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Gastric polyps indicate the disturbance of gastric microecology and inflammatory status, which may affect bone metabolism. We aimed to investigate the association between gastric polyps and bone mineral density (BMD) in patients with chronic gastritis (CG). In this cross-sectional study, we collected the clinical data of 627 inpatients with CG between July 2017 and August 2022. Gastric polyps were diagnosed through gastroscopy. BMD was measured using dual energy X-ray absorptiometry. Osteopenia or osteoporosis was defined as decreased BMD. Linear regression analysis was employed to assess the relationship between BMD with gastric polyps. Logistic regression analysis was conducted to evaluate the correlation between decreased BMD and gastric polyps. In results, the prevalence of gastric polyps in males and females with CG was 17.3% and 18.3%, respectively. The occurrence of decreased BMD was observed in 51.4% and 65.1% of males and females, respectively. Gastric polyps were negatively correlated with lumbar spine, femoral neck, and total femur BMD ( β =-0.025, -0.043, -0.029, p  ≤ 0.005) in females with CG. Furthermore, gastric polyps significantly elevated the risk of osteoporosis or osteopenia (OR = 2.672, p  = 0.010) among females with CG. However, no significant correlation between gastric polyps and BMD was detected in males with CG. In addition, gastric polyps in females were positively correlated with hypertension and high low-density lipoprotein cholesterol levels, while negatively correlated with high phosphorus levels. In conclusion, gastric polyps are negatively correlated with BMD and significantly increase the risk of osteoporosis or osteopenia in females with CG.

Two major treatment strategies employed in non-small cell lung cancer, NSCLC, are tyrosine kinase inhibitors, TKIs, and immune checkpoint inhibitors, ICIs. The choice of strategy is based on heterogeneous biomarkers that can dynamically change during therapy. Thus, there is a compelling need to identify comprehensive biomarkers that can be used longitudinally to help guide therapy choice. Herein, we report a 18 F-FDG-PET/CT-based deep learning model, which demonstrates high accuracy in EGFR mutation status prediction across patient cohorts from different institutions. A deep learning score (EGFR-DLS) was significantly and positively associated with longer progression free survival (PFS) in patients treated with EGFR-TKIs, while EGFR-DLS is significantly and negatively associated with higher durable clinical benefit, reduced hyperprogression, and longer PFS among patients treated with ICIs. Thus, the EGFR-DLS provides a non-invasive method for precise quantification of EGFR mutation status in NSCLC patients, which is promising to identify NSCLC patients sensitive to EGFR-TKI or ICI-treatments. EGFR mutations are common in non-small cell lung cancer and patients with these mutations are treated with tyrosine kinase inhibitors. Here, the authors show that EGFR mutation status can be predicted from 18 F-FDG-PET/CT images, which may enable the stratification of patients for treatment.

Composition regulation of zeotropic mixture working fluid for a thermodynamic cycle is an effective way to improve energy conversion efficiency, which offers the potential to construct efficient, flexible and intelligent cycles. Current research on cycle construction of zeotropic mixture composition regulation still heavily relies on construction methods using pure working fluids, where the characteristics of flexible composition variations fail to be utilized. In this paper, the research progress of cycle construction methods and composition regulated structures are comprehensively reviewed, aiming to clarify the potential for enhancing a thermodynamic cycle based on composition regulation. The characteristics of different cycle construction methods are firstly summarized and compared. Then, the composition-regulated structures of a physical-based method and chemical-based method are introduced, and the composition regulation performance are also concluded. Finally, a future outlook on the cycle design and structure design is provided. The review results show that the combination of 3D construction method and superstructure/intelligences construction method has the potential to maximize the cycle performance, where the improvement of each thermal process and the optimization of complex cycles can be considered simultaneously. The composition regulation based on a passive physical method has the advantage of being readily applicable; however, the composition regulation range is limited. In addition, the distillation and hydrate method have a wider regulation range through extra energy input, where the trade-off between energy consumption and cycle performance improvement should be considered in the future. This study greatly assists in the design of thermodynamic cycles involving zeotropic mixture composition regulation and the corresponding composition regulation structures.

