Dipolarization fronts (DFs) are believed to play important roles in transferring plasmas, magnetic fluxes, and energies in the magnetotail. Using the Cluster observations in 2003, electromagnetic ...energy conversion at the DFs is investigated by case and statistical studies. The case study indicates strongest energy conversion at the DF. The statistical study shows the similar features that the energy of the fields can be significantly transferred to the plasmas (load, J · E > 0) at the DFs. These results are consistent with some recent simulations. Examining the electromagnetic fluctuations at the DFs, we suggest that the wave activities around the lower hybrid frequency may play an important role in the energy dissipation.
Key Points
Strongest energy conversion at the DFs
Energy of the fields can be significantly transferred to the plasmas
Wave activities may play an important role in the energy dissipation
Ureteral stents have been widely used in kidney transplantation to prevent postoperative ureter-related complications such as ureteral stricture, ureteral obstruction, and ureteral leakage; however, ...a longer indwelling ureteral stent time corresponds to a greater risk of complications such as urinary tract infections. Currently, transplantation centers have not yet reached an agreement on the time to remove ureteral stents. Several randomized controlled trials (RCTs) have evaluated the optimal removal time for ureteral stents.
This meta-analysis was designed to evaluate and discuss the optimal removal time for ureteral stents after kidney transplantation.
We used key words to search PubMed, Embase, and Cochrane Library and retrieve published articles. A total of 568 kidney transplantation patients from 5 RCTs were included in this meta-analysis. We collected information regarding postoperative complications related to indwelling stents, such as ureteral stricture, ureteral obstruction, ureteral leakage, and urinary tract infection, and evaluated whether early removal of ureteral stents (≤7 days) was superior to late removal (≥14 days).
A significant difference was observed in the incidence of urinary tract infection between the early removal group and the late removal group (risk ratio RR = 0.43, 95% confidence interval CI 0.32, 0.59, P < .01). No significant between-group difference was observed in the incidence of major urological complications (MUCs) (RR = 1.87, 95% CI 0.45, 7.70, P > .05).
Early removal of ureteral stents of transplanted kidneys after kidney transplantation (≤7 days) did not significantly increase the incidence of postoperative MUCs (ureteral stricture, ureteral obstruction, and ureteral leakage) relative to late removal (≥14 days). Early removal may significantly reduce the incidence of postoperative urinary tract infection relative to late removal.
Owing to a group of permanent magnets (PMs) with the same magnetization direction are replaced by salient iron core, the consequent-pole (CP) PM machines generally suffer from asymmetry flux density. ...This will leads to the even-order back-EMF harmonics, which have negative influence on the electromagnetic performance. It is widely known that the even-order back-EMF harmonics cannot be eliminated for the machines with odd back-EMF phasor belongs to one phase in one machine periodicity, i.e., <inline-formula><tex-math notation="LaTeX">{\boldsymbol{N}_0}</tex-math></inline-formula> is odd (<inline-formula><tex-math notation="LaTeX">{\boldsymbol{N}_0} = {\boldsymbol{N}_{\boldsymbol S}}/\boldsymbol{mt}</tex-math></inline-formula>, where <inline-formula><tex-math notation="LaTeX">{\boldsymbol{N}_{\boldsymbol S}}</tex-math></inline-formula> is the number of slot for one machine, t is the unit sub-machine periodicity, m is the number of phase). Hence, this paper proposes a general modularization method solving this problem. The elimination principle of even-order back-EMF harmonics in the modular stator (MS) is explained by the star of slots. Further, the MS with auxiliary winding (AW) and auxiliary teeth (AT) are proposed to improve the electromagnetic performance of the MS CP (MSCP) PM machine. Then, the electromagnetic characteristics, including open circuit field distribution and back-EMFs, torque characteristics, unbalanced magnetic force (UMF), loss distribution characteristics as well as efficiency contours are comprehensively compared. Finally, the MSCP PM machine with auxiliary winding (MSCP-AW) is fabricated and tested to verify the theoretical analysis as well as the finite element (FE) results.
