Search

Existing image manipulation detection methods rely on manipulation traces, leading to sub-optimal performance. This is primarily due to their challenges in distinguishing manipulation traces amidst extensive noisy information in the entire image and overlooking artifact relations between manipulated and authentic regions. Toward this end, we propose an Auto-Focus Graph Contrastive Learning, called AFGCL, for image manipulation detection, incorporating two innovative modules: multi-scale view generation (MSVG) and artifact relations modeling (ARM). The MSVG module focuses on generating a pair of contrastive views, each encompassing a different scale region of interest, namely the manipulated region and its surrounding authentic region. Meanwhile, the ARM module emphasizes modeling artifact relations between the pixels of the region of interest to learn a discriminative representation. By minimizing the distance between representations and artifact relations of corresponding views, the AFGCL automatically focuses on the region of interest. This enables a thorough exploration of artifact relations, facilitating accurate manipulation detection. The results show that AFGCL outperforms previous state-of-the-art methods on widely used benchmarks. Code is available at: https://github.com/pwy-cmd/AFGCL. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the feasibility and efficacy of Mirabilite combined with Lactulose in older patients after abdominal surgery. Design: It is a retrospective observational cohort study with a pre and post intervention group. Methods: Medical records were retrospectively reviewed of postoperative Intensive Care patients with postoperative gastrointestinal tract dysfunction (aged >60 years) in the Surgical Intensive Care Unit from January 2017–December 2018. Results: One hundred and sixty‐seven post‐surgical Intensive Care patients with postoperative gastrointestinal tract dysfunction were analysed; 74 patients received Mirabilite + Lactulose treatment and 93 patients received Lactulose treatment. The recovery rate of bowel sounds was better in the Mirabilite + Lactulose group (62.16%) compared with the Lactulose group (37.63%) after 3‐day treatment (p = 0.002) and the relative risk (RR) was 1.65 (95% CI, 1.20, 2.27). Moreover 70.27% patients in the Mirabilite + Lactulose group finally had flatus or defecation compared with 46.24% patients in Lactulose group (p = 0.003) and the RR was 1.52 (1.17, 1.98). The abdominal girth and Inter Abdominal Pressure in Mirabilite + Lactulose group showed significantly greater decrease over a 3‐day period compared with Lactulose group (4.86 vs. 3.46 cm, p = 0.027; 4.80 vs. 3.11 mmHg, p = 0.002 respectively). The pain score had greater decrease from the baseline in Mirabilite + Lactulose group than in Lactulose group (2.40 vs. 1.11; p < 0.01). Patients in the Mirabilite + Lactulose group had shorter hospital stay than the Lactulose group 12.5 (SD 3.51) versus 13.9 (SD 5.14), p = 0.05. Conclusions: This study demonstrated that external use of Mirabilite combined with Lactulose can be considered as an easy intervention to improve postoperative gastrointestinal mobility in older intensive care patients who suffer from postoperative gastrointestinal tract dysfunction after surgery. Impact: Our results provide a great option to alleviate the sufferings of postoperative patients. The externally use Mirabilite is a painless and safe interventions that is easy to implement by ICU nurses. [ABSTRACT FROM AUTHOR]

• The DN value of solvent has effect on PPy's preparation. • The lower the DN value, the less structural defects of PPy. • The lower the DN value, the higher conductivity of PPy. • PPy prepared in nitromethane solutions own the best corrosion protection performances. To clarify the effect of solvents with different donor number (DN) on the preparation and corrosion protection ability of polypyrrole (PPy) films, PPy were firstly synthesized in water or acetonitrile or nitromethane solutions containing NaClO 4 + pyrrole by a potentiostatic method. The corrosion protection performances of these films with stainless steel as a substrate were investigated by open circuit potential, potentiodynamic polarization and electrochemical impedance spectroscopy in 1 M H 2 SO 4. Results indicated that all PPy films showed spherical structure in scanning electron microscopy photograph and corrosion protection ability. Particularly, PPy prepared in nitromethane solutions performed the best due to the lowest DN value. Nitromethane had the weakest interaction with the intermediates of pyrrole polymerization which results in the smallest particles, the most compact accumulation, the highest conductivity and the longest conjugated chain. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide OBJECTIVES Postoperative delirium is a common severe complication in patients in the intensive care unit after cardiac surgery. We developed a two-stage prediction model and quantified the risk of developing postoperative delirium to assist in early prevention before and after surgery. METHODS We conducted a prospective cohort study and consecutively recruited adult patients after cardiac surgery. The Confusion Assessment Method for patients in the intensive care unit was used to diagnose delirium 5 days postoperatively. The stage I model was constructed using patient demographics, health conditions and laboratory results obtained preoperatively, whereas the stage II model was built on both pre- and postoperative predictors. The model was validated internally using the bootstrap method and externally using data from an external cohort. RESULTS The two-stage model was developed with 654 patients and was externally validated with 214 patients undergoing cardiac surgery. The stage I model contained 6 predictors, whereas the stage II model included 10 predictors. The stage I model had an area under the receiver operating characteristic curve of 0.76 (95% confidence interval: 0.68–0.81), and the stage II model's area under the receiver operating characteristic curve increased to 0.85 [95% confidence interval (CI): 0.81–0.89]. The external validation resulted in an area under the curve of 0.76 (95% CI: 0.67–0.86) for the stage I model and 0.78 (95% CI: 0.69–0.86) for the stage II model. CONCLUSIONS The two-stage model assisted medical staff in identifying patients at high risk for postoperative delirium before and 24 h after cardiac surgery. This model showed good discriminative power and predictive accuracy and can be easily accessed in clinical settings. Trial registration The study was registered with the US National Institutes of Health ClinicalTrials.gov (NCT03704324; registered 11 October 2018). [ABSTRACT FROM AUTHOR]

