Search

Graphical Abstract: Irradiation response and dislocation loop damage in coarse-grained (a) and nanocrystallinegrained (b) W-based HEAs as compared to coarse-grained (c) and nanocrystalline-grained (d) pure W material.

Background: The Forrest classification is widely applied to guide endoscopic hemostasis for peptic ulcer bleeding. Accordingly, practice guidelines suggest medical treatment only for ulcer with a Forrest IIc lesion because it has low rebleeding risk even without endoscopic therapy, ranging from 0 to 13%. However, the risk ranges widely and it is unclear who is at risk of rebleeding with such a lesion. This study assessed whether the Rockall score, which evaluates patients holistically, could indicate the risk of recurrent bleeding among patients with a Forrest IIc lesion at the second-look endoscopy. Methods: Patients who had peptic ulcer bleeding with Ia-IIb lesions received endoscopic hemostasis at the primary endoscopy, and they were enrolled if their Ia-IIb lesions had been fading to IIc at the second-look endoscopy after 48- to 72-h intravenous proton pump inhibitor (PPI) infusion. Primary outcomes were rebleeding during the 4th–14th day and 4th–28th day after the first bleeding episode. Results: The prospective cohort study enrolled 140 patients, who were divided into a Rockall scores ≥ 6 group or a Rockall scores < 6 group. The rebleeding rates in the Rockall scores ≥ 6 group and the Rockall scores < 6 group during the 4th–14th day and the 4th–28th day were 13/70 (18.6%) versus 2/70 (2.9%), p = 0.003 and 17/70 (24.3%) versus 3/70 (4.3%), p = 0.001, respectively, based on an intention-to-treat analysis and 5/62 (8.1%) versus 0/68 (0%), p = 0.023 and 6/59 (10.2%) versus 0/67 (0%), p = 0.009, respectively, based on a per-protocol analysis. The Kaplan–Meier curves showed that the Rockall scores ≥ 6 group had a significantly lower cumulative rebleeding-free proportion than the Rockall scores < 6 group (p = 0.01). Conclusions: Combined Rockall scores ≥ 6 on arrival with a Forrest IIc lesion at the second-look endoscopy can identify patients at risk of recurrent peptic ulcer bleeding following initial endoscopic and intravenous PPI treatment.

The binding sites of transcription factors (TFs) in upstream DNA regions are called transcription factor binding sites (TFBSs). TFBSs are important elements for regulating gene expression. To date, there have been few studies on the profiles of TFBSs in plants. In total, 4,873 sequences with 5ʹ upstream regions from 8530 wheat fl-cDNA sequences were used to predict TFBSs. We found 4572 TFBSs for the MADS TF family, which was twice as many as for bHLH (1951), B3 (1951), HB superfamily (1914), ERF (1820), and AP2/ERF (1725) TFs, and was approximately four times higher than the remaining TFBS types. The percentage of TFBSs and TF members showed a distinct distribution in different tissues. Overall, the distribution of TFBSs in the upstream regions of wheat fl-cDNA sequences had significant difference. Meanwhile, high frequencies of some types of TFBSs were found in specific regions in the upstream sequences. Both TFs and fl-cDNA with TFBSs predicted in the same tissues exhibited specific distribution preferences for regulating gene expression. The tissue-specific analysis of TFs and fl-cDNA with TFBSs provides useful information for functional research, and can be used to identify relationships between tissue-specific TFs and fl-cDNA with TFBSs. Moreover, the positional distribution of TFBSs indicates that some types of wheat TFBS have different positional distribution preferences in the upstream regions of genes.

