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Giant esophageal leiomyoma usually requires a thoracotomy or thoracoscopic surgery, which is more invasive than an endoscopic treatment. The purpose of this study is to evaluate the efficacy and safety of piecemeal submucosal tunneling endoscopic resection (P-STER) for giant leiomyoma originating from the muscularis propria (MP) layer of the esophagus. This is a retrospective study. Patients with giant esophageal leiomyoma (transverse diameter ≥ 3 cm) who underwent P-STER were enrolled from November 2012 to May 2023. Clinical data and results were investigated. A total of 16 patients were enrolled for analysis. The lesion mean transverse diameter and longitudinal diameter were 4.22 ± 1.20 cm and 6.20 ± 1.57 cm, respectively. Our mean operation time was 195.38 ± 84.99 min. The mean number of piecemeal resected was 4.31 ± 2.36. An adverse event noted was an esophageal fistula that occurred in one case (6.25%) and was treated conservatively. The mean length of hospital stay was around 11.81 ± 7.30 days. The mean total hospitalization cost was U.S. dollars (USD) $5976.50 ± 2866.39. No recurrence or metastasis was found during the follow-up period. P-STER can be an effective and safe treatment for giant leiomyoma originating from the MP layer of the esophagus. [ABSTRACT FROM AUTHOR]

The association between metabolic-associated fatty liver disease (MAFLD) and disease progression in patients with the coronavirus disease 2019 (COVID-19) are unclear. To explore the association between MAFLD and the severity of COVID-19 by meta-analysis. We conducted a literature search using PubMed, EMBASE, Medline (OVID), and MedRxiv from inception to July 6, 2020. Newcastle-Ottawa Scale (NOS) and Stata 14.0 were used for quality assessment of included studies as well as for performing a pooled analysis. A total of 6 studies with 1,293 participants were included after screening. Four studies reported the prevalence of MAFLD patients with COVID-19, with a pooled prevalence of 0.31 for MAFLD (95CI 0.28, 0.35, I2 = 38.8%, P = 0.179). MAFLD increased the risk of COVID-19 disease severity, with a pooled OR of 2.93 (95CI 1.87, 4.60, I2 = 34.3%, P = 0.166). In this meta-analysis, we found that a high percentage of patients with COVID-19 had MAFLD. Meanwhile, MAFLD increased the risk of disease progression among patients with COVID-19. Thus, better intensive care and monitoring are needed for MAFLD patients infected by SARS-COV-2. [ABSTRACT FROM AUTHOR]

Background and Aims Esophageal stricture is a common adverse event after endoscopic submucosal dissection (ESD) when it involves the entire circumference of the esophagus. We aimed to assess the effectiveness and safety of endoscopic transplantation of autologous esophageal mucosa in preventing stricture formation after circumferential ESD. Methods Nine patients who underwent circumferential ESD for early esophageal cancer were enrolled. After the patients underwent ESD, autologous esophageal mucosal patches were attached to the ulcer surface by using hemoclips and were then fixed with a covered metal mesh stent. The stent was removed 7 days after the procedure. The patients were followed up with endoscopy at scheduled times. Results Epithelialization occurred within a median of 7.1 days, with a graft survival rate of 96.5%. Strictures occurred at a mean of 24.7 days (range 18-34 days) after the procedure. The median number of endoscopic balloon dilatation sessions was 2.7 (range 0-6). Conclusions Transplantation of autologous esophageal mucosa could be a safe way of relieving the severity of esophageal stricture after circumferential ESD. [ABSTRACT FROM AUTHOR]

Background: Real-time ultrasound elastography (RTE) is used to examine liver fibrosis and benign and malignant lesions, but its use for the diagnosis of liver trauma has not been examined. The purpose of this study was to examine the use of RTE for the evaluation of differential penetrating liver trauma in a rabbit model.Material and Methods: Eighty New Zealand rabbits were divided into 2 groups. In one group, a single incision (type "-" lesion) was made, and in the other group a hash mark incision (type "#" lesion) was made (about 0.5cm in depth; 1.0-2.0cm in length). RTE was performed at 10, 30, and 60min after injury.Results: There were no differences in mean RTE scores between the 2 types of lesions at 10 and 30min. However, the mean values for the 2 types of lesions increased from 10min to 60min (type '-' lesion: 0.88±0.32 to 2.06±0.88; type '#' lesion: 0.89±0.34 to 2.63±1.16). At 60min, the mean elasticity score in the type '#' lesion group was significantly higher than in the type '-' lesion group (P<.001). Strain ratios were not different between the groups at each time point, but in each group the values decreased from the 10min time point to the 60min time point (P-value for the trends, <.001).Conclusions: RTE may be able to distinguish mild or severe penetrating liver trauma at 60min or more after injury. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) is the third cause of cancer-related death worldwide. However, the treatments for HCC are limited, and most of them are only available to the early stage. In the later stages, traditional chemotherapy has only marginal effects and may include toxicity. Thus, the identification of new predictive markers is urgently needed. New targets for non-conventional treatments will help to accelerate research on the molecular pathogenesis of HCC. A new class of transcripts, long non-coding RNAs (lncRNAs), has recently been found to be pervasively transcribed in the human genome. Aberrant expression of several lncRNAs was found to be involved in the tumorigenesis of HCC. In this review, we describe the possible molecular mechanisms that underlie lncRNA expression changes in HCC, as well as potential future applications of lncRNA research in the diagnosis and treatment of HCC. [ABSTRACT FROM AUTHOR]

