Search

Purpose: The primary goal of this study was to identify characteristic features of peripheral degenerative retinoschisis (RS), schisis detachment (SD) and retinal detachment (RD) on both fundus autofluorescence (FAF) and infrared (IR) imaging, using spectral domain optical coherence tomography (SD-OCT) imaging of the peripheral retina as the confirmatory imaging tool. Methods: This is a descriptive case series study. A total of 27 eyes of 22 patients were included. Thirteen eyes of 10 patients diagnosed with RS, 4 eyes of 3 patients diagnosed with SD, and 10 eyes of 9 patients diagnosed with RD were included. Patients with images of poor quality were excluded. Heidelberg Spectralis HRA + OCT machine (Heidelberg Engineering, Heidelberg, Germany) were used to acquire the images. Results: All conditions appeared as areas of hypo-AF on FAF and hypo-reflectance on IR imaging. Accentuated vasculature of the lesion was noted with IR imaging due to elevation of the RS and RD, which was less frequently observed with FAF. On FAF, a hyper-AF leading edge around the RS lesion indicated the presence of intraretinal or subretinal fluid and an extension of the RS. Retinal breaks/holes were best visualized with IR imaging. SD-OCT confirmed the diagnosis in all performed cases. Conclusions: We were unable to differentiate between RS and RD based solely on findings from FAF and IR imaging. However, the combination of them with SD-OCT can assist in the diagnosis of RS from RD and in the evaluation of RS progression. OCT remains the main modality imaging to differentiate these conditions.

Background: The assessment of coronary microvascular dysfunction (CMD) using invasive methods is a field of growing interest, however the preferred method remains debated. Bolus and continuous thermodilution are commonly used methods, but weak agreement has been observed in patients with angina with non-obstructive coronary arteries (ANOCA). This study examined their agreement in revascularized acute coronary syndromes (ACS) and chronic coronary syndromes (CCS) patients. Objective: To compare bolus thermodilution and continuous thermodilution indices of CMD in revascularized ACS and CCS patients and assess their diagnostic agreement at pre-defined cut-off points. Methods: Patients from two centers underwent paired bolus and continuous thermodilution assessments after revascularization. CMD indices were compared between the two methods and their agreements at binary cut-off points were assessed. Results: Ninety-six patients and 116 vessels were included. The mean age was 64 ± 11 years, and 20 (21 %) were female. Overall, weak correlations were observed between the Index of Microcirculatory Resistance (IMR) and continuous thermodilution microvascular resistance (Rµ) (rho = 0.30p = 0.001). The median coronary flow reserve (CFR) from continuous thermodilution (CFRcont) and bolus thermodilution (CFRbolus) were 2.19 (1.76–2.67) and 2.55 (1.50–3.58), respectively (p

Objective: The impact of adjunctive manual thrombus aspiration (TA) in patients with stent thrombosis (ST) treated with percutaneous intervention has not been evaluated in the current era of potent P2Y12 agents and new-generation drug-eluting stents. We sought to assess the effect of TA using data from a large contemporary registry. Methods: The study population was derived from the Essex ST Investigation Registry (ESTHIR), which contains all consecutive cases of angiographically determined definite ST undergoing interventional treatment in a tertiary cardiac centre between November 2015 and June 2018. Propensity score matching was performed to match patients who underwent TA (TA group) to those who did not (n-TA group). The study endpoints were final TIMI flow and survival free of cardiovascular death (CD) or target lesion revascularisation (TLR). Results: A total of 128 ST patients were included in the present analysis. The mean age was 65 ± 11 years, and 84% were male. About 90% of the patients presented with STEMI, and 85% had very late ST. Seventy-two patients (56%) underwent TA. After propensity score matching, 30 patients were included in each study group. A higher rate of final TIMI III flow was observed in the TA group (TA vs n-TA group, 100% vs 83%), but this difference did not reach statistical significance (p = 0.052). At 1000 days of follow-up, survival free of CD or TLR was not different between the two groups (p = 0.8). Conclusion: In a propensity-matched population of ST patients undergoing PCI in a contemporary setting, TA was not associated with improved final TIMI flow or long-term cardiovascular outcomes.

Objectives: To assess differences in HIV testing at 6-months intervals over 24 months among intramuscular depot medroxyprogesterone acetate (DMPA-IM) injectable, levonorgestrel implant, or copper intrauterine devices (IUD) users in KwaZulu-Natal, South Africa, and Lusaka, Zambia. Testing at recommended intervals has not been previously assessed in long-acting reversible contraceptive (LARC) users (implant and IUD users) compared to those using effective but shorter-acting methods (such as DMPA-IM) in sub-Saharan Africa. Study design: As part of the longitudinal contraceptive use beyond ECHO (CUBE) study, we measured HIV testing over 24 months. Participants were considered continuous users of DMPA-IM, levonorgestrel implant, or copper IUD if they used the same method across all months of their study participation, or not continuous users of their baseline CUBE method if they switched or discontinued their method. We used multivariable logistic regression models with generalized estimating equations and robust standard errors, stratified by country, to assess differences in HIV testing. Results: Among the 498 participants, HIV testing rates were higher in Zambia for all methods compared to South Africa. In bivariate analyses, continuous implant or IUD users (the LARC users) were significantly less likely to report having received HIV testing at the 6-months and 24-months surveys, compared to continuous DMPA-IM users. In adjusted longitudinal models, continuous IUD users (adjusted odds ratio: 0.42, 95% CI: 0.24, 0.74), continuous implant users (adjusted odds ratio: 0.23, 95% CI: 0.12, 0.42) in South Africa had significantly lower odds of HIV testing compared to continuous DMPA-IM users. There were no significant differences in Zambia in the adjusted models. Conclusion: LARC use may reduce opportunities for HIV testing and users should be counseled on regular HIV testing and the option of HIV self-testing. Implications: Due to infrequent clinical contacts which may lead to lower rates of HIV testing at recommended intervals, LARC users should be provided opportunities to test for HIV at home or when seeking other health services.