Aims: To investigate the beliefs and attitudes of intensive care unit (ICU) nurses and patients' family members towards an open visitation policy in the ICU in China and to explore the reasons that promote or hinder open visitation to improve visitation policy. Background: Open visitation policies are widely recommended in many countries. However, there are gaps between evidence and practice. Most ICUs in China still use a restrictive policy for family visits, which raises controversy. There are limited visiting times, and family visitors are not allowed to enter the ICU. Study Design: A multicentre survey was conducted in seven hospitals in China. The Beliefs and Attitudes towards Visitation in the Intensive Care Unit Questionnaire (BAVIQ) was administered to ICU nurses and patient families from 11 the ICUs of seven hospitals. A total of 275 questionnaires were completed and returned by ICU nurses and 139 by patients' family members. Results: Among nurses, the belief scale score was 2.87 ± 0.33 (range 2–4), and the attitude scale score was 5.53 ± 1.12 (range 2.33–7). The belief scale was divided into three subscales: nurses, patients, and patients' families. The subscale score for patients' families was the highest, and the nurses' subscale score was the lowest. Most (84.0%) of the nurses were satisfied with the current ICU visitation policy. The belief and attitude scores were 3.13 ± 0.39 (range 1.96–4) and 6.18 ± 1.20 (range 1.67–7), respectively, for family members. The scores of the three subscales, that is, patients, patients' families and nurses, were 3.13 ± 0.40, 3.26 ± 0.43, and 3.04 ± 0.49, respectively. Conclusion: Nurses' beliefs and attitudes towards implementing an open visitation policy in China are at a less positive level than those of patient family members. Relevance to Clinical Practice: The beliefs and attitudes of nurses towards open visitation policy in China need to be improved. The question of how to mobilize nurses' enthusiasm for an open visitation policy poses a challenge for ICU management. [ABSTRACT FROM AUTHOR]

Background: Patients treated in the intensive care unit (ICU) may experience a reversal of day and night. The circadian rhythm in ICU patients can be disturbed. Methods: To explore the relationship between ICU delirium and the circadian rhythms of melatonin, cortisol and sleep. A prospective cohort study was carried out in a surgical ICU of a tertiary teaching hospital. Patients who were conscious during the ICU stay after surgery and were scheduled to stay in the ICU for more than 24 h were enrolled. Serum melatonin and plasma cortisol levels were measured three times a day by drawing arterial blood on the first three days after ICU admission. Daily sleep quality was assessed by the Richard-Campbell Sleep Questionnaire (RCSQ). The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) was performed twice a day to screen for ICU delirium. Results: A total of 76 patients were included in this study, and 17 patients developed delirium during their ICU stay. Melatonin levels were different at 8:00 (p = 0.048) on day 1, at 3:00 (p = 0.002) and at 8:00 (p = 0.009) on day 2, and at all three time points on day 3 (p = 0.032, 0.014, 0.047) between delirium and non-delirium patients. The plasma cortisol level in the delirium patients was significantly lower than that in the non-delirium patients at 16:00 on day 1 (p = 0.025). The changes in melatonin and cortisol secretion levels exhibited obvious biological rhythmicity in non-delirium patients (p < 0.001 for melatonin, p = 0.026 for cortisol), while no rhythmicity was found in melatonin and cortisol secretion levels in the delirium group (p = 0.064 for melatonin, p = 0.454 for cortisol). There was no significant difference in RCSQ scores in the first three days between the two groups. Conclusions: The disturbance of the circadian rhythm of melatonin and cortisol secretion was associated with the development of delirium in ICU patients. Clinical staff should pay more attention to the importance of maintaining patients' normal circadian rhythms in the ICU. Trial registration: The study was registered with the US National Institutes of Health ClinicalTrials.gov(NCT05342987) (25/04/2022). [ABSTRACT FROM AUTHOR]

