Publications by authors named "Bo Cheng"

303 Publications

Multi-auxiliary domain transfer learning for diagnosis of MCI conversion.

Neurol Sci 2021 Sep 12. Epub 2021 Sep 12.

Department of Logistics Management, Chongqing Three Gorges University, Chongqing, 404100, China.

In the early stage of Alzheimer's disease (AD), mild cognitive impairment (MCI) has a higher risk of progression to AD, so the prediction of whether an MCI subject will progress to AD (known as progressive MCI, PMCI) or not (known as stable MCI, SMCI) within a certain period is particularly important in practice. It is known that such a task could benefit from jointly learning-related auxiliary tasks such as differentiating AD from PMCI or PMCI from normal control (NC) in order to take full advantage of their shared commonality. However, few existing methods along this line fully consider the correlations between the target and auxiliary tasks according to the clinical practice of AD pathology for diagnosis. To deal with this problem, in this paper, treating each task domain as a different one, we borrow the idea from transfer learning and propose a novel multi-auxiliary domain transfer learning (MaDTL) method, which explicitly utilizes the correlations between the target domain (task) and multi-auxiliary domains (tasks) according to the clinical practice. Specifically, the proposed MaDTL method incorporates two key modules. The first one is a multi-auxiliary domain transfer-based feature selection (MaDTFS) model, which can select a discriminative feature subset shared by the target domain and the multi-auxiliary domains. In the MaDTFS model, to combine more training data from multi-auxiliary domains and simultaneously suppress the negative effects resulting from the irrelevant parts of multi-auxiliary domains, we proposed a sparse group correlation Lasso that includes a proposed group correlation Lasso penalty (i.e., [Formula: see text]) and a proposed correlation Lasso penalty (i.e., [Formula: see text]). The second module in MaDTL is a multi-auxiliary domain transfer-based classification (MaDTC) model that improves the voting with linear weighting-based ensemble learning. This model extends the constraints of the linear weighting method so that it can simultaneously combine training data from multi-auxiliary domains and achieve a robust classifier by minimizing negative effects from the irrelevant part of multi-auxiliary domains. Experimental results on 409 subjects from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database with the baseline magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) data validate the effectiveness of the proposed method by significantly improving the classification accuracy to 80.37% for the identification of MCI-to-AD conversion, outperforming the state-of-the-art methods.
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http://dx.doi.org/10.1007/s10072-021-05568-6DOI Listing
September 2021

Challenge of Nail Psoriasis: An Update Review.

Clin Rev Allergy Immunol 2021 Sep 3. Epub 2021 Sep 3.

Department of Dermatology, the First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350000, Fujian, China.

Nail psoriasis is a refractory disease that affects 50-79% skin psoriasis patients and up to 80% of patients with psoriatic arthritis (PsA). The pathogenesis of nail psoriasis is still not fully illuminated, although some peculiar inflammatory cytokines and chemokines seems to be the same as described in psoriatic skin lesions. Psoriatic nail involving matrix can cause pitting, leukonychia, red spots in lunula, and nail plate crumbling, while nail bed involvement can result in onycholysis, oil-drop discoloration, nail bed hyperkeratosis, and splinter hemorrhages. The common assessment methods of evaluating nail psoriasis includes Nail Psoriasis Severity Index (NAPSI), Nail Assessment in Psoriasis and Psoriatic Arthritis (NAPPA), Nail Psoriasis Quality of life 10 (NPQ10), and so on. Treatment of nail psoriasis should be individualized according to the number of involving nail, the affected site of nail and presence of skin and/or joint involvement. Generally, topical therapies are used for mild nail psoriasis, while biologic agents such as etanercept are considered for severe nail disease and refractory nail psoriasis. Even though the current literature has shown some support for the pathogenesis, clinical presentation, or therapies of nail psoriasis, systemic review of this multifaceted disease is still rare to date. We elaborate recent developments in nail psoriasis epidemiology, pathogenesis, anatomy, clinical manifestation, diagnosis, differential diagnosis, and therapies to raise better awareness of the complexity of nail psoriasis and the need for early diagnosis or intervention.
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http://dx.doi.org/10.1007/s12016-021-08896-9DOI Listing
September 2021

Benoxacor caused developmental and cardiac toxicity in zebrafish larvae.

Ecotoxicol Environ Saf 2021 Aug 26;224:112696. Epub 2021 Aug 26.

Ganzhou Key Laboratory for Drug Screening and Discovery, School of Geography and Environmental Engineering, Gannan Normal University, Ganzhou 341000, Jiangxi, China; College of Chemistry and Chemical Engineering, Gannan Normal University, Ganzhou 341000 Jiangxi, China; Jiangxi Engineering Laboratory of Zebrafish Modeling and Drug Screening for Human Diseases, Jiangxi Key Laboratory of Developmental Biology of Organs, Affiliated Hospital of Jinggangshan University, Ji'an 343009, China. Electronic address:

Benoxacor (BN) is a highly effective antidote of dichloroacetamide herbicides generally used to protect crops from herbicidal damage. As a commonly used agrochemical, this herbicide antidote is continuously discharged in watercourses thus causing toxicity to aquatic organisms, and ultimately leading to contamination of the food chain. To date, its potential toxicity to the cardiac development of aquatic organisms has not been evaluated. In the present study, we have selected the zebrafish as a model to study the impact of BN on embryonic developmental and cardiac toxicity. The zebrafish embryos were exposed in 0.5, 1.0 and 2.0 mg/L BN from 5.5 to 72 h post-fertilization (hpf). The results indicated that the exposure to BN led to increased mortality and diminished heart and hatching rates in the embryos. BN exposure also brought pericardial edema (PE) and linear stretching of heart. Besides, exposure to BN induced an excessive accumulation of reactive oxygen species (ROS) in the zebrafish embryos and abnormal activities of the antioxidant enzymes, including catalase (CAT) and malondialdehyde (MDA). Moreover, exposure to BN caused serious cardiac toxicity of the embryos, accompanied by abnormality of heart development- and apoptosis-related genes. Surprisingly, astaxanthin (ASTA), as a common antioxidant, was found to be able to partially rescue the cardiac toxicity caused by BN, which indicated that ROS are probably the major reason for the resulting cardiotoxicity in zebrafish embryos. Our results suggest the need for a comprehensive safety evaluation of the regular consumption of benoxacor, which provides scientific basis for the development of health standards and assessment of potential risk in aquatic organisms or even human.
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http://dx.doi.org/10.1016/j.ecoenv.2021.112696DOI Listing
August 2021

Dupilumab successfully treated refractory bullous pemphigoid with early clinical manifestations imitating atopic dermatitis: A case letter.

