Plural long short term memory (<inline-formula> <tex-math notation="LaTeX">{p} </tex-math></inline-formula>LSTM) applying to a multiple voltage-current (mVC) system has been proposed in order to ...estimate the void fraction <inline-formula> <tex-math notation="LaTeX">\hat {\alpha } </tex-math></inline-formula> accurately in gas-liquid flows. The <inline-formula> <tex-math notation="LaTeX">{p} </tex-math></inline-formula>LSTM consists of two LSTMs, one for flow regime identification ( fri -LSTM) and the other for void fraction estimation ( vfe -LSTM). The fri -LSTM identifies a flow regime <inline-formula> <tex-math notation="LaTeX">{q} </tex-math></inline-formula> from current vectors <inline-formula> <tex-math notation="LaTeX">{i} </tex-math></inline-formula>, corresponding to gas distribution, measured by mVC system. Based on the identification result and <inline-formula> <tex-math notation="LaTeX">{i} </tex-math></inline-formula>, the customized vfe -LSTM to each <inline-formula> <tex-math notation="LaTeX">{q} </tex-math></inline-formula> estimates <inline-formula> <tex-math notation="LaTeX">\hat {\alpha } </tex-math></inline-formula>. For training, <inline-formula> <tex-math notation="LaTeX">{i} </tex-math></inline-formula> are experimentally measured at 36 points of the true void fraction <inline-formula> <tex-math notation="LaTeX">\alpha </tex-math></inline-formula>, which is calculated by the drift flux model. On the other hand, <inline-formula> <tex-math notation="LaTeX">{i} </tex-math></inline-formula> for test data are measured under 12 points of <inline-formula> <tex-math notation="LaTeX">\alpha </tex-math></inline-formula>. Two parameters of each LSTM, one is sequence length <inline-formula> <tex-math notation="LaTeX">{S} </tex-math></inline-formula> representing time dependence length considered within the LSTM and the other is the number of LSTM blocks <inline-formula> <tex-math notation="LaTeX">{M} </tex-math></inline-formula> related to the estimation performance, are optimized so that accurate void fraction estimation is achieved. As a result, <inline-formula> <tex-math notation="LaTeX">{p} </tex-math></inline-formula>LSTM applying to mVC system achieves a 100% accuracy of flow regime identification and less ±0.00034 standard error of void fraction estimation in liquid single-phase flow, bubble flow, slug flow, and churn flow. Accurate estimation is caused by the fact that <inline-formula> <tex-math notation="LaTeX">{p} </tex-math></inline-formula>LSTM can consider the time dependence of gas-liquid flows suitable for each flow regime and neglect the effect of the flow regime on <inline-formula> <tex-math notation="LaTeX">{i} </tex-math></inline-formula>.
To investigate the residual pattern of esophageal cancer in the esophageal wall after neoadjuvant chemotherapy (NAC) and its clinical significance.
NAC is a standard treatment for locally advanced ...esophageal cancer; however, residual tumor patterns in resected specimens after NAC and their clinico-pathological characteristics remain unknown.
One hundred twenty consecutive patients with cT3 or deeper esophageal cancer underwent curative esophagectomy after NAC and achieved grade 2 histological responses between 2000 and 2016. Hematoxylin-eosin staining of residual tumor sections revealed 4 remnant categories: Type 1: shallow, Type 2: central, Type 3: deep, and Type 4: diffuse. We examined associations between these Types and clinico-pathological factors, including prognosis.
Forty-five (38%) specimens had no residual tumor cells in the mucosal layer. The adventitia layer displayed the lowest residual tumor cell frequency (18%) among all layers. Types 1, 2, 3, and 4 residual tumor patterns were found in 49 (41%), 33 (28%), 9 (8%), and 29 (24%) patients, respectively. Type 4 showed the maximum standard uptake value after NAC; Types 3 and 4 had higher ratios of venous invasion than Type 1 or 2. Patients with Type 3 or 4 more frequently developed pleural dissemination or distant metastasis than patients with Type 1 or 2. Survival was similar among the 4 Types.
After NAC for locally advanced esophageal cancer, the shallow residual tumor pattern was most common, but approximately 40% of specimens showed no tumor cells in the mucosal layer. Deep and diffuse remnant patterns were associated with high risks of pleural dissemination and distant metastasis.
To evaluate pathological response to NAC in metastatic LNs, and assess its clinical prognostic significance in patients with EC.
The pathological response to preoperative treatment is commonly ...evaluated in the PT. However, LN metastases strongly correlate with systemic micro-metastases. Thus, pathological evaluation of LN response could more accurately predict prognosis in EC patients undergoing NAC before surgery.