Abstract: Impact of climate change on energy use in office buildings in a city within each of the five major architectural climates across China – Harbin (severe cold), Beijing (cold), Shanghai (hot summer and cold winter), Kunming (mild) and Hong Kong (hot summer and warm winter) – was investigated for two emissions scenarios. For low forcing, the estimated increase in cooling energy use was 18.5% in Harbin, 20.4% in Beijing, 11.4% in Shanghai, 24.2% in Kunming and 14.1% in Hong Kong; and the reduction in heating 22.3% in Harbin, 26.6% in Beijing, 55.7% in Shanghai, 13.8% in Kunming and 23.6% in Hong Kong. Space heating is usually provided by oil- or gas-fired boiler plants, whereas space cooling mainly relies on electricity. There would certainly be a shift towards electrical power demand. More energy use in buildings would lead to larger emissions, which in turn would exacerbate climate change and global warming. Energy conservation measures were considered to mitigate the impact of climate change on building energy use. These included building envelope, indoor condition, lighting load density and chiller coefficient of performance. It was found that raising the summer indoor design condition by 1–2°C could result in significant energy savings and have great mitigation potential. [Copyright &y& Elsevier]

Abstract: Sprouty-related EVH1 domain (Spred) proteins modulate growth factor receptor signaling by inhibiting the Ras/ERK pathway. In particular, the Sprouty-related domain (SPR) of Spred2 is essential for the Spred2-mediated inhibitory effect, but the molecular mechanism is largely unknown. We show here that the p85 subunit of phosphatidylinositol 3-kinase (PI3K) is a new binding partner of Spred2 via interaction with the SPR domain. Mutation of three tyrosines 303/343/353 within the SPR domain not only abolish EGF-induced p85 binding to Spred2 but also attenuate the inhibitory effect on Ras/ERK activation by Spred2. This results in increased Hela cell proliferation and neurite outgrowth in PC12 cells. We further demonstrate that p85 binding to Spred2 enhances the Spred2-mediated inhibitory effect via increased Ras binding to Spred2 and decreased Spred2 ubiquitination. We also show that Spred2 constitutively associates with epidermal growth factor receptor (EGFR) via its SPR domain and dissociates from EGFR upon EGF stimulation. Moreover, mutation of tyrosines 303/343/353 together enhances Spred2 binding to EGFR. Taken together, these results suggest critical roles of the three tyrosines 303/343/353 within the SPR domain in regulating Spred2 signaling and provide a mechanism for the SPR domain of Spred2 to mediate the inhibitory effect on the Ras/ERK pathway. [Copyright &y& Elsevier]

Background: Delirium is a common postoperative complication after cardiac surgery. The relationship between delirium and cardiac function has not been fully elucidated. Aims: The aim of this study was to identify the association between preoperative cardiac function and delirium among patients after cardiac surgery. Methods: We prospectively recruited 635 cardiac surgery patients with a planned cardiac intensive care unit admission. Postoperative delirium was diagnosed using the confusion assessment method for the intensive care unit. Preoperative cardiac function was assessed using N-terminal prohormone of brain natriuretic peptide (NT-proBNP), New York Heart Association functional classification and left ventricular ejection fraction. Results: Delirium developed in 73 patients (11.5%) during intensive care unit stay. NT-proBNP level (odds ratio (OR) 1.24, 95% confidence interval (CI) 1.01–1.52) and New York Heart Association functional classification (OR 2.34, 95% CI 1.27–4.31) were both independently associated with the occurrence of delirium after adjusting for various confounders. The OR of delirium increased with increasing NT-proBNP levels after the turning point of 7.8 (log-transformed pg/ml). The adjusted regression coefficients were 1.19 (95% CI 0.95–1.49, P =0.134) for NT-proBNP less than 7.8 (log-transformed pg/ml) and 2.78 (95% CI 1.09–7.12, P =0.033) for NT-proBNP greater than 7.8 (log-transformed pg/ml). No association was found between left ventricular ejection fraction and postoperative delirium. Conclusion: Preoperative cardiac function parameters including NT-proBNP and New York Heart Association functional classification can predict the incidence of delirium following cardiac surgery. We suggest incorporating an early determination of preoperative cardiac function as a readily available risk assessment for delirium prior to cardiac surgery. [ABSTRACT FROM AUTHOR]

