were obtained.•Shear stability of PAA-Cr complex was higher than that of PAA-Ni complex.•Selective separation of Cr and Ni was achieved by shear induced dissociation.
Removal of Ni (II) and Cr (III) from aqueous solutions by complexation-ultrafiltration and the selective separation by shear induced dissociation were investigated using rotating disk membrane (RDM). Experiments were carried out as a function of pH and mass ratio of PAAS to metal (P/M) for the removal of Ni (II) and Cr (III) by polyacrylate sodium (PAAS) as complexing agent and the results revealed that the optimum conditions were pH 7.0 and P/M 25. Effect of rotating speed (n) on the rejection of complexes of PAAS with nickel (PAA-Ni) and chromium (PAA-Cr) at different pHs were studied and the results proved that both PAA-Ni and PAA-Cr complex would dissociate when n exceeded a certain value. The critical shear rates, at which PAA-Ni or PAA-Cr complex began to dissociate, were calculated at different pH values, and the critical shear rate of PAA-Cr complex was greater than that of PAA-Ni complex at the same pH, which indicated that the stability of PAA-Cr complex was stronger than that of PAA-Ni complex. Furthermore, the influences of operation parameters on selective separation coefficient (βNi/Cr) were investigated and the results showed that the rotating speed and pH significantly affected βNi/Cr. Finally, shear induced dissociation was used to effectively separate Ni(II) and Cr(III) and regenerate PAAS at 1800 and 2500 rpm, respectively.
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