Realization of high-efficiency AlGaN deep ultraviolet light-emitting diodes with polarization-induced doping of the p-AlGaN hole injection layer

We investigate the polarization-induced doping in the gradient variation of Al composition in the pAl_(0.75)Ga_(0.25)N/Al_xGa_(1-x)N hole injection layer(HIL)for deep ultraviolet light-emitting diodes(DUV-LEDs)with an ultrathin p-GaN(4 nm)ohmic contact layer capable of emitting 277 nm.The experimental results show that the external quantum efficiency(EQE)and wall plug efficiency(WPE)of the structure graded from 0.75 to 0.55 in the HIL reach 5.49%and 5.04%,which are improved significantly by 182%and 209%,respectively,compared with the structure graded from 0.75 to 0.45,exhibiting a tremendous improvement.Both theoretical speculations and simulation results support that the larger the difference between 0.75 and x in the HIL,the higher the hole concentration that should be induced;thus,the DUV-LED has a higher internal quantum efficiency(IQE).Meanwhile,as the value of x decreases,the absorption of the DUV light emitted from the active region by the HIL is enhanced,reducing the light extraction efficiency(LEE).The IQE and LEE together affect the EQE performance of DUV-LEDs.To trade off the contradiction between the enhanced IQE and decreased LEE caused by the decrease in Al composition,the Al composition in the HIL was optimized through theoretical calculations and experiments.

Presbyphagia:Dysphagia in the elderly

Dysphagia has been classified as a“geriatric syndrome”and can lead to serious complications that result in a tremendous burden on population health and healthcare resources worldwide.A characteristic age-related change in swa-llowing is defined as“presbyphagia.”Medical imaging has shown some changes that seriously affect the safety and efficacy of swallowing.However,there is a general lack of awareness of the effects of aging on swallowing function and a belief that these changes are part of normal aging.Our review provides an overview of presbyphagia,which has been a neglected health problem for a long time.Attention and awareness of dysphagia in the elderly population should be strengthened,and targeted intervention measures should be actively imple-mented.

Targeting mTOR network in colorectal cancer therapy

The mechanistic target of rapamycin(mTOR)integrates growth factor signals with cellular nutrient and energy levels and coordinates cell growth,proliferation and survival.A regulatory network with multiple feedback loops has evolved to ensure the exquisite regulation of cell growth and division.Colorectal cancer is the most intensively studied cancer because of its high incidence and mortality rate.Multiple genetic alterations are involved in colorectal carcinogenesis,including oncogenic Ras activation,phosphatidylinositol 3-kinase pathway hyperactivation,p 53 mutation,and dysregulation of wnt pathway.Many oncogenic pathways activate the mTOR pathway.mTOR has emerged as an effective target for colorectal cancer therapy.In vitro and preclinical studies targeting the mTOR pathway for colorectal cancer chemotherapy have provided promising perspectives.However,the overall objective response rates in major solid tumors achieved with single-agent rapalog therapy have been modest,especially in advanced metastatic colorectal cancer.Combination regimens of mTOR inhibitor with agents such as cytotoxic chemotherapy,inhibitors of vascular endothelial growth factor,epidermal growth factor receptor and Mitogen-activated protein kinase kinase(MEK)inhibitors are being intensively studied and appear to be promising.Further understanding of the molecular mechanism in mTOR signaling network is needed to develop optimized therapeutic regimens.In this paper,oncogenic gene alterations in colorectal cancer,as well as their interaction with the mTOR pathway,are systematically summarized.The most recent preclinical and clinical anticancer therapeutic endeavors are reviewed.New players in mTOR signaling pathway,such as nonsteroidal anti-inflammatory drug and metformin with therapeutic potentials are also discussed here.

