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Purpose: This study aims to report correlations between thyroid-stimulating immunoglobulin (TSI) and both clinical and radiological parameters in recent-onset symptomatic thyroid eye disease (TED) patients. Methods: A prospective cohort study of TED patients managed at the Chinese University of Hong Kong from January 2014 to May 2022. Serum TSI levels were determined with the functional assay. Outcomes included the Clinical Activity Score (CAS), marginal reflex distance1 (MRD1), extraocular muscle motility restriction (EOMy), exophthalmos, and diplopia. The radiological assessment included cross-sectional areas and signal of extraocular muscles on STIR-sequence MRI. Results: A total of 255 (197 female) treatment-naive patients, with an average onset age of 50 ± 14 years (mean ± s.d.), were included. Elevated pre-treatment TSI level was observed in 223 (88%) patients. There was a weak positive correlation between TSI and CAS (r = 0.28, P = 0.000031), MRD1 (r = 0.17, P = 0.0080), and the size of the levator palpebrae superioris/superior rectus complex (r = 0.25, P = 0.018). No significant correlation existed between TSI and STIR signals. The AUC and optimal cut-off value for clinical active TED were 0.67 (95% CI: 0.60–0.75) and 284% (specificity: 50%, sensitivity: 85%). In total, 64 patients received intravenous methylprednisolone (IVMP) during the study interval, and they had a higher baseline TSI level than those who did not have IVMP (P = 0.000044). Serial post-IVMP TSI among the 62 patients showed a significant reduction compared to the baseline level (P < 0.001). Both the baseline and post-IVMP TSI levels, and percentages of TSI changes were comparable between patients who responded and did not respond to the first course of IVMP. Conclusion: TSI can be a serum biomarker for the diagnosis, prognosis, and treatment response of TED. Further validation should be warranted.

Willingness to enroll in experiments plays a vital role in user-centered design, particularly in emerging domains such as wearable robots for daily living assistance, where recruiting older adults poses challenges. Guided by the integration of prospect theory and the senior technology acceptance model, this study aims to investigate the persuasive effects of message framing, specifically the valence (gain: positive framing versus loss: negative framing), in the form of flyers on older adults’ willingness to participate in real-life wearable robot experiments. The survey data were collected from 176 online participants (Mage = 61.05; SD = 6.49). Multivariate analysis of variance indicates that gain-framed messages significantly influence perceived health benefits (F(1, 174) = 14.363, p < .001, ɳ2 = .09, 95% CI: .03-1.00). However, message frames do not directly impact the perceived effectiveness of flyers or willingness to enroll. Mediation analysis reveals that gain-framed messages enhance older adults’ willingness to enroll in wearable robot experiments through their perception of health benefits (IE: β = −.19, 95% CI: −.38– −.06, p = .017). This study contributes to the understanding of the persuasive effects of message framing on older adults’ willingness to enroll in wearable robot experiments, ultimately fostering advancements in the field and enhancing health outcomes and well-being for older adults.

BackgroundThis study examined the social well-being of single older adults through the companionship of a social robot, LOVOT (Love+Robot; Groove X). It is designed as a companion for older adults, providing love and affection through verbal and physical interaction. We investigated older adults’ perceptions of the technology and how they benefitted from interacting with LOVOT, to guide the future development of social robots. ObjectiveThis study aimed to use a phenomenological research design to understand the participants’ experiences of companionship provided by the social robot. Our research focused on (1) examining the social well-being of single older adults through the companionship of social robots and (2) understanding the perceptions of single older adults when interacting with social robots. Given the prevalence of technology use to support aging, understanding single older adults’ social well-being and their perceptions of social robots is essential to guide future research on and design of social robots. MethodsA total of 5 single women, aged 60 to 75 years, participated in the study. The participants interacted independently with the robot for a week in their own homes and then participated in a poststudy interview to share their experiences. ResultsIn total, 4 main themes emerged from the participants’ interactions with LOVOT, such as caring for a social robot, comforting presence of the social robot, meaningful connections with the social robot, and preference for LOVOT over pets. ConclusionsThe results indicate that single older adults can obtain psychosocial support by interacting with LOVOT. LOVOT is easily accepted as a companion and makes single older adults feel like they have a greater sense of purpose and someone to connect with. This study suggests that social robots can provide companionship to older adults who live alone. Social robots can help alleviate loneliness by allowing single older adults to form social connections with robots as companions. These findings are particularly important given the rapid aging of the population and the increasing number of single-person households in Singapore.

Over the years, the Shaying River Basin has experienced frequent instances of river pollution. The presence of numerous critical pollutant discharge enterprises and sewage-treatment plants in the vicinity of the Shaying River has transformed it a major tributary with relatively serious pollution challenge within the upper reaches of Huaihe River Basin. To study the sources of manganese (Mn), chromium (Cr), nickel (Ni), arsenic (As), cadmium (Cd) and lead (Pb) in Shaying River water, 123 sets of surface water samples were collected from 41 sampling points across the entire basin during three distinct phases from 2019 to 2020, encompassing normal water period, dry season and wet season. The primary origins of heavy metals in river water were determined by analyzing the heavy metal contents in urban sewage wastewater, industrial sewage wastewater, groundwater, mine water, and the heavy metal contributions from agricultural non-point source pollution. The analytical findings reveal that Mn primarily originates from shallow groundwater used for agricultural irrigation, While Cr mainly is primarily sourced from urban sewage treatment plant effluents, coal washing wastewater, tannery wastewater, and industrial discharge related to metal processing and manufacturing. Ni is mainly contributed by urban sewage treatment plant effluents and industrial wastewater streams associated with machinery manufacturing and metal processing. Cd primarily linked to industrial wastewater, particularly from machinery manufacturing and metal processing facilities, while Pb is predominantly associated with urban sewage treatment plant effluents and wastewater generated in Pb processing and recycling wastewater. These research provides a crucial foundation for addressing the prevention and control of dissolved heavy metals at their sources in the Shaying River.

The microstructure and corrosion performance of wrought, laser powder bed fusion (LPBF), and MoNi over-alloyed LPBF type 316L stainless steel is compared. Adding Mo and Ni to LPBF 316L stainless steel resulted in ẟ-ferrite. Potentio-dynamic polarisation was used to rank all microstructures, with LPBF + MoNi has more resistant than LPBF and wrought material. Bipolar electrochemistry was applied, with LPBF samples having the lowest critical pitting potential and highest pit growth kinetics. The best corrosion performance was for LPBF + MoNi stainless steel. Different pitting corrosion resistance as function of process directions were found. The tiny pores negatively impacted the pitting performance.

Abstract Purpose Detecting tumor progression of glioma continues to pose a formidable challenge. The role of fibroblast activation protein (FAP) in gliomas has been demonstrated to facilitate tumor progression. Glioma-circulating biomarkers have not yet been used in clinical practice. This study seeks to evaluate the feasibility of glioma detection through the utilization of a serum FAP marker. Methods We adopted enzyme-linked immunosorbent assay (ELISA) technique to quantify the relative FAP level of serum autoantibodies in a cohort of 87 gliomas. The correlation between preoperative serum autoantibody relative FAP levels and postoperative pathology, including molecular pathology was investigated. A series of FAP tests were conducted on 33 cases of malignant gliomas in order to ascertain their efficacy in monitoring the progression of the disease in relation to imaging observations. To validate the presence of FAP expression in tumors, immunohistochemistry was conducted on four gliomas employing a FAP-specific antibody. Additionally, the investigation encompassed the correlation between postoperative tumor burden, as assessed through volumetric analysis, and the relative FAP level of serum autoantibodies. Results A considerable proportion of gliomas exhibited a significantly increased level of serum autoantibody relative FAP level. This elevation was closely associated with both histopathology and molecular pathology, and demonstrated longitudinal fluctuations and variations corresponding to the progression of the disease The correlation between the rise in serum autoantibody relative FAP level and tumor progression and/or exacerbation of symptoms was observed. Conclusions The measurement of serum autoantibody relative FAP level can be used to detect the disease as a valuable biomarker. The combined utilization of its detection alongside MR imaging has the potential to facilitate a more accurate and prompt diagnosis.

