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Background. Bone mineral density is widely used by clinicians for screening osteoporosis and assessing bone strength. However, its effectiveness has been reported unsatisfactory. In this study, it is demonstrated that bone organic-inorganic phase ratio is a fundamental determinant of bone material quality measured by stiffness, strength, and toughness. Methods and Results. Two-hundred standard bone specimens were fabricated from bovine legs, with a specialized manufacturing method that was designed to reduce the effect of bone anisotropy. Bone mechanical properties of the specimens, including Young’s modulus, yield stress, peak stress, and energy-to-failure, were measured by mechanical testing. Organic and inorganic mass contents of the specimens were then determined by bone ashing. Bone density and organic-inorganic phase ratio in the specimens were calculated. Statistical methods were applied to study relationships between the measured mechanical properties and the organic-inorganic phase ratios. Statistical characteristics of organic-inorganic phase ratios in the specimens with top material quality were investigated. Bone organic-inorganic phase ratio had strong Spearman correlation with bone material properties. Bone specimens that had the highest material quality had a very narrow scope of organic-inorganic phase ratio, which could be considered as the “optimal” ratio among the tested specimens. Conclusion. Bone organic-inorganic phase ratio is a fundamental determinant of bone material quality. There may exist an “optimal” ratio for the bone to achieve top material quality. Deviation from the “optimal” ratio is probably the fundamental cause of various bone diseases. This study suggests that bone organic-inorganic phase ratio should be considered in clinical assessment of fracture risk.

Neural machine translation technologies are having increasing applications in clinical and healthcare settings. In multicultural countries, automatic translation tools provide critical support to medical and health professionals in their interaction and exchange of health messages with migrant patients with limited or non-English proficiency. While research has mainly explored the usability and limitations of state-of-the-art machine translation tools in the detection and diagnosis of physical diseases and conditions, there is a persistent lack of evidence-based studies on the applicability of machine translation tools in the delivery of mental healthcare services for vulnerable populations. Our study developed Bayesian machine learning algorithms using relevance vector machine to support frontline health workers and medical professionals to make better informed decisions between risks and convenience of using online translation tools when delivering mental healthcare services to Spanish-speaking minority populations living in English-speaking countries. Major strengths of the machine learning classifier that we developed include scalability, interpretability, and adaptability of the classifier for diverse mental healthcare settings. In this paper, we report on the process of the Bayesian machine learning classifier development through automatic feature optimisation and the interpretation of the classifier-enabled assessment of the suitability of original English mental health information for automatic online translation. We elaborate on the interpretation of the assessment results in clinical settings using statistical tools such as positive likelihood ratios and negative likelihood ratios.

The treatment of infectious diseases with antimicrobial agents continues to present problems in modern-day medicine with many studies showing significant increase in the incidence of bacterial resistance to several antibiotics. The screening of antimicrobial activity of plant extracts and natural products has shown that medicinal plants are made up of a potential source of new anti-infective agents. The aim of this study was to evaluate the antimicrobial and antioxidant activities of extracts and compounds from the whole plant Trifolium baccarinii Chiov. and to determine their modes of antibacterial action. The plant extracts were prepared by maceration in organic solvents. The antimicrobial activities were evaluated using the broth microdilution method. The antioxidant activity was evaluated using the 2,2 ′ -diphenyl-1-picrylhydrazyl radical (DPPH) and 2,2 ′ -azino-bis(3-ethylbenzothiazoline-6-sulphonic acid) diammonium salt (ABTS) assays. The mechanisms of antibacterial action were determined by lysis, salt tolerance assays, and antioxidant enzyme activities. The cytotoxic effect on the erythrocytes was determined by a spectrophotometric method. Biochanin A, formononetin, luteolin, luteolin-4 ′ -O-β-D-glucopyranoside, 4,7,2 ′ -trihydroxy-4 ′ -methoxyisoflavanol, sissotrin, 1-methyl-β-D-glucopyranoside, ononin, D-mannitol, and 3-O-β-D-glucuronopyranosylsoyasapogenol B were isolated from Trifolium baccarinii. The MeOH, EtOAc, and n-BuOH extracts as well as biochanin A, formononetin, luteolin, luteolin-4 ′ -O-β-D-glucopyranoside, 4,7,2 ′ -trihydroxy-4 ′ -methoxyisoflavanol, and sissotrin from Trifolium baccarinii displayed the highest antimicrobial and antioxidant activities. The MeOH extract and 4,7,2 ′ -trihydroxy-4 ′ -methoxyisoflavanol exhibited antibacterial activity through the bacteriolytic effect and reduction of the antioxidant defenses in the bacterial cells. The present study portrays Trifolium baccarinii as a potential natural source of antibacterial, antifungal, and antioxidant agents.

Obstructive sleep apnea (OSA) is characterized by repetitive complete or partial collapse of the upper airway and reduction of airflow during sleep. It is associated with significantly increased daytime muscle sympathetic nerve activity thought to result from the repetitive intermittent periods of hypoxemia during sleep and brain alterations that are likely to result. Different brain regions are affected by subsequent hypoxia/anoxia. Neurodegenerative processes result in measurable atrophy of cortical gray matter in the temporal lobes and posterior cingulate cortex, as well as in subcortical structures such as the hippocampus, amygdala, and thalamus. This study involved a group of firstly diagnosed, therapy-naive, nonalcoholic fatty liver disease (NAFLD) patients, out of which 144 (96 males and 48 females), aged 34–57 (mean 47.88 ± 6.07), satisfied the recruiting criteria for the study and control groups. All the patients underwent MRI scanning, polysomnography testing, and cognitive evaluation. Cognitively, worse results were obtained in the group with OSA ( p < 0.05 ) and NAFLD ( p = 0.047 ). A significant decrease in volumes of cortical and subcortical structures was revealed ( p < 0.001 ). In conclusion, brain deterioration followed by cognitive impairment is, most likely, the result of intermittent hypoxia and anoxia episodes that initiate the domino process of deteriorating biochemical reactions in the brain.

A simple, fast, and cost-effective LC-MS/MS method for quantification of rifampicin in human plasma was developed and fully validated. The plasma samples containing rifampicin and isotopically labelled internal standard rifampicin D8, were cleaned up using a Captiva ND Lipids filtration plate. Chromatographic separation was achieved on an 1290 Infinity liquid chromatograph coupled to 6460 Triple Quadrupole operated in positive mode on a core-shell Kinetex C18 column (50 % 2.1 mm, 2.6 %m) by gradient elution using 0.1% formic acid in water and acetonitrile as a mobile phase. The proposed method is the fastest method published by now, both in terms of sample preparation (approximately one minute per sample) and chromatographic analysis (total run time 2.4 min). Another key benefit is the outstanding sensitivity and wide analytical range (5-40000 %g/L) with good linearity, accuracy, and precision. The method showed almost complete recovery (92%) and absence of any significant matrix effect as demonstrated by uniform responses from QC samples prepared in blood plasma from 6 volunteers (RSD

Raw salads are regularly implicated in food-borne disease outbreaks globally. Consumption of kachumbari, a raw vegetable salad, alongside roast meat is widespread in Kenya. The aim of this study was to evaluate the bacteriological quality of kachumbari samples (n=39) collected from a cross section of roasted meat eateries in Kenya. The United Kingdom’s Health Protection Agency guidelines were used to infer safety of the salads due to lack of local criteria for microbiological safety of ready-to-eat fresh produce placed in the market. Based on Escherichia coli counts, 14 (35.9%) of the samples were of satisfactory microbial quality (2 CFU/g), and 18 (46.2%) unsatisfactory (>102 CFU/g). All samples examined for staphylococci had counts falling within the borderline range (20–≤104 CFU/g). Collectively, 3 (7.7%) of the sampled salads were classified as potentially harmful to health and/or unfit for human consumption due to the presumptive presence of 2 (5.1%) Campylobacter spp. and 1 (2.6%) E. coli O157. Salmonella was not detected in any of the samples. The presence of hygiene indicator microorganisms and pathogens demonstrates that kachumbari salads present a public health risk.

Sleep architecture alterations, among which sleep fragmentation is highly prevalent, represent risk factors for a variety of diseases, ranging from cardiovascular to brain disorders, including anxiety. What mediates anxiety occurrence upon sleep fragmentation is still a matter of debate. We hypothesized that the sleep fragmentation effects on anxiety are dependent on its duration and mediated by increased oxidative stress and alterations in the number of parvalbumin (PV+) interneurons in the hippocampus. Sleep was fragmented in rats by the treadmill method during a period of 14 days (SF group). Rats with undisturbed sleep in the treadmill (TC group) and those receiving equal amounts of treadmill belt motion (EC group) served as controls. To assess anxiety, we subjected rats to the open field, elevated plus maze, and light-dark tests on the 0, 7th, and 14th day. Upon the last test, brain structures were sampled for oxidative stress assessment and PV+ interneuron immunohistochemistry. The results of ethological tests of anxiety-linked behavior suggested duration-dependent anxiogenic potential of sleep fragmentation. Rats’ anxiety-linked behavior upon sleep fragmentation significantly correlated with oxidative stress. The rats with fragmented sleep (SF) showed significantly higher oxidative stress in the hippocampus, thalamus, and cortex, compared to controls (TC and EC), while the antioxidant enzymes’ activity was significantly decreased. No significant differences were observed in hippocampal PV+ interneurons among these groups. Our results showed that duration of sleep fragmentation is a significant determinant of anxiety-linked behavior, and these effects are mediated through oxidative distress in the brain. Herein, it is revealed that the sleep fragmentation-oxidative stress-anxiety axis contributes to our better understanding of pathophysiological processes, occurring due to disrupted sleep patterns.

