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Background: The goal of this study was to compare the procedural safety and long-term outcome associated with a combined catheter ablation and left atrial appendage occlusion (LAAO) procedure utilizing intracardiac echocardiography (ICE) guidance versus transesophageal echocardiography (TEE) guidance. The study focuses on implementing LAmbre and Watchman devices in patients diagnosed with nonvalvular atrial fibrillation (AF). Methods: A total of 363 patients diagnosed with nonvalvular AF and who underwent a combined procedure were prospectively enrolled between November 2017 and May 2022. Following 1:1 propensity score matching, the TEE group (n = 132) and ICE group (n = 132) were systematically compared in terms of the combined procedure, imaging parameters, events related to the procedure, and subsequent outcomes during follow-up, including mortality, stroke, bleeding, device-related thrombus (DRT), and peri-device leaks (PDLs). Results: The ICE group exhibited a significant reduction in total procedural duration (153.71 ± 31.71 vs. 174.74 ± 18.79 min), fluoroscopy radiation dosage (207.24 ± 108.39 vs. 268.61 ± 122.88 mGy), left atrial appendage occlusion procedure time (34.69 ± 10.91 vs. 51.46 ± 15.84 min), and contrast agent exposure (108.71 ± 37.59 vs. 158.41 ± 45.00 mL) compared to the TEE group. Angiography and ICE demonstrated a substantial correlation between the left atrial appendage (LAA) orifice and landing zone/LAA ostium (Pearson’s correlation coefficient r = 0.808 and 0.536/0.697, two-tailed p < 0.001). No occurrences of device-related embolism, thromboembolism, significant bleeding, or unexpected fatalities were observed in either group. Comparable rates of all-cause death (0.76% vs. 0.76%), stroke or transient ischemic attack (2.27% vs. 1.52%), severe bleeding (1.52% vs. 0.76%), PDL (23.81% vs. 24.62%), and DRT (1.52% vs. 1.52%) were noted after an average follow-up of 18.46 ± 7.70 months in both groups, with no discernible differences. Multivariate logistic regression analysis identified a correlation between LAA velocity and the risk of PDL. Conclusions: The effectiveness and safety of ICE-guided combined treatment were demonstrated to be comparable to TEE guidance, accompanied by the additional advantages of decreased procedure time and fluoroscopy radiation exposure. Clinical Trial Registration: NCT04391504, https://register.clinicaltrials.gov.

Abstract Purpose In recent years, considerable research has been conducted on the use of plant growth regulators (PGRs) to improve crop yields. Large amounts of PGRs are applied to regulate crop growth. However, few studies have assessed the impact of PGRs, which leave soil residues, on soil microorganisms, especially rhizobia. Methods In this study, the influence of inoculation of soybean roots with Sinorhizobium fredii and Bradyrhizobium japonicum exposed to gibberellin A3 (GA3) and mepiquat chloride (MC) on nodule number, nitrogenase activity, and a symbiotic nitrogen fixation gene (fixA) expression was studied. The nitrate content, free amino acids, and nitrate reductase activity of the roots, and seed yield and quality of soybean were measured. Result Nodulation was promoted to some extent, whereas nitrogenase activity and fixA expression were inhibited to some extent by treatment with GA3; however, these effects were reversed by treatment with MC. In a pot experiment to study phenotypic characteristics, rhizobia treatment in combination with GA3 or MC significantly improved soybean yield and seed nitrogen content, and increased the root nitrate content, free amino acid content, and nitrate reductase activity. Conclusion The results indicated that PGRs, which leave soil residues, have significant positive effects on the growth and activity of soybean and rhizobia.