Risk factors for lymph node metastasis in T1 esophageal squamous cell carcinoma:A systematic review and meta-analysis

BACKGROUND Lymph node metastasis(LNM)affects the application and outcomes of endoscopic resection in T1 esophageal squamous cell carcinoma(ESCC).However,reports of the risk factors for LNM have been controversial.AIM To evaluate risk factors for LNM in T1 ESCC.METHODS We searched Embase,PubMed and Cochrane Library to select studies related to LNM in patients with T1 ESCC.Included studies were divided into LNM and non-LNM groups.We performed a meta-analysis to examine the relationship between LNM and clinicopathologic features.Odds ratio(OR),mean differences and 95%confidence interval(CI)were assessed using a fixed-effects or randomeffects model.RESULTS Seventeen studies involving a total of 3775 patients with T1 ESCC met the inclusion criteria.After excluding studies with heterogeneity based on influence analysis,tumor size(OR=1.93,95%CI=1.49-2.50,P<0.001),tumor location(OR=1.46,95%CI=1.17-1.82,P<0.001),macroscopic type(OR=3.17,95%CI=2.33-4.31,P<0.001),T1 substage(OR=6.28,95%CI=4.93-8.00,P<0.001),differentiation(OR=2.11,95%CI=1.64-2.72,P<0.001)and lymphovascular invasion(OR=5.86,95%CI=4.60-7.48,P<0.001)were found to be significantly associated with LNM.Conversely,sex,age and infiltrative growth pattern were not identified as risk factors for LNM.CONCLUSION A tumor size>2 cm,lower location,nonflat macroscopic type,T1b stage,poor differentiation and lymphovascular invasion were associated with LNM in patients with T1 ESCC.

Determination of rock resistant coefficient based on Mohr-Coulomb criterion for underwater tunnel

According to the load-structure method, the wall rock with lining can bear the load caused by the surrounding rock, and the rock resistant coefficient (RRC) is a key parameter for evaluating the capacity of this wall rock. Based on the Mohr-Coulomb yield criterion, this paper develops a formula for calculating the RRC, which has been applied to the real engi-neering project, such as Xiamen Xiang’an East Passage Underwater Tunnel Project. The fact shows that this formula is helpful for designers to determine the RRC value.

Potential factors associated with clinical stage of nasopharyngeal carcinoma at diagnosis: a case–control study

Background: In China, most patients with nasopharyngeal carcinoma(NPC) are diagnosed at a late stage and con?sequently have a poor prognosis. This study aimed to investigate potential factors associated with the clinical stage of NPC at diagnosis.Methods: Data were obtained from 118 patients with early?stage NPC and 274 with late?stage NPC who were treated at Sun Yat?sen University Cancer Center between August 2014 and July 2015. Patients were individually matched by age, sex, and residence, and a conditional logistic regression model was applied to assess the associa?tions of clinical stage at diagnosis with socioeconomic status indicators, knowledge of NPC, physical examinations, patient interval, and risk factors for NPC.Results: Although knowledge of early NPC symptoms, smoking cessation, and patient interval were important fac?tors, the number of cigarettes smoked per day, motorbike ownership, and physical examination exhibited the strong?est associations with the clinical stage of NPC at diagnosis. Compared with smoking fewer than ten cigarettes a day, smoking 10–30 cigarettes [odds ratio(OR) 4.03; 95% confidence interval(CI) 1.11–14.68] or more than 30 cigarettes(OR 11.46; 95% CI 1.26–103.91) was associated with an increased risk of late diagnosis. Compared with not owning a motorbike, owning a motorbike(OR 0.38; 95% CI 0.23–0.64) was associated with early diagnosis. Subjects who under?went physical examinations were less likely to receive a late diagnosis than those who did not undergo examinations(OR 0.50; 95% CI 0.28–0.89). However, indicators of wealth were not significant factors.Conclusions: Initiatives to improve NPC patient prognosis should aim to promote knowledge about early symptoms and detection, health awareness, and accessibility to health facilities among all patients, regardless of socioeconomic status.