Alzheimer’s disease (AD) is an irreversible neurodegenerative disease, and, at present, once it has been diagnosed, there is no effective curative treatment. Accurate and early diagnosis of Alzheimer’s disease is crucial for improving the condition of patients since effective preventive measures can be taken in advance to delay the onset time of the disease. 18F-Fluorodeoxyglucose positron emission tomography (18F-FDG PET : PET) is an effective biomarker of the symptom of AD and has been used as medical imaging data for diagnosing AD. Mild cognitive impairment (MCI) is regarded as an early symptom of AD, and it has been shown that MCI also has a certain biomedical correlation with PET. In this paper, we explore how to use 3D PET images to realize the effective recognition of MCI and thus achieve the early prediction of AD. This problem is then taken as the classification of three categories of PET images, including MCI, AD, and NC (normal controls). In order to get better classification performance, a novel network model is proposed in the paper based on 3D convolution neural networks (CNN) and support vector machines (SVM) by utilizing both the excellent abilities of CNN in feature extraction and SVM in classification. In order to make full use of the optimal property of SVM in solving binary classification problems, the three-category classification problem is divided into three binary classifications, and each binary classification is being realized with a CNN + SVM network. Then, the outputs of the three CNN + SVM networks are fused into a final three-category classification result. An end-to-end learning algorithm is developed to train the CNN + SVM networks, and a decision fusion algorithm is exploited to realize the fusion of the outputs of three CNN + SVM networks. Experimental results obtained in the work with comparative analyses confirm the effectiveness of the proposed method.

Background. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a pandemic of pneumonia spreading around the world, leading to serious threats to public health and attracting enormous attention. There is an urgent need for sensitive diagnostic testing implementation to control and manage SARS-CoV-2 in public health laboratories. The quantitative reverse transcription PCR (RT-qPCR) assay is the gold standard method, but the sensitivity and specificity of SARS-CoV-2 testing are dependent on a number of factors. Methods. We synthesized RNA based on the genes published to estimate the concentration of inactivated virus samples in a biosafety level 3 laboratory. The limit of detection (LOD), linearity, accuracy, and precision were evaluated according to the bioanalytical method validation guidelines. Results. We found that the LOD reached around 3 copies/reaction. Furthermore, intra-assay precision, accuracy, and linearity met the accepted criterion with an RSD for copies of less than 25%, and linear regression met the accepted R 2 of 0.98. Conclusions. We suggest that synthesized RNA based on the database of the NCBI gene bank for estimating the concentration of inactivated virus samples provides a potential opportunity for reliable testing to diagnose coronavirus disease 2019 (COVID-19) as well as limit the spread of the disease. This method may be relatively quick and inexpensive, and it may be useful for developing countries during the pandemic era. In the long term, it is also applicable for evaluation, verification, validation, and external quality assessment.

Purpose. To evaluate the clinical outcomes after bilateral mix-and-match cataract surgery using extended depth of focus (EDOF) and diffractive multifocal (DMF) intraocular lenses (IOLs). Setting. Asan Medical Center, Seoul, South Korea. Design. Prospective clinical study. Methods. Thirty-seven patients underwent TECNIS Symfony EDOF IOL (ZXR00) implantation in the dominant eye, and TECNIS +3.25 DMF IOL (ZLB00) implantation in the nondominant eye. Patients were followed up for 3 months; uncorrected and corrected distance visual acuity (UDVA and CDVA), uncorrected intermediate and near visual acuity (UIVA and UNVA), contrast sensitivity, defocus curves, stereopsis, and patient satisfaction were assessed. Results. At 3 months, the mean logarithm of the minimum angle of resolution (logMAR) of UDVA was 0.07 ± 0.09 in EDOF IOL eyes, 0.12 ± 0.11 in DMF IOL eyes, and 0.02 ± 0.05 in both eyes. UIVA was 0.11 ± 0.11 in EDOF IOL eyes, 0.16 ± 0.12 in DMF IOL eyes, and 0.04 ± 0.07 in both eyes. UNVA was 0.25 ± 0.15 in EDOF IOL eyes, 0.22 ± 0.16 in DMF IOL eyes, and 0.13 ± 0.13 in both eyes. Thirty patients (81.1%) were more than satisfied with near vision, and 8 patients (21.6%) complained of severe glare and halo. Spectacle independence for near vision was achieved in 34 patients (91.9%), and 31 patients (83.8%) had better than a 50-second arc of stereopsis. Conclusion. Mix-and-match cataract surgery with EDOF and DMF IOL implantation provided good visual outcomes for all distances. Additionally, excellent patient satisfaction was achieved with a high level of spectacle independence and acceptable photic phenomena.

Background. Hemodynamic responses to laryngoscopy and endotracheal intubation are transient in most patients. However, in some patients with a history of heart disease, systemic hypertension, or cerebrovascular disease, these may lead to dangerous complications. This study is aimed at determining the effectiveness of intravenous nitroglycerin bolus doses in reducing hemodynamic responses to laryngoscopy and endotracheal intubation. Material and Method. In this double-blind randomized controlled trial, 78 patients aged 18 to 65 years were randomly divided into three groups: 1 μg/kg dose of nitroglycerin (first group), 2 μg/kg dose of nitroglycerin (second group), and normal saline or placebo (third group). 26 samples were allocated for each group. Patients’ hemodynamic responses to laryngoscopy and endotracheal intubation were measured at different times. Data were analyzed using SPSS V 16. Results. Patients in the three study groups were similar in terms of age, sex, and weight. There was no significant difference between the mean saturation of peripheral oxygen (SPO2) and the mean heart rate between the three groups before endotracheal intubation and 1 to 10 minutes after intubation ( P > 0.05 ). The difference of mean arterial blood pressure between study groups was only significant in the first and fifth minutes after intubation. Mean systolic and diastolic blood pressure in the first, third, and fifth minutes after intubation was significantly lower in the intervention groups than the control group ( P < 0.05 ). However, no significant difference was observed between the intervention groups. The frequency of systolic blood pressure decrease was significantly different in the first and fifth minutes after intubation in the three study groups ( P < 0.05 ). Conclusion. Bolus doses of 1 and 2 μg/kg nitroglycerin in noncardiac elective surgery prevents the increase of mean systolic, diastolic, and arterial blood pressure but has no significant effect on heart rate after intubation.

Background. Mongolian medicine is a systematic theoretical system, which is based on the balance among Heyi, Xila, and Badagan. However, the underlying mechanisms remain unclear. This study aimed to explore the characteristics of intestinal microbiota and metabolites in different rat models of Mongolian medicine. Methods. After establishing rat models of Heyi, Xila, and Badagan, we integrated 16S rRNA gene sequencing and metabolomics. Results. Heyi, Xila, and Badagan rats had significantly altered intestinal microbial composition compared with rats in the MCK group. They showed 11, 18, and 8 significantly differential bacterial biomarkers and 22, 11, and 15 differential metabolites, respectively. The glucosinolate biosynthesis pathway was enriched only in Heyi rats; the biosynthesis of phenylpropanoids pathway and phenylpropanoid biosynthesis pathway were enriched only in Xila rats; the isoflavonoid biosynthesis pathway, the glycine, serine, and threonine metabolism pathway, and the arginine and proline metabolism pathway were enriched only in Badagan rats. Conclusions. The intestinal microbiota, metabolites, and metabolic pathways significantly differed among Heyi, Xila, and Badagan rats compared with control group rats.

Background. Colorectal cancer (CRC) is recognized as one of the most common malignancies with a high mortality rate worldwide, supporting the necessity for an effective novel antitumor drug to improve current therapy’s effectiveness. Substance P (SP) is the essential member of the tachykinins (TKs) family, which binds to the specific receptors, known as neurokinin-1 receptor (NK1R), exerting its multiple influences such as tumor cell proliferation, angiogenesis, and metastasis. Aprepitant, as a specific NK1R antagonist, is suggested as a novel antitumor agent, promoting apoptotic processes in tumor cells; however, the exact antitumor mechanism of aprepitant on molecular signaling in CRC is not entirely known. Method. The resazurin assay was conducted to assess the cytotoxic effects of aprepitant on the viability of the CRC cell line (SW480). The level of reactive oxygen species (ROS) was measured after 24-hour treatment with SP and aprepitant. PI/annexin V-FITC staining was conducted to assess apoptosis. Also, the expression of NF-κB antiapoptotic target genes and proapoptotic p53 target genes was measured by real-time- (RT-) PCR assay. Western blotting assay was performed to determine the expression of PI3k/AKT/NF-κB proteins. Results. We found that aprepitant stimulates apoptotic cell death and attenuates the PI3K/Akt pathway and its downstream proapoptotic target gene, including NF-κB in SW480 cells. Also, the obtained results from the quantitative RT-PCR assay showed that aprepitant could decrease the level of mRNA of NF-κB antiapoptotic target genes. Conclusion. Towards this end, this study suggests that SP/NK1R system plays a vital role in the development of CRC, and pharmaceutical targeting of NK1R using aprepitant might be a promising treatment against CRC.

