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Abstract Telemedicine has gained popularity due to the increasing use of technology in our lives. However, no studies have explored the demographic factors affecting acceptability, desirability and adherence (ADA) to telemedicine in Singapore. Our study aims to evaluate the level of ADA of telemedicine services within demographic factors and to explore the association of potential demographic factors with the degree of acceptability, desirability and adherence of telemedicine among older adults in Singapore. A cross-sectional study was conducted with Singapore citizens or permanent residents aged 40–99 years, who were able to provide informed consent. Interviewers conducted door-to-door surveys in 67 Blocks of Housing & Development Board flats in Singapore, offering a self-administered electronic questionnaire available in four languages. Random sampling without replacement determined the order of blocks, floors and units visited. The questionnaire utilised Qtelemediab scoring and covered sociodemographic data, usage of telemedicine, as well as ADA towards telemedicine. A total of 324 valid responses were analysed. Increased age was associated with a significant decrease across all three domains of ADA namely acceptability (β = − 0.02, 95%CI − 0.03; − 0.02, p-value = 0.002), desirability (β = − 0.02, 95%CI − 0.02; − 0.02, p-value

Rationale: Warthin tumor (WT) is the second most common benign tumor in salivary gland. It has a slow growth rate and most frequently occurs in the parotid gland. Most patients present with an incidental finding of a painless mass inferior/anterior to the ear. Besides the epithelial component of the tumor, WT is characteristically associated with lymphoid stroma that is considered benign. While there have been a few reports of malignant transformation of the lymphoid components in WT, cases of WT concomitant with mantle cell lymphoma (MCL) are extremely rare. To the best of our knowledge, two cases have been described in the English literature. Herein, we report a case of WT concomitant with MCL in a 70-year-old female patient, and emphasize the importance of careful examination of lymphoid stroma in WT so that concurrent lymphoma is not missed. Patient concerns: A 70-year-old Chinese woman with a 40-year history of cigarette smoking presented with a one year history of a right submaxillary mass with recent enlargement. Diagnosis: Cervical ultrasound (US) and computed tomography (CT) scans of the neck revealed a well-circumscribed mass in the right parotid with a maximum diameter of 3.1 cm. Surgical resection of the mass was performed. Histopathological examination revealed a characteristic double-layer of neoplastic epithelium with prominent lymphoid stroma, suggesting WT. In addition, morphology and immunohistochemistry studies confirmed the coexistence of MCL. Thereafter, the final diagnosis of this case was WT concomitant with MCL. Interventions: The patient was staged as stage I after clinical assessment. Due to the slow growth of parotid lesions, close observation was decided with periodic clinical and radiological monitoring. Outcomes: Currently, the patient demonstrates a stable disease by clinical evaluation. Lessons: To the best of our knowledge, reported cases of WT concomitant with MCL are very rare. This case highlights the importance of a comprehensive assessment of the lymphoid stroma of WT to avoid missed diagnosis of a lymphoma component in a collision tumor. [ABSTRACT FROM AUTHOR]

