Preoperative evaluation of the number of lymph node metastasis (LNM) is the basis of individual treatment of locally advanced gastric cancer (LAGC). However, the routinely used preoperative ...determination method is not accurate enough.
We enrolled 730 LAGC patients from five centers in China and one center in Italy, and divided them into one primary cohort, three external validation cohorts, and one international validation cohort. A deep learning radiomic nomogram (DLRN) was built based on the images from multiphase computed tomography (CT) for preoperatively determining the number of LNM in LAGC. We comprehensively tested the DLRN and compared it with three state-of-the-art methods. Moreover, we investigated the value of the DLRN in survival analysis.
The DLRN showed good discrimination of the number of LNM on all cohorts overall C-indexes (95% confidence interval): 0.821 (0.785–0.858) in the primary cohort, 0.797 (0.771–0.823) in the external validation cohorts, and 0.822 (0.756–0.887) in the international validation cohort. The nomogram performed significantly better than the routinely used clinical N stages, tumor size, and clinical model (P < 0.05). Besides, DLRN was significantly associated with the overall survival of LAGC patients (n = 271).
A deep learning-based radiomic nomogram had good predictive value for LNM in LAGC. In staging-oriented treatment of gastric cancer, this preoperative nomogram could provide baseline information for individual treatment of LAGC.
•Evaluation of the lymph node metastasis (LNM) is the basis of individual treatment of locally advanced gastric cancer (LAGC).•Deep leaning radiomic nomogram (DLRN) based on CT images can preoperatively determine the number of LNM in LAGC.•DLRN is significantly superior to the routinely used clinical N stages, tumor size, and clinical model.•DLRN is significantly associated with the overall survival of LAGC.
Since December 2019, the novel coronavirus disease 2019 (COVID-19) that emerged in Wuhan city has spread rapidly around the world. The risk for poor outcome dramatically increases once a patient ...progresses to the severe or critical stage. The present study aims to investigate the risk factors for disease progression in individuals with mild to moderate COVID-19.
We conducted a cohort study that included 1007 individuals with mild to moderate COVID-19 from three hospitals in Wuhan. Clinical characteristics and baseline laboratory findings were collected. Patients were followed up for 28 days for observation of disease progression. The end point was the progression to a more severe disease stage.
During a follow up of 28 days, 720 patients (71.50%) had recovered or were symptomatically stable, 222 patients (22.05%) had progressed to severe disease, 22 patients (2.18%) had progressed to the critically ill stage and 43 patients (4.27%) had died. Multivariate Cox proportional hazards models identified that increased age (hazard ratio (HR) 2.56, 95% CI 1.97–3.33), male sex (HR 1.79, 95% CI 1.41–2.28), presence of hypertension (HR 1.44, 95% CI 1.11–1.88), diabetes (HR 1.82, 95% CI 1.35–2.44), chronic obstructive pulmonary disease (HR 2.01, 95% CI 1.38–2.93) and coronary artery disease (HR 1.83, 95% CI 1.26–2.66) were risk factors for disease progression. History of smoking was protective against disease progression (HR 0.56, 95% CI 0.34–0.91). Elevated procalcitonin (HR 1.72, 95% CI 1.02–2.90), urea nitrogen (HR 1.72, 95% CI 1.21–2.43), α-hydroxybutyrate dehydrogenase (HR 3.02, 95% CI 1.26–7.21) and D-dimer (HR 2.01, 95% CI 1.12–3.58) at baseline were also associated with risk for disease progression.
This study identified a panel of risk factors for disease progression in individuals with mild to moderate COVID-19.
SmB6, a well-known Kondo insulator, exhibits a transport anomaly at low temperature. This anomaly is usually attributed to states within the hybridization gap. Recent theoretical work and transport ...measurements suggest that these in-gap states could be ascribed to topological surface states, which would make SmB6 the first realization of topological Kondo insulator. Here by performing angle-resolved photoemission spectroscopy experiments, we directly observe several dispersive states within the hybridization gap of SmB6. These states show negligible kz dependence, which indicates their surface origin. Furthermore, we perform photoemission circular dichroism experiments, which suggest that the in-gap states possess chirality of the orbital angular momentum. These states vanish simultaneously with the hybridization gap at around 150 K. Together, these observations suggest the possible topological origin of the in-gap states.
MicroRNAs have been shown to play an important role in normal hematopoisis and leukemogenesis. Here, we report function and mechanisms of miR-181 family in myeloid differentiation and acute myeloid ...leukemia (AML). The aberrant overexpression of all the miR-181 family members (miR-181a/b/c/d) was detected in French-American-British M1, M2 and M3 subtypes of adult AML patients. By conducting gain- and loss-of-function experiments, we demonstrated that miR-181a inhibits granulocytic and macrophage-like differentiation of HL-60 cells and CD34+ hematopoietic stem/progenitor cells (HSPCs) by directly targeting and downregulating the expression of PRKCD (which then affected the PRKCD-P38-C/EBPα pathway), CTDSPL (which then affected the phosphorylation of retinoblastoma protein) and CAMKK1. The three genes were also demonstrated to be the targets of miR-181b, miR-181c and miR-181d, respectively. Significantly decreases in the expression levels of the target proteins were detected in AML patients. Inhibition of the expression of miR-181 family members owing to Lenti-miRZip-181a infection in bone marrow blasts of AML patients increased target protein expression levels and partially reversed myeloid differentiation blockage. In the mice implanted with AML CD34+ HSPCs, expression inhibition of the miR-181 family by Lenti-miRZip-181a injection improved myeloid differentiation, inhibited engraftment and infiltration of the leukemic CD34+ cells into the bone marrow and spleen, and released leukemic symptoms. In conclusion, our findings revealed new mechanism of miR-181 family in normal hematopoiesis and AML development, and suggested that expression inhibition of the miR-181 family could provide a new strategy for AML therapy.