The ecological stoichiometric characteristics of soil elements have greatly enhanced our understanding of the circulation of soil nutrients. However, there is limited knowledge regarding the alteration of carbon, nitrogen, and phosphorus stoichiometric ratios in deep soil after afforestation. To examine the variations in stoichiometric ratios of soil elements with different vegetation types, restoration times, and soil depths, we collected soil samples from grassland, Caragana korshinskii shrubland, and Picea asperata forestland at different stand ages (10a, 25a, and 40a) in Xining City, which is located on the Loess Plateau. Our results showed that, at 25a, the carbon-to-nitrogen (C:N) and carbon-to-phosphorus (C:P) ratios were significantly higher in the grassland soil than under other vegetation types, whereas the nitrogen-to-phosphorus (N:P) ratio had no significant difference among the three vegetation types. At 40a, the ratios of soil C:N, C:P, and N:P in the shrubland were the highest. With the increasing of the restoration time, the ratios of soil C:N, C:P, and N:P in grassland with 25a became higher than for 40a or 10a. The ratios in the shrubland were highest at 40a, followed by 25a and then 10a, while the ratios in the forestland showed no significant difference. At 40a, the soil C:N, C:P, and N:P ratios of shrubland were highest at the soil depth of 40–100 cm. The soil C:N, C:P, and N:P ratios showed positive correlations with soil ammonium nitrogen and nitrate nitrogen, and the soil N:P ratios showed a negative correlation with soil available phosphorus. Plant diversity significantly influenced the soil stoichiometric ratio of the upper soil layer. In the upper soil layer (0–40 cm), species richness showed a positive correlation with soil C:N, C:P, and N:P ratios, and the Margalef index exhibited a positive correlation with soil C:N and C:P ratios. The results of this study indicate that the stoichiometric ratio and nutrient availability of Caragana korshinskii shrubland were the highest over time. Therefore, these findings can be served as a valuable reference for local revegetation and ecological restoration.

Abstract Background Spatial epidemiology plays an important role in public health. Yet, it is unclear whether the current university education in spatial epidemiology in China could meet the competency-oriented professional demands. This study aimed to understand the current situation of education and training, practical application, and potential demands in spatial epidemiology among public health postgraduates in China, and to assess the critical gaps in a future emerging infectious diseases (EID) pandemic preparedness and response. Methods This study was divided into three parts. The first part was a comparative study on spatial epidemiology education in international public health postgraduate training. The second part was a cross-sectional survey conducted among public health professionals. The third part was a nationwide cross-sectional survey conducted among public health postgraduates at Chinese universities from October 2020 to February 2021. Data was collected by the WeChat-based questionnaire star survey system and analyzed using the SPSS software. Results International education institutions had required public health postgraduates to master the essential knowledge and capacity of spatial epidemiology. A total of 198 public health professionals were surveyed, and they had a median of 4.00 (IQR 3.13–4.53) in demand degree of spatial epidemiology. A total of 1354 public health postgraduates were surveyed from 51 universities. Only 29.41% (15/51) of universities offered spatial epidemiology course. Around 8.05% (109/1354) of postgraduates had learned spatial epidemiology, and had a median of 1.05 (IQR 1.00–1.29) in learning degree and a median of 1.91 (IQR 1.05–2.78) in practical application degree of spatial epidemiology. To enhance professional capacity, 65.95% (893/1354) of postgraduates hoped that universities would deliver a credit-course of spatial epidemiology. Conclusions A huge unmet education and training demand in spatial epidemiology existed in the current education system of public health postgraduates in China. To enhance the competency-oriented professional capacity in preparedness and response to a future pandemic, it is urgent to incorporate the teaching and training of spatial epidemiology into the compulsory curriculum system of public health postgraduates in China.

Objective To investigate the clinical features, diagnosis and treatment of osteomyelitis of the jaw caused by an actinomycotic infection and to provide a reference for clinical diagnosis and treatment. Methods A case of osteomyelitis in the bilateral maxilla and the left zygomatic bone and arch caused by a mixed bacterial infection dominated by Actinomycetes was reviewed and analyzed in combination with the literature. Results The patient had left upper posterior tooth pain with repeated left facial swelling for 7 months. The patient's left face was swollen before surgery, the left maxillary alveolar bone was necrotic, and the upper palate showed fistula discharge. A maxillofacial magnetic resonance imaging scan excluded tumors and other space-occupying lesions. According to CBCT images, the initial diagnoses were left infraorbital space infection and osteomyelitis of the bilateral maxillary, the left zygomatic bone, the left zygomatic arch and the lateral orbital wall. Necrosis of the left maxilla and the zygomatic bone was excised, the focus was cleared and the focal tooth was extracted under general anesthesia. Histopathological results confirmed osteomyelitis and actinomycotic infection. Anti-inflammatory therapy with penicillin sodium was given before surgery, and piperacillin sodium and tazobactam sodium, dexamethasone sodium phosphate, tranexamic acid and mecobalamine were given after surgery. The patients' 6-month follow-up results showed that the maxillofacial shape was basically symmetrical; no ulceration, pus or abnormal secretion was found in the skin or intraoral mucosa; and the surgical area showed good recovery. A review of the relevant literature showed that Actinomyces is an opportunistic pathogen, and factors such as trauma and dental infection have been implicated in the pathogenesis of osteomyelitis. In addition to surgery, antibiotics are used to treat the disease and multidisciplinary symptomatic treatment combined with supportive treatment is required to achieve a better prognostic effect. Conclusion Actinomycotic osteomyelitis occurring in the maxilla and the zygomatic bone is an extremely rare disease that can be diagnosed by clinical manifestations, bacteriological examination and biopsy. Appropriate and effective penicillin drugs should be given at the initial stage of treatment, more sensitive antibiotics should be selected according to the results of the drug sensitivity test, and the lesions should be surgically removed when the patient's condition improves. Active symptomatic and supportive treatment should be performed during the treatment period.

Objectives A well-functioning health system ensures timely routine measles vaccinations for age-appropriate children, minimising measles risk. However, there is limited knowledge about the impact of the performance of immunisation programmes in health systems on the timeliness of measles vaccination. This study aimed to identify health system barriers to timely routine measles vaccination in rural southwest China, integrating the perspectives of township vaccination professionals and village doctors.Design, setting and participants Qualitative study among township vaccination professionals and village doctors in rural Guangxi, southwest China.Methods 20 focus group discussions (FGDs) at township level and 120 in-depth interviews (IDIs) at village level, based on a four-theme framework. We used convenience sampling to recruit 60 township vaccination professionals and 120 village doctors in 2015. Instruments used were a semistructured questionnaire and interview outlines. We collected township and village-level data focusing on themes of health resources allocation, pattern of vaccination services, management and supervision of vaccination services, and perceptions of vaccination policy. The FGDs and IDIs were audio-recorded and transcribed. Braun and Clarke’s thematic analysis approach was adopted to synthesise findings into meaningful subthemes, narrative text and illustrative quotations.Results The health system barriers to timely routine vaccinations were explored across four themes. Barriers in the health resources allocation theme comprised (1) inadequacy of vaccination-related human resources (eg, lack of township vaccination professionals and lack of young village doctors), and (2) incompatible and non-identical information system of vaccination services across regions. Barriers in the pattern of vaccination services theme included inflexible vaccination services models, for example, routine vaccination services being offered monthly on fixed vaccination days, limited numbers of vaccination days per month, vaccination days being set on non-local market days, vaccination days being clustered into a specific period and absence of formal vaccination appointments. Ineffective economic incentive mechanism was identified as a barrier in the management and supervision of vaccination services theme. Low-degree participation of village doctors in routine vaccination services was identified as a barrier in the perceptions of vaccination policy theme.Conclusions We encourage policymakers and stakeholders to apply these findings to improve the timeliness of routine vaccination. Barriers to timely routine vaccination include inadequate allocation of vaccination-related resources and inflexible vaccination service delivery models. Financial and non-financial incentives should be used to retain and recruit vaccination professionals and village doctors. Strengthening information systems with unified data standards enables cross-regional data exchange. Optimising immunisation services and rationalising vaccination days could eliminate health system barriers and improve vaccination timeliness in rural China.