Panax notoginseng saponins (PNS) are the main active components of Panax notoginseng. But after oral administration, they need to be converted into rare ginsenosides by human gut microbiota and gastric juice before they can be readily absorbed into the bloodstream and exert their effects. The sources of rare ginsenosides are extremely limited in P. notoginseng and other medical plants, which hinders their application in functional foods and drugs. Therefore, the production of rare ginsenosides by the transformation of PNS using Aspergillus fumigatus was studied in this research. During 50 days at 25 ℃ and 150 rpm, A. fumigatus transformed PNS to 14 products (1–14). They were isolated by varied chromatographic methods, such as silica gel column chromatography, Rp-C18 reversed phase column chromatography, semi-preparative HPLC, Sephadex LH-20 gel column chromatography, and elucidated on the basis of their 1H-NMR, 13C-NMR and ESIMS spectroscopic data. Then, the transformed products (1–14) were isolated and identified as Rk3, Rh4, 20 (R)-Rh1, 20 (S)-Protopanaxatriol, C-K, 20 (R)-Rg3, 20 (S)-Rg3, 20 (S)-Rg2, 20 (R)-R2, Rk1, Rg5, 20 (S)-R2, 20 (R)-Rg2, and 20 (S)-I, respectively. In addition, all transformed products (1–14) were tested for their antimicrobial activity. Among them, compounds 5 (C-K) and 7 [20 (S)-Rg3] showed moderate antimicrobial activities against Staphylococcus aureus and Candida albicans with MIC values of 6.25, 1.25 μg/mL and 1.25, 25 μg/mL, respectively. This study lays the foundation for production of rare ginsenosides. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effect of homemade green ripe period chewing tablets on gastrointestinal function in mice. The free combination of Kunming mice was divided into a blank control group, a positive control group, a model control group, a green ripe period Tuokexun apricot fruit group, a low-dose group of green ripe period Tuokexun apricot chewable tablets, a medium dose group of green ripe period Tuokexun apricot chewable tablets, and a high-dose group of green ripe period Tuokexun apricot chewable tablets. After 7 days of adaptive feeding, loperamide hydrochloride was used in the mouse model of constipation, through studies of gastrointestinal function in mice, the effects of first blue stool time, the number of defecation grains, fecal moisture content, small bowel propulsion rate, colon water content, and gastric emptying rate were obtained. Results showed that there were significant differences in various indicators between the low, medium, and high dose groups of the green ripening stage Tuokexun apricot chewing tablets and the constipation model control group, positive control group, and green ripening stage Tuokexun apricot fruit group. This indicated that the green ripe period Tuokexun apricot chewing tablets could significantly improve the small intestine propulsion rate, shorten the defecation time, increase the number of defecated particles in 6 hours, increase gastric emptying rate, fecal water content, and colon water content in constipation model mice, through deeply studying the laxative mechanism, showing that it could regulate the content of P substance and vasoactive intestinal peptide, promote intestinal peristalsis, and improve constipation. [ABSTRACT FROM AUTHOR]

In situ cyclized polyacrylonitrile (CPAN) is developed to replace n‐type metal oxide semiconductors (TiO2 or SnO2) as an electron selective layer (ESL) for highly efficient and stable n‐i‐p perovskite solar cells (PSCs). The CPAN layer is fabricated via facile in situ cyclization reaction of polyacrylonitrile (PAN) coated on a conducting glass substrate. The CPAN layer is robust and insoluble in common solvents, and possesses n‐type semiconductor properties with a high electron mobility of 4.13×10−3 cm2 V−1 s−1. With the CPAN as an ESL, the PSC affords a power conversion efficiency (PCE) of 23.12 %, which is the highest for the n‐i‐p PSCs with organic ESLs. Moreover, the device with the CPAN layer holds superior operational stability, maintaining over 90 % of their initial efficiency after 500 h continuous light soaking. These results confirm that the CPAN layer would be a desirable low‐cost and efficient ESL for n‐i‐p PSCs and other photoelectronic devices with high performance and stability. [ABSTRACT FROM AUTHOR]

The effect of compatibilizer on the nanofibril morphology, vlscoelas;ticity, mechanical properties;, and CFIM behavior of polypropylene (PP)/nylon6 (PA6) composite through a combination of in-ssitu fibrillation (INF) and chemical foam injection molding (CFIM) technologies;. The ressults; indicated that the addition of PP-g-MAH compatibilizer reduced the sSize of PA6 dispersion phasse significantly, and PA6 microfibers were uniformly distributed in the PP matrix with an average diameter of about 265nm. The existence of a microfiber network structure and the synergistic enhancement effect of phasse interface improved the mechanical strength of INF composites; significantly. The tensile sstrength and impact sStrength of the composites; are 26. 2 % and 62 % higher than thosse of pure PP, respectively. Bassed on the CFIM experiment using the sself-made endothermic-exothermic equilibrium chemical foaming agent, the INF composite foam product was; prepared with a cell size of 62 ^m and a cell density of nearly 5 X105 cells/cm3. The ass-prepared ssample obtained a decreasse in the weight by 12 %. Compared to pure PP foam, the composite foam exhibited an increase in the sSpecific tensile sStrength and impact strength by 17 % and 46 %, resspectively. [ABSTRACT FROM AUTHOR]