Australas J Dermatol 2021 Aug 26. Epub 2021 Aug 26.

Department of Dermatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.

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http://dx.doi.org/10.1111/ajd.13692DOI Listing
August 2021

PFOI stimulates the motility of T24 bladder cancer cells: Possible involvement and activation of lncRNA malat1.

Chemosphere 2021 Aug 21;287(Pt 1):131967. Epub 2021 Aug 21.

Hubei Key Laboratory of Environmental and Health Effects of Persistent Toxic Substances, Institute of Environment and Health, Jianghan University, Wuhan, 430056, China. Electronic address:

Perfluorinated iodine alkanes (PFIs) can serve as an important raw materials for the synthesis of various perfluorinated chemical products through telomerization reaction. The estrogenic effects of PFIs have been reported previously by some in vitro and in vivo screening assays. To explore the potential epigenetic toxicity of PFIs, activation of lncRNAs was screened, and the cell motility changes induced by perfluorooctyl iodide (PFOI) were analyzed in this study. High metastatic bladder cell line (T24) was used to investigate the cellular migration function affected by PFOI. PFOI exposure significantly induced the upregulation of lncRNA anril, thorlnc, hotairm1, meg3, and malat1. The migration and invasion of T24 cells were also enhanced upon PFOI exposure. The transcription level of matrix metalloenzyme genes, epidermal growth factors, cytoskeleton genes, and the upstream factors involved in cell motility pathways were examined to illustrate possible mechanisms. Additionally, the basic role of malat1 in cellular motility was investigated by lncRNA knockdown and migration assays. The knockdown of malat1 inhibited the cellular motility induced by PFOI. The levels of MMP-2/-9 genes were also down-regulated by the treatment of si-malat1. Overall, the perturbation of cytoskeleton genes (E-cadherin/N-cadherin) may account for the impact on the motility of T24 cells. Our studies indicate that perfluorinated chemicals might regulate the lncRNAs, thus promoting the metastasis of the tumor cells.
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http://dx.doi.org/10.1016/j.chemosphere.2021.131967DOI Listing
August 2021

Structural Design and Preliminary Tests of a Novel Patient Transfer Apparatus for Medical Scenarios.

J Healthc Eng 2021 3;2021:2770846. Epub 2021 Aug 3.

Parallel Robot and Mechatronic System Laboratory of Hebei Province, Yanshan University, Qinhuangdao 066004, China.

Patient transfer has always been a difficult problem, usually requiring multiple caregivers to work together, which is time consuming and can easily cause secondary injuries to the patient. In addition, with the crisis of COVID-19, the issue of patient transfer is even more critical, as caregivers are at a high risk of infection, causing significant damage to healthcare resources. In this paper, a patient transfer assist system named E-pat-plus (Easy Patient Transfer plus) has been proposed; it can assist caregivers in transferring patients, reduce direct contact between them, and avoid secondary injuries. In the mechanical structure of this apparatus, a novel five-gear assembly module and a synchronous belt pulley set are proposed; they are the key points to the basic functional realization of the device and can reduce the cost of the prototype. Furthermore, a fuzzy (proportion-integration-differentiation) PID-based cross-coupling control strategy is applied to the apparatus to ensure the stability and safety of the operation. Finally, some preliminary experiments, including current experiments and error experiments, are carried out to verify the reliability of the device and lay the foundation for clinical tests.
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http://dx.doi.org/10.1155/2021/2770846DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8357520PMC
August 2021

State-space aerodynamic model reveals high force control authority and predictability in flapping flight.

J R Soc Interface 2021 08 4;18(181):20210222. Epub 2021 Aug 4.

Mechanical Engineering Department, The Pennsylvania State University, University Park, PA 16801, USA.

Flying animals resort to fast, large-degree-of-freedom motion of flapping wings, a key feature that distinguishes them from rotary or fixed-winged robotic fliers with limited motion of aerodynamic surfaces. However, flapping-wing aerodynamics are characterized by highly unsteady and three-dimensional flows difficult to model or control, and accurate aerodynamic force predictions often rely on expensive computational or experimental methods. Here, we developed a computationally efficient and data-driven state-space model to dynamically map wing kinematics to aerodynamic forces/moments. This model was trained and tested with a total of 548 different flapping-wing motions and surpassed the accuracy and generality of the existing quasi-steady models. This model used 12 states to capture the unsteady and nonlinear fluid effects pertinent to force generation without explicit information of fluid flows. We also provided a comprehensive assessment of the control authority of key wing kinematic variables and found that instantaneous aerodynamic forces/moments were largely predictable by the wing motion history within a half-stroke cycle. Furthermore, the angle of attack, normal acceleration and pitching motion had the strongest effects on the aerodynamic force/moment generation. Our results show that flapping flight inherently offers high force control authority and predictability, which can be key to developing agile and stable aerial fliers.
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http://dx.doi.org/10.1098/rsif.2021.0222DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8331236PMC
August 2021

Glycan Labeling and Analysis in Cells and In Vivo.

Annu Rev Anal Chem (Palo Alto Calif) 2021 07 27;14(1):363-387. Epub 2021 Jul 27.