Abstract Background Plant shape and structure are important factors in peanut breeding research. Constructing a three-dimension (3D) model can provide an effective digital tool for comprehensive and quantitative analysis of peanut plant structure. Fast and accurate are always the goals of the plant 3D model reconstruction research. Results We proposed a 3D reconstruction method based on dual RGB-D cameras for the peanut plant 3D model quickly and accurately. The two Kinect v2 were mirror symmetry placed on both sides of the peanut plant, and the point cloud data obtained were filtered twice to remove noise interference. After rotation and translation based on the corresponding geometric relationship, the point cloud acquired by the two Kinect v2 was converted to the same coordinate system and spliced into the 3D structure of the peanut plant. The experiment was conducted at various growth stages based on twenty potted peanuts. The plant traits’ height, width, length, and volume were calculated through the reconstructed 3D models, and manual measurement was also carried out during the experiment processing. The accuracy of the 3D model was evaluated through a synthetic coefficient, which was generated by calculating the average accuracy of the four traits. The test result showed that the average accuracy of the reconstructed peanut plant 3D model by this method is 93.42%. A comparative experiment with the iterative closest point (ICP) algorithm, a widely used 3D modeling algorithm, was additionally implemented to test the rapidity of this method. The test result shows that the proposed method is 2.54 times faster with approximated accuracy compared to the ICP method. Conclusions The reconstruction method for the 3D model of the peanut plant described in this paper is capable of rapidly and accurately establishing a 3D model of the peanut plant while also meeting the modeling requirements for other species' breeding processes. This study offers a potential tool to further explore the 3D model for improving traits and agronomic qualities of plants.

BackgroundGiven the rapidly aging nature of our global population, policy makers around the world are now emphatically promoting active aging. To address the psychosocial needs of older persons and support active aging, researchers are exploring the use of assistive technologies, specifically social robots as companions. However, there is limited evidence on the efficacy of social robots in promoting active aging for older people in the Hong Kong and Singapore contexts. ObjectiveThis study presents the protocol of a study that investigates the acceptance and quality of interaction between a Japanese social robot, LOVOT, and single older adults in Hong Kong and Singapore. MethodsWe used a baseline assessment to measure the primary outcome, participants’ acceptance of technology, and a sense of loneliness, namely, the participants’ differences in responses to LOVOT before and following their interaction with the social robot in this multimethod study design. The baseline assessment consisted of the Qualtrics survey, which measures senior technology acceptance, loneliness, older people’s quality of life, subjective happiness, cultural values, willingness to pay, and demographic characteristics, along with the LOVOT’s sociability and system usability. In the study, participants interacted with LOVOT in 3 sessions before being surveyed to measure the older people’s acceptance and attitudes toward LOVOT. A pre–social robot intervention also occurred in the first session. The study was conducted in both Hong Kong and Singapore. A total of 15 single older adults (ie, individuals who live alone) from Hong Kong and another 15 from Singapore were recruited. Participants were 60-75 years of age, lived by themselves, and had no known cognitive or mental issues. ResultsThe study began recruiting in March 2022, and recruitment was completed at the end of October 2022. Data collection and data set construction were completed at the end of January 2023. Analysis of the data is currently being conducted, and we plan to publish the results by mid-2023. ConclusionsAt an individual level, the study will clarify if LOVOT influences single older adults’ psychosocial well-being by reducing their loneliness. At a community level, the study’s findings will illustrate whether LOVOT can provide increased social connectedness while decreasing individual loneliness. Last, this study’s conclusions can inform policy makers to provide social robots to older people to improve their quality of life. Findings can also inform gerontechnology developers on which aspects and cultural considerations to take into account for future inventions. International Registered Report Identifier (IRRID)DERR1-10.2196/48618

In grassland ecosystems, the decomposition of litter serves as a vital conduit for nutrient transfer between plants and soil. The aim of this study was to depict the dynamic process of grass litter decomposition and explore its major driver. Three typical grasses [Stipa bungeana Trin (St. B), Artemisia sacrorun Ledeb (Ar. S), and Thymus mongolicus Ronniger (Th. M)] were selected for long-term litter decomposition. Experiments were conducted using three single litters, namely, St. B, Ar. S, and Th. M, and four different compositions of mixed litter: ML1 (55% St. B and 45% Th. M), ML2 (55% St. B and 45% Ar. S), ML3 (75% St. B and 25% Th. M), and ML4 (75% St. B and 25% Ar. S). The dynamic patterns of mass and microelements (Ca, Mg, Fe, Mn, Cu, and Zn) within different litter groups were analyzed. Our findings indicated that, after 1035 days of decomposition, the proportion of residual mass for the single litters was as follows: Th. M (60.6%) > St. B (47.3%) > Ar. S (44.3%), and for the mixed groups it was ML1 (48.0%) > ML3 (41.6%) > ML2 (40.9) > ML4 (38.4%). Mixed cultivation of the different litter groups accelerated the decomposition process, indicating that the mixture of litters had a synergistic effect on litter decomposition. The microelements of the litter exhibited an initial short-term increase followed by long-term decay. After 1035 days of decomposition, the microelements released from the litter were, in descending order, Mg > Ca > Fe > Cu > Mn > Zn. Compared to the separately decomposed St. B litter, mixing led to an inhibition of the release of Ca (antagonistic effect), while it promoted the release of Mg, Cu, and Zn (synergistic effect). For the single litter, the stepwise regression analysis showed that Ca was the dominant factor determining early litter decomposition. Mg, Mn, and Cu were the dominant factors regulating later litter decomposition. For the mixed litter groups, Ca, Mn, and Mg were the dominant factors closely related to early decomposition, and TN emerged as a key factor regulating the mass loss of mixtures during later decomposition. In summary, nitrogen and microelements co-drive the decomposition of typical grass litter. Our study underscores that, in the succession process of grassland, the presence of multiple co-existing species led to a faster loss of plant-derived materials (litter mass and internal elements), which was primarily modulated by species identity and uniformity.

Abstract Current therapies for treatment of proliferative retinopathy focus on retinal neovascularization (RNV) during advanced disease and can trigger adverse side-effects. Here, we have tested a new strategy for limiting neurovascular injury and promoting repair during early-stage disease. We have recently shown that treatment with a stable, pegylated drug form of the ureohydrolase enzyme arginase 1 (A1) provides neuroprotection in acute models of ischemia/reperfusion injury, optic nerve crush, and ischemic stroke. Now, we have determined the effects of this treatment on RNV, vascular repair, and retinal function in the mouse oxygen-induced retinopathy (OIR) model of retinopathy of prematurity (ROP). Our studies in the OIR model show that treatment with pegylated A1 (PEG-A1), inhibits pathological RNV, promotes angiogenic repair, and improves retinal function by a mechanism involving decreased expression of TNF, iNOS, and VEGF and increased expression of FGF2 and A1. We further show that A1 is expressed in myeloid cells and areas of RNV in retinal sections from mice with OIR and human diabetic retinopathy (DR) patients and in blood samples from ROP patients. Moreover, studies using knockout mice with hemizygous deletion of A1 show worsened RNV and retinal injury, supporting the protective role of A1 in limiting the OIR-induced pathology. Collectively, A1 is critically involved in reparative angiogenesis and neuroprotection in OIR. Pegylated A1 may offer a novel therapy for limiting retinal injury and promoting repair during proliferative retinopathy.