AbstractA new cladosporol derivative xylophilum A (1), together with 10 known compounds (2–11), were isolated from the rice fermentation of the fungus Cladosporium xylophilum. Their structures were established by extensive spectroscopic methods and comparison of their NMR data with literatures. The antimicrobial activity of compound 1 against 11 kinds of pathogenic microbial was evaluated, but no significant activity was found (MIC >100 μg/ml). [ABSTRACT FROM AUTHOR]

Hyperspectral anomaly detection can separate sparse anomalies from the low-rank background component under an unsupervised behavior due to sufficient spectral information. Therefore, hyperspectral image anomaly detection technology has great application potential and value in public security and national defense. Currently, most existing models attempt to detect anomalous targets with a sparsity prior, without further considering the visual saliency of the targets themselves. To tackle this issue, this paper proposes a saliency-guided sparse low-rank tensor approximation model, called SSLR, to detect anomalous targets from hyperspectral remote sensing images in an unsupervised manner. Specifically, we first explore the saliency information of each pixel for regularizing the sparse anomaly matrix. We then suggest a three-directional tensor nuclear norm to obtain a low-rank background to characterize the background component. We solve the SSLR optimization problem by an efficient alternating direction method of multipliers framework. Experiments conducted on benchmark hyperspectral datasets demonstrate that the proposed SSLR outperforms some state-of-the-art anomaly detection methods. [ABSTRACT FROM AUTHOR]

Background: Deuterium metabolic imaging (DMI) has emerged as a promising non-invasive technique for studying metabolism in vivo. This review aims to summarize the current developments and discuss the futures in DMI technique in vivo. Methods: A systematic literature review was conducted based on the PRISMA 2020 statement by two authors. Specific technical details and potential applications of DMI in vivo were summarized, including strategies of deuterated metabolites detection, deuterium-labeled tracers and corresponding metabolic pathways in vivo, potential clinical applications, routes of tracer administration, quantitative evaluations of metabolisms, and spatial resolution. Results: Of the 2,248 articles initially retrieved, 34 were finally included, highlighting 2 strategies for detecting deuterated metabolites: direct and indirect DMI. Various deuterated tracers (e.g., [6,6′-2H2]glucose, [2,2,2′-2H3]acetate) were utilized in DMI to detect and quantify different metabolic pathways such as glycolysis, tricarboxylic acid cycle, and fatty acid oxidation. The quantifications (e.g., lactate level, lactate/glutamine and glutamate ratio) hold promise for diagnosing malignancies and assessing early anti-tumor treatment responses. Tracers can be administered orally, intravenously, or intraperitoneally, either through bolus administration or continuous infusion. For metabolic quantification, both serial time point methods (including kinetic analysis and calculation of area under the curves) and single time point quantifications are viable. However, insufficient spatial resolution remains a major challenge in DMI (e.g., 3.3-mL spatial resolution with 10-min acquisition at 3 T). Conclusions: Enhancing spatial resolution can facilitate the clinical translation of DMI. Furthermore, optimizing tracer synthesis, administration protocols, and quantification methodologies will further enhance their clinical applicability. Relevance statement: Deuterium metabolic imaging, a promising non-invasive technique, is systematically discussed in this review for its current progression, limitations, and future directions in studying in vivo energetic metabolism, displaying a relevant clinical potential. Key points: • Deuterium metabolic imaging (DMI) shows promise for studying in vivo energetic metabolism. • This review explores DMI's current state, limits, and future research directions comprehensively. • The clinical translation of DMI is mainly impeded by limitations in spatial resolution. [ABSTRACT FROM AUTHOR]