Recent studies have emphasized the changes in large-scale brain networks related to healthy aging, with the ultimate purpose to aid in differentiating normal neurocognitive aging from neurodegenerative disorders that also arise with age. Emerging evidence from functional Magnetic Resonance Imaging (fMRI) indicates that connectivity patterns within specific brain networks, especially the Default Mode Network (DMN), distinguish those with Alzheimer's disease from healthy individuals. In addition, disruptive alterations in the large-scale brain systems that support high-level cognition are shown to accompany cognitive decline at the behavioral level, which is commonly observed in the aging populations, even in the absence of disease. Although fMRI is useful for assessing functional changes in brain networks, its high costs and limited accessibility discourage studies that need large populations. In this study, we investigated the aging-effect on large-scale networks of the human brain using high-density electroencephalography and electrophysiological source imaging, which is a less costly and more accessible alternative to fMRI. In particular, our study examined a group of healthy subjects in the age range from middle- to older-aged adults, which is an under-studied range in the literature. Employing a high-resolution computation model, our results revealed age associations in the connectivity pattern of DMN in a consistent manner with previous fMRI findings. Particularly, in combination with a standard battery of cognitive tests, our data showed that in the posterior cingulate / precuneus area of DMN higher brain connectivity was associated with lower performance on an episodic memory task. The findings demonstrate the feasibility of using electrophysiological imaging to characterize large-scale brain networks and suggest that changes in network connectivity are associated with normal aging.

Abstract Background Pulmonary endothelial injury and microcirculatory thromboses likely contribute to hypoxemic respiratory failure, the most common cause of death, in patients with COVID‐19. Randomized controlled trials (RCTs) suggest differences in the effect of therapeutic heparin between moderately and severely ill patients with COVID‐19. We did a systematic review and meta‐analysis of RCTs to determine the effects of therapeutic heparin in hospitalized patients with COVID‐19. Methods We searched PubMed, Embase, Web of Science, medRxiv, and medical conference proceedings for RCTs comparing therapeutic heparin with usual care, excluding trials that used oral anticoagulation or intermediate doses of heparin in the experimental arm. Mantel‐Haenszel fixed‐effect meta‐analysis was used to combine odds ratios (ORs). Results and Conclusions There were 3 RCTs that compared therapeutic heparin to lower doses of heparin in 2854 moderately ill ward patients, and 3 RCTs in 1191 severely ill patients receiving critical care. In moderately ill patients, there was a nonsignificant reduction in all‐cause death (OR, 0.76; 95% CI, 0.57‐1.02), but significant reductions in the composite of death or invasive mechanical ventilation (OR, 0.77; 95% CI, 0.60 0.98), and death or any thrombotic event (OR, 0.58; 95% CI, 0.45‐0.77). Organ support‐free days alive (OR, 1.29; 95% CI, 1.07‐1.57) were significantly increased with therapeutic heparin. There was a nonsignificant increase in major bleeding. In severely ill patients, there was no evidence for benefit of therapeutic heparin, with significant treatment‐by‐subgroup interactions with illness severity for all‐cause death (P = .034). In conclusion, therapeutic heparin is beneficial in moderately ill patients but not in severely ill patients hospitalized with COVID‐19.

Objectives: Invasive cervical cancer (ICC) is the leading cause of cancer-related death among women in Malawi. Barriers to screening for ICC in Malawi, such as long distances to health facilities and lack of public education about ICC, have hindered participation of women in ICC prevention programs. Given the burden of disease and barriers to screening, we implemented a community-based ICC screen-and-treat pilot study and present its successes and challenges. Study design: This study was a screen-and-treat pilot study using Visual Inspection with Acetic acid (VIA) for screening and same-day thermal ablation for treatment of pre-cancerous lesions. The pilot was implemented in four rural community settings in Lilongwe District, Malawi. Methods: With consultation from local leaders, as well as the UNC Project-Malawi Community Department and the Community Advisory Board, a team of researchers designed a rural, community-based ICC screen-and-treat pilot study. Over a 5-week period, we travelled to four rural communities to provide information about and screening for ICC and HIV through our study. The four selected rural locations were about an hour drive from Lilongwe City, Malawi. Detailed field notes were taken by study staff and then later analyzed and categorized as either strengths or challenges. Results: Successes included support from local leaders, high uptake of screening (408 women underwent VIA, representing 88% of eligible women), positive experiences during screening, and good communication between study staff and participants. This communication enabled us to quickly address misperceptions about the study intent and procedures and to better understand some of the barriers to care. Challenges included insufficient medication for diagnosed sexually transmitted infections, finding ways to engage interested women who were ineligible due to young age, and not screening interested women because they needed male partner approval. Conclusion: Community-based screen-and-treat programs with thermal ablation for ICC can be an effective way to engage hard-to-reach women in ICC preventive care. Our findings support existing literature which suggests that involvement of local leadership, women from the community, and their male partners, as well as ongoing peer education, may facilitate greater participation in ICC screening and treatment. In addition, we found ongoing communication between study staff and participants to be mutually beneficial. Finally, we suggest that future interventions consider bundling sexually transmitted infection treatment into ICC preventive care when engaging hard-to-reach populations.