Practice has witnessed that the retail platform usually withholds strategic inventory in the reselling channel to improve channel efficiency. This intensifies the channel competition, which is essential to supplier encroachment in the retail platform. Thus far, the existing literature leaves the influence of strategic inventory holding behavior on supplier encroachment in the retail platform supply chain unexplored. In this paper, we build a two-period dynamic model to explore the connection between supplier encroachment and the retail platform's strategic inventory withholding behavior. Results show that without encroachment, the retail platform's strategic inventory decisions hinge on the holding cost, with encroachment, the retail platform's strategic inventory decisions are moderated by the commission rate when the holding cost is intermediate. Moreover, the supplier's optimal encroachment strategies are jointly moderated by the commission rate and slotting fee. Importantly, the retail platform's strategic inventory withholding behavior mitigates supplier encroachment from a qualitative and quantitative perspective, and supplier encroachment narrows the region of the strategic inventory holding. Interestingly, supplier encroachment could bring all-win outcomes, however, low inventory holding cost induces a small region of all-win outcomes. • Without encroachment, the strategic inventory decisions hinge on the holding cost. • With encroachment, the commission rate moderates the strategic inventory holding decision if the holding cost is intermediate. • The commission rate and slotting fee jointly moderate the supplier's optimal encroachment strategies. • Platform's strategic inventory-holding behavior mitigates supplier encroachment. • Supplier encroachment narrows the region of strategic inventory withholding. [ABSTRACT FROM AUTHOR]

Background Workplace violence is a serious problem for clinical nurses, as it leads to a series of adverse consequences. However, little information is available on the prevalence and influencing factors of workplace violence in China. Objectives To determine the prevalence of workplace violence against Chinese nurses, and its influencing factors. Design A multi-center, cross-sectional study. Settings The seven geographical regions (i.e., northeast, north, central, east, south, northwest, and southwest) of China. Participants Four thousand one hundred and twenty-five nurses. Methods We randomly selected 28 hospitals, located in 14 cities over 13 provinces across the seven geographical regions. We distributed 4125 questionnaires between May 4 and September 23, 2014. The questionnaire included demographic information, the Workplace Violent Incident Questionnaire, the Jefferson Scale of Empathy-Health Professionals, and the Practice Environment Scale of Nursing Work Index. Workplace violence was assessed in terms of physical violence, non-physical violence, sexual harassment, and organized healthcare disturbances. We then performed descriptive analyses and logistic regressions on the collected data. Results The response rate was 92.97% (n = 3835). Additionally, we obtained valid questionnaires from 3004 individuals. Of these, 25.77% reported experiencing physical violence, 63.65% non-physical violence, 2.76% sexual harassment, and 11.72% organized healthcare disturbances. A logistic regression analysis revealed that nurses who have less experience, work a rotating roster, work in emergency rooms and pediatrics departments, have low empathy levels, and who work in poor nursing environments have greater odds of experiencing violence. Conclusions Experiences of workplace violence are prevalent among Chinese nurses, and several complex factors are associated with a greater risk of such violence, including nurses’ personal characteristics, work settings, and work environments. Our results might help nursing managers understand their employees’ work status. We recommend that nursing leaders provide and enhance education and support for high-risk groups to help protect Chinese nurses from workplace violence. [ABSTRACT FROM AUTHOR]