The specific demands of a combat-sport discipline may be reflected in the perceptual–motor performance of its athletes. Taekwondo, which emphasizes kicking, might require faster perceptual processing to compensate for longer latencies to initiate lower-limb movements and to give rapid visual feedback for dynamic postural control, while Karate, which emphasizes both striking with the hands and kicking, might require exceptional eye–hand coordination and fast perceptual processing. In samples of 38 Taekwondo athletes (16 females, 22 males; mean age = 19.9 years, SD= 1.2), 24 Karate athletes (9 females, 15 males; mean age = 18.9 years, SD= 0.9), and 35 Nonathletes (20 females, 15 males; mean age = 20.6 years, SD= 1.5), we measured eye–hand coordination with the Finger–Nose–Finger task, and both perceptual-processing speed and attentional control with the Covert Orienting of Visual Attention (COVAT) task. Eye–hand coordination was significantly better for Karate athletes than for Taekwondo athletes and Nonathletes, but reaction times for the upper extremities in the COVAT task—indicative of perceptual-processing speed—were faster for Taekwondo athletes than for Karate athletes and Nonathletes. In addition, we found no significant difference among groups in attentional control, as indexed by the reaction-time cost of an invalid cue in the COVAT task. The results suggest that athletes in different combat sports exhibit distinct profiles of perceptual–motor performance.

The index of hemoglobin (IHb) has not been applied in colonoscopy to correlate the histological features of colon polyps. This study tested whether the net change of IHb values between polyp and normal mucosa correlates with the pathological features of colon polyps.

The index of hemoglobin (IHb) has not been applied in colonoscopy to correlate the histological features of colon polyps. This study tested whether the net change of IHb values between polyp and normal mucosa correlates with the pathological features of colon polyps. This study consecutively enrolled patients who underwent colonoscopy during September 2011–August 2012 in a single tertiary referral colorectal unit. Endoscopic pictures and IHb values of each part of the colon were taken at the levels of cecum, ascending colon, transverse colon, sigmoid colon, and rectum. The net change of IHb values was calculated as follows: IHb value of colon polyp minus that of the surrounding mucosa. A total of 117 patients (32 with hyperplastic polyp, 5 with sessile serrated adenoma, 53 with tubular adenoma, 10 with villotubular adenoma, and 3 with adenocarcinoma) were recruited. The net change of IHb values increased in following order: hyperplastic polyp, tubular adenoma, sessile serrated adenoma, villotubular adenoma, and adenocarcinoma (−3.8 ± 6.3, −1.2 ± 1.7, −1.2 ± 5.7, 2.9 ± 8.1, and 12.7 ± 9.3, respectively; p< 0.001). Alcohol drinking and serum hemoglobin level were two independent factors related to the IHb values of non‐polyp colon mucosa. Using a cutoff value of 2.4 for the net change of IHb values, selected based on the receiver operating characteristic curve analysis, the optimal sensitivity (52.9%) and specificity (75.6%) could be achieved for defining the polyp histology as an advanced colon lesion. The net change of IHb values between colon polyp and nonpolyp mucosa can correlate with the pathological features of colon polyps. A positive net change of IHb values may indicate a more adverse histological pattern with a higher malignant potential.

Adequate bowel preparation is an important quality indicator of colonoscopy. This study validated whether the bowel cleansing quality and adenoma detection rate (ADR) could be different between two bowel preparation schedules in individuals receiving health examinations.

Adequate bowel preparation is an important quality indicator of colonoscopy. This study validated whether the bowel cleansing quality and adenoma detection rate (ADR) could be different between two bowel preparation schedules in individuals receiving health examinations. We enrolled individuals who had received a colonoscopy as part of the regimen for their health checkup program with split‐dose phosphosoda for bowel preparation. Prior to December 31, 2012, the second dose of phosphosoda was administered at 10:00 pmbefore the day of the colonoscopy and the individuals were defined as the 10‐pmgroup. After January 1, 2013, the schedule was changed to 4:00 amthe same day as the colonoscopy and was defined as the 4‐amgroup. The bowel cleansing quality was assessed using the Aronchick scale. A total of 431 individuals were included, 259 in the 10‐pmgroup and 172 in the 4‐amgroup. The 4‐amgroup individuals had a higher rate of excellent or good bowel cleansing quality as compared with the 10‐PM group (77.3% vs. 22%, respectively; p< 0.001). The ADR was also higher in the 4‐amgroup than in the 10‐pmgroup (36% vs. 25.5%, respectively; p= 0.019). Modifying the time schedule of bowel preparation could improve bowel cleansing quality and increase the colonic ADR in a health management center.