Three-electrode configurations allow targeted studies of reaction mechanisms, including charge storage in and interphase formation on electrode materials for emerging sodium-ion batteries. However, using sodium metal as a reference electrode results in spontaneous formation of electroactive soluble decomposition products in an ester-based electrolyte. These electrolyte decomposition products undergo oxidation at carbon electrodes at potentials that can be mistaken for reversible sodium (de)intercalation, thus obscuring true measurements of material properties. Keywords: Sodium-ion batteries, Electroanalytical chemistry, Electrolyte decomposition

Background The prognostic impact of comorbidities in patients with sarcomas is not well defined. The aims of this study were to examine the implications of comorbidities and abnormal peripheral blood indices in patients with sarcomas.Methods A population-based database was assembled to extract patients with sarcoma in Hong Kong between January 2004 and March 2018. Charlson’s Comorbidity Index (CCI) score and prevalence of comorbidities, neutrophil, lymphocyte and platelet counts at diagnosis were assessed. The prognostic values of CCI, neutrophil-lymphocyte (NLR) and platelet-lymphocyte ratios (PLR) were estimated using Cox proportional hazard models. Restricted cubic spline plots were used to explore the association of baseline NLR and PLR with all-cause and cancer-specific mortality.Results Among 3358 eligible patients with sarcomas, 52.2% died after a median 26 months of follow-up. The most common comorbidities were diabetes mellitus (9.8%) and cerebrovascular disease (4.8%). Patients with higher CCI had higher mortality (CCI=3 vs CCI=2; HR 1.49; 95% CI 1.19 to 1.87; p

Vitreous biopsy is essential for establishing a definitive diagnosis and guiding potential therapy in patients with refractory vitritis and posterior uveitis, among other indications. Especially in cases where one must rule out intraocular lymphoma, obtaining a significant amount of undiluted vitreous increases diagnostic yield. We demonstrate our technique for obtaining a significant amount of undiluted vitreous using pars plana vitrectomy with air infusion.

Purpose: To characterize the phenotype of patients with mild calpain-5 Neovascular Inflammatory Vitreoretinopathy (ADNIV). Observations: The CAPN5 p.R243L mutation is typically associated with onset in the twenties and severe, progressive uveitis, retinal neovascularization, and intraocular fibrosis. Two subjects with this CAPN5 variant only showed mild peripheral retinal pigmentary degeneration and loss of the ERG b-wave at age 45 and 69, respectively, without signs of uveitis or neovascularization. Conclusions/Importance: The phenotypic penetrance of a specific variant in CAPN5-vitreoretinopathy may vary significantly in severity. Patients with pigmentary retinal dystrophy may consider CAPN5 gene testing.

Purpose: To profile vitreous protein expression of intermediate uveitis (IU) patients. Observations: We identified a mean of 363 ± 41 unique proteins (mean ± SD) in IU vitreous and 393 ± 69 unique proteins in control samples using liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis of liquid vitreous biopsies collected during pars plana vitrectomy. A total of 233 proteins were differentially expressed among control and IU samples, suggesting a protein signature that could distinguish the two groups. Pathway analysis identified 22 inflammatory mediators of the interleukin-12 (IL-12) signaling pathway in IU vitreous. Upstream regulator analysis identified downstream mediators of IL-23 and myeloid differentiation primary response protein (MYD88), both of which are involved in the recruitment and differentiation of myeloid cells. Taken together, our results suggest the recruitment of myeloid cells as an upstream pathway in the pathogenesis of IU. Conclusions: This study provides insights into proteins that will serve as biomarkers and therapeutic targets for IU. These biomarkers will help design future clinical trials using rational molecular therapeutics.

Objectives: Our primary objective was to compare geometric mean levonorgestrel concentrations between levonorgestrel implant users who were or were not taking the antiretroviral efavirenz, for up to 30 months after implant initiation. Our secondary objective was to evaluate the pregnancy rate among levonorgestrel implant users on efavirenz. Study design: We performed a subanalysis of 42 Malawian women randomized to initiate the levonorgestrel implant as part of a parent randomized clinical trial. Our subset included 30 HIV-infected women taking efavirenz and 12 HIV-uninfected women not taking efavirenz. They underwent urine pregnancy testing every 3 months and serum levonorgestrel testing at day 3 and months 1, 3, 6, 12, 18, 24, 27 and 30 after implant initiation. Geometric mean levonorgestrel concentrations were calculated for efavirenz users and non-efavirenz users at each time point. Results: The geometric mean levonorgestrel concentrations were lower for efavirenz users than non-efavirenz users at every time point; the geometric mean ratio for efavirenz users:non-efavirenz users ranged from 0.60 [90% confidence interval (CI) 0.46–0.79] at 1 month to 0.27 (90% CI 0.12–0.61) at 30 months after implant insertion. No pregnancies occurred over 60 woman-years of concomitant levonorgestrel implant and efavirenz use, although 11 women had levonorgestrel concentrations