The study aimed to analyze the application of diffusion tensor imaging (DTI) in the surgery of benign and malignant intracranial tumors through improved fuzzy C-means (FCM). First, a method of combining the maximum and minimum distances was proposed to improve the FCM algorithm. Then, the optimized FCM was applied to the diffusion tensor imaging (DTI) diagnosis. The patients were rolled into the benign tumor group and the malignant tumor group, and relevant parameters were compared. Finally, the postoperative total resection rate and disability rate of the DTI experimental group and the traditional control (Ctrl) group were evaluated. It was found that the segmentation accuracy of the optimized FCM algorithm was higher than traditional one and the obtained corpus callosum edge contour was clearer. In 63 patients with intracranial space, there were obvious differences in pairwise comparison of meningioma and glioma, metastatic tumor’s apparent diffusion coefficient (ADC) value, relative apparent diffusion coefficient (r ADC) value, and relative anisotropy fraction (r FA) P < 0.05 . In terms of the ADC, r ADC, and r FA values of tumor parenchymal area, those of benign tumors were larger than malignant tumors P < 0.05 . The ADC value (8.21 ± 1.87) and r FA value (1.36 ± 0.41) of the contralateral normal white matter area of malignant tumor were greater than the ADC value (7.23 ± 2.31) and r FA value (0.61 ± 0.24) of the peritumor white matter area, with statistically significant differences P < 0.05 . The total cut rates of the experimental group and the Ctrl were 87.5% and 54.84%, and the disability rates were 6.25% and 34.38%. In conclusion, the optimized FCM has high accuracy. The ADC, r ADC, and r FA values of DTI are important in the diagnosis of intracranial tumors. Besides, DTI can improve the survival rate in guiding intracranial tumor resection.

Background. Preformed metal crowns (PMCs), as an effective technique recommended for the enduring restoration of primary molar defects, have not been widely implemented in China as well as that in Western countries. This study is aimed at assessing the knowledge on the clinical use of the PMC technique and its effective factors among dentists in Chengdu, China. Thus, the present study is aimed at providing the best available evidence on clinical decision-making to manage dental caries in children and the overall benefits. Methods. The self-designed questionnaire in this study consisted of two main sections, including the sociodemographic characteristics of the respondents and their perception and use of PMCs. The anonymous questionnaire was distributed among 1000 dentists practicing in Chengdu via SO JUMP. Results. The response rate was 45%. Most respondents (69.6%) did not use PMCs. Academic qualification, working specialty, and professional experience were associated with dentists’ use of PMCs. The lack of knowledge about the PMC technique was the main obstacle to the dental practitioners’ use of PMCs (41.7%). The lack of understanding of the rationale behind PMCs was the main reason for parents’ acceptance of PMC restorations (43.6%). Attending continuing education programs was the main approach to learning the PMC restorative technique (59.1%). Conclusions. The clinical use of PMCs was not very popular in Chengdu city. To promote this restorative technique, knowledge and practical training should be incorporated into routine courses of undergraduate dental education.

Statistical analysis of Bactrocera grooming behavior is important for pest control and human health. Based on DeepLabCut, this study proposes a noninvasive and effective method to track the key points of Bactrocera minax and to detect and analyze its grooming behavior. The results are analyzed and calculated automatically by a computer program. Traditional movement tracking methods are invasive; for instance, the use of artificial pheromone may affect the behavior of Bactrocera minax, thus directly affecting the accuracy and reliability of experimental results. Traditional research studies mainly rely on manual work for behavior analysis and statistics. Researchers need to play the video frame by frame and record the time interval of each grooming behavior manually, which is time-consuming, laborious, and inaccurate. So the advantages of automated analysis are obvious. Using the method proposed in this paper, the image data of 94538 frames from 5 adult Bactrocera were analyzed and 14 key points were tracked. The overall tracking accuracy was as high as 96.7%. In the behavior analysis and statistics, the average accuracy rate of the five grooming behavior was all above 96%, and the accuracy rate of the remaining two grooming behavior was over 87%. The experimental results show that the automatic noninvasive method designed in this paper can track many key points of Bactrocera minax with high accuracy and ensure the accuracy of insect behavior recognition and analysis, which greatly reduces the manual observation time and provides a new method for key points tracking and behavior recognition of related insects.

A field experiment was conducted on 2019 growing season to evaluate effects of different rates of nitrogen, phosphorus, and sulfur on growth and yield of garlic under supplemental irrigation. A local variety, Tuma, was used and treated with six rates of NPS (T1 (0 : 0 : 0 kg/ha NPS) (control), T2 (19 : 38 : 7 kg/ha NPS), T3 (28.5 : 57 : 10.5 kg/ha NPS), T4 (47.5 : 76 : 14 kg/ha NPS), T5 (47.5 : 95 : 17.5 kg/ha NPS), and T6 (57 : 114 : 21 kg/ha NPS)). The experiment was laid out in randomized complete block design and replicated three times. Data were collected for days to 50% emergence, plant height, leaf number, leaf length, bulb weight, and total bulb yield. SAS version 9.2 was used to analyze the data. Means were separated using Fisher’s test at 5% level of significance. All parameters were significantly P < 0.05 affected by the rates of NPS. The early days to 50% emergence (16) was recorded from T6 (57 : 114 : 21 kg/ha NPS), whereas the late days to 50% emergence was recorded from the control treatment (T1). Significantly highest leaf length (41.51 cm), leaf number (13.63), plant height (61.19 cm), bulb weight (39.44 g), and total bulb yield (14.91 ton ha−1) were recorded from T6 (57 : 114 : 21 kg/ha NPS). Therefore, from the result of this study, it can be concluded that the maximum total bulb yield of garlic was obtained with the application of 57 : 114 : 21 kg/ha NPS rate.

Bacterial meningitis (BM) is a public health burden in developing countries, including Central Asia. This disease is characterized by a high mortality rate and serious neurological complications. Delay with the start of adequate therapy is associated with an increase in mortality for patients with acute bacterial meningitis. Cerebrospinal fluid culture, as a gold standard in bacterial meningitis diagnosis, is time-consuming with modest sensitivity, and this is unsuitable for timely decision-making. It has been shown that bacterial meningitis differentiation from viral meningitis could be done through different parameters such as clinical signs and symptoms, laboratory values, such as PCR, including blood and cerebrospinal fluid (CSF) analysis. In this study, we proposed the method for distinguishing the bacterial form of meningitis from enteroviral one. The method is based on the machine learning process deriving making decision rules. The proposed fast-and-frugal trees (FFTree) decision tree approach showed an ability to determine procalcitonin and C-reactive protein (CRP) with cut-off values for distinguishing between bacterial and enteroviral meningitis (EVM) in children. Such a method demonstrated 100% sensitivity, 96% specificity, and 98% accuracy in the differentiation of all cases of bacterial meningitis in this study. These findings and proposed method may be useful for clinicians to facilitate the decision-making process and optimize the diagnostics of meningitis.

The rise of blockchain has led to discussions on new governance models and the cooperation of multiple participants. Due to the cognitive defects of the blockchain protocol in terms of intelligent contracts and decentralized autonomous organizations (DAOs), it is often unclear as to how to make decisions about the evolution of blockchain applications. Many autonomous organizations, with the support of network technologies such as blockchain, blindly absorb members and expand the scale of the capital pool, while ignoring the cost advantage of traditional autonomous organizations based on social relations and mutual supervision to fight information asymmetry. In this context, this study analyzes the evolutionary trend of autonomous organizations and their members’ strategies under different policy environments. To this end, under the digital economy background, based on game theory, the evolutionary dynamics method, and the form of the mutual insurance organization, this study constructs an evolutionary dynamics model of distributed autonomous organizations. The results show that blind expansion without review aggravates the overall risk pool’s moral hazard, in the context of mutual insurance. Organizational strategies, such as risk pool splits, can effectively improve the risk pool’s operating performance and establish a benign competition elimination mechanism. Driven by cooperation efficiency and split supervision based on homogeneous clustering, the comprehensive application of the market elimination mechanism can effectively combat moral hazards, restrain the adverse effects of member flow, expand the living space of small- and medium-sized insurance organizations, curb the emergence of a large-scale monopoly risk pool, and improve market vitality. These conclusions and suggestions also apply to autonomous organizations based on social relations and mutual supervision. The results offer specific decision-making guidance and suggestions for the government, insurance companies, and risk management.