Although fullerenes were discovered nearly three decades ago, the mechanism of their formation remains a mystery. Many versions of the classic ‘bottom-up’ formation mechanism have been advanced, starting with C 2 units that build up to form chains and rings of carbon atoms and ultimately form those well-known isolated fullerenes (for example, I h -C 60 ). In recent years, evidence from laboratory and interstellar observations has emerged to suggest a ‘top-down’ mechanism, whereby small isolated fullerenes are formed via shrinkage of giant fullerenes generated from graphene sheets. Here, we present molecular structural evidence for this top-down mechanism based on metal carbide metallofullerenes M 2 C 2 @ C 1 (51383)-C 84 (M = Y, Gd). We propose that the unique asymmetric C 1 (51383)-C 84 cage with destabilizing fused pentagons is a preserved ‘missing link’ in the top-down mechanism, and in well-established rearrangement steps can form many well-known, high-symmetry fullerene structures that account for the majority of solvent-extractable metallofullerenes. An asymmetric pentalene-containing C 1 (51383)-C 84 fullerene cage is found in two different metal carbide metallofullerenes. This particular cage can, in simple steps, rearrange into many well-known fullerene cages that are more stable and more symmetric, suggesting it is likely that metallofullerenes are generated by a ‘top-down’ formation mechanism.

Background and purpose: We previously established a radiological protocol to discriminate Parkinsonism-predominant multiple system atrophy (MSA-P) from Parkinson’s disease (PD). However, we do not know if it can differentiate early-stage disease. This study aimed to investigate whether the morphological and intensity changes in susceptibility weighted imaging (SWI) of the lentiform nucleus (LN) could discriminate MSA-P from PD at early stages. Methods: We retrospectively enrolled patients with MSA-P, PD and sex- and age-matched controls whose brain MRI included SWI, between January 2015 and January 2022 at the Movement Disorder Center. Two specialists at the center reviewed the medical records and made the final diagnosis, and two experienced neuroradiologists performed MRI analysis, based on a defined and revised protocol for conducting morphological measurements of the LN and signal intensity. Results: Nineteen patients with MSA-P and 19 patients with PD, with less than two years of disease duration, and 19 control individuals were enrolled in this study. We found that patients with MSA-P presented significantly decreased size in the short line (SL) and corrected short line (cSL), ratio of the SL to the long line (SLLr) and corrected SLLr (cSLLr) of the LN, increased standard deviation of signal intensity (SIsd_LN, cSIsd_LN) compared to patients with PD and controls (P < 0.05). With ROC analysis, this finding had a sensitivity of 89.5% and a specificity of 73.7% to distinguish MSA-P from PD. Conclusions: Compared to PD and controls, patients with MSA-P are characterized by a narrowing morphology of the posterior region of the LN. Quantitative morphological changes provide a potential marker for differentiating MSA-P from PD at early stages.

Active flow control aircraft (AFCA) represent a significant development direction in next-generation aircraft design. Among them, rudderless flight control (RFC) and short takeoff and landing (STOL) are gaining widespread attentions and are gradually applied as disruptive technologies of next-generation aircraft, displaying marked strategic and engineering value. In 2020, DARPA launched “Control of Revolutionary Aircraft with Novel Effectors” (CRANE) project, where active flow control (AFC) was incorporated as a critical dimension of overall design with the goal of developing the next-generation AFCA. The full-scale demonstrator of CRANE was officially named X-65 in 2023. Two of the critical technologies being validated are RFC and STOL. This article reviews the developing process of typical AFCA adopting above technologies and provides an outlook on the futural development tendency. AFCA adopting STOL developed earlier, and comprehensive evaluations and flight tests have already been conducted on full-scale commercial and military aircraft, demonstrating a high level of technological maturity. In contrast, AFCA adopting RFC developed later and have so far undergone flight tests only on small-scale UAVs, needing further evaluation on full-scale aircraft. Future research hotspots and challenges of AFCA will contain AFC implementation scheme combining the bleed air system and synthetic jet actuators, full-envelope high-efficiency AFC technology, coordination control of multiple AFC technologies, flight dynamics modeling of AFCA, redundant high-reliability flight control, high-stealth heavy-payload wide-speed-range large-airspace flight platform, and aircraft overall design integrating AFC.