Abstract Cases of multiple ectopic meningiomas in the lung coexisting with pulmonary malignancies are extremely rare in the clinic. On imaging, it is difficult to distinguish multiple ectopic meningiomas from lung cancer, which puts forward higher requirements for treatment. A 65‐year‐old female patient was admitted to our department for multiple nodules in both lungs. The patient underwent thoracoscopic wedge resection and segmental resection. Postoperative pathological examination found lung meningioma, atypical adenomatoid hyperplasia (AAH), carcinoma in situ (AIS), invasive adenocarcinoma, and other pathological types. In this case, pulmonary meningioma, AAH, AIS, and invasive adenocarcinoma of various pulmonary nodules were observed. This case, which has not been reported before, is unique in that it has multiple pathologic types in one organ. This puts forward higher requirements for clinical diagnosis and treatment.

Multi-objective evolutionary algorithm based on decomposition (MOEA/D) is effective to solve most multi-objective optimization problems (MOPs) in the past 20 years. However, the algorithm MOEA/D with constant weight vectors has bad performance in solving several MOPs with discontinuous Pareto front (PF). This paper analyses the limitations of the constant weight vectors in MOEA/D and explains the necessity of adjusting the weight vectors in the processing. This paper proposes a weight vector adjustment method for MOEA/D (MOEA/D-WVA). It deletes the weight vectors which have bad search direction, and adds some new weight vectors in the processing. Experimental studies are conducted on several MOPs with discontinuous PF to compare the MOEA/D-WVA with other state-of-the-art multi-objective optimization algorithms in solving those MOPs with complex PF. The results show MOEA/D-WVA performs better than other algorithms on those MOPs with discontinuous PF.

Multi-objective evolutionary algorithm based on decomposition (MOEA/D) has achieved great success in the field of evolutionary multi-objective optimization. It decomposes a multi-objective optimization problem into a number of scalar optimization sub-problems. Each sub-problem is optimized by using information from its neighboring sub-problems. Therefore, the neighborhood size of each sub-problem plays an important role in MOEA/D. Different neighborhood sizes are tested in this paper. Experimental results demonstrate that larger neighborhood size helps achieve better convergence and diversity with more CPU time and vice versa. MOEA/D uses constant neighborhood size during the whole process, and it is difficult to balance the convergence, diversity and running time. Therefore, this paper propose an algorithm based on MOEA/D. The algorithm adjusts the neighborhood size dynamically in different generations and different sub-problems to reduce the running time while the convergence and diversity of this algorithm are similar or better than other state-of-the-art algorithms. Compared to the original MOEA/D, experimental results show that adjusting the neighborhood size dynamically is a good way to reduce the running time significantly while maintaining the convergence and diversity. Furthermore, the algorithm proposed in this paper is compared with five state-of-the-art algorithms based on MOEA/D. The experimental results show that the proposed algorithm outperforms the others in efficiency while performs similarly in convergence and diversity.

Abstract Objective The present study aimed to investigate whether different preoperative left atrial appendage emptying speeds (LAAEVs) have an effect on left atrial function in patients with sinus arrhythmia after left atrial appendage closure (LAAC) combined with catheter ablation (CA). Methods A total of 163 patients with persistent non-valvular atrial fibrillation who received combined LAAC+CA surgery were included in the present study. Regular follow-up was conducted for 12 months, and patients with complete data and successful sinus rhythm recovery were selected as the study subjects (n = 82). The patients were divided into two groups: the LAAEV

Microglial abnormalities may contribute to neurodevelopmental disorders. PTEN is implicated as a susceptibility gene for autism spectrum disorders and its germline ablation in mice causes behavioral abnormalities. Here we find postnatal PTEN deletion in microglia causes deficits in sociability and novel object recognition test. Mutant mice harbor markedly more activated microglia that manifest enhanced phagocytosis. Interestingly, two-week postponement of microglia PTEN ablation leads to no social interaction defects, even though mutant microglia remain abnormal in adult animals. Disturbed neurodevelopment caused by early PTEN deletion in microglia is characterized by insufficient VGLUT1 protein in synaptosomes, likely a consequence of enhanced removal by microglia. In correlation, in vitro acute slice recordings demonstrate weakened synaptic inputs to layer 5 pyramidal neurons in the developing cortex. Therefore, microglial PTEN safeguards integrity of neural substrates underlying sociability in a developmentally determined manner.