Abstract Cetirizine hydrochloride (CTZ), an antiallergic drug, is a new‐generation H1 receptor antagonist and a second‐generation H1 antihistamine. We aimed to prepare cetirizine hydrochloride liposomes, based on which cetirizine hydrochloride liposomal (CTZL) in situ gel (ISG) was prepared, to improve the retention time in the eye. CTZL were prepared by the ethanol injection method combined with the ammonium sulfate gradient method. A CTZ liposomal temperature‐sensitive gel was prepared using the cold dissolution method. Large‐eared white rabbits were used in retention and irritation experiments. The liposomes were small single‐chambered liposomes, spherical or sphere‐like, with a vesicle size of 187.03 ± 6.20 nm, an encapsulation efficiency of 70.39 ± 1.13%, and a drug loading capacity of 4.63 ± 0.06%. The gelling temperatures before and after dilution by simulated tear fluid were 26.1 ± 0.2°C and 34.2 ± 0.2°C, the vesicle size was 184.94 ± 7.28 nm, and the liposomes were spherical or sphere‐like in the gel matrix. The in vitro dissolution and release experiments indicate that the gel was released upon dissolution and exhibited a zero‐level release pattern. Preparation into liposomes and liposomal gels prolonged the ocular retention time of the formulation without ocular irritation.

Abstract Due to the rise in bacterial resistance, the antibacterial extractions from Chinese herbs have been used more frequently for wound care. In this work, baicalin, an extraction from the Chinese herb Scutellaria baicalensis, was utilized as the antibacterial component in the poly(ε-caprolactone)/MXene (PCL/Ti3C2TX) hybrid nanofibrous membranes for wound dressing. The results revealed that the presence of Ti3C2TX aided in the diameter reduction of the electrospun nanofibers. The PCL hybrid membrane containing 3 wt% Ti3C2TX nanoflakes and 5 wt% baicalin exhibited the smallest mean diameter of 210 nm. Meanwhile, the antibacterial tests demonstrated that the PCL ternary hybrid nanofibers containing Ti3C2TX and baicalin exhibited adequate antibacterial activity against the Gram-positive bacterial S. aureus due to the good synergistic effects of Ti3C2TX naoflakes and baicalin. The addition of Ti3C2TX nanoflakes and baicalin could significantly improve the hydrophilicity of the membranes, resulting in the release of baicalin from the nanofibers. In addition, the cytotoxicity of the nanofibers on rat skeletal myoblast L6 cells confirmed their good compatibility with these PCL-based nanofibrous membrances. This work offers a feasible way to prepare antibacterial nanofibrous membranes using Chinese herb extraction for wound dressing applications.

Zinc exposure has been linked with disordered glucose metabolism and type 2 diabetes mellitus (T2DM) development. However, the underlying mechanism remains unclear. We conducted population-based studies and in vitro experiments to explore potential role of microRNAs (miRNAs) in zinc-related hyperglycemia and T2DM. In the discovery stage, we identified plasma miRNAs expression profile for zinc exposure based on 87 community residents from the Wuhan-Zhuhai cohort through next-generation sequencing. MiRNAs profiling for T2DM was also performed among 9 pairs newly diagnosed T2DM-healthy controls. In the validating stage, plasma miRNA related to both of zinc exposure and T2DM among the discovery population was measured by qRT-PCR in 161 general individuals derived from the same cohort. Furthermore, zinc treated HepG2 cells with mimic or inhibitor were used to verify the regulating role of miR-144-3p. Based on the discovery and validating populations, we observed that miR-144-3p was positively associated with urinary zinc, hyperglycemia, and risk of T2DM. In vitro experiments confirmed that zinc-induced increase in miR-144-3p expression suppressed the target gene Nrf2 and downstream antioxidant enzymes, and aggravated insulin resistance. Our findings provided a novel clue for mechanism underlying zinc-induced glucose dysmetabolism and T2DM development, emphasizing the important role of miR-144-3p dysregulation.

Awards are ubiquitous but unique. Individual and organizational impacts of an award have been extensively discussed in the fields of business, manufacturing, education, and social work; little effort has been devoted to understanding the multilevel impacts of an award. This article seeks to propose an adapted socio-ecological model for the award program based on the Wofoo Asian Award for Advancing family well-being (3A Project), using a multimethod qualitative research design. Findings suggest that a multilevel perspective should be adopted in evaluating an award program; the 3A Project exhibited positive impacts at four levels. At the professional level, the 3A Project acted as a platform for multidisciplinary collaboration and knowledge transfer. At the organizational level, it encompassed six major impacts: being vision-driven, being growth-anchored, being leadership-sharing, being platform-sustaining, being knowledge-depositing, and being ecology-optimizing. At the community level, it cultivated positive values and beliefs about family well-being. At the regional and international level, it set a role model for promoting family well-being and achieved a special consultative status granted by the United Nations. The multilevel impacts made visible by the 3A Project provided insight into a social-ecological model of an award program that may help social workers and organizations strive for recognition.

Abstract. To better understand and gauge the severity of anhedonia, the Dimensional Anhedonia Rating Scale (DARS) was developed which focuses on assessing the four pleasure domains of anhedonia. Lacking any Asian data in the original study, a Chinese version of the DARS (C-DARS) was evaluated in this study. The scale was developed by backward and forward translations and reviewed by an expert panel and a focus group. One hundred fifty-one depressed patients were recruited. The internal consistency and test–retest reliability were confirmed (McDonald’s ω = .82); a confirmatory factor analysis showed a second-order model with adequate fit (RMSEA = .078, CFI = .945). Concurrent validity was examined by the correlations with the Chinese version of the Snaith–Hamilton Pleasure Scale (r = −.72, p < .001), while discriminant validity was examined with the Hamilton Depression Rating Scale (r = −.34, p < .001). The C-DARS was shown to be a psychometrically sound and valid measure of anhedonia severity ready for clinical use.

Antibiotic-producing organisms need to co-evolve self-protection mechanisms to avoid any damage to themselves caused by the antibiotic pharmacophore (the reactive part of the compound). In this study, the authors report a self-defense strategy in naphthyridinomycin (NDM)-producing Streptomyces lusitanus, that comprises reductive inactivation of the hemiaminal pharmacophore by short-chain dehydrogenases/reductases (SDRs) NapW and HomW.

3-Decalinoyltetramic acids (DTAs) are a class of natural products with chemical diversity and potent bioactivities. In fungal species there is a general biosynthetic route to synthesize this type of compounds, which usually features a polyketide synthase-nonribosomal peptide synthetase (PKS-NRPS) and a lipocalin-like Diels-Alderase (LLDAse). Using a synthetic biology approach, combining the bioinformatics analysis prediction and heterologous expression, we mined a PKS-NRPS and LLDAse encoding gene cluster from the plant pathogenic fungus Macrophomina phaseolina and characterized the cluster to be responsible for the biosynthesis of novel DTAs, macrophasetins. In addition, we investigated the biosynthesis of these compounds and validated the accuracy of the phylogeny-guided bioinformatics analysis prediction. Our results provided a proof of concept example to this approach, which may facilitate the discovery of novel DTAs from the fungal kingdom.

The recent increase in online instruction caused by the 2020 pandemic has reignited the debate over the efficacy of online instruction compared to in-person instruction. This study explored the impact various modes of instruction had on student achievement and compared students’ stated modality preference with their actual attendance behavior. Results show that while most students preferred in-person instruction (74%), only 47% of those who indicated they preferred in-person instruction attended class only in-person. Many attended classes utilizing a modality other than in-person, and several students switched their preferred modality away from in-person instruction. In general, students who attended class using a mixed modality or in-person achieved slightly better results than those attending class live online. However, the only statistically significant difference was between those participating predominantly in person and those watching class recordings (88% compared to 84% on average). Overall, many students achieved high grades regardless of their chosen instructional modality. In addition, students reported appreciating the option of multiple modalities when they could not attend class in their preferred modality. These results suggest offering a choice of modalities benefited many students.