College of Chemistry and Molecular Engineering, Peking University, Beijing 100871, China; email:

As one of the major types of biomacromolecules in the cell, glycans play essential functional roles in various biological processes. Compared with proteins and nucleic acids, the analysis of glycans in situ has been more challenging. Herein we review recent advances in the development of methods and strategies for labeling, imaging, and profiling of glycans in cells and in vivo. Cellular glycans can be labeled by affinity-based probes, including lectin and antibody conjugates, direct chemical modification, metabolic glycan labeling, and chemoenzymatic labeling. These methods have been applied to label glycans with fluorophores, which enables the visualization and tracking of glycans in cells, tissues, and living organisms. Alternatively, labeling glycans with affinity tags has enabled the enrichment of glycoproteins for glycoproteomic profiling. Built on the glycan labeling methods, strategies enabling cell-selective and tissue-specific glycan labeling and protein-specific glycan imaging have been developed. With these methods and strategies, researchers are now better poised than ever to dissect the biological function of glycans in physiological or pathological contexts.
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http://dx.doi.org/10.1146/annurev-anchem-091620-091314DOI Listing
July 2021

Determination of Pendimethalin Dynamic Residual Distribution in Crucian Carp Tissues and Associated Risk Assessment.

Int J Anal Chem 2021 2;2021:9984230. Epub 2021 Jul 2.

Key Laboratory of Control of Quality and Safety for Aquatic Products (Ministry of Agriculture and Rural Affairs), Chinese Academy of Fishery Sciences, Beijing 100141, China.

Pendimethalin has been considered a moderately to extremely toxic compound for fish and aquatic organism. This study developed the determination of dynamic residual distribution for pendimethalin in crucian carp tissues (muscle, liver, kidney, gill, and blood) under semistatic exposure system by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method. The pendimethalin residues in various fish tissues increased initially and then decreased, and the residue amount of pendimethalin varied from tissue to tissue of crucian carp. Particularly, the pendimethalin accumulation in most fish tissues made significant decreases at two-time points. Pendimethalin was initially absorbed and enriched by fish body, and then partial pendimethalin was discharged into the outside environment through the metabolism function of crucian carp. The residue levels of pendimethalin distributed in crucian carp were ranked in the following decreasing order: liver > kidney > gill or muscle > blood, attributed to the fact that pendimethalin tends to accumulate in lipid-rich tissues of fish. Risk assessment results indicated that the chronic risk from dietary exposure to pendimethalin through crucian carp consumption for Chinese residents was acceptable, along with a lower estimated exposure dose (EED) than acceptable daily intake (ADI) and risk quotient (RQ) < 1. This study performed the first analysis for pendimethalin residual distribution in crucian carp tissues under semistatic exposure condition and provided a reference for pollution control and risk assessment of pendimethalin aimed at aquatic products.
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http://dx.doi.org/10.1155/2021/9984230DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8270702PMC
July 2021

[Research Progress of FAM60A in the Regulation of Cellular Function].

Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2021 Jun;43(3):469-474

Department of Pathology,the First Hospital,Lanzhou University,Lanzhou 730000,China.

FAM60A,a cell cycle protein,is a subunit of the SIN3 transcription regulator family member A/histone deacetylase(SIN3-HDAC)complex and plays an important role in cell cycle regulation,cell morphology change,cell proliferation,differentiation and migration,early embryogenesis and so on.Studies in recent years have shown that FAM60A plays a role in the occurrence and development of tumors including human osteosarcoma,esophageal cancer,gastric cancer,lung cancer and liver cancer,providing a new research direction for tumor diagnosis and treatment.Based on the research results in recent years at home and abroad,this paper discussed the effects of FAM60A on cellular functions.
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http://dx.doi.org/10.3881/j.issn.1000-503X.13430DOI Listing
June 2021

Insufficient ablation promotes the metastasis of residual non-small cell lung cancer (NSCLC) cells via upregulating carboxypeptidase A4.

Int J Hyperthermia 2021 ;38(1):1037-1051

Soochow University Medical College, Suzhou, China.

Background: Thermal ablation is a potentially curative therapy for early-stage non-small cell lung cancer (NSCLC). Early recurrence after thermal ablation necessitates our attention.

Methods: The invasion and migration abilities of NSCLC after sublethal heat stimulus were observed and . Sublethal thermal stimulus molecular changes were identified by RNA sequencing. A xenograft model of NSCLC with insufficient ablation was established to explore the epithelial-to-mesenchymal transition (EMT) and metastasis-related phenotypes alteration of residual tumors.

Results: , the invasion and migration abilities of NSCLC cells were enhanced 72 h after 44 °C and 46 °C thermal stimulus. Epithelial-mesenchymal transition (EMT) phenotypes were also upregulated under these conditions. RNA sequencing revealed that the expression of carboxypeptidase A4 (CPA4) was significantly upregulated after thermal stimulus. Significant upregulation of CPA4 and EMT phenotypes was also found in the xenograft model of insufficient NSCLC ablation. The EMT process and invasion and migration abilities can be reversed by silencing CPA4.

Conclusions: This study demonstrates that sublethal heat stimulus caused by insufficient ablation can promote EMT and enhance the metastatic capacity of NSCLC. CPA4 plays an important role in these biological processes. Inhibition of CPA4 might be of great significance for improving early-stage NSCLC survival after ablation.
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http://dx.doi.org/10.1080/02656736.2021.1947530DOI Listing
August 2021

Toxicity of thioacetamide and protective effects of quercetin in zebrafish (Danio rerio) larvae.

Environ Toxicol 2021 Oct 6;36(10):2062-2072. Epub 2021 Jul 6.

Center for drug screening and research, School of Geography and Environmental Engineering, Gannan Normal University, Ganzhou, Jiangxi, China.