AIM:To report our precaution practices for ocular surgeries under local anesthesia during COVID-19 outbreak and evaluate the respiration situation among the patients with medical face masks under ocular surgeries.METHODS:Sixty Chinese patients needed eye surgery treatment were recruited and given medical face masks as one of the COVID-19 precaution practices during eye surgery with local anesthesia. Oxygen supplementation and negative pressure drainage were applied to relieve the potential respiratory discomfort, and the respiratory comfort score was evaluated.RESULTS:Patients with medical face masks experienced mild to moderate respiratory discomfort with an overall mean score of 2.34±0.73. Supplementation of oxygen together with negative pressure drainage relieved this discomfort(overall mean score of 0.15±0.75; P

(1) Background: This study aimed to investigate the effect of an additional catheter ablation (CA) procedure on the risk of post-procedure adverse events during CA combined with left atrial appendage closure (LAAC). (2) Methods: From July 2017 to February 2022, data from 361 patients with atrial fibrillation who underwent LAAC at our center were analyzed retrospectively. The adverse events were compared between CA + LAAC and LAAC-only groups. (3) Results: The incidence of device-related thrombus (DRT) and embolic events was significantly lower in the CA + LAAC group than in the LAAC-only group (p = 0.01 and 0.04, respectively). A logistic regression analysis revealed that the combined procedure served as a protective factor for DRT (OR = 0.09; 95% confidence interval: 0.01–0.89; p = 0.04). Based on a Cox regression analysis, the risk of embolism marginally increased in patients aged ≥65 years (HR = 7.49, 95% CI: 0.85–66.22 p = 0.07), whereas the combined procedure was found to be a protective factor (HR = 0.25, 95% CI: 0.07–0.87 p = 0.03). Further subgroup and interaction analyses revealed similar results. (4) Conclusions: The combined procedure may be associated with a lower rate of post-procedure DRT and embolization without a higher occurrence of other adverse events after LAAC. A risk-score-based prediction model was conducted, showing a good prediction performance.

Combined ultrasound–microwave techniques and pre-enzymatic treatment (hemicellulase and cellulase) enhance essential oil isolation from Citrus reticulata Blanco (tangerine) leaves (CrBL). Subsequently, synergistic effects of modified amorphous octenyl succinic anhydride starch (OSA-MS), almond oil, and high-energy microfluidics were studied in synergy with ultrasound techniques in the production of CrBL essential oil (CrBL-EO) nanoemulsion (CrBL-EONE). GC–MS was used to study the extraction technique. Dynamic light scattering (DLS) analysis was used with confocal laser scanning microscopy (CLSM) techniques to investigate the nanoemulsion matrices’ physical and chemical properties. The D-limonene nanoemulsion (D-LNE) reached the optimal size of droplets (65.3 ± 1.1 r.nm), polydispersity index (PDI) (0.167 ± 0.015), and ζ-potential (−41.0 ± 0.4 mV). Besides, the CrBL-EONE obtained the optimal size of droplets (86.5 ± 0.5 r.nm), PDI (0.182 ± 0.012), and ζ-potential (−40.4 ± 0.8 mV). All the nanoparticle treatments showed significant values in terms of the creaming index (CI%) and inhibition activity (IA%) in the β-carotene/linoleate system with a low degradation rate (DR). The current study’s findings showed that integrated ultrasound–microwave techniques and pre-enzymatic treatment could enhance the extraction efficiency of the CrBL-EO. In addition, OSA-MS and almond oil can also be employed to produce CrBL-EONE and D-LNE.