Objectives: Cervical cancer can often be cured by surgery alone, if diagnosed and treated early. However, of the cancer patients who live in the world's poorest countries less that 5% have access to safe, effective and timely cancer surgery. We designed a novel, competency-based curriculum to rapidly build surgical capacity for the treatment of cervical cancer. Here we report experiences and early outcomes of its implementation in Malawi. Methods: Curriculum implementation consisted of preoperative evaluation of patients and surgical video review, discussion of surgical instruments and suture material, deconstruction of the surgical procedure into critical subcomponents including trainees walking through the steps of the procedure with the master trainers, high-volume surgical repetition over a short time interval, intra-operative mentoring, post-operative case review, and mental narration. This was preceded by self-directed learning and followed by clinical mentorship through electronic communication and quarterly on-site visits. Results: Between June 2015–June 2017, 28 patients underwent radical abdominal hysterectomy with bilateral pelvic lymphadenectomy. The first 8 surgeries were performed over 5 days. After the 7th case the trainee could perform the procedure alone. During and between quarterly mentoring-visits the trainee independently performed the procedure on 20 additional patients. Major surgical complications were rare. Conclusions: Life-saving surgical treatment for cervical cancer is now available for the first time, as a routine clinical service, in Central/Northern, Malawi. Keywords: Cervical cancer, Radical hysterectomy, Pelvic lymphadenectomy, Competency-based surgical training

Background: Metastatic breast cancer exhibits diverse and rapidly evolving intra- and inter-tumor heterogeneity. Patients with similar clinical presentations often display distinct tumor responses to standard of care (SOC) therapies. Genome landscape studies indicate that EGFR/HER2/RAS “pathway” activation is highly prevalent in malignant breast cancers. The identification of therapy-responsive and prognostic biomarkers is paramount important to stratify patients and guide therapies in clinical oncology and personalized medicine. Methods: In this study, we analyzed matched pairs of tumor specimens collected from 182 patients who received neoadjuvant systemic therapies (NST). Statistical analyses were conducted to determine whether EGFR/HER2/RAS pathway biomarkers and clinicopathological predictors, alone and in combination, are prognostic in breast cancer. Findings: SIAH and EGFR outperform ER, PR, HER2 and Ki67 as two logical, sensitive and prognostic biomarkers in metastatic breast cancer. We found that increased SIAH and EGFR expression correlated with advanced pathological stage and aggressive molecular subtypes. Both SIAH expression post-NST and NST-induced changes in EGFR expression in invasive mammary tumors are associated with tumor regression and increased survival, whereas ER, PR, and HER2 were not. These results suggest that SIAH and EGFR are two prognostic biomarkers in breast cancer with lymph node metastases. Interpretation: The discovery of incorporating tumor heterogeneity-independent and growth-sensitive RAS pathway biomarkers, SIAH and EGFR, whose altered expression can be used to estimate therapeutic efficacy, detect emergence of resistant clones, forecast tumor regression, differentiate among partial responders, and predict patient survival in the neoadjuvant setting, has a clear clinical implication in personalizing breast cancer therapy. Funding: This work was supported by the Dorothy G. Hoefer Foundation for Breast Cancer Research (A.H. Tang); Center for Innovative Technology (CIT)-Commonwealth Research Commercialization Fund (CRCF) (MF14S-009-LS to A.H. Tang), and National Cancer Institute (CA140550 to A.H. Tang).

Long-term fertilization contributes to the accumulation of cadmium (Cd) in soils and crops, yet the effects of different fertilization regimes on soil Cd dynamics and its uptake in rice remain poorly understood. This long-term field experiment aimed to elucidate how different fertilization regimes influence Cd bioavailability and mobility in soil, thereby affecting Cd accumulation in rice. Four fertilization treatments were tested, including chemical fertilizer (CF), rice straw incorporation (RF), and low (LM) and high (HM) rates of manure fertilizers. Results revealed that manure fertilizers treatments (LM and HM) significantly reduced Cd concentrations in brown rice compared to other fertilization regimes, with levels falling below 0.2 mg kg -1 . Compared to CF, the average Cd concentrations in brown rice under LM and HM were significantly reduced by 33.14 % and 15.88 %, respectively, and which was significantly reduced by 42.53 % and 27.70 % compared with RF. Additionally, the concentration of Cd in brown rice was significantly higher under HM than LM treatment. Partial least squares path model revealed that reductions in Avail-Cd and AciCd, coupled with the formation of low-crystalline iron plaque (IP-Feh and IP-Feh-Cd), were critical factors in decreasing Cd concentration in brown rice. Manure fertilizers reduced the availability of Cd in soil by increasing soil organic matter (SOM), pH, and the abundance of microbial phyla such as Latescibacterota and Gemmatimonadota. Manure application also increased cation exchange capacity (CEC) and Fe 2+ concentrations in soil, promoting IP formation on rice roots and effectively preventing Cd 2+ uptake. In conclusion, the application of manure fertilizers at low rates, particularly in combination with chemical fertilizer, is recommended to ensure the safe production of rice by mitigating Cd uptake., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Long-term exposure to high ammonia concentrations could severely impact chicken health. On the other hand, luteolin has been shown to protect against ammonia poisoning. Although phosphorylation is critically involved in toxicity induction, the specific role of phosphorylated proteins in ammonia poisoning remains unclear. Herein, we constructed an in vitro model to study chicken ammonia poisoning and also analyzed the protective effects of luteolin. Specifically, a combined series of organic techniques such as protein extraction, enzyme digestion, modified peptide enrichment, Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS) analysis, and bioinformatics analysis were employed for a quantitative omics study of phosphorylation modification in three groups of samples. Our findings revealed thousands of Differentially Expressed Proteins (DEPs). The differentially expressed modified proteins were subjected to GO classification, KEGG pathway analysis, cluster analysis, and protein interaction analysis, revealing the detoxification mechanism encompassed mitochondrial maintenance, signal transduction, transcriptional regulation, and cytoskeleton regulation. In the process, mitochondria and Golgi apparatus were the key organelles. Furthermore, the AKT1/FOXO signaling pathway and Heat Shock Proteins (HSPs) were the key core modifiers of the proteins. We hope that our findings will provide a theoretical basis and experimental support for future research on luteolin's detoxification mechanism against ammonia poisoning., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Has patent pending to. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

