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COVID-19 pandemic has affected many businesses from all around the globe and one of them is the hospitality segment. Because of COVID-19 lockdowns and restrictions on travel, many hotels from all around the globe have suffered huge losses. After the COVID-19 restrictions were relaxed, hotels started opening the door for tourists with various precautionary measures. As the hospitality segment tries to recover from the setback due to COVID-19, this study explores the steps or strategies taken by hotels from five countries (China, Indonesia, India, Malaysia, and Thailand) in the Asia–Pacific region to attract tourists and improve their operations in the post-COVID era. For this study, the strategies undertaken and the customer reviews pertaining to 100 hotels from each of these five countries were considered. A mixed-method approach is used to analyze the effectiveness of the operations undertaken by the hotels. The study concludes with implications and future directions.

Kashin–Beck disease (KBD) is an endemic disease in China with the highest incidence rate in Tibet region. Promoted generation of oxygen free radicals by semiquinone structure of humic substance (HS) in drinking water was considered to be one of its pathogeneses. Therefore, detailed analysis of HS was performed in water and sediment samples collected from three endemic and three disease-free areas in Changdu Region, Tibet, China. After purification of the HS in the samples, the fractions of HS were characterized using electron paramagnetic resonance, 13C nuclear magnetic resonance, fluorescence spectroscopy with parallel factor analysis and Fourier transform infrared spectroscopy (FTIR). The organic carbon content of HS did not show a significant difference between endemic and disease-free areas or correlation with KBD-associated morbidity. Except FTIR, all techniques succeeded in characterization of the quinone redox system, indicating their validity and consistency. The quinone redox system in aquatic HS exhibited significantly higher level of the following indexes in endemic areas than disease-free areas: semiquinone radical content of fulvic acid (FA) (p

Background: Lung malignancy is a main source of disease passing all throughout the planet, whereas the transthyretin (TTR) is a specific biomarker for clinical diagnosis. However, its role in lung malignancy stays to be obscure. Materials and Methods: In the current examination, the authors made an endeavor to research impact of abnormal expression of TTR on nonsmall cell lung carcinoma (NSCLC) by overexpression or knockdown of TTR. To further explore the instruments' fundamental mechanism part of TTR in NSCLC, several signal pathways were searched and verified. To confirm the effect of TTR overexpression on tumors, in vivo experiments were conducted. Result: It was found that upregulated TTR clearly stifled cell proliferation, migration, invasion, and expanded apoptosis. Significant suppression of phosphor-extracellular signal-regulated kinase (ERK) was observed in TTR-treated NSCLC cells, implying that TTR was important for cellular progress by regulating mitogen-activated protein kinase/ERK signaling pathway. In in vivo experiment, overexpression of TTR promoted cell apoptosis and inhibited tumor growth. Conclusion: Overall, the results suggest that TTR has a potential antitumor effect in human NSCLC progression, which provides theoretical basis for the diagnosis and treatment of NSCLC. Above all, further understanding of TTR was useful for clinical care. Clinical Trial Registration Number: 2016-08.

BackgroundAlveolar echinococcosis (AE) is a chronic zoonosis caused by the larval form ofEchinococcus multilocularis(E. multilocularis). Current chemotherapy against AE has relied on albendazole and mebendazole, which only exhibit parasitostatic and not parasiticidal efficacy. Therefore, novel compounds for the treatment of this disease are needed.MethodsPhosphoglucose isomerase (PGI) assays were used for compound screening of seven neonicotinoids. The anti-parasitic effects of thiacloprid were then evaluated onE. multilocularismetacestode vesicles, germinal cells and protoscoleces in vitro. Human foreskin fibroblasts (HFF) and Reuber rat hepatoma (RH) cells were used to assess cytotoxicity. Glucose consumption inE. multilocularisprotoscoleces and germinal cells was assessed by measuring uptake of 2-deoxyglucose (2-DG). Molecular docking was used to evaluate the potential binding sites of thiacloprid to acetylcholine receptors. In vivo efficacy of thiacloprid was evaluated in mice by secondary infection withE. multilocularis. In addition, ELISA and flow cytometry were used to evaluate the effects of cytokines and T lymphocyte subsets after thiacloprid treatment. Furthermore, collagen deposition and degradation in the host lesion microenvironment were evaluated.ResultsWe found that thiacloprid is the most promising compound, with an IC50of 4.54 ± 1.10 μM and 2.89 ± 0.34 μM, respectively, against in vitro-culturedE. multilocularismetacestodes and germinal cells. Thiacloprid was less toxic for HFF and RH mammalian cell lines than for metacestodes. In addition, thiacloprid inhibited the acetylcholinesterase activity in protoscoleces, metacestodes and germinal cells. Thiacloprid inhibited glucose consumption by protoscoleces and germinal cells. Subsequently, transmission electron microscopy revealed that treatment with thiacloprid damaged the germinal layer. In vivo, metacestode weight was significantly reduced following oral administration of thiacloprid at 15 and 30 mg/kg. The level of CD4+T lymphocytes in metacestodes and spleen increased after thiacloprid treatment. Anti-echinococcosis-related cytokines (IL-2, IL-4, IL-10) were significantly increased. Furthermore, thiacloprid inhibited the expression of matrix metalloproteinases (MMPs 1, 3, 9, 13) and promoted collagen deposition in the host lesion microenvironment.ConclusionsThe results demonstrated that thiacloprid had parasiticidal activity againstE. multilocularisin vitro and in vivo, and could be used as a novel lead compound for the treatment of AE.Graphical abstract