Various hydrophobic groups were used to modify the silica membranes by the co-hydrolysis and condensation of 1,2-bis(triethoxysilyl)ethane and alkylsilanes. The hydrophobic property and surface roughness of silica membranes were characterized by water contact angle measurement and atomic force microscope, respectively. The results show that the hydrophobic property of modified silica membranes increases with increasing concentration of alkylsilane in the mixture, increasing surface roughness and increasing length of carbon chain in the alkyl groups.

Organic-inorganic hybrid silica were prepared via surfactant-mediated assembly of 1,2-bis (triethoxysilyl) ethane in a modified stöber process. Factors that affect the size of silica particles were investigated in detail. It is found that larger silica spheres are obtained under lower surfactant concentration, higher ammonia concentration and lower synthesis temperature; The size and dispersibility of silica particles also depend strongly on the amount of water in the mixture.

ABSTRACTThis study is conducted to explore the association between health behaviors and the COVID-19 vaccination based on the risk compensation concept among health-care workers in Taizhou, China. We conducted a self-administered online survey to estimate the health behaviors among the staff in a tertiary hospital in Taizhou, China, from May 18 to 21 May 2021. A total of 592 out of 660 subjects (89.7%) responded to the questionnaire after receiving an e-poster on WeChat. Subjects who had been inoculated with the COVID-19 vaccine were asked to mention the differences in their health behaviors before and after the vaccination. The results showed that there were no statistical differences in health behaviors between vaccinated and unvaccinated groups, except in terms of the type of gloves they used (62.8% in the vaccinated group and 49.2% in the unvaccinated group, p= .048). Subjects who received earlier COVID-19 vaccinations exhibited better health behaviors (22.40% increased for duration of wearing masks (P= .007), 25.40% increased for times of washing hands (P= .01), and 20.90% increased for times of wearing gloves (P= .01)). Subjects also revealed better health behaviors (washing hands, wearing gloves, and wearing masks) after vaccination compared to that before. In conclusion, concept of risk compensation was not applied in our findings. The health behaviors did not reduce after the COVID-19 vaccination, which even may improve health behaviors among health-care workers in the hospital setting.

Abstract: Background: We assessed whether the esophageal mucosa index of hemoglobin (IHb) could assist the Los Angeles (LA) classification in defining the severity of erosive reflux esophagitis (RE) and predicting the treatment response by esomeprazole. Methods: Five hundred twenty-four subjects (424 RE and 100 controls) with normal body mass index and hemoglobin had undergone endoscopy to confirm the RE grade by LA classification and to check the series of IHb values at every centimeter of the esophageal mucosa while withdrawing the endoscope to above the esophageal–gastric junction (EGJ). The RE cases had received esomeprazole for 8 weeks (40 mg/day) to assess the cumulative proportions of sustained symptomatic response (SSR). Results: The IHb value at the EGJ was higher in RE patients than in controls (P < 0.001). Selecting 70 as the cutoff IHb value at the EGJ, the efficacy to define RE achieved 95.8% (406/424) sensitivity and 94% (94/100) specificity. For the patients with same the LA grade, the length of IHb value >70 above the EGJ (L-IHb70) that is greater than 4 cm correlated with a poor cumulative rate of SSR (P < 0.01). Conclusion: The IHb value >70 at the EGJ is a reliable indicator of RE. The L-IHb70 can serve as a supplementary indicator to predict the response to esomeprazole index within the same LA grade.

Long-term surveillance of pyogenic liver abscess remains unavailable. We thus aimed to identify the recurrence rates of pyogenic liver abscess among various etiologies and pathogens, and to elucidate the factors related with this recurrence.