We enrolled 371 consecutive patients who underwent triplet NAC followed by surgery for EC between January 2010 and December 2016. Pathological LN regression grade was defined by the proportion of viable tumor area within the whole tumor bed area for all metastatic LNs: grade I, >50%; II, 10%-50%; III, <10%; and IV, 0%. We analyzed the correlation of grade with clinico-pathological parameters.
Among 319 patients with clinically positive LNs, pathological LN regression grades were I/II/III/IV in 115/51/58/95 patients, and 191 patients (59.9%) showed discordance between the PT and LN pathological regression grades. LN regression grade significantly correlated with cN positive number, ypTNM, lymphovascular invasion, and clinical/pathological PT response. Multivariate analysis for recurrence-free survival revealed that LN regression grade hazard ratio (HR) = 2.25, P < 0.001, ypT (HR = 1.65, P = 0.005), and ypT (HR = 1.62, P = 0.004) were independent prognostic factors, but not pathological PT regression grade (P = 0.67).
Compared to PT response, pathological LN response better predicted long-term survival in EC patients who received NAC plus curative surgery.
Notch1 transactivates Notch3 to drive terminal differentiation in stratified squamous epithelia. Notch1 and other Notch receptor paralogs cooperate to act as a tumor suppressor in squamous cell ...carcinomas (SCCs). However, Notch1 can be stochastically activated to promote carcinogenesis in murine models of SCC. Activated form of Notch1 promotes xenograft tumor growth when expressed ectopically. Here, we demonstrate that Notch1 activation and epithelial-mesenchymal transition (EMT) are coupled to promote SCC tumor initiation in concert with transforming growth factor (TGF)-β present in the tumor microenvironment. We find that TGFβ activates the transcription factor ZEB1 to repress Notch3, thereby limiting terminal differentiation. Concurrently, TGFβ drives Notch1-mediated EMT to generate tumor initiating cells characterized by high CD44 expression. Moreover, Notch1 is activated in a small subset of SCC cells at the invasive tumor front and predicts for poor prognosis of esophageal SCC, shedding light upon the tumor promoting oncogenic aspect of Notch1 in SCC.
Background:Whether all atrial fibrillation (AF) patients should be evaluated for sleep apnea before catheter ablation (CA) remains controversial. Watch-type peripheral arterial tonometry (W-PAT) is a ...home sleep testing device and an easier tool for diagnosing sleep apnea than polysomnography. We investigated the prevalence and predictors of sleep apnea using W-PAT in unscreened sleep apnea patients with AF before CA.Methods and Results:The study was conducted under a retrospective, single-center, observational design. We included 776 consecutive patients who underwent both W-PAT and AF ablation. Sleep apnea assessments were successfully performed in 774 patients (99.7%; age 65±11 years, 73.3% male; body mass index BMI 24.1±3.5, 56.8% paroxysmal AF). The mean apnea-hypopnea index (AHI) was 20.1±15.6. Although 81.7% of the patients had normal Epworth sleepiness scores (mean 6.5), only 88 (11.4%) had a normal AHI (AHI <5) and 412 (53.2%) had moderate-severe sleep apnea (AHI ≥15). Obesity, male sex, nonparoxysmal AF, hypertension, and a left atrial diameter (LAd) ≥40 mm were predictors of moderate-severe sleep apnea. However, the prevalence of moderate-severe sleep apnea in patients without those predictors (i.e., non-obesity (44.2%), female sex (43.0%), paroxysmal AF (43.9%), no hypertension (45.5%)), and LAd <40 mm (41.0%) was considerably high.Conclusions:Almost all patients successfully underwent W-PAT to diagnose sleep apnea. Patients undergoing AF ablation had a high prevalence of sleep apnea, and screening for sleep apnea was important in those patients even if they did not have sleepiness or risk factors.
The purpose of this study was to examine aging and bimanual effects on finger spatial stability during precision grip. Twenty-one older and 21 younger adults performed precision grip tasks consisting ...of a single task (grip and lift an object with the thumb and index finger) and a dual task (the grip-lifting task with one hand and a peg board task with the other hand). The center of pressure (COP) trajectory and the grip force were evaluated using a pressure sensor with a high spatial resolution. In the COP trajectory, the main effects of age for the thumb (
= 46.17,
< 0.01) and index finger (
= 22.14,
< 0.01) and task difficulty for the thumb (
= 6.47,
= 0.01) were significant based on ANCOVA. The COP trajectory was statistically decreased in the older adults. The COP trajectory was also decreased in the dual task, regardless of age. The results suggest the existence of a safety strategy to prioritize the spatial stability in the elderly group and in the dual task. This study provides new insights into the interpretation of the COP trajectory.