The transition-metal-based kagome metals provide a versatile platform for correlated topological phases hosting various electronic instabilities. While superconductivity is rare in layered kagome ...compounds, its interplay with nontrivial topology could offer an engaging space to realize exotic excitations of quasiparticles. Here, we use scanning tunneling microscopy to study a newly discoveredZ2topological kagome metalCsV3Sb5with a superconducting ground state. We observe charge modulation associated with the opening of an energy gap near the Fermi level. When across single-unit-cell surface step edges, the intensity of this charge modulation exhibits aπ-phase shift, suggesting a three-dimensional2×2×2charge density wave ordering. Interestingly, while conventional Caroli–de Gennes–Matricon bound states are observed inside the superconducting vortex on the Sb surfaces, a robust zero-bias conductance peak emerges that does not split in a large distance when moving away from the vortex center on the Cs2×2surfaces, resembling the Majorana bound states arising from the superconducting Dirac surface states inBi2Te3/NbSe2heterostructures. Our findings establishCsV3Sb5as a promising candidate for realizing exotic excitations at the confluence of nontrivial lattice geometry, topology and multiple electronic orders.
Flexible thermoelectric (TE) materials have wide applications in fabricating portable/wearable devices owing to the advantages of being bendable, small size, and lightweight. Inorganic material–based ...flexible thin films have attracted much attention owing to their high TE performance. So far, developing high TE properties and environment friendly flexible thin films for practical applications is still a considerable challenge. Copper selenide (Cu2Se) is a non-toxic and low-cost material, providing relatively safe TE modules for thin film devices. In this work, Cu2Se-based thin films with single crystal phase have been fabricated successfully at a flexible substrate by an efficient layer-by-layer combination reaction method. By optimizing the composition, a high power factor of 5.3 μWcm−1K−2 and dimensionless figure of merit value of 0.35 with low thermal conductivity are achieved at room temperature. Through bending tests, it has been shown that the prepared thin films possess good flexibility and the designed flexible device displays stable output power, which demonstrates the potential of inorganic TE materials to be mountable on flexible/wearable substrates for energy harvesting and management devices.
The well-crystallized Cu2Se thermoelectric thin films have been synthesized via an efficient layer-by-layer combination reaction method, and the high power factor of 5.3 μWcm−1K−2 and ZT value of 0.35 with low thermal conductivity are achieved at room temperature by optimizing the composition. Cu2Se, copper selenide; ZT, dimensionless figure of merit. Display omitted
•The layer-by-layer combination reaction method was used for preparing high-performance copper selenide (Cu2Se) thin films.•The self-assembled growth of Cu2Se with single crystal phase was successfully realized.•A high power factor of 5.3 μWcm−1K−2 and dimensionless figure of merit value of 0.35 are achieved at room temperature.•The thin film possesses good flexibility, and the designed flexible device displays stable output power.
•The SS biochar produced at 450°C is the most suitable one for garlic cultivation.•The favourable C:S ratio drifted when the biochar production temperature changed.•General heavy metal accumulation ...in the garlic root & bulb occurred for the most enriched Zn and Cu in the biochar.•Heavy metal bioaccumulation increased with heavy metal leaching from biochars but did not increase with increased C:S ratio.
Applying biochar products from sewage sludge (SS) pyrolysis as soil amendment for plant cultivation was investigated in this study with special attention paid to heavy metal accumulation in the plants when pyrolysis temperature and biochar-to-soil mass ratio (C:S) were changed. Biochar obtained at four different temperatures were adopted as soil amendment for Allium sativum L. garlic plant cultivation. Experimental results revealed that biochars were rich in nutrient contents and they improved garlic yields. Although contents of heavy metals including As, Zn, Pb, Ni, Cd, Cr and Cu, etc. were elevated in the biochars compared to local soil, they fell within the acceptable limits for land application and SS is a suitable biochar resource, especially biochar produced at 450°C had rich micropores, relatively stable functional groups in structure and rugged surface to contact well with soil, conducive to its usage as a biochar. The garlic grew faster when planted in the biochar-amended soil and had higher final dry matter yields than those planted in the reference soil, especially biochar produced at 450°C corresponding to the highest final yields. The C:S ratio related to the highest garlic yields changed when the pyrolysis temperature was changed and this ratio was 1:4 for the biochar produced at 450°C. General heavy metal accumulation in the garlic occurred only for the most enriched Zn and Cu, and mainly in the roots & bulbs; in addition this bioaccumulation was increasing as leaching from biochar increased but not increasing with C:S ratio. The garlic planted in soil amended with biochar of 450°C contained the lowest level of heavy metals compared to other biochars. Those results indicated that heavy metal accumulation in plants can be inhibited through proper pyrolysis temperature choice and prevention of heavy metal leaching from the SS biochar.
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