诊断时鼻咽癌临床分期相关的潜在因素:一项病例对照研究

背景与目的在我国,大多数鼻咽癌(nasopharyngeal carcinoma,NPC)患者都是在晚期才被诊断出来的,并且患者预后较差。本研究旨在探讨与诊断时NPC临床分期相关的潜在因素。方法将2014年8月至2015年7月在中山大学肿瘤防治中心接受治疗的118例早期NPC患者和274例晚期NPC患者的临床数据纳入本研究。按照年龄、性别和居住地对患者进行匹配,应用条件logistic回归模型评估诊断时临床分期与社会经济状况指标、NPC的认知、体格检查、患病检查间隔时间和NPC风险因素的相关性。结果虽然早期NPC症状的认知、戒烟和患病检查间隔时间是重要因素,但患者每天的吸烟量、摩托车拥有情况和体检与诊断时NPC的临床分期密切相关。与每天吸烟少于10支相比,每天吸烟10–30支[比值比(odds ratio,OR)=4.03;95%置信区间(confidence interval,CI):1.11–14.68]或每天吸烟30支以上(OR=11.46;95%CI:1.26–103.91)延迟诊断的风险增加。拥有摩托车(OR=0.38;95%CI:0.23–0.64)比不拥有摩托车会被更早诊断出来。接受体检的患者比未接受检查的患者被延迟诊断的可能性更小(OR=0.50;95%CI:0.28–0.89)。但是,财富指标并不是显著因素。结论改善NPC患者预后的措施应旨在提高所有患者对早期症状和体检的认知、健康意识和卫生设施的可及性,而不论其社会经济状况如何。

Risk factors for renal outcomes in children with antineutrophil cytoplasmic antibody-associated vasculitis:a nationwide retrospective study in China

Background Pediatric antineutrophil cytoplasmic antibody-associated vasculitis(AAV)is a life-threatening systemic vasculitis featured by liability to renal involvement.However,there are few studies on the risk factors and predictive models for renal outcomes of AAV in children.Methods Data from 179 AAV children in multiple centers between January 2012 and March 2020 were collected retrospectively.The risk factors and predictive model of end-stage renal disease(ESRD)in AAV were explored.Results Renal involvement was the most typical manifestation(95.5%),and the crescent was the predominant pathological lesion(84.9%).The estimated glomerular filtration rate(eGFR)was evaluated in 114 patients,of whom 59.6%developed ESRD,and the median time to ESRD was 3.20 months.The eGFR[P=0.006,odds ratio(OR)=0.955,95%confidence interval(CI)=0.924–0.987]and the percentages of global glomerulosclerosis(pGGS;P=0.018,OR=1.060,95%CI=1.010–1.112)were independent risk factors for ESRD of renal biopsy.Based on the pGGS and eGFR at renal biopsy,we developed three risk grades of ESRD and one predictive model.The Kaplan‒Meier curve indicated that renal outcomes were significantly different in different risk grades(P<0.001).Compared with serum creatinine at baseline,the predictive model had higher accuracy(0.86 versus 0.58,P<0.001)and a lower coefficient of variation(0.07 versus 0.92)in external validation.Conclusions Renal involvement is the most common manifestation of pediatric AAV in China,of which more than half deteriorates into ESRD.The predictive model based on eGFR at renal biopsy and the pGGS may be stable and accurate in speculating the risk of ESRD in AAV children.

Combination patterns of precipitation and its concentration degree determining the risk of dengue outbreaks in China

The amount and distribution of precipitation can determine dengue risk by affecting mosquito breeding;however,previous studies failed to incorporate this bivariate characteristic to examine dengue fever transmission.In the present research,nationwide data on daily dengue cases in China between January 2005 and December 2020 were obtained,and the top 12 cities accounting for 78%of total cases were selected for analysis.Precipitation patterns were quantified by weekly precipitation and precipitation concentration degree(PCD).On the basis of the combinations of both parameters,the exposure-response relationships of precipitation with dengue risk were established using generalised additive models,and the high-dengue-risk thresholds of precipitation patterns were further identified.Dengue burden was assessed by calculating attributable dengue cases.For the same amount of precipitation,the dispersed precipitation in the pre-summer rainy season leads to a higher dengue risk in autumn.The weekly precipitation of 100-150 mm and PCD of 0.2-0.4 constitute the highest risk scenario,and the average frequency of precipitation associated with dengue risk in 2013-2020 is 1.6 times higher than that in 2005-2012.A total of 3093 attributable dengue cases are identified.From 2005 to 2020,the amount of dispersed precipitation increased in southern and southwestern China and posed high dengue risks in central China.This study has improved the understanding of the health impacts of irregular rainfall under climate change.Our approach to identifying thresholds provides information for early warning systems and helps reduce the risk of dengue transmission in the long run.