BackgroundYanshan ginger (Alpinia zerumbet) is a perennial herb used as a medicine and spice, and is beneficial for soil and water conservation in karst areas. Given the widespread utilization of Yanshan ginger in China and continuing expansion of the planting area, disposal of waste materials is problematic. The branches and leaves of Yanshan ginger contain a variety of potent antibacterial compounds, such as volatile oils, phenols, and diterpenoids, which hinder their rapid degradation by microorganisms. In this study, we screened and constructed a composite microbial system to provide a technical reference for production of organic fertilizer from the branches and leaves of Yanshan ginger.MethodsA composite microbial system, "YanShan Jun" (YSJ), was developed by screening for efficient detoxification and degradation of the branches and leaves of Yanshan ginger. High-throughput sequencing technology was used to investigate the stability and diversity of YSJ subcultures. The culture conditions for YSJ were optimized by sequential single-factor experiments and response surface analysis. Yanshan ginger leaves and branches were inoculated with YSJ to study its effects on composting efficiency.ResultsThe microbial composition of YSJ was stable and rich in diversity through continuous subculture. Through response surface analysis, the optimized culture conditions for YSJ were determined as follows: peptone 8.0 g/L, sodium chloride 9.0 g/L, calcium carbonate 5.2 g/L, yeast powder 1.6 g/L, cultivation temperature 56.1°C, and culture duration 6 d. Under these conditions, the degradation rate of Yanshan ginger was 58.32%, which was 14.22% higher than that before optimization. The ability of YSJ to degrade the antibacterial compounds of ginger after optimization was significantly enhanced. Inoculation of Yanshan ginger compost with YSJ increased the fermentation temperature, prolonged the high-temperature period, and reduced the water content and pH of the compost in the early stage.ConclusionsInoculation of plant compost with YSJ bacteria improves the nutritional environment of the compost, promotes the composting reaction, promotes the rapid formation of a strong indigenous microflora, forms a beneficial microecological environment, and increases the composting efficiency. This study provides a theoretical basis for practical application of YSJ for organic fertilizer production from Yanshan ginger.

Background. The combined procedure of left atrial appendage closure (LAAC) and catheter ablation (CA) is a safe and feasible therapy to treat patients with atrial fibrillation (AF). However, the effect of the combined procedure on cardiac function remains unclear. This study aimed to investigate the changes in endocrine and mechanical function of the heart following the combined procedure. Methods. This retrospective study included 62 consecutive patients who underwent the combined procedure of AF ablation and WATCHMAN LAAC and 62 sex and age-matched patients who only received AF ablation. During follow-up, patients were examined for brain natriuretic peptide (BNP) levels to represent endocrine cardiac function. Mechanical cardiac function was assessed during echocardiographic examination by means of the LA ejection fraction, LA strain (Ƹ), and LA strain rate (SR). Results. (1) The BNP levels decreased acutely after the procedure, rose at day 3 postoperation, but trended downwards at 3 months postoperation in both groups. No significant difference was observed between the two groups. (2) LA ejection fraction, LA Ƹ, and SR exhibited a continuous upward trend over a 3-month follow-up in both groups. There was no significant difference in LA ejection fractions, SRe (the parameter of LA conduit function), and SRa (the parameter of LA booster pump function) between the two groups. However, the Ƹ and SRs (the parameters of LA reservoir function) improved in patients treated with CA alone. Conclusions. The combined procedure of LAAC and CA significantly improved the endocrine and mechanical function of the heart. Compared to simple CA, based on CA with LAAC intervention, it does not significantly change LA endocrine function but may lead to a decline in the LA reservoir function.