Aim: The aims of this study are: (a) to determine the incidence of postoperative delirium (POD) among surgical intensive care unit (ICU) patients in China and identify risk factors, especially, which are modifiable and have value for developing a prediction model; (b) to develop and validate a prediction model of delirium to recognize high‐risk patients in surgical ICUs; (c) to investigate the short‐ and long‐term outcomes of delirious patients and identify the predictors of patient outcomes. Design: A single‐centre prospective cohort study. Methods: Patients will be enrolled from three surgical ICUs in a tertiary teaching hospital. Delirium assessment and perioperative data will be collected throughout the hospitalization. Delirious patients will be followed up for 2 years. The study was approved by the ethics committee in May 2018 and was funded by the clinical research grant from Zhongshan hospital, Fudan University, Shanghai. Discussion: Developing POD can be a burden to patients both for the short‐ and long‐term period. Due to the lack of effective treatments for POD, prevention remains the best strategy. This study will provide an effective tool for early screening of high‐risk patients of POD and provide a better understanding of the aetiology and outcome of delirium. Impact: In clinical practice, a prediction model will offer an effective tool for ICU nurses to assess high‐risk patients, which can support them to implement preventive strategies at the early stages to targeted patients. The follow‐up results will help us better understand the impact of delirium on patients' long‐term outcome. [ABSTRACT FROM AUTHOR]

Inhibition of histone deacetylase (HDAC) has been regarded as a potential therapeutic approach for treatment of multiple diseases including cancer. Based on pharmacophore model of HDAC inhibitors, a series of quinoline-based N -hydroxycinnamamides and N -hydroxybenzamides were designed and synthesized as potent HDAC inhibitors. All target compounds were evaluated for their in vitro HDAC inhibitory activities and anti-proliferative activities and the best compound 4a surpass Vorinostat in both enzymatic inhibitory activity and cellular anti-proliferative activity. In terms of HDAC isoforms selectivity, compounds 4a exhibited preferable inhibition for class I HDACs, especially for HDAC8, the IC 50 value (442 nM) was much lower than that of Vorinostat (7468 nM). Subsequently, we performed class I & IIa HDACs whole cell enzyme assay to evaluate inhibitory activity in whole cell context. Compounds 4a and 4e displayed much better cellular activity for class I HDACs than that for class IIa HDACs, which indicated that 4a and 4e might be potent class I HDAC inhibitors. Meanwhile, flow cytometry analysis showed that compound 4a and 4e can promote cell apoptosis in vitro . [ABSTRACT FROM AUTHOR]

Many studies have developed or validated prediction models to estimate the risk of delirium after cardiac surgery, but the quality of the model development and model applicability remain unknown. To systematically review and critically evaluate currently available prediction models for delirium after cardiac surgery. PubMed, EMBASE, and MEDLINE were systematically searched. This systematic review was registered in PROSPERO (Registration ID: CRD42021251226). Prospective or retrospective cohort studies were considered eligible if they developed or validated prediction models or scoring systems for delirium in the ICU. We included studies involving adults (age ≥ 18 years) undergoing cardiac surgery and excluded studies that did not validate a prediction model. Data extraction was independently performed by two authors using a standardized data extraction form based on the Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modeling Studies checklist. Quality of the models was assessed with the Prediction Model Risk of Bias Assessment Tool (PROBAST). Of 5469 screened studies, 13 studies described 10 prediction models. The postoperative delirium incidence varied from 11.3 % to 51.6 %. The most frequently used predictors were age and cognitive impairment. The reported areas under the curve or C-statistics were between of 0.74 and 0.91 in the derivation set. The reported AUCs in the external validation set were between 0.54 and 0.90. All the studies had a high risk of bias, mainly owing to poor reporting of the outcome domain and analysis domain; 10 studies were of high concern regarding applicability. The current models for predicting postoperative delirium in the ICU after cardiac surgery had a high risk of bias according to the PROBAST. Future studies should focus on improving current prediction models or developing new models with rigorous methodology. [ABSTRACT FROM AUTHOR]

A mild method to convert optically pure amino acid thiourea and urea derivatives to thiohydantoins and hydantoins, respectively, is described. It provides an efficient way to realize enantioselective synthesis of thiohydantoins and hydantoins with good to high isolated yields and enantiomeric purities. We found that the enantiomeric purities were highly dependent on the reaction conditions including bases, solvents, and temperature. [ABSTRACT FROM AUTHOR]

The article presents chemical equations related to the article "Enantioselective Synthesis of 3,5-Disubstituted Thiohydantoins and Hydantoins" by Yu Chen published in the "Tetrahedron" in 2015.