The medical devices are subjected to dynamic loads and surrounding physiological condition of the bodily fluids, which will impact the degradation behavior of magnesium (Mg) alloy implants. In this work, the corrosion fatigue (CF) and corrosion behaviors of Mg-xGa (x = 1, 1.5, and 2 wt%) alloys in Hank's balanced salt solutions (HBSS) with 1 g/L and 3 g/L glucose are thoroughly studied. It is concluded that Mg-2Ga alloy exhibits excellent mechanical and fatigue behaviors. Its ultimate tensile strength (UTS) is 234 MPa, yield strength (YS) is 145 MPa, elongation (EL) is 15%, fatigue limits (σ f ) is 111 MPa in air, 48 MPa in HBSS with 1 g/L glucose, and 66 MPa in HBSS with 3 g/L glucose. The high glucose content in simulated bodily fluids has the function of inhibiting the corrosion reaction of alloy which is favorable to CF., Competing Interests: Declaration of competing interest We declare that we do not have any financial and personal relationships with other people or organizations that would improperly influence our work, and that there is no professional or other personal interest of any nature or kind in any product, service and/or company that could be interpreted to influence the position presented or the review of the manuscript titled., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: The concept "one airway, one disease" for childhood rhinitis and asthma has been challenged in recent years. This study aimed to evaluate associations of environmental exposures with alone and co-morbid symptoms of rhinitis and asthma and identify critical risk factor., Methods: 5828 children aged 3-6 years in Shanghai were surveyed in 2019. Rhinitis and wheezing symptoms in the past 12 months were collected using questionnaire. 11 outdoor environment exposure factors were assessed by high-resolution spatial-temporal model based on residences. Logistic regression and random forest were applied to evaluate and rank the association of environmental exposure with rhinitis and wheezing symptoms., Results: The proportions of children with rhinitis alone, wheezing & rhinitis, and wheezing alone were 37.2 %, 4.6 %, and 2.6 %, respectively. Regression modeling of two exposure factors adjusted for each other showed that PM 1 , PM 2.5 and nighttime light(NTL) remained the robust significant associations with rhinitis alone, whereas NO 2 had the robust significant association with wheezing & rhinitis and wheezing alone. Random forest ranking analysis further corroborated the most significant environmental exposure for rhinitis alone was PM 1 , and for wheezing symptoms (both wheezing & rhinitis and wheezing alone) was NO 2 . Significant additive and multiplicative interactions were examined between indoor dampness and PM 1 exposure on rhinitis alone., Conclusion: Children's current rhinitis alone was more susceptible to ambient PM 1 and PM 2.5, while asthmatic wheezing symptom, either with or without rhinitis, was more susceptible to NO 2 . Co-exposure to indoor dampness and PM 1 exposure had synergistic effects on rhinitis alone., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Only 2% to 6% aneurysmal bone cyst (ABC) involve the cranial region, and even fewer show sphenoid and orbital involvement. The spheno-orbital ABC is prone misdiagnosis and can result in intraoperative bleeding and residual lesions. The study was to summarize the clinical and therapeutic characteristics of patients with spheno-orbital ABC in children., Method: We retrospectively analyzed three childhood-onset spheno-orbital ABC cases at our hospital. A literature review was conducted and the spheno-orbital ABC cases were retrieved. The characteristics of clinical manifestations, treatment outcomes, and follow-ups were analyzed., Result: All three cases involved the sphenoid and orbital bones, and had a history of surgery or biopsy before being transferred to our hospital. Two of them were terminated due to severe bleeding. The surgeries were performed through frontotemporal craniotomy, where the masses and the surrounding suspected diseased bones were removed. The pathological diagnosis was ABC. All the patient's eye symptoms improved. A review of the literature reveals that ABC typically presents as bone destruction, with some lesions containing fluid levels. Tumors that significantly enhance on contrast-enhanced MRI are often misdiagnosed. ABC is more prevalent in children. The ABC can lead to excessive intraoperative bleeding and residual lesions. Gross total resection is the treatment of choice., Conclusion: Spheno-orbital ABC should avoid transorbital approach in favor of craniotomy. It is imperative to remove as much of the affected bone as possible and to intensify subsequent monitoring. It is essential to prepare blood prior to surgery to manage potential severe bleeding., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Unilateral hydrophobic flocculant and unsatisfactory floc separation constrained the efficacious purification of oil-containing wastewater. Illumined by the hunting behavior of mimic octopus, a biomimetic flocculant (CNSDA) with temperature-sensitive chains (color pouch) and hollow silica cores (mantle) was manufactured to derive hydrophilic-hydrophobic convertibility and auto-separation capabilities. Physical-chemical information of CNSDA was elucidated through characterization analysis. The flocculation behaviors of temperature-sensitive chains and hollow silica cores were evaluated by flocculation experiments. Results indicated that the configuration of CNSDA molecular chains varied from extension to constriction and revealed hydrophobicity as the temperature crossed 29.6 ℃. Compared with 20 ℃, the flocculation efficiencies rocketed at 40 ℃ by CNSDA, and excess flocculants were adsorbed by as-formed flocs through nonpolar interactions (the residual was low to 2.27 % at 160 mg/L). Concomitantly, the contracted molecular chains were contributed to generating dense flocs with low moisture content that flocked into large ones and expedited the solid-liquid separation process (60 % shorter than cationic polyacrylamide) with the auxiliary of low-density cores. The hydrophobic adsorption mechanism actuated by temperature-sensitive character was the decisive factor for high-efficiency flocculation. This study can provide meaningful references for the conception and exploitation of oily wastewater disposal agents., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