Objective. Long non-coding RNAs (lncRNAs) play many important roles in gene regulation and disease pathogenesis. Here, we sought to determine that mitochondrial dynamic related lncRNA (MDRL) modulates NLRP3 inflammasome activation and apoptosis of vascular smooth muscle cells (VSMCs) and protects arteries against atherosclerosis. Methods. In vivo experiments, we applied LDLR knockout (LDLR-/-) mice fed the high-fat diet to investigate the effects of MDRL on atherosclerosis. In vitro experiments, we applied mouse aortic smooth muscle cells to determine the mechanism of MDRL in abrogating NLRP3 inflammasome and inhibiting cell apoptosis through miR-361/sequentosome 1 (SQSTM1) by TUNEL staining, quantitative RT-PCR, western blot, microribonucleoprotein immunoprecipitation, and luciferase reporter assay. Results. Downregulated MDRL and increased NLRP3 were observed in mouse atherosclerotic plaques, accompanied with the increase of miR-361. The results showed that MDRL overexpression significantly attenuated the burden of atherosclerotic plaque and facilitated plaque stability through inhibiting NLRP3 inflammasome activation and cell apoptosis, and vice versa. Mechanically, MDRL suppressed NLRP3 inflammasome activation and VSMC apoptosis via suppressing miR-361. Furthermore, miR-361 directly bound to the 3’UTR of SQSTM1 and inhibited its translation, subsequently activating NLRP3 inflammasome. Systematic delivery of miR-361 partly counteracted the beneficial effects of MDRL overexpression on atherosclerotic development in LDLR-/- mice. Conclusions. In summary, MDRL alleviates NLRP3 inflammasome activation and apoptosis in VSMCs through miR-361/SQSTM1/NLRP3 pathway during atherogenesis. These data indicate that MDRL and inhibition of miR-361 represent potential therapeutic targets in atherosclerosis-related diseases.

Aims: Catheter ablation of paroxysmal atrial fibrillation (PAF) has been shown to be effective and safe. However, recurrence of PAF varies between 10 and 30% for radiofrequency ablation. There have been no reports comparing long-term recurrence rates following radiofrequency ablation, cryoablation, and three-dimensional guided cryoablation plus radiofrequency ablation. The aim of this study was to observe the long-term recurrence rate of PAF when treated by these three catheter ablation methods, and to explore clinical factors that can potentially predict PAF recurrence following catheter ablation.Methods: There were 238 patients involved in this study, including 106 radiofrequency (RF) ablation cases (RF group), 66 cryoablation cases (Freeze group), and 66 cases treated by three-dimensional guided cryoablation combined with radiofrequency ablation (Freeze-plus-RF group). All patients underwent standardized follow-up. The recurrence rate of atrial fibrillation (AF) in the three groups was calculated. Predictive factors for the recurrence of AF were also investigated.Results: At 48 months (the median follow-up period), the sinus rhythm maintenance rate was 77.4% in the RF group, 72.7% in the Freeze group, and 81.8% in the Freeze-plus-RF group. The maintenance rate of sinus rhythm was highest in the Freeze-plus-RF group, but differences among the three groups were not statistically significant. Further analysis found that the preoperative left atrial appendage emptying velocity (LAAEV) (recurrence vs. no recurrence, 56.58 ± 18.37 vs. 65.59 ± 18.83, respectively, p = 0.003), left atrial (LA) anteroposterior dimension (recurrence vs. no recurrence, 36.56 ± 4.65 vs. 35.00 ± 4.37, respectively; p = 0.028), and LA vertical dimension (recurrence vs. no recurrence, 56.31 ± 6.96 vs. 53.72 ± 6.52, respectively; p = 0.035) were related to postoperative recurrence. Multiple Cox regression analysis showed that only LAAEV was predictive of postoperative recurrence of PAF (hazard ratio: 0.979; 95% confidence interval: 0.961–0.997).Conclusion: Our study found that there was no statistically significant difference in long-term recurrence rates among the RF, Freeze, and Freeze-plus-RF groups. Preoperative LAAEV is an independent predictor of postoperative recurrence of PAF.