This study is aimed at comparing the efficacy of heat softening and ultrasonic removal of root-end gutta-percha during retrograde preparation for root apical microsurgery. Recently extracted single-rooted premolars ( n = 40 ) were prepared with standardized endodontically treated and root-end resection and then randomly divided into four groups that received root-end cavity preparation using four different instruments: a diamond-coated ultrasonic tip (AS3D; SACTEON, Paris, France), AS3D with the modified plugger of cordless heat carrier (MSE; B&L Biotech, Bala Cynwyd, PA, USA), stainless steel ultrasonic tip (Jetip-2; B&L Biotech, Bala Cynwyd, PA, USA), or Jetip-2 with MSE. The time required for root-end preparation was recorded. The root apex samples were examined by scanning electron microscopy to assess root surface microcracks and marginal integrity. The remnants of gutta-percha on the cavity walls were evaluated using a stereomicroscope. Statistical analysis was performed using Student’s t -test and Wilcoxon rank-sum test ( P < 0.05 ). Usage of MSE with Jetip-2 significantly reduced preparation time from 99.8 ± 6.8 s to 32.4 ± 1.0 s ( P = 0.009 ), the number of microcracks from 42 to 13 ( P = 0.036 ), and the remnants of gutta-percha from 80% to 20% ( P = 0.041 ). Similar results were observed for AS3D with MSE. The heat softening of MSE was effective in cleaning gutta-percha, thus greatly improving the efficiency of the root-end preparation, thereby producing a root-end cavity with fewer microcracks and better marginal integrity.

Introduction. Moxibustion, a traditional Chinese medicine technique, involves the use of moxa smoke from Folium Artemisia argyi to treat various disorders, especially superficial infections. However, there is a higher health risk for people exposed to high levels of moxa smoke for extended durations. Here, we report the first ultra-high-performance liquid chromatography (UHPLC) fingerprint profiles and pharmacodynamic evaluation of moxa smoke, as well as evaluation of its aqueous solution on a rat model of superficial infection. Methods. A novel method for moxa smoke fingerprint profiling was developed using UHPLC under characteristic wavelength. Chromatographic peaks were further analyzed by ultra-high-performance liquid chromatography quadrupole-time-of-flight mass spectrometry (UHPLC-QTOF/MS). 12 sample batches obtained from various Chinese provinces were then analyzed using similarity evaluation, clustering analysis, and principal component analysis. The pharmacodynamics of moxa smoke and moxa aqueous solution were investigated on a rat model of acute skin wound infection. Results. UHPLC fingerprint profiles of 12 batches of moxa smoke were generated at 270 nm wavelength and 21 chromatographic peaks extracted as common peaks. Similarity between the 12 batches ranged from 0.341 to 0.982. Based on cluster analysis, the 12 batches of moxa smoke samples were clustered into five groups. Principal component analysis showed that the cumulative contribution of the three principal components reached 90.17%. Eigenvalues of the first, second, and third principal components were 10.794, 6.504, and 1.638, respectively. The corresponding variance contribution rates were 51.40%, 30.97%, and 7.80%, respectively. Pharmacological analysis found that wound healing was slow in the model group relative to the mupirocin ointment, moxa smoke, and aqueous moxa smoke solution groups. Histological analysis revealed markedly reduced tissue inflammation in rats treated with moxa smoke or its aqueous solution. Conclusions. Moxa smoke and its aqueous solution significantly promote wound healing upon superficial infection. A novel quality control method for moxa smoke was established and evaluated for the first time. As its main effects are unchanged, the transformation of moxa smoke into aqueous moxa smoke improves safety and is a simple and controllable process.

Objective. Peritoneal adhesion (PA) is an abnormal connective tissue that usually occurs between tissues adjacent to damaged organs during processes such as surgery. In this study, the anti-inflammatory and antioxidant effects of Portulaca oleracea (PO) were investigated against postoperative-induced peritoneal adhesion. Methods. Thirty healthy male Wistar rats ( 220 ± 20 g , 6-8 weeks) were randomly divided into four groups: (1) normal, (2) control (induced peritoneal adhesion), and (3) and (4) PO extracts (induced peritoneal adhesion and received 100 or 300 mg/kg/day of PO extract for seven days). Finally, macroscopic and microscopic examinations were performed using different scoring systems and immunoassays in the peritoneal lavage fluid. Results. We found that the levels of adhesion scores and interleukin- (IL-) 1β, IL-6, IL-10, tumour necrosis factor- (TNF-) α, transforming growth factor- (TGF-) β1, vascular endothelial growth factor (VEGF), and malondialdehyde (MDA) were increased in the control group. However, PO extract (100 and 300 mg/kg) notably reduced inflammatory (IL-1β, IL-6, and TNF-α), fibrosis (TGF-β1), angiogenesis (VEGF), and oxidative (MDA) factors, while increased anti-inflammatory cytokine IL-10, antioxidant factor glutathione (GSH), compared to the control group. Conclusion. Oral administration of PO improved postoperational-induced PA by alleviating the oxidative factors, fibrosis, inflammatory cytokines, angiogenesis biomarkers, and stimulating antioxidative factors. Hence, PO can be considered a potential herbal medicine to manage postoperative PA. However, further clinical studies are required to approve the effectiveness of PO.

Corynebacterium pseudotuberculosis is the etiologic agent of Caseous Lymphadenitis (CLA), a disease leading to severe damage in sheep and goats farming due to the lack of serological diagnosis, treatment, and effective prophylaxis. In this context, several strategies in an attempt to discover new antigens to compose diagnosis assays or vaccines are fundamental. Therefore, this study aimed to use bioinformatics software to evaluate the critical chemical characteristics of unknown proteins of C. pseudotuberculosis by selecting them for heterologous expression in Escherichia coli. For this purpose, six protein sequences of ascorbate transporter subunit, UPF protein, MMPL family transporter, Ribonuclease, Iron ABC transporter domain-containing permease, and fimbrial subunit were obtained. In silico analyses were performed using amino acid sequences to access immunodominant epitopes and their antigenic and allergenic potential and physicochemical characterization. The expressed proteins were used as an antigen for serological diagnosis by ELISA. All proteins showed distinct immunodominant epitopes and potential antigenic characteristics. The only proteins expressed were PTS and Ribonuclease. In parallel, we expressed CP40 and all were used with ELISA antigen in 49 CLA positive sera and 26 CLA negative sera. The proteins alone showed 100% sensitivity and 96.2%, 92.3%, and 88.5% specificity for rPTS, rRibonuclease, and rCP40, respectively. When proteins were combined, they showed 100% sensitivity and 84.6%, 92.3%, 88.5%, and 92.3% specificity for rPTS/rCp40, rRibonuclease/rCP40, rPTS/rRibonuclease, and rPTS/rRibonuclease/rCP40, respectively. The results of this study show an excellent correlation of sensitivity and specificity with all proteins. None of the specificity values preclude the potential of rPTS, rRibonuclease, or rCP40 for use in ELISA diagnostic assays since the results of this work are superior to those of other studies on CLA diagnosis described in the literature.

Purpose. To report the functional outcomes and reading speeds following PRESBYOND laser blended vision (LBV) using nonlinear aspheric ablation profiles with micro-monovision with the Carl Zeiss Meditec MEL 90 platform. Methods. Data have been collected retrospectively for all patients who underwent PRESBYOND LBV using the MEL 90 excimer laser. Postoperative binocular uncorrected distance and near visual acuity, stereo-acuity, contrast sensitivity, and reading performance were compared with pre-op values measured with patient’s progressive glasses. Mean follow-up was 6 ± 1.2 months. Results. Sixty eyes of 30 patients (mean age 50.47 ± 6.43 years) were included. Of these, 18 patients were hyperopic and 12 patients were myopic with mean SE of 1.28 ± 1.38 D and −2.84 ± 1.86 D, respectively. At 6 months, the mean binocular UDVA was ≥−0.03 ± 0.06 log MAR and the mean binocular UNVA was ≥0.22 ± 0.04 log MAR. The uncorrected reading speeds (words per minute) at the preferred reading distance of 46.17 cm, 60 cm, and 80 cm were significantly better ( p value p > 0.05 for all distances). Uncorrected contrast sensitivity log values showed mild reduction; however, this was not statistically significant for any spatial frequency. There was a significant reduction in post uncorrected stereopsis to 89.67 arc sec, compared with pre-op corrected stereopsis (50.67 arc sec); however, it recovered fully with near correction (53.33 arc sec, p > 0.05 compared with pre). Conclusion. PRESBYOND LBV resulted in significantly better reading speeds and satisfactory functional visual outcomes, without a permanent change in stereo-acuity and contrast sensitivity 6 months postoperatively.