Abstract Background Measles outbreaks re-emerged in 2013–2014 in Guangxi Zhuang Autonomous Region of China, where measles immunisation coverage is high. The discrepancy between the vaccination coverage and outbreaks indicates that timeliness is crucial, yet there is limited knowledge on the health system barriers to timely vaccination. Using integrated evidence at the household, village clinic, and township hospital levels, this study aimed to identify the determinants of failure in receiving timely measles vaccinations among children in rural Guangxi. Methods A multi-stage stratified cluster sampling survey with a nested qualitative study was conducted among children aged 18–54 months in Longan, Zhaoping, Wuxuan, and Longlin counties of Guangxi from June to August 2015. The status of timely vaccinations for the first dose of measles-containing vaccine (MCV1) and the second dose of measles-containing vaccine (MCV2) was verified via vaccination certificates. Data on household-level factors were collected using structured questionnaires, whereas data on village and township-level factors were obtained through in-depth interviews and focus group discussions. Determinants of untimely measles vaccinations were identified using multilevel logistic regression models. Results A total of 1216 target children at the household level, 120 villages, and 20 township hospitals were sampled. Children were more likely to have untimely vaccination when their primary guardian had poor vaccination knowledge [MCV1, odds ratio (OR) = 1.72; MCV2, OR = 1.51], had weak confidence in vaccines (MCV1, OR = 1.28–4.58; MCV2, OR = 1.42–3.12), had few practices towards vaccination (MCV1, OR = 12.5; MCV2, OR = 3.70), or had low satisfaction with vaccination service (MCV1, OR = 2.04; MCV2, OR = 2.08). This trend was also observed in children whose village doctor was not involved in routine vaccination service (MCV1, OR = 1.85; MCV2, OR = 2.11) or whose township hospital did not provide vaccination notices (MCV1, OR = 1.64; MCV2, OR = 2.05), vaccination appointment services (MCV1, OR = 2.96; MCV2, OR = 2.74), sufficient and uniformly distributed sessions for routine vaccination (MCV1, OR = 1.28; MCV2, OR = 1.17; MCV1, OR = 2.08), or vaccination service on local market days (MCV1, OR = 2.48). Conclusions Guardians with poor knowledge, weak beliefs, and little practice towards vaccination; non-involvement of village doctors in routine vaccinations; and inconvenient vaccination services in township hospitals may affect timely measles vaccinations among children in rural China. Graphical abstract

Background: Acrolein is a significant high priority hazardous air pollutant with pulmonary toxicity and the leading cause of most noncancer adverse respiratory effects among air toxics that draws great attention. Whether and how acrolein exposure impacts pulmonary function remain inconclusive. Objectives: To assess the association of acrolein exposure with pulmonary function and the underlying roles of oxidative DNA damage, inflammation, and pulmonary epithelium integrity. Methods: Among 3,279 Chinese adults from the Wuhan-Zhuhai cohort, associations of urinary acrolein metabolites (N-Acetyl-S-(2-carboxyethyl)-L-cysteine, CEMA; N-Acetyl-S-(3-hydroxypropyl)-L-cysteine, 3HPMA) as credible biomarkers of acrolein exposure with pulmonary function were analyzed by linear mixed models. Joint effects of biomarkers of oxidative DNA damage (8-hydroxy-deoxyguanosine), inflammation (C-reactive protein, CRP), and pulmonary epithelium integrity (Club cell secretory protein, CC16) with acrolein metabolites on pulmonary function and the mediating roles of these biomarkers were assessed. Besides, a subgroup (N = 138) was randomly recruited from the cohort to assess the stabilities of acrolein metabolites and their longitudinal associations with pulmonary function change in three years. Results: Significant inverse dose–response relationships between acrolein metabolites and pulmonary function were found. Each 10-fold increment in CEMA, 3HPMA, or ΣUACLM (CEMA + 3HPMA) was cross-sectionally related to a 68.56-, 40.98-, or 46.02-ml reduction in FVC and a 61.54-, 43.10-, or 50.14-ml reduction in FEV1, respectively (P

Abstract Background The prevalence of stress urinary incontinence (SUI) in adult female in Taiyuan and what are the related risk factors are not clear. The aim of this study was to provide a basis for exploring the prevention and treatment of SUI in adult female in Taiyuan. Methods A voluntary online questionnaire was used to investigate adult female in the community and surrounding townships of Taiyuan. Most of the questionnaires refer to the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms, and adapt to the specific circumstances of the region. Data were analyzed using SPSS software (version 22.0). Results A total of 4004 eligible questionnaires were obtained. The prevalence of SUI in adult female in Taiyuan was 33.5%. Univariate analysis and multivariate logistic regression analysis showed that place of residence, smoking, body mass index, diet, number of deliveries, mode of delivery, dystocia, menopause, oral contraceptives, urinary tract infection, making the bladder empty faster by pushing down and holding urine were risk factors for adult female stress urinary incontinence in Taiyuan. Conclusion The prevalence of SUI in adult female in Taiyuan was high, and based on risk factors identified in this survey, population-level intervention strategies should be developed for the prevention and treatment of adult female SUI in Taiyuan.

We report a case of aseptic abscess in the cavernous body at the base of the penis. In our clinical observation, the patient underwent puncture and drainage of the corpus cavernosum abscess, followed by surgical resection of the abscess wall, with the incisions closed layer by layer with primary suture. In addition, we paid attention to strengthening the postoperative management by using elastic bandages to wrap the penis intermittently to prevent edema; the incision would not be covered with dressings from the third day after the operation, so as to keep the incision site dry in an open way. During the period of indwelling of the catheter after the operation, we noticed the care of the external orifice of the urethra to reduce the occurrence of catheter-related infections. Finally, the patient was diagnosed with a penile aseptic abscess in the cavernous body at the base of the penis. The patient recovered well after surgery and was discharged 1 week later. At 1.5 years after the operation, the shape of the penis returned to normal, and the erectile function was normal. It was seen that good nursing concept is of great help for prognosis, which could avoid infection and edema, and is conducive to wound healing.

This paper explores a way of deploying the classical algorithm named genetic algorithm (GA) with the memristor. The memristor is a type of circuit device with both characteristics of storage and computing, which provides the similarity between electronic devices and biological components, such as neurons, and the structure of the memristor-based array is similar to that of chromosomes in genetics. Besides, it provides the similarity to the image gray-value matrix that can be applied to image restoration with GA. Thus, memristor-based GA is proposed and the experiment about image restoration using memristor-based GA is carried out in this paper. And parameters, such as the size of initial population and the number of iterations, are also set different values in the experiment, which demonstrates the feasibility of implementing GA with memristors.1

Acrylamide (ACR) exposure and consequent health hazards are alarming public health issues that attract worldwide concern. The World Health Organization urges more researches into health hazards from ACR exposure. However, whether and how ACR exposure increases cardiovascular risk remain unclear, and we sought to address these issues in this prospective cohort study conducted on 3024 general adults with 3-year follow-up (N = 871 at follow-up). Individual urinary ACR metabolites (N-Acetyl-S-(2-carbamoylethyl)-L-cysteine [AAMA] and N-Acetyl-S-(2-carbamoyl-2-hydroxyethyl)-L-cysteine [GAMA]) as credible biomarkers of ACR exposure were detected to assess their cross-sectional and longitudinal relationships with 10-year cardiovascular disease (CVD) risk, a well measure of overall cardiovascular risk. Besides, biomarkers of oxidative stress (urinary 8-hydroxy-deoxyguanosine [8-OHdG] and 8-iso-prostaglandin-F2α [8-iso-PGF2α]) and inflammation (circulating mean platelet volume [MPV] and plasma C-reactive protein [CRP]) as well as plasma transforming growth factor-β1 (TGF-β1) were measured to assess their mediating/mechanistic roles in the relationships of ACR metabolites with 10-year CVD risk. We found AAMA, GAMA, and ΣUAAM (AAMA + GAMA) were cross-sectionally and longitudinally related to increased 10-year CVD risk with odds ratios (95% confidence intervals [CIs]) of 1.32 (1.04, 1.70), 1.81 (1.36, 2.40), and 1.40 (1.07, 1.82), respectively, and risk ratios (95% CIs) of 1.99 (1.10, 3.60), 2.48 (1.27, 4.86), and 2.13 (1.15, 3.94), respectively. Furthermore, 8-OHdG, 8-iso-PGF2α, MPV, CRP, and TGF-β1 were found to significantly mediate 8.06–48.92% of the ACR metabolites-associated 10-year CVD risk increment. In summary, daily ACR exposure of general adults was cross-sectionally and longitudinally associated with increased cardiovascular risk, which was partly mediated by oxidative stress, inflammation, and TGF-β1, suggesting for the first time that ACR exposure may well increase cardiovascular risk of general adult population partly by mechanisms of inducing oxidative stress, inflammation, and TGF-β1. Our findings have important public health implications that provide potent epidemiological evidence and vital mechanistic insight into cardiovascular risk increment from ACR exposure.