Abstract This study was designed to investigate whether delta opioid receptor (DOR) is involved in the neuroprotective effect induced by hypoxic preconditioning (HPC) in the asphyxial cardiac arrest ...(CA) rat model. Twenty-four hours after the end of 7-day HPC, the rats were subjected to 8-min asphyxiation and resuscitated with a standardized method. In the asphyxial CA rat model, HPC improved the neurological deficit score (NDS), inhibited neuronal apoptosis, and increased the number of viable hippocampal CA1 neurons at 24 h, 72 h, or 7 days after restoration of spontaneous circulation (ROSC); however, the above-mentioned neuroprotection of HPC was attenuated by naltrindole (a selective DOR antagonist). The expression of hypoxia-inducible factor-1α (HIF-1α) and DOR, and the content of leucine enkephalin (L-ENK) in the brain were also investigated after the end of 7-day HPC. HPC upregulated the neuronal expression of HIF-1α and DOR, and synchronously elevated the content of L-ENK in the rat brain. HIF-1α siRNA was used to further elucidate the relationship between HIF-1α and DOR in the HPC-treated brain. Knockdown of HIF-1α by siRNA markedly abrogated the HPC induced upregulation of HIF-1α and DOR. The present study demonstrates that the expression of DOR in the rat brain is upregulated by HIF-1α following exposure to 7-day HPC, at the same time, HPC also increases the production of endogenous DOR ligand L-ENK in the brain. DOR activation after HPC results in prolonged neuroprotection against subsequent global cerebral ischemic injury, suggesting a new mechanism of HPC-induced neuroprotection on global cerebral ischemia following CA and resuscitation.
We report the observation of new properties of primary iron (Fe) cosmic rays in the rigidity range 2.65 GV to 3.0 TV with 0.62×10^{6} iron nuclei collected by the Alpha Magnetic Spectrometer ...experiment on the International Space Station. Above 80.5 GV the rigidity dependence of the cosmic ray Fe flux is identical to the rigidity dependence of the primary cosmic ray He, C, and O fluxes, with the Fe/O flux ratio being constant at 0.155±0.006. This shows that unexpectedly Fe and He, C, and O belong to the same class of primary cosmic rays which is different from the primary cosmic rays Ne, Mg, and Si class.
Voriconazole is frequently utilized for the prevention and treatment of invasive fungal infections (IFIs), and is extensively metabolized by the cytochrome P450 (CYP) system. The impact of activity ...of the genes encoding CYP3A4, CYP3A5, and CYP2C9 on the pharmacokinetics of voriconazole cannot be ignored because, second to CYP2C19, they are the most important enzymes involved in voriconazole metabolism. The influence of genetic polymorphisms in
CYP3A4
,
CYP3A5
, and
CYP2C9
on the plasma concentrations of voriconazole was evaluated in the present study. The study cohort comprised 158 patients with IFIs in whom 22 single-nucleotide polymorphisms (SNPs) in
CYP3A4
,
CYP3A5
, and
CYP2C9
were genotyped using the Sequenom MassARRAY RS1000 system, and voriconazole plasma concentrations were measured by high-performance liquid chromatography (HPLC). 40, 91, and 27 patients presented with low (<1 mg/L), normal (1–4 mg/L), and high (>4 mg/L) plasma voriconazole concentrations, respectively. Correlation analysis between polymorphisms and the plasma voriconazole concentration revealed an association between the presence of the rs4646437 T allele and a higher plasma voriconazole concentration
p
= 0.033, odds ratio (OR) = 2.832, 95 % confidence interval (CI) = 1.086–7.384. This study has identified a new SNP related to the metabolism of voriconazole, potentially providing novel insight into the influence of CYP3A4 on the pharmacokinetics of this antifungal agent.
Immune checkpoint inhibitors in combination with tyrosine kinase inhibitors are standard treatments for advanced clear cell renal cell carcinoma (RCC). This phase III RENOTORCH study compared the ...efficacy and safety of toripalimab plus axitinib versus sunitinib for the first-line treatment of patients with intermediate-/poor-risk advanced RCC.
Patients with intermediate-/poor-risk unresectable or metastatic RCC were randomized in a ratio of 1 : 1 to receive toripalimab (240 mg intravenously once every 3 weeks) plus axitinib (5 mg orally twice daily) or sunitinib 50 mg orally once daily for 4 weeks (6-week cycle) or 2 weeks (3-week cycle). The primary endpoint was progression-free survival (PFS) assessed by an independent review committee (IRC). The secondary endpoints were investigator-assessed PFS, overall response rate (ORR), overall survival (OS), and safety.