Acanthopanax giraldii Harms is commonly used in traditional Chinese medicine to treat rheumatism, improve joints, and strengthen muscles and bones. The polysaccharides present in A. giraldii Harms contain major bioactive substances, which have antioxidant, anticancer, and antiviral activities. In this study, the structural characterization of the homogeneous polysaccharide isolated from A. giraldii Harms, known as AHP-II, and its immunomodulatory effects in vivo will be studied. High-performance ion chromatography (HPIC) and high-performance gel permeation chromatography (HPGPC) based analyses revealed that AHP-II was composed of various monosaccharides, which included rhamnose, arabinose, galactose, glucose, mannose, galacturonic acid, and glucuronic acid in molar ratios of 29.5 : 24.6 : 23.8 : 4.4 : 5.7 : 8.8 : 3.1, respectively, and had a collective molecular weight of 80.21 × 103 Da. Fourier-transform infrared (FTIR) spectroscopy indicated the presence of a pyranose ring and β-type glycosidic linkages in AHP-II. In addition, immunomodulatory effect analyses of AHP-II that used a cyclophosphamide-induced immunosuppressive mouse model demonstrated that its treatment could significantly restore spleen and thymus indices, promote the proliferation of splenic lymphocytes, elevate CD4+ T lymphocyte percentage and CD4+ : CD8+ ratio in the spleen, promote macrophage phagocytosis, and restore cytokines (IL-6, TNF-α, IgM, and IgG) levels. These results suggested that AHP-II could potentially be used as natural immunomodulator and as an alternative treatment to reduce chemotherapy-induced immunosuppression.

Spinal cord injury (SCI) is a traumatic disease that can cause severe nervous system dysfunction. SCI often causes spinal cord mitochondrial dysfunction and produces glucose metabolism disorders, which affect neuronal survival. Zinc is an essential trace element in the human body and plays multiple roles in the nervous system. This experiment is intended to evaluate whether zinc can regulate the spinal cord and neuronal glucose metabolism and promote motor functional recovery after SCI. Then we explore its molecular mechanism. We evaluated the function of zinc from the aspects of glucose uptake and the protection of the mitochondria in vivo and in vitro. The results showed that zinc elevated the expression level of GLUT4 and promoted glucose uptake. Zinc enhanced the expression of proteins such as PGC-1α and NRF2, reduced oxidative stress, and promoted mitochondrial production. In addition, zinc decreased neuronal apoptosis and promoted the recovery of motor function in SCI mice. After administration of AMPK inhibitor, the therapeutic effect of zinc was reversed. Therefore, we concluded that zinc regulated the glucose metabolism of the spinal cord and neurons and promoted functional recovery after SCI through the AMPK pathway, which is expected to become a potential treatment strategy for SCI.

Cellular senescence is a state of irreversible cell proliferation arrest induced by various stressors including telomere attrition, DNA damage, and oncogene induction. While beneficial as an acute response to stress, the accumulation of senescent cells with increasing age is thought to contribute adversely to the development of cancer and a number of other age-related diseases, including neurodegenerative diseases for which there are currently no effective disease-modifying therapies. Non-cell-autonomous effects of senescent cells have been suggested to arise through the SASP, a wide variety of proinflammatory cytokines, chemokines, and exosomes secreted by senescent cells. Here, we report an additional means of cell communication utilised by senescent cells via large numbers of membrane-bound intercellular bridges—or tunnelling nanotubes (TNTs)—containing the cytoskeletal components actin and tubulin, which form direct physical connections between cells. We observe the presence of mitochondria in these TNTs and show organelle transfer through the TNTs to adjacent cells. While transport of individual mitochondria along single TNTs appears by time-lapse studies to be unidirectional, we show by differentially labelled co-culture experiments that organelle transfer through TNTs can occur between different cells of equivalent cell age, but that senescent cells, rather than proliferating cells, appear to be predominant mitochondrial donors. Using small molecule inhibitors, we demonstrate that senescent cell TNTs are dependent on signalling through the mTOR pathway, which we further show is mediated at least in part through the downstream actin-cytoskeleton regulatory factor CDC42. These findings have significant implications for the development of senomodifying therapies, as they highlight the need to account for local direct cell-cell contacts as well as the SASP in order to treat cancer and diseases of ageing in which senescence is a key factor.

COVID-19 has sparked a worldwide pandemic, with the number of infected cases and deaths rising on a regular basis. Along with recent advances in soft computing technology, researchers are now actively developing and enhancing different mathematical and machine-learning algorithms to forecast the future trend of this pandemic. Thus, if we can accurately forecast the trend of cases globally, the spread of the pandemic can be controlled. In this study, a hybrid CNN-LSTM model was developed on a time-series dataset to forecast the number of confirmed cases of COVID-19. The proposed model was evaluated and compared with 17 baseline models on test and forecast data. The primary finding of this research is that the proposed CNN-LSTM model outperformed them all, with the lowest average MAPE, RMSE, and RRMSE values on both test and forecast data. Conclusively, our experimental results show that, while standalone CNN and LSTM models provide acceptable and efficient forecasting performance for the confirmed COVID-19 cases time series, combining both models in the proposed CNN-LSTM encoder-decoder structure provides a significant boost in forecasting performance. Furthermore, we demonstrated that the suggested model produced satisfactory predicting results even with a small amount of data.

The main aim is to evaluate the cyclic fatigue resistance of blue heat-treated instruments with different kinematics. Twenty-four endodontic instruments of the same brand were used for each of three experimental groups: VB (Vortex Blue 40/0.04), RB (RECIPROC Blue 40/0.06), and XB (X1 Blue 40/0.06). The instruments were randomly distributed and subjected to temperatures of 20°C and 37°C. The fatigue test was performed using a stainless steel device. Data were analysed using the Shapiro–Wilk test, Student’s t-test, the F test, and Tukey’s and Tamhane tests at significance level P = 0.05 . The instruments’ cyclic fatigue resistance at both temperatures differed significantly for each instrument type ( P < 0.001 ). The RB instruments displayed greater cyclic fatigue resistance at the tested temperatures compared with the VB and XB instruments ( P < 0.001 ). Reciprocating kinematics positively influenced cyclic fatigue resistance. Blue heat-treated instruments showed decreased cyclic fatigue resistance as the temperature increased ( P < 0.001 ).

Objectives. This study is aimed at identifying the best clinical model to predict poststroke independence at 6 and 18 months, considering sociodemographic and clinical characteristics, and then identifying differences between countries. Methods. Data was retrieved from the International Stroke Trial 3 study. Nine clinical variables (age, gender, severity, rt-PA, living alone, atrial fibrillation, history of transient ischemic attack/stroke, and abilities to lift arms and walk) were measured immediately after the stroke and considered to predict independence at 6 and 18 months poststroke. Independence was measured using the Oxford Handicap Scale. The adequacy, predictive capacity, and discriminative capacity of the models were checked. Countries were added to the final models. Results. At 6 months poststroke, 35.8% ( n = 1088 ) of participants were independent, and at 18 months, this proportion decreased to 29.9% ( n = 747 ). Both 6 and 18 months poststroke predictive models obtained fair discriminatory capacities. Gender, living alone, and rt-PA only reached predictive significance at 18 months. Poststroke patients from Poland and Sweden showed greater chances to achieve independence at 6 months compared to the UK. Poland also achieved greater chances at 18 months. Italy had worse chances than the UK at both follow-ups. Discussion. Six and eight variables predicted poststroke independence at 6 and 18 months, respectively. Some variables only reached significance at 18 months, suggesting a late influence in stroke patients’ rehabilitation. Differences found between countries in achieving independence may be related to healthcare system organization or cultural characteristics, a hypothesis that must be addressed in future studies. These results can allow the development of tailored interventions to improve the outcomes.

Purpose. Hepatocellular carcinoma (HCC) accounts for approximately ninety percent of primary liver cancer. This study attempted to investigate the effects of the long noncoding RNA MIR100HG (MIR100HG) in HCC and the underlying molecular mechanism. Materials and Methods. qRT-PCR was implemented to analyze the expression of MIR100HG, microRNA-146b-5p (miR-146b-5p), and Chromobox 6 (CBX6). The correlation between MIR100HG and clinicopathological features of HCC patients was assessed. Additionally, the effects of MIR100HG knockdown on HCC cell viability, migration, and invasion were explored. The interactions among MIR100HG, miR-146b-5p, and CBX6 were confirmed. Furthermore, rescue experiments were conducted to investigate whether MIR100HG knockdown modulates HCC cell behaviors through modulating the miR-146b-5p/CBX6 axis. Results. The expression of MIR100HG and CBX6 was enhanced, while miR-146b-5p was inhibited in HCC cells. High MIR100HG expression was positively associated with the TNM tumor stage and Edmondson-Steiner grading in HCC patients. MIR100HG knockdown considerably reduced the HCC cell viability, migration, and invasion. In addition, MIR100HG directly targeted miR-146b-5p, and miR-146b-5p directly targeted CBX6 in HCC cells. Moreover, miR-146b-5p suppression or CBX6 elevation evidently rescued the suppressed viability, migration, and invasion of HCC cells caused by MIR100HG knockdown. Conclusions. Knockdown of MIR100HG inhibited the viability, migration, and invasion of HCC cells by targeting the miR-146b-5p/CBX6 axis, offering a potential therapeutic target for HCC therapy.