In recent years, the automatic machine for microbial identification and antibiotic susceptibility tests has been introduced into the microbiology laboratory of our hospital, but there are still many steps that need manual operation. The purpose of this study was to establish an auto-verification system for bacterial naming to improve the turnaround time (TAT) and reduce the burden on clinical laboratory technologists. After the basic interpretation of the gram staining results of microorganisms, the appearance of strain growth, etc., the 9 rules were formulated by the laboratory technologists specialized in microbiology for auto-verification of bacterial naming. The results showed that among 70,044 reports, the average pass rate of auto-verification was 68.2%, and the reason for the failure of auto-verification was further evaluated. It was found that the main causes reason the inconsistency between identification results and strain appearance rationality, the normal flora in the respiratory tract and urine that was identified, the identification limitation of the mass spectrometer, and so on. The average TAT for the preliminary report of bacterial naming was 35.2 h before, which was reduced to 31.9 h after auto-verification. In summary, after auto-verification, the laboratory could replace nearly 2/3 of manual verification and issuance of reports, reducing the daily workload of medical laboratory technologists by about 2 h. Moreover, the TAT on the preliminary identification report was reduced by 3.3 h on average, which could provide treatment evidence for clinicians in advance. [ABSTRACT FROM AUTHOR]

Multimodal composing has become increasingly common among language learners who encounter and produce multimodal texts in their daily lives. This study investigates the multimodal texts produced by English as a Foreign Language (EFL) learners who were provided with the opportunity to practice multimodal composing, with a focus on how semiotic modes are combined to form meaning. This study first examines the types of semiotic modes the learners embedded in their multimodal texts and then analyzes how these modes, in conjunction with textual descriptions, contribute to the overall meaning of the texts, using the concept of rhetorical purposes. The findings suggest affordances of semiotic modes are related to their rhetorical purposes in multimodal texts and that knowledge of these affordances can help learners compose more effective multimodal texts. [ABSTRACT FROM AUTHOR]

Background: Organophosphate flame retardants (OPFRs) are widely distributed in the environment and their metabolites are observed in urine, but little is known regarding OPFRs in a broad-spectrum young population from newborns to those aged 18 years. Objectives: Investigate urinary levels of OPFRs and OPFR metabolites in Taiwanese infants, young children, schoolchildren, and adolescents within the general population. Methods: Different age groups of subjects (n=136) were recruited from southern Taiwan to detect Σ10 OPFR metabolites in urine samples. Associations between urinary OPFRs and their corresponding metabolites and potential health status were also examined. Results: The mean level of urinary S10 OPFR in this broad-spectrum young population is 2.25 mg/L (standard deviation (SD) of 1.91 µg/L). 10 OPFR metabolites in urine are 3.25 ± 2.84, 3.06 ± 2.21, 1.75 ± 1.10, and 2.32 ± 2.29 mg/L in the age groups comprising of newborns, 1-5 year-olds, 6-10 year-olds, and 11-18 year-olds, respectively, and borderline significant differences were found in the different age groups (p=0.125). The OPFR metabolites of TCEP, BCEP, DPHP, TBEP, DBEP, and BDCPP predominate in urine and comprise more than 90% of the total. TBEP was highly correlated with DBEP in this population (r=0.845, p<0.001). The estimated daily intake (EDI) of Σ5OPFRs (TDCPP, TCEP, TBEP, TNBP, and TPHP) was 2,230, 461, 130, and 184 ng/kg bw/day for newborns, 1-5 yr children, 6-10 yr children, and 11-17 yr adolescents, respectively. The EDI of Σ5OPFRs for newborns was 4.83-17.2 times higher than the other age groups. Urinary OPFR metabolites are significantly correlated with birth length and chest circumference in newborns. Conclusion: To our knowledge, this is the first investigation of urinary OPFR metabolite levels in a broad-spectrum young population. There tended to be higher exposure rates in both newborns and pre-schoolers, though little is known about their exposure levels or factors leading to exposure in the young population. Further studies should clarify the exposure levels and factor relationships. [ABSTRACT FROM AUTHOR]