Objective: We aim to analyze the effects of polycyclic aromatic hydrocarbons (PAHs) exposure and genetic predisposition on blood lipid through a longitudinal epidemiological study. Methods: We enrolled 4,356 observations who participated at baseline (n = 2,435) and 6-year follow-up (n = 1,921) from Wuhan-Zhuhai cohort. Ten urinary PAHs metabolites and blood lipid (i.e., total cholesterol [TC], triglycerides [TG], low-density lipoprotein cholesterol [LDL-C], and high-density lipoprotein cholesterol [HDL-C]) were measured at both baseline and follow-up. The polygenic risk scores (PRS) of blood lipid were constructed by the corresponding genome-wide association studies. Linear mixed models were fit to identify associations between urinary PAHs metabolites, blood lipid, and lipid-PRSs in the repeated-measure analysis. Besides, longitudinal relationships of blood lipid with urinary PAHs metabolites and respective lipid-PRSs were examined by using linear regression models. Results: Compared with subjects who had persistently low urinary total hydroxyphenanthrene (ΣOHPh), those with persistently high levels had an average increase of 0.137 mmol/l for TC and 0.129 mmol/l for LDL-C over 6 years. Each 1-unit increase of TC-, TG-, LDL-C-, and HDL-C-specific PRS were associated with an average increase of 0.438 mmol/l for TC, 0.264 mmol/l for TG, 0.198 mmol/l for LDL-C, and 0.043 mmol/l for HDL-C over 6 years, respectively. Compared with subjects who had low genetic risk and persistently low ΣOHPh, subjects with high LDL-specific PRS and persistently high ΣOHPh had an average increase of 0.652 mmol/l for LDL-C. Conclusions: Our results suggest that high-level ΣOHPh exposure is associated with an average increase of LDL-C over 6 years, and those relationships can be aggravated by a higher LDL-C-genetic risk. No significant relationships were observed between other PAHs metabolites (including hydroxynaphthalene, hydroxyfluorene, and hydroxypyrene) and blood lipid changes over 6 years. Our findings emphasize the importance of preventing PAHs exposure, particularly among those with a higher genetic predisposition of hyperlipidemia.

Background: The World Health Organization recommends young children aged 6–59 months receive influenza vaccination (IV) annually. This study investigated the IV incidence in a 12-month follow-up period among 24–59 month-old children and identified its predictors based on the theory of planned behavior (TPB). Methods: A population-based random telephone survey was conducted at baseline (March–June 2011) among Chinese parents of 24–59 month-old children in Hong Kong, China, and a follow-up survey was conducted 12 months afterwards (N = 440). Results: The IV prevalence was 63.2% at follow-up (3% increased from baseline). The IV incidence during the follow-up period for all sampled, ever-vaccinated, and never-vaccinated children was 35.6, 58.5, and 7.7 per 100 person-years, respectively. Stratified analyses of logistic regression were performed for the ever-vaccinated and never-vaccinated children. After adjusting for significant socio-demographic variable(s), parental positive attitude, norm, and behavioral intention were significant predictors of IV at follow-up among ever-vaccinated children, while intention was the only significant predictor among never-vaccinated children. Conclusions: Most of the IVs received during the follow-up period were re-vaccinations rather than first-time vaccinations. Efforts should target never-vaccinated children's parents, who reported low incidence and intention. TPB also worked less well among never-vaccinated children, and thus research for other predictors of never-vaccinated children's first-time vaccination are warranted. Promotion programs should consider segmentation by children's prior vaccination status.

The common method for evaluating the extent of grape disease is to classify the disease spots according to the area. The prerequisite for this operation is to accurately segment the disease spots. This paper presents an improved DeepLab v3+ deep learning network for the segmentation of grapevine leaf black rot spots. The ResNet101 network is used as the backbone network of DeepLab v3+, and a channel attention module is inserted into the residual module. Moreover, a feature fusion branch based on a feature pyramid network is added to the DeepLab v3+ encoder, which fuses feature maps of different levels. Test set TS1 from Plant Village and test set TS2 from an orchard field were used for testing to verify the segmentation performance of the method. In the test set TS1, the improved DeepLab v3+ had 0.848, 0.881, and 0.918 on the mean intersection over union (mIOU), recall, and F1-score evaluation indicators, respectively, which was 3.0, 2.3, and 1.7% greater than the original DeepLab v3+. In the test set TS2, the improved DeepLab v3+ improved the evaluation indicators mIOU, recall, and F1-score by 3.3, 2.5, and 1.9%, respectively. The test results show that the improved DeepLab v3+ has better segmentation performance. It is more suitable for the segmentation of grape leaf black rot spots and can be used as an effective tool for grape disease grade assessment.

Background: Phthalates have been largely used for years in varieties of products worldwide. However, research on the joint toxic effect of various phthalates exposure on the liver is lacking. Objectives: We aimed to assess exposure to phthalates on liver function tests (LFTs). Methods: This analysis included data on 6046 adults (≥20 years old) who participated in a National Health and Nutrition Examination Survey (NHANES) in 2007–2016. We employed linear regression and Bayesian kernel machine regression (BKMR), to explore the associations of urinary phthalate metabolites with 8 indicators of LFTs. Results: Di(2-ethylhexyl) phthalate (ΣDEHP) was found to be positively associated with serum alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT) and alkaline phosphatase (ALP) (all P FDR

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein is the main target for neutralizing antibodies. These antibodies can be elicited through immunization or passively transferred as therapeutics in the form of convalescent-phase sera or monoclonal antibodies (MAbs).

l-Kynurenine (Kyn) is an intermediate in the kynurenine pathway and is also found to be a building block or biosynthetic precursor to bioactive natural products. Recent studies revealed that l-Kyn can be incorporated via nonribosomal peptide synthetase (NRPS) biosynthetic routes to generate 1-benzazepine-containing compounds, while 1-benzazepine is a pharmaceutically important scaffold that is rarely found in natural products. Using a core biosynthetic enzyme-guided genome-mining approach, we discovered a biosynthetic gene cluster from Neosartorya pseudofischeri and identified that it encodes for the biosynthesis of pseudofisnins, novel 1-benzazepine-containing compounds. The biosynthetic pathway of pseudofisnins was elucidated through in vivo and in vitro experiments. The methyltransferase PseC from the pathway was biochemically characterized to be an iterative methyltransferase that catalyzes off-NRPS line di-methylation on an amine group.

For the problem of bending fatigue strength test of involute helical gear, the change regulations of bending stress and load distribution relation of helical gears with different tooth width and helical angle are researched by using RomaxDesigner. The contact line positions and the maximum stress are got, and it can be used to determine the loading position and load of helical gear in single tooth bending fatigue test. The simulation values of bending stress of different helical angle gears and the calculated values obtained by a series of correction coefficients in GB/T 3480—1997 are compared and analyzed. It is found that there is a big difference between them, which proves the necessity of bending fatigue test of helical gear. The test scheme of helical gear bending fatigue strength is raised. The results of helical gear bending fatigue test according to the method can be transformed into the national standard, which can be used in future to improve the accuracy of evaluating helical gear bending strength.