Quercetin is a flavonoid compound with a variety of biological properties that is widely distributed throughout the plant kingdom. Studies have found that quercetin has anti-inflammatory, antioxidant, and liver-protective effects, while thioacetamide (TAA) can cause inflammation and liver damage in zebrafish larvae. The purpose of this study was to evaluate whether quercetin can prevent TAA-induced inflammation and liver damage in zebrafish larvae and to investigate the molecular mechanisms involved. Zebrafish Tg transgenic lines were used as the experimental animals. Behavioral, oxidative stress level, proliferative antigen chromogenic antibody, and western blot analyses were carried out on zebrafish larvae in the control group and groups treated with TAA and 12 μM quercetin. The results indicated that quercetin promoted the development of zebrafish larvae damaged by TAA, exhibited antioxidant and anti-inflammatory properties, and promoted cell proliferation. Quercetin reduced the expression of p53 protein in zebrafish larvae injured by TAA, resulting in decreased levels of Bax and increased levels of Bcl-2. The findings suggested quercetin has antiapoptotic action. Quercetin reduced the expression of DKK1 and DKK2 genes related to the Wnt signaling pathway in zebrafish larvae damaged by TAA and increased the expression of Lef1 and wnt2bb. Quercetin may regulate the development of zebrafish larvae damaged by TAA through the Wnt signaling pathway. This study provides the scientific basis for the development and utilization of quercetin and the development of new related drugs.
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http://dx.doi.org/10.1002/tox.23323DOI Listing
October 2021

[Sensitivity of spring phenology to elevation in Qinling Mountains, China].

Ying Yong Sheng Tai Xue Bao 2021 Jun;32(6):2089-2097

Hubei Province Laboratory for Geographical Process Analyzing & Modeling, Wuhan 430079, China.

Vegetation phenology, a regular and periodic phenomenon in nature, is an important indicator for natural environment, especially climate change. The study of spatiotemporal variations of vegetation phenology is of great significance for monitoring the changes of terrestrial vegetation. In this study, the Savitzky-Golay (S-G) filtering method was used to reconstruct time-series MODIS enhanced vegetation index (EVI) data in the Qinling Mountains from 2001 to 2018. The dynamic threshold method was used to extract the spring phenological parameter (start of growth season, SOS). The correlation between multi-year mean SOS and interannual variation with altitude and slope was analyzed. The results showed that SOS was delayed by 1.82 d with every 100 m increase in altitude in the Qinling Mountains. The interannual change trends of SOS mainly concentrated in 0-5 d·(10 a). The pixels with delaying trend were mainly distributed in low-altitude regions, with the delaying degree being gradually decreased with the elevation. The interannual change trend of SOS in high-altitude regions was more complex than that in lower-altitude regions. The multi-year average SOS in the northern slope was approximately 2.9 d earlier than that of the southern slope, whereas the southern slope had a more significant advancing trend. The interannual change trends of SOS in both north and south slopes showed a delaying trend in low-altitude, with little difference between north and south slopes. The advancing trend in middle and high altitude was significantly different.
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http://dx.doi.org/10.13287/j.1001-9332.202106.016DOI Listing
June 2021

Metal-free C(sp)-H functionalization of sulfonamides strain-release rearrangement.

Chem Sci 2021 Jan 22;12(11):4034-4040. Epub 2021 Jan 22.

Institute of Advanced Synthesis, School of Chemistry and Molecular Engineering, Jiangsu National Synergetic Innovation Center for Advanced Materials, Nanjing Tech University Nanjing 211816 China

With the increasing awareness of sustainable chemistry principles, the development of an efficient and mild strategy for C(sp)-H bond activation of nitrogen-containing compounds without the utilization of any oxidant and metal is still highly desired and challenging. Herein, we present a metal-free reaction system that enables C-H bond functionalization of aliphatic sulfonamides using DABCO as a promoter under mild conditions, affording a series of α,β-unsaturated imines in good yields with high selectivities. This protocol tolerates a broad range of functionalities and can serve as a powerful synthetic tool for the late-stage modification of complex compounds. More importantly, control experiments and detailed DFT calculations suggest that this process involves [2 + 2] cyclization/ring-cleavage reorganization, which opens up a new platform for the establishment of other related reorganization reactions.
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http://dx.doi.org/10.1039/d0sc06603fDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8179522PMC
January 2021

Large bandwidth and high-efficiency plasmonic quarter-wave plate.

Opt Express 2021 May;29(11):16939-16949

A large bandwidth and high-efficiency subwavelength quarter-wave plate (QWP) is an indispensable component of an integrated miniaturized optical system. The bandwidth of existing plasmonic quarter-wave plates with a transmission efficiency of more than 50% is less than 320 nm in the near-infrared band. In this paper, a metallic quarter-wave plate with a bandwidth of 600 nm (0.95-1.55 µm) and an average transmittance of more than 70% has been designed and shows excellent potential to be used in miniaturized optical polarization detection systems and as an optical data storage device. For TE mode incident waves, this miniaturized optical element can be equivalent to a Fabry-Pérot (FP) resonator. Meanwhile, for the TM mode incident wave, the transmission characteristics of this structure are controlled by gap surface plasmon polaritons (G-SPPs) existing in the symmetric metal/insulator/metal (MIM) configuration.
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http://dx.doi.org/10.1364/OE.426006DOI Listing
May 2021

Distributional Soft Actor-Critic: Off-Policy Reinforcement Learning for Addressing Value Estimation Errors.

IEEE Trans Neural Netw Learn Syst 2021 Jun 8;PP. Epub 2021 Jun 8.

In reinforcement learning (RL), function approximation errors are known to easily lead to the Q-value overestimations, thus greatly reducing policy performance. This article presents a distributional soft actor-critic (DSAC) algorithm, which is an off-policy RL method for continuous control setting, to improve the policy performance by mitigating Q-value overestimations. We first discover in theory that learning a distribution function of state-action returns can effectively mitigate Q-value overestimations because it is capable of adaptively adjusting the update step size of the Q-value function. Then, a distributional soft policy iteration (DSPI) framework is developed by embedding the return distribution function into maximum entropy RL. Finally, we present a deep off-policy actor-critic variant of DSPI, called DSAC, which directly learns a continuous return distribution by keeping the variance of the state-action returns within a reasonable range to address exploding and vanishing gradient problems. We evaluate DSAC on the suite of MuJoCo continuous control tasks, achieving the state-of-the-art performance.
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http://dx.doi.org/10.1109/TNNLS.2021.3082568DOI Listing
June 2021

Perioperative red blood cell infusion and deep vein thrombosis in patients with femoral and pelvic fractures: a propensity score matching.

Authors:
Linqin Wu Bo Cheng

J Orthop Surg Res 2021 Jun 5;16(1):360. Epub 2021 Jun 5.

Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Background: The relationship between perioperative red blood cell (RBC) infusion and deep vein thrombosis (DVT) has not been determined.

Objectives: To analyze the time-event relationship between perioperative RBC infusion and DVT in patients with femoral and pelvic fractures after adjusting for confounding factors and to provide reference for optimizing DVT risk factors.

Methods: The clinical data of 569 patients with femoral and pelvic fractures who received surgical treatment from May 2018 to December 2019 were retrospectively analyzed. Propensity score matching (PSM) was performed on 20 covariates of DVT. With the formation or progression of DVT after RBC infusion as the end point, the time-event relationship between perioperative RBC infusion and DVT in patients was analyzed by binary logistic regression.

Results: After 1:1 PSM of 569 patients included in this study, 126 patients were in the transfusion group and the non-transfusion group, respectively. Before PSM (P = 0.023, OR = 1.496 [95% CI, 1.058-2.115]), perioperative RBC infusion was associated with DVT formation for femoral and pelvic fractures. This conclusion was still obtained after PSM (P = 0.038, OR = 1.728, 95% CI = (1.031, 2.896)). The risk of DVT in patients with RBC infusion of 2-4U and > 4U is 1.833 and 2.667 times that of ≤ 2U, respectively. After excluding patients who received preoperative RBC infusion and had DVT formation or progression prior to RBC infusion, perioperative RBC infusion was still associated with the formation of DVT in femoral and pelvic fractures (P = 0.037, OR = 2.231 [95% CI, 1.049-4.745]).

Conclusion: Perioperative RBC infusion is one of the causes of DVT in patients with femoral and pelvic fractures, and the risk of DVT is positively correlated with the amount of RBC infusion.
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http://dx.doi.org/10.1186/s13018-021-02510-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8178849PMC
June 2021

Bio-functional strontium-containing photocrosslinked alginate hydrogels for promoting the osteogenic behaviors.

Mater Sci Eng C Mater Biol Appl 2021 Jul 24;126:112130. Epub 2021 Apr 24.

Hubei Tumor Biological Behavior Key Laboratory, Center of stomatology, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China. Electronic address:

In recent years, photocrosslinked alginate hydrogel has been widely studied in bone tissue engineering, owing to its numerous advantages. However, there are still some shortcomings like insufficient mechanical strength and lack of bone induction. To compensate for these deficiencies, in this work, a novel doped strontium (Sr) photocrosslinked methacrylated alginate (Sr-PMA) hydrogel was developed. Photocrosslinked alginate hydrogel fabricated via crosslinking methacrylate-modified alginate under ultraviolet (UV) light was placed into strontium solutions to prepare Sr-PMA gel by chelating reaction. The chemical structures, swelling behaviors, degradation profiles, elastic moduli, Sr ion release and surface morphology of the Sr-PMA hydrogel were characterized, and we found that physical properties of the gels can be tailored by varying concentration of Sr ions. And MC3T3-E1 cell viability, proliferation and mineralization outside the hydrogel were also investigated. Further research on cell survival, multiplication, osteogenic differentiation of the cells encapsulated in Sr-PMA hydrogels were explored. In vitro studies of biological properties revealed that incorporation of Sr into photocrosslinked alginate gels significantly improved osteogenic differentiation capabilities and mineralization via stimulating expression of osteogenesis related genes and proteins of the cells compared to strontium-free photocrosslinked alginate gels. The research demonstrates that the innovative Sr-PMA hydrogels possessing adjustable physical performances, excellent biocompatibility and osteogenic differentiation capabilities could be potentially applied to bone tissue engineering and regenerative medicine. Meanwhile, it also provides a reference for the modification of biological properties of biomaterials.
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http://dx.doi.org/10.1016/j.msec.2021.112130DOI Listing
July 2021

Non-In Situ Technique of Heart-Lung Transplantation: Case Series and Technique Description.

Ann Thorac Surg 2021 08 23;112(2):661-664. Epub 2021 Apr 23.

Department of Thoracic Surgery/Oncology, State Key Laboratory and National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. Electronic address:

Purpose: Heart-lung transplantation (HLTx) is a life-saving treatment option for patients with advanced cardiopulmonary failure. However, posterior mediastinal bleeding and phrenic nerve damage are still intraoperative challenges for the traditional surgical method. This study reports an innovative non-in situ HLTx performed in our center, preventing posterior mediastinal bleeding and phrenic nerve damage effectively.

Description: Between September 2015 and September 2020, 12 patients without previous heart surgery underwent a traditional HLTx and were deemed a control group, and 3 patients underwent an innovative non-in situ HLTx. The operative time, cold ischemic time, intraoperative bleeding, intraoperative transfusion, and the intensive care unit and hospital lengths of stay were assessed between traditional HLTx and non-in situ HLTx.

Evaluation: The innovative non-in situ HLTx was successfully performed in the 3 patients. We found that the intensive care unit and hospital lengths of stay, total surgical time, cold ischemic time, intraoperative bleeding, and intraoperative transfusion were decreased in the 3 patients compared with the traditional surgical method.

Conclusion: Non-in situ HLTx may decrease posterior mediastinal bleeding and phrenic nerve damage effectively.
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http://dx.doi.org/10.1016/j.athoracsur.2021.03.101DOI Listing
August 2021

Inhaled corticosteroids and risk of lung cancer among chronic obstructive pulmonary disease patients: a comprehensive analysis of nine prospective cohorts.

Transl Lung Cancer Res 2021 Mar;10(3):1266-1276

Department of Thoracic Surgery and Oncology, China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

Background: It remains uncertain whether there is a protective effect of inhaled corticosteroids (ICs) against lung cancer in chronic obstructive pulmonary disease (COPD) patients.

Methods: Databases including PubMed, Web of Science, EMBASE, and Medline were comprehensively searched. Random-effects model meta-analysis was conducted to calculate the hazard ratios (HRs) for lung cancer incidence among ICs users versus non-ICs users in patients with COPD. Stratified analysis was performed based on region and age of each study. This review was registered on PROSPERO (registration number CRD42020159082).