Background Fragile X-associated tremor/ataxia syndrome (FXTAS) is a late onset, X-linked genetic, neurodegenerative disorder caused by a “premutation (PM)” in the fragile X mental retardation 1 ( FMR1 ) gene. Here we report a case of FXTAS from mainland of China who presented with rare orthostatic tremor. A review of tremor of FXTAS in the literature is also included. Case presentation A 67-year-old right-handed farmer started with tremor of both legs 8 years ago which was present while standing but absent when sitting or lying and progressed with unsteady gait one and a half years ago. The brain MRI showed high intensity signal in the bilateral middle cerebellar peduncles (MCP) in T2-weighted and fluid-attenuated inversion recovery (FLAIR) images and gene test for premutation for FMR1 was positive with 101 CGG repeats. The patient met the the diagnosis of definite FXTAS. Clonazepam and topiramate were administered to control tremor. We reviewed the literature and identified 64 cases with detailed clinical and genetic information. Orthostatic tremor associated with FXTAS is very rare. We found 85.2% patients reported tremor,42.6% with intention tremor,36.1% with kinetic tremor,32.8% with rest tremor and 29.5% with posture tremor. 37.7% of patients who have tremor showed at least two types of tremor. There were 6 patients with isolated rest tremor. There was 2 patient with voice tremor and 6 with head tremor. We also found that 74.6% FXTAS patients had family history of FMR1 gene associated diseases including Fragile X syndrome (FXS), FXTAS or fragile X-associated primary ovarian insufficiency (FXPOI). Conclusions Adding our data to the available literature suggests that orthostatic tremor could be a rare initial manifestation of FXTAS and the review will increasing our understanding the phenotype of tremor in FXTAS. Family history of FMR1 gene associated diseases might be an important clue to the diagnosis.

It is reported that radiomic features extracted from quantitative susceptibility mapping (QSM) had promising clinical value for the diagnosis of Parkinson's disease (PD). We aimed to explore the usefulness of radiomics features based on magnitude images to distinguish PD from non-PD controls. We retrospectively recruited PD patients and controls who underwent brain 3.0T MR including susceptibility-weighted imaging (SWI). A total of 396 radiomics features were extracted from the SN of 95 PD patients and 95 non-PD controls based on SWI. Intra-/inter-observer correlation coefficients (ICCs) were applied to measure the observer agreement for the radiomic feature extraction. Then the patients were randomly grouped into training and validation sets in a ratio of 7:3. In the training set, the maximum correlation minimum redundancy algorithm (mRMR) and the least absolute shrinkage and selection operator (LASSO) were conducted to filter and choose the optimized subset of features, and a radiomics signature was constructed. Moreover, radiomics signatures were constructed by different machine learning models. Area under the ROC curves (AUCs) were applied to evaluate the predictive performance of the models. Then correlation analysis was performed to evaluate the correlation between the optimized features and clinical factors. The intro-observer CC ranged from 0.82 to 1.0, and the inter-observer CC ranged from 0.77 to 0.99. The LASSO logistic regression model showed good prediction efficacy in the training set [AUC = 0.82, 95% confidence interval (CI, 0.74-0.88)] and the validation set [AUC = 0.81, 95% CI (0.68-0.91)]. One radiomic feature showed a moderate negative correlation with Hoehn-Yahr stage ( = -0.49, = 0.012). Radiomic predictive features based on SWI magnitude images could reflect the Hoehn-Yahr stage of PD to some extent.