To overcome the jolt vibration impact of marine circuit breakers, this paper studies the relationship between the influence parameters and the contact performance of the contact system. A parametric approach is utilized to explore the effects of load size, pulse width, and different waveform loads on the vibration response of the contact system. The results show that the vibration increases with the increase in acceleration at peak contact acceleration. The ultimate upsetting acceleration peak of the contact system is determined to be 9.2 g. Large acceleration impacts should be avoided. As far as pulse width is concerned, the vibration response of the system with narrow pulse width is more sensitive than that with broad pulse width. So, monitoring of narrow pulses should be increased. Additionally, under various forms of load, the range of safe contact areas is triangular load, half-sine load, and step load in that order. Thus, circuit breakers need to increase the detection of step loads to prevent faults. The findings provide a theoretical foundation and guidance for the design of low-vibration marine circuit breakers and the improvement of their contact performance. [ABSTRACT FROM AUTHOR]

This research utilized single‐cell RNA sequencing to map the immune cell landscape in sepsis, revealing 28 distinct cell clusters and categorizing them into nine major types. Delving into the monocyte/macrophage subclusters, 12 unique subclusters are identified and pathway enrichment analyses are conducted using KEGG and GO, discovering enriched pathways such as oxidative phosphorylation and antigen processing. Further GSVA and AUCell assessments show varied activation of interferon pathways, especially in subclusters 4 and 11. The clinical correlation analysis reveals genes significantly linked to survival outcomes. Additionally, cellular differentiation in these subclusters is explored. Building on these insights, the differential gene expression within these subclusters is specifically scrutinized, which reveal MYOF as a key gene with elevated expression levels in the survivor group. This finding is further supported by in‐depth pathway enrichment analysis and the examination of cellular differentiation trajectories, where MYOF's role became evident in the context of immune response regulation and sepsis progression. Validating the role of the MYOF gene in sepsis, a dose‐dependent response to LPS in THP‐1 cells and C57 mice is observed. Finally, inter‐cellular communications are analyzed, particularly focusing on the MYOF+Mono/Macro subcluster, which indicates a pivotal role in immune regulation and potential therapeutic targeting. [ABSTRACT FROM AUTHOR]

Background: Immunotherapy based on the application of immune checkpoint inhibitors (ICIs) is one of the standard treatments for advanced non-small cell lung cancer (NSCLC). Non-alcoholic fatty liver Disease (NAFLD) has demonstrated predictive value for response to immunotherapy in non-lung cancer types. Our study investigated the effect of NAFLD on the efficacy of real-life use of ICIs for patients with stage III / IV NSCLC. Methods: The clinical and imaging data of patients with stage III / IV NSCLC who were first admitted to Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from March 2020 to July 2022 were retrospectively collected to ensure that they underwent at least one CT scan before treatment. A total of 479 patients were divided into the NAFLD group (Liver/Spleen density ratio ≤ 1) and the non-NAFLD group (Liver/Spleen density ratio > 1) by measuring the baseline liver and spleen CT value. The overall survival (OS), progression-free survival (PFS), objective response rate (ORR) and disease control rate (DCR) of the patients were obtained. Results: A total of 118 patients with NAFLD and 361 patients without NAFLD were included in the study. Patients with NAFLD tended to have higher BMI and higher total bilirubin compared to patients without NAFLD. The median duration of follow-up in the study was 22 m (IQR, 17–29 m). Both of 2 groups had a higher DCR (94% vs. 92%, p = 0.199) and ORR (38.1% vs. 44.9%, p = 0.452) respectively. There was no difference in efficacy between the two groups. In univariate analysis, NAFLD had no significant effect on PFS (p = 0.785) and OS (p = 0.851). Surprisingly, the presence of hypertension was observed to be associated with a higher OS (HR 1.471 95%CI 1.018–2.127, p = 0.040). Besides, based on multivariate analysis, lactic dehydrogenase was associated with PFS (HR 1.001 95%CI 1.000,1.002, p = 0.037) and OS (HR 1.002, 95%CI 1.001–1.003, p < 0.001). Conclusions: Among patients with NSCLC, NAFLD did not result in changes in survival or disease progression after immune checkpoint inhibitor therapy. [ABSTRACT FROM AUTHOR]