Although there is a growing interest in developing circulating microRNA (miRNA) as noninvasive diagnostic biomarkers for the detection of high-risk colorectal adenomas and early-stage CRCs, but the ...comparative diagnostic significance of serum vs. exosomal miRNAs remains unexplored.
Based upon published literature, we performed an initial discovery step by investigating the expression of a miRNA panel in 20 normal colonic mucosa, 27 adenomas, and 19 CRC tissues. We performed subsequent validation by quantifying expression of candidate miRNAs in total serum and in exosomes from 26 adenoma patients and 47 healthy controls, and evaluated their clinical significance and potential diagnostic value in colorectal adenomas.
We observed that the expression of four miRNAs, miR-21, miR-29a, miR-92a, and miR-135b, was significantly higher in colorectal adenomas vs. normal colonic mucosa. During validation, expression of miR-21, miR-29a and miR-92a in serum was significantly higher in adenomas vs. healthy controls, significantly correlated with adenoma size and total adenoma number within the colorectum, and significantly discriminated patients with advanced adenomas. In contrast, although exosomal miR-21 and miR-29a levels in adenoma patients were significantly higher than those of healthy volunteers, only exosomal miR-21 significantly correlated with adenoma size and total adenoma number, and could discriminate patients with high-risk adenomas.
Compared to exosomal miRNAs, serum levels of miR-21, miR-29a and miR-92a are superior diagnostic biomarkers in patients with high-risk adenomatous polyps.
This study examined the influence of interpersonal stressors, and interpersonal stress coping methods, on depression among teachers. Interpersonal stressors include 1) interpersonal conflict; 2) ...interpersonal blunders; and 3) interpersonal friction. Interpersonal stress coping methods are 1) positive-relationship oriented; 2) negative-relationship oriented; or 3) postponed-solution oriented. Participants were 424 teachers from preschools, elementary/middle/high schools, and special needs schools. All three types of interpersonal stressors, and the negative-relationship oriented coping method, had significant and positive influences on depression. In contrast, the postponed-solution coping method had a significant and negative effect on depression.
The purpose is to clarify the relationship between patients with retinal vein occlusion (RVO), maximal intima-media complex thickness (Max IMT), and N-terminal pro-brain natriuretic peptide ...(NT-proBNP), which is useful in assessing atherosclerosis. This was a retrospective observation, single center study. The patients were 86 RVO patients (male: female = 43:43, mean age 63.3 years), 25 with central retinal vein occlusion (CRVO) and 61 with branch retinal vein occlusion (BRVO), classified as ≧50 years old and <50 years old, Max IMT≧1.1 and less, NT-pro BNP≧55 and less. Results showed that Max IMT ≧1.1 was significantly more common in both the CRVO and BRVO groups at ≧50 years, and NT-pro BNP ≧55 was significantly more common in the CRVO group. Max IMT≧1.1 was seen in 80% of the BRVO group and in 85% of patients aged ≧50 years. Sixty-eight percent of patients in the CRVO group had Max IMT≧1.1, but none of those < 50 years had Max IMT≧1.1. Forty-eight percent of RVO patients had NT-pro BNP≧55, and significantly more patients had Max IMT≧1.1 than those who did not have NT-pro BNP more than 55 (p = 0.02). Multiple regression analysis with Max IMT as the dependent variable showed that age and NT-pro BNP were significantly associated with RVO (p = 0.015, 0.022). RVO patients were more likely to have a Max IMT≧1.1, which was associated with atherosclerosis. Max IMT and NT-pro BNP were also associated with RVO patients, so NT-pro BNP may be a marker of RVO.
The catalytic performance of Ru-NAD-type complexes Ru(tpy)(pbn)(CO)2+ (12+; tpy = 2,2′;6′,2″-terpyridine; pbn = 2-(pyridin-2-yl)benzob1,5naphthyridine) and the Ru-CO-bridged metallacycle 2+ ...was investigated in the context of the electrochemical reduction of CO2 in H2O/CH3CN at room temperature. A controlled-potential electrolysis of 12+ and 2+ afforded formate (HCOO–) as the main product, under concomitant formation of minor amounts of CO and H2. Metallacycle 2+ showed a higher selectivity toward the formation of HCOO– than 12+ (HCOO–/CO for 12+, 2.7; HCOO–/CO for 2+, 7). The generation of HCOO– via a catalytic hydride transfer from the NADH-type ligands of 12+ and 2+ to CO2 was supported by the experimental results and a comparison with the reduction of CO2 catalyzed by Ru(tpy)(bpy)(CO)2+ under similar conditions. A mechanism for the catalytic reduction of CO2 by 12+ and 2+ was proposed based on the experimental evidence. The thus-obtained results may help to expand the field of NADH-assisted reduction reactions.
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