To develop an energy-efficient system for the removal of chlorinated organic pollutants, Fe-Ni/reduced graphite oxide/polymerized polypyrrole@nickel foam was constructed as a catalytic cathode for pulsed electrocatalytic degradation, where cathode-catalyzed production of hydrogen radicals (H*) and hydroxyl radical (·OH) generated at the anode led to dechlorination of 4-chlorophenol (4-CP), and dechlorination products were mineralized and degraded under the action of·OH. When energy was continuously supplied to the reaction system in the constant potential mode, the 4-CP concentration near the electrode was insufficient, limiting the reaction rate. Conversely, in the square-wave pulsed potential mode, mass transfer limitations were mitigated, significantly enhancing reaction efficiency and reducing energy consumption. At -1.2 V (vs. Ag/AgCl), the 4-CP removal efficiency reached 93.79 % in the pulsed potential mode, surpassing the constant potential mode's performance of 81.40 %. The synergistic periodic oscillation of the potential, direct electron transfer, and catalytic generation of active free radicals in the pulsed potential mode reduced intermediate concentrations and increased 4-CP mineralization, while the degradation pathway remained unchanged. This research presents a method for the efficient treatment of chlorinated organic pollutants in water using pulsed electrocatalytic degradation., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Assessing heavy metal pollution and understanding the driving factors are crucial for monitoring and managing soil pollution. This study developed two modified assessment methods (NIPI t and NECI) based on soil type-specific background values and pollution indices, and combined them with the receptor model to evaluate pollution status. Additionally, a structural equation model was used to analyze the driving factors of soil heavy metal pollution. Results showed that the average NIPI t and NECI were 1.48 and 0.92, respectively, indicating a low pollution risk level. In some areas, Cd and Hg were the primary heavy metals contributing to pollution risk, with their highest average concentrations exceeding soil type-specific background values by 2.06 and 2.04 times, respectively. Additionally, in black soils, meadow soils, and chernozems, heavy metals primarily originated from natural sources, accounting for 48.92 %, 45.98 %, and 45.58 %, respectively. In aeolian soils, agricultural sources were predominant, contributing 43.38 %. Soil pH and organic matter were key soil properties affecting NECI and NIPI t , with direct effects of 0.36 and -0.19, respectively. This study aims to provide new methods and insights for the comprehensive assessment and driving factors analysis of soil heavy metal pollution, with the goal of enhancing pollution monitoring and reducing risk., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Osteoarthritis (OA) is the most common degenerative joint disease and the second leading cause of disability worldwide. Single-omics analyses are far from elucidating the complex mechanisms of lipid metabolic dysfunction in OA. This study identified a shared lipid metabolic signature of OA by integrating metabolomics, single-cell and bulk RNA-seq, as well as metagenomics. Compared to the normal counterparts, cartilagesin OA patients exhibited significant depletion of homeostatic chondrocytes (HomCs) (P = 0.03) and showed lipid metabolic disorders in linoleic acid metabolism and glycerophospholipid metabolism which was consistent with our findings obtained from plasma metabolomics. Through high-dimensional weighted gene co-expression network analysis (hdWGCNA), weidentified PLA2G2A as a hub gene associated with lipid metabolic disorders in HomCs. And an OA-associated subtype of HomCs, namely HomC1 (marked by PLA2G2A, MT-CO1, MT-CO2, and MT-CO3) was identified, which also exhibited abnormal activation of lipid metabolic pathways. This suggests the involvement of HomC1 in OA progression through the shared lipid metabolism aberrancies, which were further validated via bulk RNA-Seq analysis. Metagenomic profiling identified specific gut microbial species significantly associated with the key lipid metabolism disorders, including Bacteroides uniformis (P < 0.001, R = -0.52), Klebsiella pneumonia (P = 0.003, R = 0.42), Intestinibacter&#95;bartlettii (P = 0.009, R = 0.38), and Streptococcus anginosus (P = 0.009, R = 0.38). By integrating the multi-omics features, a random forest diagnostic model with outstanding performance was developed (AUC = 0.97). In summary, this study deciphered the crucial role of a integrated lipid metabolic signature in OA pathogenesis, and established a regulatory axis of gut microbiota-metabolites-cell-gene, providing new insights into the gut-joint axis and precision therapy for OA., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