Besides distribution services, retail platforms are beginning to provide unobservable promotion services to enhance traffic and demand. Thus, suppliers are incentive to consider the impact of platform promotion on distribution channel strategies. Hence, considering a retail platform supply chain in which the supplier uses an outcome-based contract to incentivize the retail platform's hidden promotion effort, this paper investigates the implications of unobservable platform promotion on the supplier's distribution channel strategies. We develop a Stackelberg game model to examine the equilibrium outcomes of reselling and agency selling under unobservable promotion action and find that the retail platform may volunteer to promote in both channels when the market potential difference is large. Interestingly, voluntary promotion may motivate the supplier to increase the wholesale price. Furthermore, we derive conditions under which the supplier prefers reselling and agency selling. When the market potential difference is small, the distribution channel strategy is a threshold policy of the commission rate, below which agency selling is preferred, and reselling is preferred otherwise. It is counterintuitive that when the market potential difference is large, the commission rate will not influence the preference of channel selection and the reselling channel is always preferred by the supplier. Interestingly, the impact of platform promotion on the threshold of distribution channel strategies is non-monotonic in the increment probability of high market potential and market potential difference. Specifically, platform promotion induces the upstream supplier to select the reselling channel suppose the increment probability of high market potential is moderate, while induces the supplier to select the agency selling (reselling) channel when the market potential difference is moderate (large) suppose the increment probability of high market potential is high. Moreover, we find that enhancing the increment probability of high market potential benefits the supplier more, but only moderate increment probability of high market potential makes the retail platform better off. • Explore promotion and channel strategies in retail platforms. • Impact of promotion on threshold of optimal channel strategies is non-monotonic. • Voluntary promotion may increase the wholesale price. • A win–win outcome occurs under moderate market potential difference. • Improving promotion capability at free of cost may make retail platforms worse off. [ABSTRACT FROM AUTHOR]

Abstract: Rapid advances in immune system knowledge have led to the exploration of immunologic approaches for eliminating tumor cells. Human telomerase reverse transcriptase (hTERT) is considered to be an ideal universal target for novel immunotherapies against cancers. Thus far, studies of effective antitumor immunotherapies have focused on the quantity and quality of the effector function of the CD8 compartment. However, increasing evidence has demonstrated that CD4+ T cells play important roles in generating and maintaining antitumor immune responses in animal models. The aim of this work was to verify whether diepitope multiple antigen peptides (MAPs) that were composed of the cytotoxic T lymphocyte (CTL) epitope of hTERT and the T-helper epitope of hTERT could improve upon the immunogenicity of a monoepitope MAP of hTERT. Dendritic cells (DCs) pulsed with diepitope MAPs composed of the CTL epitope hTERT-540 and the T-helper epitope hTERT-766 were used to evaluate immune responses against various tumor cells. A standard in vitro 4-h 51Cr-release assay was employed in this study. The results demonstrated that CTLs activated by the diepitope MAP that consisted of hTERT-540 and hTERT-766 could cause 8.56% more lysis than CTLs activated by the monoepitope MAP containing hTERT-540. Moreover, the activated CTLs could kill neither hTERT-negative tumor cells, such as U2OS cells, nor HLA-A2 negative cells, such as HepG2 cells. Our results indicate that diepitope MAPs that are generated from hTERT can be exploited for cancer immunotherapy. [Copyright &y& Elsevier]

Heavy metal pollution is one of the most serious concerns to human health because these substances are toxic and retained by the ecological system. Many efforts have been taken over the past few years for the detection of heavy metal ions in the environment. Incorporation of DNAzymes/DNA molecules (including T–T or C–C mismatches and G-quadruplexes) and nanomaterials into sensors can lead to significant improvement in the performance of sensors in terms of sensitivity, selectivity, multiplexed detection capability and portability. This review presents a recent advance in biosensors based on DNAzymes/DNA molecules functionalized nanostructures for heavy metal detection. Furthermore, advances in biosensing devices/chip based on this method for the detection of metal ions are summarized. This paper highlights the strategies for design of heavy metal biosensors benefiting from the use of DNAzymes/DNA molecules and nanomaterials. [ABSTRACT FROM AUTHOR]

Genome-wide association studies (GWASs) have identified several risk loci for coronary artery calcification. Four single-nucleotide polymorphisms (SNPs, rs1537370, rs1333049, rs2026458 and rs9349379) were associated with coronary artery calcification with P values less than 5 × 10 −8 in GWASs. It is unclear if these associations exist in other vascular beds. Thus, we evaluated the impacts of these four SNPs on carotid artery and aortic arch calcification in this study. Computed tomography was applied to quantify the calcification of carotid artery and aortic arch. 860 patients with stroke completed calcification quantification and genotype testing were included in data analysis. Each SNP was evaluated for the association with carotid artery calcification, and with aortic arch calcification using generalized linear model. Among the four tested SNPs, rs2026458 was associated with calcification in both carotid artery (β = 0.31, 95% confidence interval [CI] 0.10–0.52, P = 0.003) and aortic arch (β = 0.32, 95% CI 0.10–0.54, P = 0.004), while rs1333049 was only associated with carotid artery calcification (β = 0.28, 95% CI 0.06–0.50, P = 0.011). In gender-stratified analyses, rs2026458 had significant impacts on carotid artery ( P = 0.003) and aortic arch calcification ( P = 0.008) in male, but not in female patients; while rs1537370 was significantly associated with carotid artery calcification in female ( P = 0.013), but not in male patients. In conclusion, SNPs associated with coronary artery calcification may also increase the risk of calcification in other arteries such as carotid artery and aortic arch. [ABSTRACT FROM AUTHOR]