Purpose To evaluate the efficacy and toxicity of induction chemotherapy followed by concurrent chemoradiotherapy vs. concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma (NPC). Methods We reviewed data of locoregionally advanced NPC patients who underwent 2 different treatment plans, 1 with induction chemotherapy followed by concurrent chemoradiotherapy (IC + CCRT) and the other with only concurrent chemoradiotherapy (CCRT). All patients received cisplatin 80 mg/m 2 3 weeks one cycle concurrently with intensity-modulated radiation therapy, and three IC protocols were included for the IC + CCRT group. Results Data of 262 patients treated from May 2011 to November 2014 were found eligible for our study. With a median follow-up of 29.02 months, no significant differences were detected between the two groups on the 2-year overall survival or OS rates (96.63 vs. 92.86%, P  = 0.169), 2-year distant metastasis-free survival or DMFS rates (91.57 vs. 86.90%, P  = 0.246) and 3-year DMFS rates (90.45 vs. 82.14%, P  = 0.093). However, they were statistically different on 2-year locoregional failure-free survival or LFFS rates (94.94 vs. 86.90%, P  = 0.020), 3-year OS rates (95.51 vs. 82.14%, P  = 0.002) and 3-year LFFS rates (93.82 vs. 79.76%, P  = 0.001). The most common severe (grade 3–4) adverse events we recorded were Nausea/vomiting (36.52 vs. 33.33%), leukopenia (14.04 vs. 4.76%), thrombocytopenia (3.93 vs. 3.57%) and hepatic toxicity (3.37 vs. 2.38%). Conclusion Compared with CCRT, the treatment plan IC + CCRT produced significantly encouraging outcomes in locoregionally advanced NPC patients on local progression-free survival and 3-year overall survival position, but might raise the risk of certain adverse reactions.

Breast cancer is recognized as a major public health problem in developing countries; however, there is very little evidence of behavioral factors associated with breast cancer risk. This study was conducted to identify lifestyles as risk factors for breast cancer among Central African women. A case-control study was conducted with 174 cases confirmed histologically by the pathology unit of the National Laboratory and 348 age-matched controls. Data collection tools included a questionnaire with interviews and medical records of patients. Data were analyzed using SPSS software version 20. Odd ratio (OR) and 95% confidence intervals (95% CI) were obtained by unconditional logistic regression. In total, 522 women were studied with a mean age of 45.8 (SD = 13.4) years. By unconditional logistic regression model, women with breast cancer were more likely to have attained illiterate and elementary education level [11.23 (95% CI, 4.65-27.14) and 2.40 (95% CI, 1.15-4.99)], married [2.09 (95% CI, 1.18-3.71)], positive family history [2.31 (95% CI, 1.36-3.91)], radiation exposure [8.21 (95% CI, 5.04-13.38)], consumption charcuterie [10.82 (95% CI, 2.39-48.90)], fresh fish consumption [4.26 (95% CI, 1.56-11.65)], groundnut consumption [6.46 (95% CI, 2.57-16.27)], soybean consumption [16.74 (95% CI, 8.03-39.84)], alcohol [2.53 (95% CI, 1.39-4.60)], habit of keeping money in bras[3.57 (95% CI, 2.24-5.69)], overweight [5.36 (95% CI, 4.46-24.57)] and obesity [3.11(95% CI, 2.39-20.42)]. However, decreased risk of breast cancer was associated with being employed [0.32 (95% CI, 0.19-0.56)], urban residence [0.16 (95% CI, 0.07-0.37)], groundnut oil consumption [0.05 (95% CI, 0.02-0.14)], wine consumption [0.16 (95% CI, 0.09-0.26)], non habit of keeping cell phone in bras [0.56 (95% CI, 0.35-0.89)] and physical activity [0.71(95% CI, 0.14-0.84)]. The study showed that little or no education, marriage, positive family history of cancer, radiation exposure, charcuterie, fresh fish, groundnut, soybean, alcohol, habit of keeping money in bras, overweight and obesity were associated with breast cancer risk among Central African women living in Bangui. Women living in Bangui should be more cautious on the behavioral risk associated with breast cancer.