A total of 421 patients were randomized to receive toripalimab plus axitinib (n = 210) or sunitinib (n = 211). With a median follow-up of 14.6 months, toripalimab plus axitinib significantly reduced the risk of disease progression or death by 35% compared with sunitinib as assessed by an IRC hazard ratio (HR) 0.65, 95% confidence interval (CI) 0.49-0.86; P = 0.0028. The median PFS was 18.0 months in the toripalimab–axitinib group, whereas it was 9.8 months in the sunitinib group. The IRC-assessed ORR was significantly higher in the toripalimab–axitinib group compared with the sunitinib group (56.7% versus 30.8%; P < 0.0001). An OS trend favoring toripalimab plus axitinib was also observed (HR 0.61, 95% CI 0.40-0.92). Treatment-related grade ≥3 adverse events occurred in 61.5% of patients in the toripalimab–axitinib group and 58.6% of patients in the sunitinib group.
In patients with previously untreated intermediate-/poor-risk advanced RCC, toripalimab plus axitinib provided significantly longer PFS and higher ORR than sunitinib and had a manageable safety profile
ClinicalTrials.gov NCT04394975
•Toripalimab plus axitinib provided significantly better PFS than sunitinib as a first-line treatment for advanced RCC.•A significantly higher ORR was found in patients who received toripalimab plus axitinib than those who received sunitinib.•The combination of toripalimab plus axitinib was generally well tolerated.•No new safety signals were identified in the combination outside the known safety profile of toripalimab or axitinib.
Background
The prognostic role of intratumoral programmed cell death ligand 1 (PD-L1) expression in hepatocellular carcinoma (HCC) has been investigated by several meta-analyses. However, the ...prognostic value of pretreatment peripheral PD-L1 (PPPD-L1) level in HCC remains undetermined. Thus, this systemic review aimed to establish PPPD-L1 as a new prognostic marker in HCC according to available evidence.
Methods
Case–control studies investigating the prognostic role of PPPD-L1 in HCC were systemically sought in the database of PubMed and Web of Science until March 25th, 2020. Our main concern is survival results, including overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS). The combined results were summarized in narrative form according to data extracted from each included study.
Results
Finally, nine studies published from 2011 to 2019, were incorporated into this systemic review. Among these, six studies evaluated the PD-L1 expression by enzyme-linked immunosorbent assay (ELISA) from blood serum, and three studies evaluated the PD-L1 expression by flow cytometric analysis from peripheral blood mononuclear cells (PBMC). According to the extracted evidence, high PPPD-L1 expression, measured in either blood serum or PBMC, is associated with poor OS, poor DFS, and poor PFS. Meanwhile, PPPD-L1 was also correlated with enlarged tumor size and more likely with advanced tumor stage as well as vascular invasion.
Conclusion
High PPPD-L1 level is associated with increased mortality rate and increased recurrence rate in HCC. As a convenient serum marker, PPPD-L1 could be a promising marker of prognosis in HCC patients.
Apolygus lucorum is the predominant pest of Bacillus thuringiensis (Bt) cotton in China. 20‐hydroxyecdysone (20E) plays a key role in the reproduction of this insect. To better understand the ...mechanism underlying 20E‐regulated reproduction, the nuclear hormone receptor E75 isoform‐A of Ap. lucorum (Al‐E75A) was cloned and its expression analysed. A 2241‐bp sequence of Al‐E75A cDNA encoded an open reading frame of a polypeptide with a predicted molecular mass of 69.04 kDa. Al‐E75A mRNA was detected in female adult stages of Ap. lucorum with peak expression in 7‐day‐old animals. Al‐E75A was also expressed in several tissues, particularly in the fat body and ovary. A 3.2 kb Al‐E75A mRNA was detected in all tissues by Northern blot. The fecundity and longevity were significantly decreased in female adults treated with Al‐E75A small interfering RNA. The rates of egg incubation rates were considerably lower in the RNA interference‐treated animals compared to the untreated controls. In order to investigate the molecular mechanism underlying the effects described above, vitellogenin (Al‐Vg) was selected for further investigation. The expression pattern of Al‐Vg was similar to that of Al‐E75A and was up‐regulated by 20E. After knockdown of Al‐E75A, the expression profile of Al‐Vg and the protein levels were down‐regulated. These findings suggest that Al‐E75A plays a crucial role in the regulation of Al‐Vg expression in Ap. lucorum.
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