As the key point of function for aspirin to educe anti-platelet effects, cyclooxygenase-1 (COX-1) gene polymorphisms have long been suspected as a potential cause for aspirin nonresponsiveness. But this hypothesis has not been confirmed by large longitudinal studies. This study prospectively evaluated the impacts of COX-1 gene polymorphisms on stroke recurrence and other vascular events in a large cohort of Chinese patients with ischemic stroke and treated with aspirin. Between December 2009 and October 2012, consecutive patients with ischemic stroke and treated with aspirin were enrolled. Polymorphisms of four alleles (rs1330344, rs10306114, rs3842788 and rs5788) in COX-1 gene were determined at baseline. The primary endpoint was a composite of nonfatal ischemic stroke, myocardial infarction, and death from cardiovascular causes. Impacts of COX-1 gene polymorphisms on vascular outcomes were evaluated with multivariate analysis. A total of 859 patients were included in data analysis. The minor allele frequencies of rs1330344, rs10306114, rs3842788 and rs5788 were 38.53%, 0.12%, 6.64% and 5.53%, respectively. During 14.64 ± 7.44 months of follow-up, primary endpoint was observed in 67 (7.80%) patients. Incidence of primary endpoint was higher in patients with CC genotype of rs1330344 than in patients with CT or TT genotype (HR = 1.916, 95% CI: 1.126–3.260, P = 0.016). After being adjusted for potential confounding factors, rs1330344 CC genotype was still independently associated with incidence of primary endpoint (HR = 1.958, 95% CI: 1.151–3.332, P = 0.013). The impacts of other three tested polymorphisms on primary endpoint were unremarkable. In conclusion, in Chinese patients with ischemic stroke and treated with aspirin, CC genotype of rs1330344 may increase the risk of subsequent vascular events. [ABSTRACT FROM AUTHOR]

Abstract: Background and purpose: S100B and its scavenger, soluble receptor for advanced glycation end products (sRAGE), participate in various acute and chronic brain disorders. However, their impact on hemorrhage-prone small vessel disease represented by cerebral microbleeds (CMBs) is unclear. The purpose of this study was to investigate the relationship of CMBs with plasma S100B and sRAGE. Methods: A cohort of 147 consecutive patients with first-ever acute lacunar stroke was prospectively enrolled. We collected demographic, clinical, and laboratory data, including plasma levels of S100B and sRAGE, and presence and number of CMBs using susceptibility-weighted imaging (SWI). Associations between plasma S100B, sRAGE levels and the presence, number, and location of CMBs were determined. Results: CMBs were present in 58 patients (39.5%). Each 1SD-increase in S100B and sRAGE levels was significantly associated with presence of CMBs (adjusted odds ratio [OR], 3.06; 95% confidence interval [CI], 1.81–5.17 and adjusted OR, 0.29; 95% CI, 0.16–0.53; respectively) and number of CMBs (adjusted relative risk [RR], 4.07; 95% CI, 3.60–5.65 for S100B and RR 0.34; 95% CI, 0.25–0.46 for sRAGE). When stratified by location, plasma S100B and sRAGE levels were similarly associated with presence of deep CMBs (adjusted OR, 3.65; 95% CI, 1.99–6.69 and adjusted OR, 0.23; 95% CI, 0.12–0.46; respectively), but not with strictly lobar CMBs. Conclusions: Higher levels of S100B and lower levels of sRAGE are independently associated with presence and number of CMBs in patients with first-ever acute lacunar stroke, particularly in those with deep CMBs. [Copyright &y& Elsevier]

Abstract: The aim of this study was to determine the characteristic of muscle crush injury at quantitative ultrasonographic elastography using supersonic shear imaging (SSI). Twenty-three New Zealand rabbits underwent crush injury to left hind leg caused by a special balloon cuff device. Conventional ultrasonography and SSI quantitative elastography were performed at both crushed and uncrushed regions of the left hind legs. Quantitative lesion elasticity was measured using the Young’s modulus (in kilopascals) at 0.5 h, 2 h, 6 h, 24 h and 72 h after the release of the crushing pressure. Compared with those from the uncrushed regions, both the maximum and mean elasticity values at these time points from the crushed regions were significantly higher (p < 0.001). A receiver operating characteristic (ROC) analysis was employed to assess diagnostic performance. ROC curves showed that extremity crush injury was diagnosed using elasticity value and the greater the elasticity value, the greater the diagnostic value. SSI provides quantitative elasticity measurements, thus, adding complementary information that potentially could help in crush injury characterization with conventional ultrasonography. [Copyright &y& Elsevier]