Responsible genes in children with primary vesicoureteral reflux: findings from the Chinese Children Genetic Kidney Disease Database

Background Primary vesicoureteral reflux(VUR)is a common congenital anomaly of the kidney and urinary tract(CAKUT)in childhood.The present study identified the possible genetic contributions to primary VUR in children.Methods Patients with primary VUR were enrolled and analysed based on a national multi-center registration network(Chinese Children Genetic Kidney Disease Database,CCGKDD)that covered 23 different provinces/regions in China from 2014 to 2019.Genetic causes were sought using whole-exome sequencing(WES)or targeted-exome sequencing.Results A total of 379 unrelated patients(male:female 219:160)with primary VUR were recruited.Sixty-four(16.9%)children had extrarenal manifestations,and 165(43.5%)patients showed the coexistence of other CAKUT phenotypes.Eighty-eight patient(23.2%)exhibited impaired renal function at their last visit,and 18 of them(20.5%)developed ESRD at the median age of 7.0(IQR 0.9–11.4)years.A monogenic cause was identified in 28 patients(7.39%).These genes included PAX2(n=4),TNXB(n=3),GATA3(n=3),SLIT2(n=3),ROBO2(n=2),TBX18(n=2),and the other 11 genes(one gene for each patient).There was a significant difference in the rate of gene mutations between patients with or without extrarenal complications(14.1%vs.6%,P=0.035).The frequency of genetic abnormality was not statistically significant based on the coexistence of another CAKUT(9.6%vs.5.6%,P=0.139,Chi-square test)and the grade of reflux(9.4%vs.6.7%,P=0.429).Kaplan–Meier survival curve showed that the presence of genetic mutations did affect renal survival(Log-rank test,P=0.01).PAX2 mutation carriers(HR 5.1,95%CI 1.3–20.0;P=0.02)and TNXB mutation carriers(HR 20.3,95%CI 2.4–168.7;P=0.01)were associated with increased risk of progression to ESRD.Conclusions PAX2,TNXB,GATA3 and SLIT2 were the main underlying monogenic causes and accounted for up to 46.4%of monogenic VUR.Extrarenal complications and renal function were significantly related to the findings of genetic factors in children with primary VUR.Like other types of CAKUT,several genes may be responsible for isolated VUR.

Evaluation of a new frequency-volume chart for children with primary monosymptomatic nocturnal enuresis:a prospective,comparative study

Introduction To improve compliance with voiding diaries in children with primary monosymptomatic nocturnal enuresis(PMNE),a new modified 3-day weekend frequency-volume chart(FVC)was designed,and the compliance and validity of this modified FVC was evaluated by comparing with the International Children's Continence Society(ICCS)recommended voiding diary.Methods A total of 1200 patients with PMNE were enrolled in the study from 13 centers in China and were randomly assigned to record this modified FVC or the ICCS-recommended voiding diary.The primary outcome measure was the compliance,assessed by comparing the completing index and the quality score of diaries between two groups.The secondary outcome measure was the validity,evaluated by comparing the constituent of subtypes,micturition parameters and response rate to desmopressin.Results Among the 1200 participants enrolled in the study,447 patients completed the ICCS-recommended voiding diary and 469 completed the modified diary.The diurnal completing index and the quality score of the modified FVC group were better than those of the ICCS group.In addition,there was no significant difference between these two groups in the subtype classification,or in the response rate to desmopressin.Conclusions The modified FVC could be applied to obtain the voiding characteristics of children with PMNE as the ICCS-recommended voiding diary does and offers a reasonable and better choice for children with PMNE from the unselected population in the future.