The 5′ untranslated region (5′ UTR) of rodent hepacivirus (RHV) and pegivirus (RPgV) contains sequence homology to the HCV type III internal ribosome entry sites (IRES). Utilizing a monocistronic expression vector with an RNA polymerase I promoter to drive transcription, we show cell-specific IRES translation and regions within the IRES required for full functionality. Focusing on RHV, we further pseudotyped lentivirus with RHV and showed cell surface expression of the envelope proteins and transduction of murine hepatocytes and we then constructed full-length RHV and RPgV replicons with reporter genes. Using the replicon system, we show that the RHV NS3-4A protease cleaves a mitochondrial antiviral signaling protein reporter. However, liver-derived cells did not readily support the complete viral life cycle.

By accelerating the aforementioned industrialisation and urbanisation, people’s way of life has undergone enormous changes. The incidence of overweight and obesity increases rapidly. This research first broke through the impact of basketball on improving physical health and then designed experiments separately. The experiment is divided into two experimental groups and a replacement group, with 150 people in total, 50 people per group, excluding the interference of gender, age, and other factors. The influencing factors are studied under the monitoring of the Internet of Things technology. One group had 8 weeks of basketball training, and the other group had 8 weeks of plant diet. The results showed that the average weight of the nutrition intervention group was reduced by 9.85 kg, and the average weight of the exercise intervention group was reduced by 7.64 kg. The percentage of body fat and blood lipid composition of the obese people have decreased, which indicates that the combination of basketball intervention under the monitoring of the Internet of Things technology can improve the physique of obese people.

Objective. This study is aimed at describing a score to assess infection control structures in Oral Health Teams (OHT) in Primary Health Care (PHC) in Brazil. Methods. Secondary data from a national external evaluation of PHC conducted in 2017 and 2018 were analyzed. The construction of the score used 14 variables, divided into the following: structural characteristics of the PHC, infection control equipment under conditions of use, and biosafety supplies in sufficient quantity. The questions were mostly dichotomous (yes/no). Descriptive analyses were carried out to characterize the OHT and factor analyses to reduce the number of observed variables to a specific number of factors. Results. Among 20,301 health units with OHT, 4,510 (22.2%) units did not have washable floors, ceilings, and walls; 8,406 (41.4%) did not have a sealer; 16,780 (82.7%) did not have taps with noncontact activation, and 4,663 (23.0%) units did not have rubber gloves. Regarding personal protective equipment (PPE), 1,618 (8.0%) units did not have a sufficient quantity of basic PPE. Three factors were defined to explain the 14 evaluated variables. The South region had the best score of infection control, while the North had the worst. Conclusions. Regional inequalities in the failures in infection control structures identified in PHC with OHT were related to the physical structure, equipment, and supplies used for infection control and the absence of PPE for OHT.

Pudendal neuralgia (PN) is a complex disease with various clinical characteristics, and there is no treatment showing definite effectiveness. This study is aimed at evaluating the clinical efficacy of ultrasound-guided high-voltage long-duration pulsed radiofrequency (PRF) for PN. Two cadavers (one male, one female) were dissected to provide evidence for localization of the pudendal nerve. Patients diagnosed as PN who failed or were intolerant in regular medication were screened for diagnostic local anesthesia block of the pudendal nerve before recruitment. Twenty PN patients were enrolled in this study. In the PRF procedure, the needle tip was inserted medially into the internal pudendal artery under ultrasound guidance. The position of the PRF needle tip was then adjusted by the response of the pudendal nerve to the electrical stimulation within the pudendal area (42°C, a series of 2 Hz, and 20 ms width pulses that lasted for 900 s). Alleviation of pain was assessed by the visual analogue scale (VAS) and sitting time pretreatment and on 7 d, 14 d, 1 m, 2 m, 3 m, and 6 m posttreatment in outpatient follow-up or by telephone interview. Two patients were lost due to intervention-irrelevant reasons. Patients showed significantly decreased VAS scores on 7 d after RFP, compared with pretreatment status ( 7.0 ± 0.9 vs. 3.2 ± 1.7 , P < 0.001 ). The efficacy remained steady till the end of 6 months, with a final remission rate of 88.9%. Sitting time also significantly lengthened following PRF (7 d, 14 d, 1 m, 2 m, 3 m, and 6 m vs. pretreatment, all P < 0.05 ). Only short-term ipsilateral involuntary convulsion of the lower extremity was reported in one patient, who recovered within 12 h. Six patients were treated with nonsteroidal drugs for a short time. All patients stopped taking medication finally. In conclusion, the ultrasound-guided high-voltage long-duration PRF approach not only reduced the pelvic pain caused by PN but also improved the quality of life by extending sitting time without nerve injury.

In order to explore the effect of magnetic resonance imaging (MRI) based on phase correction algorithm in diagnosing female pelvic abscess, firstly, the effect of phase correction algorithm on eliminating MRI image motion artifacts was studied, then it was applied to 71 female pelvic cases admitted to our hospital in the diagnosis of abscess patients with magnetic resonance imaging technology, and the results were compared with the results of multislice spiral CT and laparoscopy to explore the accuracy of MRI and CT. It was found that the results of MRI examination were close to those of laparoscopy, and the difference was not statistically significant ( P > 0.05 ); the results of CT examination and laparoscopy were significantly different, and the difference was statistically significant ( P < 0.05 ); in addition, the results of CT examination, the number of bacterial cysts (43 cases) and tuberculous cysts (12 cases), were significantly lower than the results of MRI (50 cases, 18 cases), and the difference was statistically significant ( P < 0.05 ). The size of the mass shown by the MRI examination (4.1 cm × 4.2 cm × 3.9 cm～13.9 cm × 9.5 cm × 8.7 cm) was larger than the size of the mass revealed by the CT examination (5.2 cm × 4.3 cm × 4.1 cm～15.5 cm × 10.1 cm × 9.6 cm), the difference between the two was statistically significant ( P < 0.05 ), and it was closer to the results of laparoscopic pathology (4.1 cm × 4.3 cm × 3.9 cm～14.1 cm × 9.3 cm P < 0.05 8.7 cm). In short, the phase correction algorithm could eliminate the motion artifacts of MRI images. In the imaging diagnosis of female pelvic abscess, the MRI diagnosis based on the phase correction algorithm is more ideal than the diagnosis of multislice spiral CT. It can be used as a reference basis for clinical disease treatment.

This work aimed to study the application of pelvic floor dynamic images of magnetic resonance imaging (MRI) based on the particle swarm optimization (PSO) algorithm in female stress urinary incontinence (SUI). 20 SUI female patients were selected as experimental group, and another 20 healthy females were taken as controls. PSO algorithm, K-nearest neighbor (KNN) algorithm, and back propagation neural network (BPNN) algorithm were adopted to construct the evaluation models for comparative analysis, which were then applied to 40 cases of female pelvic floor dynamic MRI images. It was found that the model proposed had relatively high prediction accuracy in both the training set (87.67%) and the test set (88.46%). In contrast to the control group, there were considerable differences in abnormal urethral displacement, urethral length changes, bladder prolapse, and uterine prolapse in experimental patients ( P < 0.05 ). After surgery, the change of urethral inclination angle was evidently reduced ( P < 0.05 ). To sum up, MRI images can be adopted to assess the occurrence of female SUI with abnormal urethral displacement, shortening of urethra length, bladder prolapse, and uterine prolapse. After surgery, the abnormal urethral movement was slightly improved, but there was no obvious impact on bladder prolapse and uterine prolapse.

Background. Although the efficacy of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR- TKI) therapy has been proven in non-small cell lung cancer (NSCLC) patients, acquired resistance to EGFR-TKIs presents a serious clinical problem. Hence, the identification of new therapeutic strategy is needed to treat EGFR-TKI-resistant NSCLC. Methods. Acquired EGFR-TKI-resistant lung cancer cell lines (HCC827, H1993, and H292 cells with acquired resistance to gefitinib or erlotinib) were used for cell-based studies. IncuCyte live cell analysis system and XFp analyzer were used for the determination of cell proliferation and energy metabolism, respectively. In vivo anticancer effect of phenformin was assessed in xenografts implanting HCC827 and gefitinib-resistant HCC827 (HCC827 GR) cells. Results. HCC827 GR and erlotinib-resistant H1993 (H1993 ER) cells exhibited different metabolic properties compared with their respective parental cells, HCC827, and H1993. In EGFR-TKI-resistant NSCLC cells, glycolysis markers including the glucose consumption rate, intracellular lactate level, and extracellular acidification rate were decreased; however, mitochondrial oxidative phosphorylation (OXPHOS) markers including mitochondria-driven ATP production, mitochondrial membrane potential, and maximal OXPHOS capacity were increased. Cell proliferation and tumor growth were strongly inhibited by biguanide phenformin via targeting of mitochondrial OXPHOS complex 1 in EGFR-TKI-resistant NSCLC cells. Inhibition of OXPHOS resulted in a reduced NAD+/NADH ratio and intracellular aspartate levels. Recovery of glycolysis by hexokinase 2 overexpression in erlotinib-resistant H292 (H292 ER) cells significantly reduced the anticancer effects of phenformin. Conclusion. Long-term treatment with EGFR-TKIs causes reactivation of mitochondrial metabolism, resulting in vulnerability to OXPHOS inhibitor such as phenformin. We propose a new therapeutic option for NSCLC with acquired EGFR-TKI resistance that focuses on cancer metabolism.