Background: Whether the weaning outcome of solid cancer patients receiving mechanical ventilation (MV) in the intensive care unit (ICU) is comparable to that in non-cancer patients is unknown. The aim of this study was to compare the weaning outcomes between non-cancer patients and patients with different types of cancer. Methods: We studied patients requiring MV during ICU stay for medical reasons between 2012 and 2014. Cancer patients were grouped into those with lung cancer (LC), head and neck cancer (HNC), hepatocellular carcinoma (HCC), and other cancers (OC). The primary endpoint was successful weaning at day 90 after the initiation of MV, and the main secondary endpoints were 28-day and 90-day mortality after ICU admission. Results: Five hundred and eighteen patients with solid cancers and 1362 non-cancer patients were recruited. The rate of successful weaning at day 90 was 57.9% in cancer patients, which was lower than 68.9% in non-cancer patients (p

Aiming to the demand for the fatigue life test of robot reducer， based on the fatigue life test method， a fatigue life test device is developed. The key parts of the test device are analyzed， and the test verification is carried out. Compared with the continuous rotary fatigue life test device， the test device adopts the inertia load of reciprocating swing， the actual working condition of the robot can be simulated， accelerated fatigue life of the precision reducer can be conducted efficiently and accurately， and the test precision is high， cost is low.

Abstract High gas‐uptake capacity is desirable for many reasons such as gas storage and sequestration. Moreover, ultrahigh capacity can enable a practical separation process by mitigating the selectivity factor that sometimes compromises separation efficiency. Herein, a single‐walled nickel–organic framework with an exceptionally high gas capture capability is reported. For example, C2H4 and C2H6 uptake capacities are at record‐setting levels of 224 and 289 cm3 g−1 at 273 K and 1 bar (169 and 110 cm3 g−1 at 298 K and 1 bar), respectively. Such ultrahigh capacities for both gases give rise to an excellent separation performance, as shown for C2H6/C2H4 with breakthrough times of 100, 60 and 30 min at 273, 283 and 298 K and under 1 atm. This new material is also shown to readily remove ethylene released from fruits, and once again, its ultrahigh capacity plays a key role in the extraordinary length of time achieved in the preservation of the fruit freshness.

The disease spots on the grape leaves can be detected by using the image processing and deep learning methods. However, the accuracy and efficiency of the detection are still the challenges. The convolutional substrate information is fuzzy, and the detection results are not satisfactory if the disease spot is relatively small. In particular, the detection will be difficult if the number of pixels of the spot is

BackgroundAs survivors of childhood cancer age, development of cancer treatment-related chronic health conditions often occur. This study aimed to describe the pattern of chronic prescription medication use and identify factors associated with polypharmacy among survivors of childhood cancer.MethodsThis was a retrospective study conducted at the pediatric oncology long-term follow-up clinic in Hong Kong. Eligible subjects included survivors who were (1) diagnosed with cancer before 18 years old, (2) were at least 3 years post-cancer diagnosis and had completed treatment for at least 30 days, and (3) receiving long-term follow-up care at the study site between 2015 and 2018. Dispensing records of eligible survivors were reviewed to identify medications taken daily for ≥30 days or used on an “as needed” basis for ≥6 months cumulatively within the past 12-month period. Polypharmacy was defined as the concurrent use of ≥5 chronic medications. Multivariable log-binomial modeling was conducted to identify treatment and clinical factors associated with medication use pattern and polypharmacy.ResultsThis study included 625 survivors (mean current age = 17.9 years, standard deviation [SD] = 7.2 years) who were 9.2 [5.2] years post-treatment. Approximately one-third (n = 219, 35.0%) of survivors were prescribed at least one chronic medication. Frequently prescribed medication classes include systemic antihistamines (26.5%), sex hormones (19.2%), and thyroid replacement therapy (16.0%). Overall prevalence of polypharmacy was 5.3% (n = 33). A higher rate of polypharmacy was found in survivors of CNS tumors (13.6%) than in survivors of hematological malignancies (4.3%) and other solid tumors (5.3%) (P = .0051). Higher medication burden was also observed in survivors who had undergone cranial radiation (RR = 6.31; 95% CI = 2.75–14.49) or hematopoietic stem-cell transplantation (HSCT) (RR = 3.53; 95% CI = 1.59–7.83).ConclusionAlthough polypharmacy was observed in a minority of included survivors of childhood cancer, chronic medication use was common. Special attention should be paid to survivors of CNS tumors and survivors who have undergone HSCT or cranial radiation. These individuals should be monitored closely for drug–drug interactions and adverse health outcomes that may result from multiple chronic medications, particularly during hospitalization in an acute care setting.

Augmentation of endogenous nitric oxide (NO) synthesis, either by the classical L-arginine-NO synthase pathway, or the recently discovered entero-salivary nitrate-nitrite-NO system, may slow the progression of autosomal dominant polycystic kidney disease (ADPKD). To test this hypothesis, the expression of NO in human ADPKD cell lines (WT 9-7, WT 9-12), and the effect of L-arginine on an in vitro model of three-dimensional cyst growth using MDCK cells, was examined. In addition, groups of homozygous Pkd1RC/RC mice (a hypomorphic genetic ortholog of ADPKD) received either low, moderate or high dose sodium nitrate (0.1, 1 or 10 mmol/kg/day), or sodium chloride (vehicle; 10 mmol/kg/day), supplemented drinking water from postnatal month 1 to 9 (n = 12 per group). In vitro, intracellular NO, as assessed by DAF-2/DA fluorescence, was reduced by >70% in human ADPKD cell lines, and L-arginine and the NO donor, sodium nitroprusside, both attenuated in vitro cyst growth by up to 18%. In contrast, in Pkd1RC/RC mice, sodium nitrate supplementation increased serum nitrate/nitrite levels by ~25-fold in the high dose group (P

BackgroundUnplanned readmissions rates are an important indicator of the quality of care provided in a psychiatric unit. However, there is no validated risk model to predict this outcome in patients with psychotic spectrum disorders.AimsThis paper aims to establish a clinical risk prediction model to predict 28-day unplanned readmission via the accident and emergency department after discharge from acute psychiatric units for patients with psychotic spectrum disorders.MethodAdult patients with psychotic spectrum disorders discharged within a 5-year period from all psychiatric units in Hong Kong were included in this study. Information on the socioeconomic background, past medical and psychiatric history, current discharge episode and Health of the Nation Outcome Scales (HoNOS) scores were used in a logistic regression to derive the risk model and the predictive variables. The sample was randomly split into two to derive (n = 10 219) and validate (n = 10 643) the model.ResultsThe rate of unplanned readmission was 7.09%. The risk factors for unplanned readmission include higher number of previous admissions, comorbid substance misuse, history of violence and a score of one or more in the discharge HoNOS overactivity or aggression item. Protective factors include older age, prescribing clozapine, living with family and relatives after discharge and imposition of conditional discharge. The model had moderate discriminative power with a c-statistic of 0.705 and 0.684 on the derivation and validation data-set.ConclusionsThe risk of readmission for each patient can be identified and adjustments in the treatment for those with a high risk may be implemented to prevent this undesirable outcome.

Abstract Background Elevated plasma homocysteine (Hcy) levels have been indicated as a strong and modifiable risk factor of ischemic stroke; the previous studies have shown that exposure to Hcy activates cultured microglia. However, whether neurotoxicity of Hcy involves microglia activation following brain ischemia and the underlying mechanisms remains incompletely understood. Methods The cerebral damage was evaluated by staining with 2,3,5-triphenyltetrazolium chloride, hematoxylin-eosin, and Fluoro Jade B. The activation state of microglia was assessed via immunoreaction using the microglial markers Iba1 and OX-42. Then, the inflammatory factors such as tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), and phosphorylated signal transducer and activator of transcription 3 (pSTAT3) were examined by Western blot analysis and fluorescence immunohistochemistry. Results Elevated Hcy level augmented brain damage and neural cell toxicity in the brain cortex and the dentate gyrus region of the hippocampus after cerebral ischemia/reperfusion. Meanwhile, Hcy activated microglia and induced the expression of the inflammatory factors such as TNF-α and IL-6. Moreover, Hcy caused an increase in pSTAT3 expression which occurs in microglial cells. AG490, a JAK2-STAT3 inhibitor, effectively inhibited the phosphorylation of STAT3, microglial cell activation and the secretion of IL-6, TNF-α raised by Hcy treatment. Conclusions STAT3 signaling pathway located in microglia plays a critical role in mediating Hcy-induced activation of microglia and neuroinflammation in rat MCAO model. This suggests the feasibility of targeting the JAK2/STAT3 pathway as an effective therapeutic strategy to alleviate the progression of Hcy-associated ischemia stroke.