In this study, we report the design and synthesis of a series of non-porous amorphous polyethyleneimine-based adsorbents, specifically PEI-PD, PEI-TC, and PEI-CC, for selective adsorption of anionic dyes from aqueous solutions. Utilizing pyromellitic dianhydride (PD), terephthaloyl chloride (TC), and cyanuric chloride (CC) as cross-linking agents, we produced adsorbents with distinct morphological and adsorption characteristics. Scanning electron microscopy (SEM) revealed that PEI-PD and PEI-TC exhibit rough, folded surfaces, with total pore volumes of 0.0001 cm³ /g, 0.0002 cm³ /g, respectively, whereas PEI-CC displays particulate features with total pore volumes of 0.0040 cm³ /g, confirming non-porous nature. XRD and SAED analyses confirmed the amorphous state. Zeta potential increased for the PEI based adsorbents, correlating with enhanced electrostatic adsorption. IGMH analysis revealed non-covalent interactions, including hydrogen bonding, also contribute to adsorption. Further adsorption studies indicated pseudo-second-order and Langmuir model fits, suggesting chemisorption and monolayer adsorption. The adsorption performance was evaluated using various dyes, demonstrating that cross linker structure significantly influences adsorption efficiency. PEI-TC demonstrates the highest adsorption capacity for Congo red, reaching 3089.49 mg/g, due to its para-substituted linkage enhancing molecular flexibility, while the adsorption capacity of PEI-CC was 793.85 mg/g, as the meta-substituted CC linkage causes the molecular chains stack closely together and reduces the available free space, leading to a decreased specific surface area. Under simulated real conditions, the removal rate remained above 90 %. This study offers insights into the critical role of building blocks in the development of efficient adsorbents, highlighting the importance of polymer structure on adsorption performance., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

In this study, we aimed to investigate the mechanism by which fluoride exposure causes bone damage and the relationship with the loss of dorsal longitudinal anastomotic vessel (DLAV) formation in zebrafish larvae to further understanding of skeletal fluorosis. We assessed the development of chondrogenesis, osteogenesis, and DLAV angiogenesis, and reactive oxygen species (ROS) in zebrafish larvae subjected to blank control group (Con), low-fluoride group (LF), and high-fluoride group (HF). Abnormal development of the cartilage area, bone mineralization accompanied with abnormal mRNA expression of osteoblast-related OC, ALP, and Runx2b genes and osteoclast-related OPG and RANKL genes, and abnormal DLAV angiogenesis and ROS levels in zebrafish larvae were affected to varying degrees with the increase of fluoride exposure. We concluded that exposure of zebrafish embryos to fluoride can affect bone development process of chondrogenesis and osteogenesis, and that bone damage might be related to the loss of DLAV angiogenesis., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Naringenin is a natural dihydro-flavonoid compound with various beneficial pharmacological activities. However, the extremely poor water solubility and bioavailability pose significant challenges for its application. In this study, chitosan-casein-naringenin nanoparticles (Cs-cas-Nar) were prepared to enhance naringenin's water solubility and bioavailability. Cs-cas-Nar had a particle size of 225.8 nm, a PDI of 0.155, a zeta potential of 27.2 mV, and an encapsulation efficiency of 87.02 %. FT-IR analysis indicated that casein encapsulated naringenin through hydrogen bonds and non-covalent interactions. Simulated gastrointestinal digestion and in vivo release results demonstrated that Cs-cas-Nar significantly improved naringenin's water solubility and bioavailability. The site-controlled and rapid release of Cs-cas-Nar provided higher drug concentration in the intestine and lung tissue. In in vivo experiments, Cs-cas-Nar provided a protective effect against Pseudomonas aeruginosa-induced pneumonia in mice. Cs-cas-Nar not only reduced weight loss and lung bacterial load of pneumonia mice, but also reduced the production of pro-inflammatory factors IL-1β and IL-6 by >50 % and restored the antioxidant capacity of the lungs. Through computer simulation technology and qPCR detection, we confirmed that Cs-cas-Nar can inhibit the assembly of P. aeruginosa flagella. These findings suggest that Cs-cas-Nar is a simple and easily manufactured formulation with potential application value in treating P. aeruginosa infection., Competing Interests: Declaration of competing interest All authors disclosed no relevant relationships., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Cellulases are divided into endoglucanase, exoglucanase, and β-glucosidase based on their catalytic activity. Eight cellulases were recombinantly expressed in Escherichia coli BL21 to investigate their effects on the enzymatic hydrolysis of wheat straw. Among them, cellulase 2006 exhibited the highest endoglucanase activity (432.25 U/mg), while Bf1 displayed superior exoglucanase and β-glucosidase activities (577.46 and 1991.63 U/mg respectively). Bioinformatic and enzymatic analyses revealed that both cellulases displayed notable thermal and pH stability. The enzyme kinetics parameters revealed that Km values for cellulases 2006 and Bf1 were 15.98 and 14.19 mg/mL, respectively, with Vmax values of 20.78 and 16.38 μmol/min/mg. In a prokaryotic co-expression system, the mixed cellulase Bf2006 exhibited endoglucanase, exoglucanase, and β-glucosidase activities (130.78, 1406.36, and 1119.25 U/mg, respectively). The enzymatic hydrolysis assay revealed that these three cellulases acted on the cellulose macromolecules in wheat straw, increasing reducing sugar content and decreasing crystallinity. Endoglucanase 2006 acted on various organic compounds rich in phenols and aromatic heterocycles, while Bf1 primarily acted on compounds containing glucose units. Bf2006 significantly affected the content of lignin, neutral detergent fiber, acid detergent fiber, and the microstructure of wheat straw, with degradation products primarily consisting of disaccharides, oligosaccharides, polysaccharides, glycosides, and other carbohydrates. This study provides theoretical guidance for the production and application of mixed cellulase Bf2006, serving as a reference for the industrial use of different cellulase types., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Medical image segmentation is currently of a priori guiding significance in medical research and clinical diagnosis. In recent years, neural network-based methods have improved in terms of segmentation accuracy and become the mainstream in the field of medical image segmentation. However, the large number of parameters and computations of prevailing methods currently pose big challenges when employed on mobile devices. While, the lightweight model has great potential to be ported to low-resource hardware devices for its high accuracy. To address the above issues, this paper proposes a lightweight medical image segmentation method combining Transformer and Multi-Layer Perceptron (MLP), aiming to achieve accurate segmentation with lower computational cost. The method consists of a multi-scale branches aggregate module (MBA), a lightweight shift MLP module (LSM) and a feature information share module (FIS). The above three modules are integrated into a U-shaped network. The MBA module learns image features accurately by multi-scale aggregation of global spatial and local detail features. The LSM module introduces shift operations to capture the associations between pixels in different locations in the image. The FIS module interactively fuses multi-stage feature maps acting in skip connections to make the fusion effect finer. The method is validated on ISIC 2018 and 2018 DSB datasets. Experimental results demonstrate that the method outperforms many state-of-the-art lightweight segmentation methods and achieves a balance between segmentation accuracy and computational cost., Competing Interests: Declaration of competing interest We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work, there is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of, the manuscript entitled., (Copyright © 2024. Published by Elsevier Ltd.)