Kidney transplantation is the promising treatment of choice for chronic kidney disease and end-stage kidney disease and can effectively improve the quality of life and survival rates of patients. However, the allograft rejection following kidney transplantation has a negative impact on transplant success. Therefore, the present study is aimed at screening novel biomarkers for the diagnosis and treatment of allograft rejection following kidney transplantation for improving long-term transplant outcome. In the study, a total of 8 modules and 3065 genes were identified by WGCNA based on the GSE46474 and GSE15296 dataset from the Gene Expression Omnibus (GEO) database. Moreover, the results of Gene Ontology (GO) annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis showed that these genes were mainly involved in the immune-related biological processes and pathways. Thus, 317 immune-related genes were selected for further analysis. Finally, 5 genes (including CD200R1, VAV2, FASLG, SH2D1B, and RAP2B) were identified as the candidate biomarkers based on the ROC and difference analysis. Furthermore, we also found that in the 5 biomarkers an interaction might exist among each other in the protein and transcription level. Taken together, our study identified CD200R1, VAV2, FASLG, SH2D1B, and RAP2B as the candidate diagnostic biomarkers, which might contribute to the prevention and treatment of allograft rejection following kidney transplantation.

This work aimed to explore the relationship between spine surgery lumbar facet joint (LFJ) and lumbar disc herniation (LDH) via compressed sensing algorithm-based MRI images to analyze the clinical symptoms of patients with residual neurological symptoms after LDH. Under weighted BM3D denoising, Epigraph method was introduced to establish the novel CSMRI reconstruction algorithm (BEMRI). 127 patients with LDH were taken as the research objects. The BEMRI algorithm was compared with others regarding peak signal-to-noise ratio (PSNR) and structural similarity index (SSIM). Patients’ bilateral LFJ angles were compared. The relationships between LFJ angles, lumbar disc degeneration, and LFJ degeneration were analyzed. It turned out that the PSNR and SSIM of BEMRI algorithm were evidently superior to those of other algorithms. The proportion of patients with grade IV degeneration was at most 31.76%. Lumbar disc grading was positively correlated with change grading of LFJ degeneration ( P < 0.001 ). LFJ asymmetry was positively correlated with LFJ degeneration grade and LDH ( P < 0.001 ). Incidence of residual neurological symptoms in patients aged 61–70 years was as high as 63.77%. The proportion of patients with severe urinary excretion disorders was 71.96%. Therefore, the BEMRI algorithm improved the quality of MRI images. Degeneration of LDH was positively correlated with degeneration of LFJ. Asymmetry of LFJ was notably positively correlated with the degeneration of LFJ and LDH. Patients aged 61–70 years had a high incidence of residual neurological symptoms after surgery, most of which were manifested as urinary excretion disorders.

Because of the ability to metabolize a large number of electron acceptors such as nitrate, nitrite, fumarate, and metal oxides, Shewanella species have attracted much attention in recent years. Generally, the use of these electron acceptors is mainly achieved through electron transfer proteins and their interactions which will dynamically change across different environmental conditions in cells. Therefore, functional analysis of condition-specific molecular networks can reveal biological information on electron transfer processes. By integrating expression data and molecular networks, we constructed condition-specific molecular networks for Shewanella piezotolerans WP3. We then identified condition-specific key genes and studied their potential functions with an emphasis on their roles in electron transfer processes. Functional module analysis showed that different flagellar assembly modules appeared under these conditions and suggested that flagellar proteins are important for these conditions. We also identified the electron transfer modules underlying these various environmental conditions. The present results could help with screening electron transfer genes and understanding electron transfer processes under various environmental conditions for the Shewanella species.

Purpose. The dynamic state of epinephrine (Ep) in the plasma of patients with out-of-hospital cardiac arrest (OHCA) remains unclear. The purpose of this study was to evaluate the relationship between the plasma levels of catecholamines (such as epinephrine (Ep), norepinephrine (Nep), and dopamine) and vasopressin (antidiuretic hormone (ADH)) and the acquisition of return of spontaneous circulation (ROSC) in OHCA patients. Methods. This was a prospective, observational clinical study. Patients with OHCA transferred to our hospital between July 2014 and July 2017 were enrolled. The levels of catecholamines and ADH in the plasma were measured using blood samples immediately obtained on arrival at our hospital and before the administration of Ep. Patients in whom Ep was already administered prior to obtaining blood samples were excluded. Patients were divided into two groups: with and without ROSC, that is, ROSC (+) and ROSC (−) groups, respectively. The plasma levels of these agents and the conditions of resuscitation were compared between the two groups. Results. A total of 96 patients with OHCA were analyzed. The ROSC (+) and ROSC (−) groups included 34 and 62 patients, respectively. There were no significant differences observed between the two groups in age, cause of cardiopulmonary arrest, and prehospital resuscitation time. The plasma levels of Ep and Nep were significantly lower in the ROSC (+) group than in the ROSC (−) group. However, there were no significant differences in the plasma levels of dopamine and ADH between the two groups. Conclusion. Increased levels of Ep in the plasma may not be associated with the acquisition of ROSC in patients with OHCA.

The aim of this study was to evaluate the biocompatibility and osteogenic potential of a Zeolite Socony Mobil-5 (ZSM-5) coating on a Ti-24 Nb-4 Zr-7.9 Sn (Ti-2448) surface. ZSM-5-modified Ti-2448 (ZSM-5/Ti-2448) and Ti-2448 (control) groups were employed. The physical and chemical properties of the two types of samples were evaluated by scanning electron microscopy, Fourier-transform infrared spectroscopy, nitrogen adsorption/desorption, and contact angle methods. The surface of the ZSM-5/Ti-2448 was rougher than that of the original Ti-2448, while the contact angle of the ZSM-5/Ti-2448 was smaller than that of Ti-2448. In addition, the ZSM-5/Ti-2448 largely increased the specific surface area and introduced silanol groups. A bone-like apatite layer could be formed on the surface of ZSM-5/Ti-2448 after 14 days of incubation in a simulated body fluid. ZSM-5/Ti-2448 was not cytotoxic. The number and alkaline phosphatase (ALP) activity of osteoblasts on ZSM-5/Ti-2448 were significantly higher than those on Ti-2448 surfaces, obtained in vitro using 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyltetrazolium bromide and ALP activity assays. Few inflammatory cells were observed around ZSM-5/Ti-2448 after insertion into the femurs of Japanese white rabbits after 4, 12, and 26 weeks through hematoxylin–eosin staining. The average gray scale of transforming growth factor-β1 (TGF-β1) on ZSM-5/Ti-2448 peaked earlier than that on Ti-2448, according to immunohistochemical staining. These results indicate that ZSM-5/Ti-2448 has a good biocompatibility and improved early osteogenic potential compared to a noncoated Ti-2448.

Mastitis is a common disease in the dairy industry that causes huge economic losses worldwide. Exosomes (carrying proteins, miRNA, lncRNA, etc.) play a vital role in the regulation of immune response. lncRNA can play a variety of regulatory roles by combining with protein, RNA, and DNA. The expression of mRNA and lncRNA in exosomes derived from bovine mammary epithelial cells infected by S. aureus is rarely understood. To explore this issue, RNA sequencing analysis was performed on exosomes derived from S. aureus-infected and noninfected MAC-T cells. Analysis of the sequencing results showed that there were 186 differentially expressed genes, 431 differentially expressed mRNAs and 19 differentially expressed lncRNAs in the exosomes derived from S. aureus-infected and noninfected MAC-T cells. By predicting lncRNA target genes, it was found that 19 differentially expressed lncRNAs all acted on multiple mRNAs in cis and trans. GO analysis revealed that differentially expressed genes and lncRNA target genes played significant roles in such metabolism (reactive oxygen species metabolic processes), transmembrane transport, cellular response to DNA damage stimulus, and response to cytokines. KEGG enrichment indicated that lncRNA target genes gathered in the TNF pathway, Notch pathway, MAPK pathway, NF-kappa B pathway, Hippo pathway, p53 pathway, reactive oxygen species metabolic processes, and longevity regulating pathway. In summary, all data indicated that differentially expressed gene, mRNA, and lncRNA in transcriptional profiling of exosomes participated in bacterial invasion and adhesion, oxidative stress, inflammation, and apoptosis-related signaling pathway. The data obtained in this study would provide valuable resource for understanding the lncRNA information in exosomes derived from dairy cow mammary epithelial cells and conduced to the study of S. aureus infection in dairy cow mammary glands.