Results: Based on data from 181,859 COPD patients with a total follow-up duration of 1,109,339.9 person-years, we identified that the use of ICs in COPD patients was associated with a decreased risk of lung cancer [HR: 0.73, 95% confidence interval (CI): 0.62-0.86; P<0.001]. The region-specific HRs for lung cancer incidence were 0.62 (95% CI: 0.62-0.86; P=0.004), 0.77 (95% CI: 0.60-0.97; P=0.028) and 0.81 (95% CI: 0.61-1.08; P=0.155) among European, Asian and North American COPD patients, respectively. Additionally, we found the consistent outcome among age groups (≥70 years old: HR: 0.73, 95% CI: 0.65-0.99, P=0.043; <70 years old: HR: 0.74, 95% CI: 0.56-0.99, P=0.040).

Conclusions: This study demonstrates that ICs have a protective effect against lung cancer in COPD patients. It could provide guidance for clinicians in the prevention of lung cancer among patients with COPD.
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http://dx.doi.org/10.21037/tlcr-20-1126DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8044471PMC
March 2021

Urodynamic findings in patients with complete and incomplete suprasacral spinal cord injury at different stages after injury.

Ann Palliat Med 2021 Mar;10(3):3171-3178

Rehabilitation Center, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.

Background: Urodynamics is the gold standard for evaluating the function of neurogenic bladder after spinal cord injury (SCI), but there are few studies on urodynamics in patients with complete and incomplete suprasacral SCI in different periods.There is a lack of sufficient evidence for the timing of the first urodynamic examination.

Methods: The urodynamic results of 101 patients with complete and incomplete suprasacral SCI at 0-30, 31-60, 61-90, and 91-365 days after injury were included. Urodynamic parameters were compared between 0-90 and 91-365 days, including detrusor overactivity (DO), bladder compliance (BC), bladder-filling sensation, maximum cystometric capacity (MCC), detrusor external sphincter dyssynergia (DESD), maximum urinary flow rate (Qmax), detrusor pressure at a maximum urinary flow rate (PdetQmax).

Results: There were 45 patients with complete SCI and 56 with incomplete SCI. With the course's prolongation, the proportion of DO increased gradually in patients with complete and incomplete injury within 90 days, while the MCC gradually decreased. The bladder-filling sensation of patients with complete SCI is mostly absent. Significant differences were found between 0-90 and 91-365 days in terms of DO, DESD, MCC, Qmax, and PdetQmax incomplete SCI, and DESD in incomplete SCI, and between complete and incomplete SCI in terms of DO, bladder filling sensation, MCC, Qmax, PdetQmax at 0-90 days after injury, and bladder filling sensation at 91-365 days after injury.

Conclusions: Urodynamic examination should be conducted as soon as possible after injury in patients with incomplete suprasacral SCI, while for those with complete injury, the urodynamic examination can be initiated following clinical symptoms within 90 days after injury.
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http://dx.doi.org/10.21037/apm-21-314DOI Listing
March 2021

Non-small cell lung cancer with MET exon 14 skipping alteration responding to immunotherapy: a case report.

Ann Transl Med 2021 Mar;9(5):424

Department of Thoracic Surgery/Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory and National Clinical Research Center for Respiratory Disease, Guangzhou, China.

Immunotherapy has been proved to be a promising candidate for advanced non-small cell lung cancer (NSCLC). Despite MET mutations are regarded as an independent factor of programmed death ligand 1 (PD-L1) high expression, the efficacy of immune checkpoint inhibitors (ICIs) across NSCLC harboring Mesenchymal-epithelial transition factor exon 14 skipping alteration (METex14) is still uncleared. Moreover, when the resistance of PD-1 antibody occurs, the questions of how to interpret the resistance and how to overcome the resistance are worth exploring. We report a case of NSCLC with METex14 developed a right femoral metastasis after responding well to neoadjuvant immunotherapy, a successful lobectomy, and adjuvant immunotherapy. The subsequent attempts of MET targeted inhibitor, concurrent chemoradiotherapy, and notably programmed cell death protein 1 (PD-1) antibody plus vascular endothelial growth factor receptor tyrosine kinase inhibitor (VEGFR-TKI) failed to prevent disease progression. However, a regimen of anti-PD-1 plus anti-cytotoxic t-lymphocyte associated protein 4 (CTLA-4) reversed the progression to a complete response. This case shows that METex14 had a significant response to immunotherapy, which would be especially beneficial for those who developed targeted therapy resistance. Importantly, this is the first case reporting that salvage CTLA-4 antibody and PD-1 antibody could reverse the progression in NSCLC harboring METex14 when the anti-PD-1 resistance occurred.
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http://dx.doi.org/10.21037/atm-20-6829DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8033371PMC
March 2021

Lung cancers and pulmonary nodules detected by computed tomography scan: a population-level analysis of screening cohorts.

Ann Transl Med 2021 Mar;9(5):372

Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Heath & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou, China.

Background: An increasing number and proportion of younger lung cancer patients have been observed worldwide, raising concerns on the optimal age to begin screening. This study aimed to investigate the association between age and findings in initial CT scans.

Methods: We searched for low-dose CT screening cohorts from electronic databases. Single-arm syntheses weighted by sample size were performed to calculate the detection rates of pulmonary nodules, lung cancers (all stages and stage I), and the proportion of stage I diseases in lung cancers. In addition, we included patients who underwent chest CT in our center as a supplementary cohort. The correlation between the detection rates and age was evaluated by the Pearson Correlation Coefficient.

Results: A total of 37 studies involving 163,442 participants were included. We found the detection rates of pulmonary nodules and lung cancers increased with age. However, the proportion of stage I diseases in lung cancers declined with increased starting age and was significantly higher in the 40-year group than in other groups (40 45, 50, 55, P<0.001). In addition, the ratio of early-stage lung cancer to the number of nodules declined with age. Similarly, in our center, the detection rates of nodules (R=0.86, P≤0.001), all lung cancer (R=0.99, P≤0.001) and stage I diseases (R=0.87, P=0.001) increased with age, while the proportion of stage I diseases consistently declined with age (R=0.97, P≤0.001).