The generation of radiological results from image data represents a pivotal aspect of medical image analysis. The latest iteration of ChatGPT-4, a large multimodal model that integrates both text and image inputs, including dermatoscopy images, histology images, and X-ray images, has attracted considerable attention in the field of radiology. To further investigate the performance of ChatGPT-4 in medical image recognition, we examined the ability of ChatGPT-4 to recognize credible osteosarcoma X-ray images. The results demonstrated that ChatGPT-4 can more accurately diagnose bone with or without significant space-occupying lesions but has a limited ability to differentiate between malignant lesions in bone compared to adjacent normal tissue. Thus far, the current capabilities of ChatGPT-4 are insufficient to make a reliable imaging diagnosis of osteosarcoma. Therefore, users should be aware of the limitations of this technology. [ABSTRACT FROM AUTHOR]

The heavy fermion physics is dictated by subtle competing exchange interactions, posing a challenge to their understanding. One-dimensional (1D) Kondo lattice model has attracted special attention in theory, because of its exact solvability and expected unusual quantum criticality. However, such experimental material systems are extremely rare. Here, we demonstrate the realization of quasi-1D Kondo lattice behavior in a monolayer van der Waals crystal NbSe2, that is driven into a stripe phase via Se-deficient line defects. Spectroscopic imaging scanning tunneling microscopy measurements and first-principles calculations indicate that the stripe-phase NbSe2 undergoes a novel charge-density wave transition, creating a matrix of local magnetic moments. The Kondo lattice behavior is manifested as a Fano resonance at the Fermi energy that prevails the entire film with a high Kondo temperature. Importantly, coherent Kondo screening occurs only in the direction of the stripes. Upon approaching defects, the Fano resonance exhibits prominent spatial 1D oscillations along the stripe direction, reminiscent of Kondo holes in a quasi-1D Kondo lattice. Our findings provide a platform for exploring anisotropic Kondo lattice behavior in the monolayer limit. The realization of heavy-fermion physics in van der Waals materials with d-electrons has attracted attention recently. Here the authors present evidence for a quasi-1D Kondo lattice in monolayer NbSe2, driven into a stripe phase by Se-deficient line defects created during growth. [ABSTRACT FROM AUTHOR]

Background: Pelvic floor dysfunction (PFD) is an extremely widespread urogynecologic disorder, the prevalence of which increases with aging. PFD has severely affected women's quality of life and has been called a social cancer. While previous studies have identified risk factors such as vaginal delivery and obesity for PFD, other reproductive factors, including age at menarche (AAMA), have been largely overlooked. Therefore, we used a Mendelian randomization (MR) study for the first time to investigate the potential causal relationship between reproductive factors and PFD. Methods: We obtained summary statistics from genome-wide association studies (GWAS) for female genital prolapse (FGP), stress urinary incontinence (SUI), and five reproductive factors. Two-sample Mendelian randomization analysis (TSMR) was performed to explore the causal associations between these factors. The causal effects of reproductive factors on FGP and SUI were primarily estimated using the standard inverse variance weighting (IVW) method, with additional complementary and sensitivity analyses conducted using multiple approaches. A multivariate Mendelian randomization (MVMR) study was also conducted to adjust for pleiotropic effects and possible sources of selection bias and to identify independent exposure factors. Results: Our findings revealed that advanced age at first sexual intercourse (AFS) and age at first birth (AFB) exhibited negative causal effects on both FGP and SUI. AAMA showed negative causal effects solely on FGP, while age at last live birth (ALB) and age at menopause (AAMO) did not demonstrate any causal effect on either FGP or SUI. And the MVMR results showed that AFB and AFS had independent negative causal effects on FGP and SUI, respectively. Conclusions: This study, for the first time, investigates the causal relationship between reproductive factors and PFD. The results suggested a causal relationship between some reproductive factors, such as AFB and AFS, and PFD, but there were significant differences between FGPand SUI. Therefore, future studies should explore the underlying mechanisms and develop preventive measures for reproductive factors to reduce the disease burden of PFD. [ABSTRACT FROM AUTHOR]