Introduction. The World Health Organization declared COVID-19 a global pandemic last year. While a clear impact of COVID-19 on the declining stroke volume has been reported, its overall impact on stroke presentation and clinical outcomes has not been established. The purpose of this study was to assess the impact of COVID-19 on acute ischemic stroke volume, presentation, treatment, and outcomes at comprehensive stroke centers. Methods. A retrospective review of patients with a discharge diagnosis of acute ischemic stroke from the Get With The Guidelines database was performed from January 1, 2019, to July 1, 2020. The following time periods were defined: Pre-COVID (January/February), Peak-COVID (March/April), and Post-COVID (May/June). Bivariate analyses were performed comparing the 2020 and 2019 time periods to determine differences in stroke volume, presentation, treatment, and outcomes. Results. Stroke volumes were significantly lower during the Peak-COVID period in 2020 compared to that in 2019, with an absolute decline of 49.5% ( P < 0.001 ). Patients were more likely to present after 24 hours from last known well during the 2020 Peak-COVID period ( P = 0.03 ). However, there was not a significant difference in the rate of treatment with either the tissue plasminogen activator (tPA) or mechanical thrombectomy during the Peak-COVID period. Interestingly, relative treatment rates increased during the 2020 Post-COVID period to 11.4% ( P = 0.01 ). Conclusions. The overall ischemic stroke volume decreased during the pandemic, and patients had a tendency to present later, beyond eligible treatment windows. However, rates of treatment, patient demographics, and stroke outcomes did not significantly change when compared to the prior year.

Acute respiratory distress syndrome (ARDS) is difficult to treat and has a high mortality rate. Mesenchymal stem cells (MSCs) have an important therapeutic effect in ARDS. While the mechanism of MSC migration to the lungs remains unclear, the role of MSCs is of great clinical significance. To this end, we constructed vimentin knockout mice, extracted bone MSCs from the mice, and used them for the treatment of LPS-induced ARDS. H&E staining and Masson staining of mouse lung tissue allowed us to assess the degree of damage and fibrosis of mouse lung tissue. By measuring serum TNF-α, TGF-β, and INF-γ, we were able to monitor the release of inflammatory factors. Finally, through immunoprecipitation and gene knockout experiments, we identified upstream molecules that regulate vimentin and elucidated the mechanism that mediates MSC migration. As a result, we found that MSCs from wild-type mice can significantly alleviate ARDS and reduce lung inflammation, while vimentin gene knockout reduced the therapeutic effect of MSCs in ARDS. Cytological experiments showed that vimentin gene knockout can significantly inhibit the migration of MSCs and showed that it changes the proliferation and differentiation status of MSCs. Further experiments found that vimentin’s regulation of MSC migration is mainly mediated by Rab7a. Rab7a knockout blocked the migration of MSCs and weakened the therapeutic effect of MSCs in ARDS. In conclusion, we have shown that the Vimentin-Rab7a pathway mediates migration of MSCs and leads to therapeutic effects in ARDS.

Objective. This study aimed to optimize the CT images of anal fistula patients using a convolutional neural network (CNN) algorithm to investigate the anal function recovery. Methods. 57 patients with complex anal fistulas admitted to our hospital from January 2020 to February 2021 were selected as research subjects. Of them, CT images of 34 cases were processed using the deep learning neural network, defined as the experimental group, and the remaining unprocessed 23 cases were in the control group. Whether to process CT images depended on the patient’s own wish. The imaging results were compared with the results observed during the surgery. Results. It was found that, in the experimental group, the images were clearer, with DSC = 0.89, precision = 0.98, and recall = 0.87, indicating that the processing effects were good; that the CT imaging results in the experimental group were more consistent with those observed during the surgery, and the difference was notable ( P < 0.05 ). Furthermore, the experimental group had lower RP (mmHg), AMCP (mmHg) scores, and postoperative recurrence rate, with notable differences noted ( P < 0.05 ). Conclusion. CT images processed by deep learning are clearer, leading to higher accuracy of preoperative diagnosis, which is suggested in clinics.

Context. Skeletal muscle insulin resistance is one of the primary contributors of type 2 diabetes (T2D). Metformin is the first-line drug for the treatment of T2D. The primary effects of metformin include decreasing glucose production in the liver and decreasing insulin resistance in the skeletal muscle. However, the molecular mechanism of metformin’s action in skeletal muscle is not well understood. Protein phosphatase 2A (PP2A), a major serine/threonine protein phosphatase, plays a pivotal role in cellular processes, such as signal transduction, cell proliferation, and apoptosis, and acts through dephosphorylating key signaling molecules such as AKT and AMPK. However, whether PP2A plays a role in metformin-induced insulin sensitivity improvement in human skeletal muscle cells remains to be elucidated. Objective. To investigate if PP2A plays a role in metformin-induced insulin sensitivity improvement in human skeletal muscle cells. Participants. Eight lean insulin-sensitive nondiabetic participants (4 females and 4 males; age: 21.0 ± 1.0 years; BMI: 22.0 ± 0.7 kg / m 2 ; 2-hour OGTT: 97.0 ± 6.0 mg / dl ; HbA1c: 5.3 ± 0.1 % ; fasting plasma glucose: 87.0 ± 2.0 mg / dl ; M value; 11.0 ± 1.0 mg / kgBW / min ). Design. A hyperinsulinemic-euglycemic clamp was performed to assess insulin sensitivity in human subjects, and skeletal muscle biopsy samples were obtained. Primary human skeletal muscle cells (shown to retain metabolic characteristics of donors) were cultured from these muscle biopsies that included 8 lean insulin-sensitive participants. Cultured cells were expanded, differentiated into myotubes, and treated with 50 μM metformin for 24 hours before harvesting. PP2Ac activity was measured by a phosphatase activity assay kit (Millipore) according to the manufacturer’s protocol. Results. The results indicated that metformin significantly increased the activity of PP2A in the myotubes for all 8 lean insulin-sensitive nondiabetic participants, and the average fold increase is 1.54 ± 0.11 ( P < 0.001 ). Conclusions. These results provided the first evidence that metformin can activate PP2A in human skeletal muscle cells derived from lean healthy insulin-sensitive participants and may help to understand metformin’s action in skeletal muscle in humans.

To analyze the risk factors of invasive pulmonary fungal infections in patients with HBV-ACL, the clinical data and risk factors of 60 patients with HBV-ACLF complicated IPFI were analyzed retrospectively including clinical parameters, broad-spectrum antibiotics usage, neutropenia, invasive medical manipulations, serum total bilirubin, international normalized ratio (INR), and MELD scores were compared with non-IPFI. Risk factors were analyzed using mathematical tools. Candida species and Aspergillus were detected as the most prominent fungal strains (61.11% and 33.33%, respectively). The risk factors included prolong broad-spectrum antibiotic usage OR = 4.362 , P = 0.008 , neutropenia OR = 3.288 , P = 0.007 , invasive procedures OR = 3.263 , P = 0.010 , serum total bilirubin OR = 1.006 , P = 0.011 , INR OR = 2.101 , P = 0.007 , and MELD scores OR = 1.074 , P = 0.008 . Candida is the main IPFI strains in patients with HBV-ACLF. Broad-spectrum antibiotics usage, neutropenia, invasive manipulations, and the severity of ACLF might be risk factors for IPFI in patients with HBV-ACLF.

Background. Parkinson’s disease (PD) is a common neurological degenerative disease that cannot be completely cured, although drugs can improve or alleviate its symptoms. Optogenetic technology, which stimulates or inhibits neurons with excellent spatial and temporal resolution, provides a new idea and approach for the precise treatment of Parkinson’s disease. However, the neural mechanism of photogenetic regulation remains unclear. Objective. In this paper, we want to study the nonlinear features of EEG signals in the striatum and globus pallidus through optogenetic stimulation of the substantia nigra compact part. Methods. Rotenone was injected stereotactically into the substantia nigra compact area and ventral tegmental area of SD rats to construct rotenone-treated rats. Then, for the optogenetic manipulation, we injected adeno-associated virus expressing channelrhodopsin to stimulate the globus pallidus and the striatum with a 1 mW blue light and collected LFP signals before, during, and after light stimulation. Finally, the collected LFP signals were analyzed by using nonlinear dynamic algorithms. Results. After observing the behavior and brain morphology, 16 models were finally determined to be successful. LFP results showed that approximate entropy and fractal dimension of rats in the control group were significantly greater than those in the experimental group after light treatment ( p < 0.05 ). The LFP nonlinear features in the globus pallidus and striatum of rotenone-treated rats showed significant statistical differences before and after light stimulation ( p < 0.05 ). Conclusion. Optogenetic technology can regulate the characteristic value of LFP signals in rotenone-treated rats to a certain extent. Approximate entropy and fractal dimension algorithm can be used as an effective index to study LFP changes in rotenone-treated rats.