Conclusions: Starting lung cancer screening at an earlier age is associated with a higher probability of identifying a curable disease, urging future research to determine the optimal starting age.
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http://dx.doi.org/10.21037/atm-20-5210DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8033365PMC
March 2021

Early extubation in operating room after single-lung transplantation: a single institutional experience.

Ann Palliat Med 2021 Apr 23;10(4):4134-4142. Epub 2021 Mar 23.

Department of Thoracic Surgery and Oncology, the First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou, China.

Background: Early endotracheal extubation in operating room (E-OR) after lung transplantation is rarely reported worldwide. Herein, we aim to explore the feasibility and safety of E-OR after lung transplantation and demonstrate its potential benefits.

Methods: This study is a single-center retrospective database analysis of 18 patients. All lung transplantation patients with E-OR attempted between June 2018 and September 2019 were included retrospectively. Perioperative variables, including ischemia time, total blood loss, blood lactic acid, the partial pressure of oxygen, partial pressure of oxygen/fraction of inspiration oxygen ratio, time of semi-open pulmonary artery occlusion clamp, extubation rate, and complications after E-OR, were analyzed. Data were compared using non-parametric tests and expressed as the median or number (percentage).

Results: Clinical data of 18 patients with E-OR attempted were collected. Overall, 15/18 (83.33%) patients successfully underwent E-OR without reintubation. Reintubation occurred in 3/18 (16.67%) patients; one patient presented with decreased blood oxygen saturation and unconsciousness, while two patients developed hypoxemia and respiratory failure after E-OR. Extracorporeal membrane oxygenation (ECMO) was not used postoperatively. No grade 3 primary graft dysfunction was observed and all eighteen patients were alive 1 year after the transplant. No postoperative hemodialysis and tracheotomy occurred. The median length of stay in the intensive care unit (ICU) for E-OR patients was 120 hours, the median length of postoperative hospital stay was 19 days, and the median hospitalization cost was 35,577 USD.

Conclusions: Early endotracheal extubation in operating room was feasible and did not delay postoperative recovery in these 18 lung transplantation recipients.
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http://dx.doi.org/10.21037/apm-20-1598DOI Listing
April 2021

MIF inhibitor ISO-1 alleviates severe acute pancreatitis-associated acute kidney injury by suppressing the NLRP3 inflammasome signaling pathway.

Int Immunopharmacol 2021 Jul 3;96:107555. Epub 2021 Apr 3.

Department of Emergency, The First Affiliated Hospital of Zhengzhou University, No 1 Eastern Jianshe Road, Zhengzhou 450052, Henan, China; Key Laboratory of Hepatobiliary and Pancreatic Surgery and Digestive Organ Transplantation of Henan Province, China; Henan Key Laboratory of Emergency and Trauma Research Medicine, China. Electronic address:

Background: Acute kidney injury (AKI) is an important complication of severe acute pancreatitis (SAP) with a poor prognosis. The methyl ester of (S,R)-3-(4-hydroxyphenyl)-4,5-dihydro-5-isoxazole acetic acid (ISO-1), an inhibitor of macrophage migration inhibitory factor (MIF), has protective effects against many diseases. Our previous study confirmed MIF inhibition alleviated SAP. Here, we explored the effects of ISO-1 in an experimental mouse model of SAP-associated AKI induced by l-arginine.

Methods: Mice were randomly divided into four treatment groups (n = 6 each): control (CON), SAP, SAP + ISO-1, and ISO-1. Histopathologic examination was used to observe damage in pancreatic and renal tissues. Biochemical and enzyme-linked immunosorbent assays (ELISA) kits were used to measure the serologic indicators amylase, lipase, creatinine, uric acid, interleukin (IL)-6, and tumor necrosis factor (TNF)-α. Immunohistochemistry was used to detect protein expression of NLRP3, ASC and caspase-1, and the infiltration of myeloperoxidase (MPO)-positive neutrophils in kidney tissue. Western blotting was used to detect NLRP3, ASC and caspase-1 and IL-1β protein expression, and real-time PCR was used to measure MIF, IL-6, TNF-α, IL-1β and IL-18 mRNA levels in kidney tissue.

Results: ISO-1 treatment alleviated pathological damage in pancreatic and renal tissues, and reduced the serum levels of amylase, lipase, creatinine, uric acid, IL-6 and TNF-α. ISO-1 also reduced protein expression of NLRP3, ASC, caspase-1 and IL-1β, mRNA expression of MIF, IL-6, TNF-α, IL-1β and IL-18, and the infiltration of MPO-positive neutrophils in kidney tissue.

Conclusion: ISO-1 has a protective effect against experimental SAP-associated AKI. And the mechanism may be associated with ISO-1 inhibiting NLRP3 inflammasome signaling pathway.
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http://dx.doi.org/10.1016/j.intimp.2021.107555DOI Listing
July 2021

Drivers' visual-distracted take-over performance model and its application on adaptive adjustment of time budget.

Accid Anal Prev 2021 May 23;154:106099. Epub 2021 Mar 23.

State Key Laboratory of Automotive Safety and Energy, School of Vehicle and Mobility, Tsinghua University, Beijing, 100084, China. Electronic address:

There are certain situations that automated driving (AD) systems are still unable to handle, preventing the implementation of Level 5 AD. Thus, a transition of control, colloquially known as take-over of the vehicle, is required when the system sends a take-over request (TOR) upon exiting the operational design domain (ODD). An adaptive TOR along with good take-over performance requires adjusting the time budget (TB) to drivers' visual distraction state, adhering to a reliable visual-distraction-based take-over performance model. Based on a number of driving simulator experiments, the percentage of face orientation to distraction area (PFODA) and time to boundary at take-over timing (TTBT) were proposed to accurately evaluate the degree of visual distraction based on merely face orientation under naturalistic non-driving related tasks (NDRTs) and to evaluate take-over performance, respectively. In order to elucidate the safety boundary, this study also proposed an algorithm to set a suitable minimum value of the TTBT. Finally, a multiple regression model was built to describe the relationship among PFODA, TB and TTBT along with a corrected coefficient of determination of 0.748. Based on the model, this study proposed an adaptive TB adjustment method for the take-over system.
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http://dx.doi.org/10.1016/j.aap.2021.106099DOI Listing
May 2021

CircNT5E promotes the proliferation and migration of bladder cancer via sponging miR-502-5p.