IMPORTANCE: There are different clinical practices regarding ultrasonography screening intervals for hepatocellular carcinoma (HCC) despite recommendations from international guidelines. OBJECTIVE: To evaluate whether ultrasonography screening using intervals suggested by international guidelines is associated with cancer stage shifting, reductions in mortality, and improved quality of life (QoL) for patients with HCC. DESIGN, SETTING, AND PARTICIPANTS: This nationwide comparative effectiveness research study estimated lifetime survival functions using interlinkages of 3 databases from Taiwan—the Taiwan National Health Insurance, Taiwan National Cancer Registry, and National Mortality Registry—combined with QoL measurements obtained from National Cheng Kung University Hospital. In total, 114?022 patients listed as having newly diagnosed HCC from 2002 through 2015 in the Taiwan National Cancer Registry were followed up until 2017. The QoL values of 1059 patients with HCC who visited National Cheng Kung University Hospital were prospectively measured with the European QoL-5 dimensions questionnaire from 2011 through 2019. Patients were categorized based on the time between their last ultrasonography screening and the index date (90 days prior to HCC diagnosis) as 1 of 5 subcohorts: 6 months (0-6 months), 12 months (7-12 months), 24 months (13-24 months), 36 months (25-36 months), and longer than 36 months (no screening in the previous 3 years). Data were analyzed from April 2020 to April 2021. MAIN OUTCOMES AND MEASURES: Life expectancy, quality-adjusted life expectancy, and loss of life expectancy or loss of quality-adjusted life expectancy compared with age-, sex-, and calendar year–matched cohorts. RESULTS: There were 59?194 patients with Barcelona Clinic Liver Cancer staging information, including 42?081 men (mean [SD] age, 62.2 [12.6] years) and 17?113 women (mean [SD] age, 69.0 [11.2] years). There was a consistent trend showing that the longer the interval between ultrasonography examinations, the higher the loss of life expectancy and loss of quality-adjusted life expectancy for both sexes. Loss of quality-adjusted life expectancy values for male subcohorts were 10.0 (95% CI, 9.1-10.9) quality-adjusted life-years (QALYs) for ultrasonography screening intervals of 6 months, 11.1 (95% CI, 10.4-11.8) QALYs for 12 months, 12.1 (95% CI, 11.5-12.7) QALYs for 24 months, 13.1 (95% CI, 12.6-13.6) QALYs for 36 months, and 14.6 (95% CI, 14.2-15.0) QALYs for longer than 36 months. Loss of quality-adjusted life expectancy values for female subcohorts were 9.0 (95% CI, 8.3-9.6) QALYs for 6 months, 9.7 (95% CI, 9.2-10.2) QALYs for 12 months, 10.3 (95% CI, 9.8-10.7) QALYs for 24 months, 10.7 (95% CI, 10.2-11.1) QALYs for 36 months, and 11.4 (95% CI, 11.0-11.8) QALYs for longer than 36 months. Patients with underlying hepatitis B virus infection or cirrhosis had the greatest improvement in life expectancy with shorter screening intervals. CONCLUSIONS AND RELEVANCE: Regular ultrasonography screening with intervals less than 6 to 12 months may be associated with early detection of HCC, save lives, and improve the quality of life for patients with HCC from a lifetime perspective.

The benefits of sodium-cooled fast reactors (SFR) are well known and include: the possibility of a closed fuel cycle, proliferation resistance, waste minimization and breeding capabilities. Metallic fuel used in SFR has well demonstrated irradiation performance. More studies are, however, necessary to optimize and extend operational and safety limits through reduction of uncertainties in transient fuel behaviors and fuel failure thresholds. This paper describes the experimental Research and Development (R&D) program aimed at providing the necessary data to support the development of SFR optimized safety limits. This program integrates Separate Effects Testing (SET) and Integral Effects Testing (IET), combined with advanced Modelling and Simulation (M&S) to provide "solution-driven, goal-oriented, science-based approach to nuclear energy development" described in the Department of Energy Office of Nuclear Energy (DOE-NE) Roadmap. This R&D program, finally, focuses on delivering the science-based information necessary for supporting the licensing and utilization of SFR based on metallic fuel. Three research areas centered on fuel development by SET testing are described in this paper: 1) Microstructural, Chemistry and Material properties; 2) Thermo-mechanical behavior; and 3) Source term and fission product behavior. Preliminary results from these SET studies and the current instruments and experimental plan are presented.