Abstract Background Indigo naturalis is a Traditional Chinese Medicine (TCM) ingredient long-recognized as a therapy for several inflammatory conditions, including psoriasis. However, its mechanism is unknown due to lack of knowledge about the responsible chemical entity. We took a different approach to this challenge by investigating the molecular profile of Indigo naturalis treatment and impacted pathways. Methods A randomized, double-blind, placebo-controlled clinical study was conducted using Indigo naturalis as topical monotherapy to treat moderate plaque psoriasis in a Chinese cohort (n = 24). Patients were treated with Indigo naturalis ointment (n = 16) or matched placebo (n = 8) twice daily for 8 weeks, with 1 week of follow-up. Results At week 8, significant improvements in Psoriasis Area and Severity Index (PASI) scores from baseline were observed in Indigo naturalis-treated patients (56.3% had 75% improvement [PASI 75] response) compared with placebo (0.0%). A gene expression signature of moderate psoriasis was established from baseline skin biopsies, which included the up-regulation of the interleukin (IL)-17 pathway as a key component; Indigo naturalis treatment resulted in most of these signature genes returning toward normal, including down-regulation of the IL-17 pathway. Using an in vitro keratinocyte assay, an IL-17-inhibitory effect was observed for tryptanthrin, a component of Indigo naturalis. Conclusions This study demonstrated the clinical efficacy of Indigo naturalis in moderate psoriasis, and exemplified a novel experimental medicine approach to understand TCM targeting mechanisms. Trial registration NCT01901705 .

Abstract Background Malignant pleural mesothelioma (MPM) is a difficult-to-treat global disease. Pegylated arginase (BCT-100) has recently shown anti-tumor effects in hepatocellular carcinoma, acute myeloid leukemia and melanoma. This study aims to investigate the effects of PEG-BCT-100 in MPM. Methods A panel of 5 mesothelioma cell lines (H28, 211H, H226, H2052 and H2452) was used to study the in vitro effects of BCT-100 by crystal violet staining. The in vivo effects of BCT-100 were studied using 211H and H226 nude mice xenografts. Protein expression (argininosuccinate synthetase, ornithine transcarbamylase, cleaved PARP, cleaved caspase 3, cyclins (A2, D3, E1 and H), CDK4 and Ki67) and arginine concentration were evaluated by Western blot and ELISA respectively. Cellular localization of BCT-100 was detected by immunohistochemistry and immunoflorescence. TUNEL assay was used to identify cellular apoptotic events. Results Argininosuccinate synthetase was expressed in H28, H226, and H2452 cells as well as 211H and H266 xenografts. Ornithine transcarbamylase was undetectable in all cell lines and xenograft models. BCT-100 reduced in vitro cell viability (IC50 values at 13–24 mU/ml, 72 h) across different cell lines and suppressed tumor growth in both 211H and H226 xenograft models. BCT-100 (60 mg/kg) significantly suppressed tumor growth (p

The stress corrosion cracking of 2024-T351 aluminum alloy was investigated by finite element simulation analysis, scanning electron microscopy/energy dispersive spectrometry, and X-ray photoelectron spectroscopy through SO2 mixed salt spray test. Results indicate that stress corrosion cracking initiates preferentially at the region of stress concentration of the C-ring top for 2024-T351 aluminum alloy. The morphologies of loose corrosion products change from fine rod-like and flocculent to plate-like. Secondary cracks form in the internal corrosion crack after 6 h, when the corrosion time increases to 480 h, and the fractures and cracks in the surface of the C-ring side penetrate the whole sample. The C-ring sample completely breaks after 720 h. The opening crack propagation is a mixed mode of transgranular and intergranular, while the main cracks extend along the normal of the C-ring and the secondary cracks extend mainly along the grain boundaries.

Objective: This paper aimed to review the current literature on the surface modification of intraocular lenses (IOLs). Data Sources: All articles about surface modification of IOLs published up to 2015 were identified through a literature search on both PubMed and ScienceDirect. Study Selection: The articles on the surface modification of IOLs were included, but those on design modification and surface coating were excluded. Results: Technology of surface modification included plasma, ion beam, layer-by-layer self-assembly, ultraviolet radiation, and ozone. The main molecules introduced into IOLs surface were poly (ethylene glycol), polyhedral oligomeric silsesquioxane, 2-methacryloyloxyethyl phosphorylcholine, TiO 2 , heparin, F-heparin, titanium, titanium nitride, vinyl pyrrolidone, and inhibitors of cytokines. The surface modification either resulted in a more hydrophobic lens, a more hydrophilic lens, or a lens with a hydrophilic anterior and hydrophobic posterior surface. Advances in research regarding surface modification of IOLs had led to a better biocompatibility in both in vitro and animal experiments. Conclusion: The surface modification is an efficient, convenient, economic and promising method to improve the biocompatibility of IOLs.

The overall prognosis of colorectal cancer (CRC) patients is unsatisfactory due to cancer metastasis after operation. This study aims to investigate the clinical significance of plasma osteopontin (OPN) levels as minimally invasive, predictive, and surrogate biomarkers for prognosis of CRC patients.This randomized study design consists of pre-operative and post-operative plasma samples from a total of 79 patients. We determined plasma levels of OPN by ELISA and examined their correlation with the clinicopathological parameters of CRC patients. The effects of endogenous and exogenous OPN on CRC metastasis were investigated by examination of the effect on regulators of epithelial to messenchymal transition and migration assay.Our findings demonstrated for the first time the clinical correlation of plasma OPN with metastasis of CRC patients. High post-operative plasma OPN level (>153.02 ng/ml) associated with development of metastasis after curative resection (p

Beginning with the 1999-2000 influenza season, physicians throughout Hawaii ordering a viral culture for patients with suspected influenza were also offered influenza rapid testing. We compared the number of viral respiratory cultures sent to the Hawaii Department of Health and the number of providers who participated in influenza surveillance over consecutive influenza seasons. The number of viral respiratory cultures rose from 396 to 2,169 between the 1998-1999 and 2000-2001 influenza seasons, and the number of providers submitting >1 influenza culture increased from 34 to 327, respectively. The number of influenza isolates obtained each season also increased (from 64 to 491). The available data suggest that the changes observed in Hawaii’s influenza surveillance were not secondary to differences in influenza activity between seasons. This is the first evaluation of integrating influenza rapid testing into public health surveillance. Coupling rapid tests with cultures appears to be an effective means of improving influenza surveillance.

Recently, the high incidence of construction firm bankruptcies has underlined the importance of forecasting defaults in the construction industry. Early warning systems need to be developed to prevent or avert contractor default; additionally, this evaluation result could facilitate the selection of firms as collaboration or investment partners. Financial statements are considered one of the key basic evaluation tools for demonstrating firm strength. This investigation provides a framework for assessing the probability of construction contractor default based on financial ratios by using the Logit model. A total of 21 ratios, gathered into five financial groups, are utilized to perform univariate logit analysis and multivariate logit analysis for assessing contractor default probability. The empirical results indicate that using multivariate analysis by adding market factor to the liquidity, leverage, activity and profitability factors can increase the accuracy of default prediction more than using only four financial factors. While considering the market factor in the multivariate Logit model, clear incremental prediction performance appears in 1-year evaluation. This study thus suggests that the market factor comprises important information to increase the prediction performance of the model when applied to construction contractors, particularly in short-term evaluation.