J Cancer 2021 1;12(8):2430-2439. Epub 2021 Mar 1.

Urology and Andrology Department, Shengli OilFiled Central Hospital, Dongying, 257034, Shandong, China.

Accumulating evidence suggest that circRNA RNAs (circRNAs) play important roles in tumor formation and development. circNT5E has been shown to be an oncogenic gene in several types of cancer, and the high expression of circNT5E lead to tumorigenesis and cancer progression. However, the precise role of circNT5E in bladder cancer (Bca) has not been characterized. In this study, we observed that circNT5E expression was augmented in Bca tissues compared with that in adjacent normal tissues, and its expression level was positively associated with larger tumor size and lower survival rate. Further experiments showed that suppression of circNT5E restrained the growth and metastasis of Bca cells . circNT5E was mainly distributed in the cytoplasm and it captured miR-502-5p to increase HOXC8 mRNA and protein expression. Moreover, decreased miR-502-5p obviously reversed the circNT5E silencing-mediated inhibition of Bca cell growth and migration. Thus, this study suggested that circNT5E may act as a pro-oncogene in the development and progression of Bca and it may become a useful tumor biomarker and promising therapeutic target for Bca treatment.
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http://dx.doi.org/10.7150/jca.53385DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7974885PMC
March 2021

Toxicity profile of epidermal growth factor receptor tyrosine kinase inhibitors for patients with lung cancer: A systematic review and network meta-analysis.

Crit Rev Oncol Hematol 2021 Apr 20;160:103305. Epub 2021 Mar 20.

Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou 510120, China. Electronic address:

Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are treatments commonly used for lung cancer. The toxicity profile including toxicity incidence, severity, and spectrum (involving various specific adverse events) of each EGFR-TKI are of particular clinical interest and importance. Data from phase II and III randomized controlled trials comparing treatments among EGFR-TKIs (osimertinib, dacomitinib, afatinib, erlotinib, gefitinib, and icotinib) and chemotherapy for lung cancer were synthesized with Bayesian network meta-analysis. The primary outcome was systemic all-grade and grade ≥3 adverse events. The secondary outcome was specific all-grade adverse events including those of the skin, gastrointestinal tract, lung, etc. 40 trials randomizing 13,352 patients were included. Generally greater toxicity for dacomitinib and afatinib, and safety for icotinib were suggested. Furthermore, we found individual EGFR-TKIs had different toxicity spectrums. These findings provide a compelling safety reference for the individualized use of EGFR-TKIs for patients with lung cancer.
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http://dx.doi.org/10.1016/j.critrevonc.2021.103305DOI Listing
April 2021

A Bayesian network approach for determining optimal ecological base flow of rivers in water shortage areas of Northwest China.

Authors:
Bo Cheng Huaien Li

Environ Sci Pollut Res Int 2021 Jul 15;28(28):37768-37780. Epub 2021 Mar 15.

State Key Laboratory of Eco-hydraulics in Northwest Arid Region of China, Xi'an University of Technology, Xi'an, 710048, China.

How to balance natural river base flow with water loss from agricultural activities such as irrigation has become an important global challenge in areas of water shortage. Using a Bayesian network model, we constructed a decision-making framework for river ecological base flow in the water shortage areas. This framework can be divided into three components: (1) calculation of economic losses caused when priority is given to protect river ecological base flow, (2) construction of a decision-making Bayesian network, and (3) determination of an optimum ecological base flow of rivers based on an acceptable probability of acceptable economic losses the decision-makers selected. We used the Baoji section of the Weihe River as a typical water shortage area case study. The results show that the optimum ecological base flows in the Baoji section of Weihe River in wet, normal, and dry years were 32.35%, 20.59%, and 14.71% of natural inflow in rivers, respectively. From an economic benefit perspective, the beneficiaries should provide more financial support to protect the ecological base flow of rivers. Our approach could be used in other water shortage areas where decisions need to be made between protection of river ecological base flows of rivers and agricultural use.
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http://dx.doi.org/10.1007/s11356-021-13384-wDOI Listing
July 2021

Concealed driver in lung adenocarcinoma with single PIK3CA mutation: a case report and single-center genotyping review.

Ann Transl Med 2021 Feb;9(3):271

China State Key Laboratory of Respiratory Disease and National Clinical Research Center for Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.

Phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA) mutation has a prevalence of approximately 2% in lung adenocarcinoma. However, cases presenting a PIK3CA mutation alone have rarely been reported, and the clinical significance of a single PIK3CA mutation has not been well discussed. We present 2 similar lung adenocarcinoma cases with a single PIK3CA alteration initially but were found to have a concurrent epidermal growth factor receptor (EGFR) mutation by another genotyping afterward. Both cases experienced an excellent partial response after combination therapy of EGFR tyrosine kinase inhibitor (EGFR-TKI) and angiogenesis inhibitor, which implies that the initial absence of EGFR mutation was a false negative. A single-center retrospective study among 2,214 cases of lung adenocarcinoma regarding their genotyping was conducted. We found that the prevalence of PIK3CA mutation in lung adenocarcinoma was 1.7%, 86.5% of which had other co-existing mutations, with EGFR mutation being the most common. PIK3CA mutation tends to be concurrent with other mutations in lung adenocarcinoma. Physicians should suspect a potential false-negative driver mutation and promptly repeat genotyping when a single PIK3CA mutation is reported in the genotyping of lung adenocarcinoma. Furthermore, physicians should consider agents targeting the driver mutation rather than agents targeting the phosphatidylinositol 3-kinase(PI3K)/Akt/mammalian target of rapamycin (mTOR) pathway for treatment.
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http://dx.doi.org/10.21037/atm-20-5948DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7940953PMC
February 2021
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