The neuropeptide FF (NPFF) system regulates various physiological and pharmacological functions, particularly pain modulation. However, the modulatory effect of NPFF system on itch remains unclear. To investigate the modulatory effect and functional mechanism induced by NPFF system on acute itch, we examined the effects of supraspinal administration of NPFF and related peptides on acute itch induced by intradermal (i.d.) injection of histamine or chloroquine in male mice. Our results indicated that intracerebroventricular (i.c.v.) administration of NPFF dose-dependently prevented histamine- or chloroquine-induced acute itch behaviors. In addition, the modulatory effect of NPFF was not affected by the selective NPFF receptor antagonist RF9. Furthermore, we investigated the effects of NPVF and dNPA, the selective agonists of NPFF 1 and NPFF 2 receptors respectively, on the acute itch. The results demonstrated that both NPFF agonists effectively prevented acute itch induced by histamine or chloroquine in a manner similar to NPFF, and their effects were also not modified by RF9. To further investigate the possible mechanism of the NPFF receptors agonists, the NPFF-derived analogues [Phg 8 ]-NPFF and NPFF(1-7)-NH 2 that could not activate NPFF receptors in cAMP assays were subsequently tested in the acute itch model. Interestingly, [Phg 8 ]-NPFF, but not NPFF(1-7)-NH 2 , prevented acute itch behavior after i.c.v. administration. In conclusion, our findings reveal that NPFF and related peptides prevent histamine- and chloroquine-induced acute itch through a NPFF receptor-independent mechanism. And it was revealed that the C-terminal phenyl structure of NPFF may play a crucial role in these modulatory effects on acute itch., Competing Interests: Declaration of competing interest None., (Copyright © 2024. Published by Elsevier Ltd.)

Egg quality traits are economically important in the poultry industry. To explore the genetic architecture and identify potential candidate genes, a genome-wide association study (GWAS) was performed for 13 egg quality traits using data from whole-genome sequencing of 299 Longyan Shan-ma female ducks, including 12 quantitative traits and one qualitative trait, eggshell color (ESC; white, light green, green). From estimation of pedigree genetic parameters, heritability (h 2 ) ranged from 0.022 to 0.996 for the 12 quantitative traits, with the highest h 2 (0.996) for eggshell color a* value (ESCA) and the lowest h 2 (0.022) for egg yolk percentage relative to EW. A total of 8,874 single nucleotide polymorphism (SNP)-based significant associations (1.0 × 10 -6 ) and 247 insertion-deletion (indel)-based significant associations (1.00 × 10 -5 ) were identified, including 5,980 SNPs and 159 indel markers. From 5,924 SNPs and 143 indels associated with ESC traits, 181 potential candidate genes were identified, and most significant SNPs and indels (P < 1.0 × 10 -20 ) were located at 1.86 Mb (44.29-46.15 Mb) on chromosome 4. The top SNP (chr4:45325309:C>A; P = 7.97 × 10 -43 ) and the top indel (chr4:45299595:delTTCCACTCCAC; P = 4.20 × 10 -36 ) for the ESC a* value were within two known ESC candidate genes; ATP-binding cassette subfamily G member 2 (ABCG2) and protein kinase cGMP-dependent 2 (PRKG2). Of 56 SNPs and 16 indels associated with other egg quality traits, 46 potential candidate genes were identified including synapse differentiation-inducing 1-like (SYNDIG1L) for EW, and core histone macro-H2A.1 (LOC101795967) and neurogenin 1 (NEUROG1) for egg shape index; and four genes including collagen type VI alpha 3 chain (COL6A3), lysine demethylase 7A (KDM7A), LOC101802169, and sperm-associated antigen 16 (SPAG16) for egg yolk weight and the percentage of yolk to total egg weight. Of the 46 genes, the molecular functions of 22 are related to protein binding, indicating important roles in the formation of egg quality traits. Our findings provide new insight into the genetic basis of egg quality traits in ducks., Competing Interests: Declaration of competing interest Authors declare that they have no competing interests., (Copyright © 2024. Published by Elsevier Inc.)