Background: The effects of transthyretin (TTR) over-expression on the proliferation and cell cycle of nonsmall cell lung cancer (NSCLC) A549 cells and its possible mechanism were verified. Methods: A total of 196 LC patients and 20 healthy controls were enrolled at Tianjin Hospital, Tianjin, China between Apr 2017 and Oct 2017. The serum TTR content was detected by ELISA. Through lentiviral transfection method, NSCLC cells were divided into non-transfected group (group A), negative control group (group B) transfected with empty vector and experimental group (group C) transfected with TTR overexpression. Cell proliferation was detected by CCK-8 method, TTR mRNA expression was detected by realtime quantitative polymerase chain reaction (RT-qPCR), and TTR protein expression was tested by Western blot (WB). Cell cycle was detected by flow cytometry, Wnt3a/β-catenin protein expression was detected by WB, and mRNA expression was detected by RT-qPCR. Results: The serum TTR content in early, middle and late LC group was remarkably lower than that in healthy group (P

Background China is a country with frequent earthquakes. Beichuan was the epicenter of what was later called the Wenchuan earthquake, which caused nearly 80% of the houses in the area to collapse, with 8,605 people killed and 9,693 people missing. The aim of our study was to explore the prevalence of post-traumatic stress disorder (PTSD) and its influence on health-related quality of life (HRQOL) among the survivors 10 years after the 2008 Wenchuan earthquake in China. Methods A total of 610 survivors from Leigu town in Beichuan County were investigated by a systematic sampling method. Post-traumatic status, HRQOL, and demographic sources were measured by the PTSD Checklist Civilian Version (PCL-C), 36-item Health Survey Short Form (SF-36), and self-questionnaire, respectively. Results Ten years after the Wenchuan earthquake, the prevalence of PTSD for survivors was 1.6%. There were significant negative correlations between survivors' SF-36 scores and the scores of PCL-C. Higher scores in post-traumatic status were associated with a higher rate of poor physical HRQOL, which was lower than the mean score [adjusted odds ratio (OR) 1/4 0.96 per SD increase, P 1/4 0.001] and mental HRQOL (adjusted OR 1/4 0.93 per SD increase, P 1/4 0.001). The independent contribution of post-traumatic status to the risk for poor physical and mental HRQOL was 4.9% and 18.7% respectively. Conclusions As time has elapsed, the incidence of PTSD has gradually declined after the Wenchuan earthquake. Post-traumatic status was found to influence the health related quality of life of survivors.

Immune thrombocytopenia is a common complication in patients in a minimally conscious state (MCS). MCS patients are prone to pulmonary infection for the reasons of long-term bed rest and tracheotomy etc., which leads to frequent immune thrombocytopenia. At present, there is no specific treatment for immune thrombocytopenia. Moreover, the cost of routine treatment is high, and clinicians need to consider different drug combinations, side effects, and the risk of drug dependence when selecting treatments. Here, we report a case of a patient in a MCS who developed immune thrombocytopenia after tracheotomy and long-term bed laying in October 2015. The patient's platelet count declined continuously, and by December 2015, she was in a critical condition, with a platelet count of less than 20×109/L. The patient firstly received routine treatment, however, this could only temporarily prevent the drop in platelets. Following a series of explorations, the patient was treated with a combination of traditional Chinese and Western medicine, which included treatment and preventive measures. For treatment, the patient was given roxithromycin dispersible administration tablets and a self-made preparation of peanut red skin, which could quickly cure the immune thrombocytopenia. Preventive measures included the addition of ursodeoxycholic acid capsules, silybin capsules, and a traditional Chinese medicine preparation. As shown by laboratory examination results, the patient's platelet count has stayed around a normal level since March 2016, and she now has normal liver and kidney function. This outcome evidence that combined traditional Chinese and Western medicine could effectively cure immune thrombocytopenia and prevent its recurrence. Moreover, the cost of the treatment was lower and there were fewer side effects than routine treatment, and at the same time, the method of treatment was simple and convenient. Our practical experience may provide a valuable clue for the treatment of immune thrombocytopenia.

A novel strip test system combining immunomagnetic separation with lateral flow immunoassay (LFIA) was established for the accurate detection of Listeria monocytogenes. In this system, a pair of matched monoclonal antibodies was used to construct a sandwich immunoassay, in which superparamagnetic particles were coupled with one of the antibodies as a labeled antibody to capture the target bacteria, while the other antibody was immobilized on the detection zone. After a 20-min reaction, the strips were analyzed by a novel instrument which could detect the magnetic signal of the immunocomplex in a magnetic field. Sensitivity evaluation showed that the limit of detection (LOD) of the superparamagnetic LFIA system for L. monocytogenes was 10(4) CFU/mL, which was at least one log lower than conventional LFIA. No cross-reaction was observed when Salmonella, Escherichia coli O157:H7, or three types of harmless Listeria strains were tested. Further evaluation with actual food samples indicated that the superparamagnetic LFIA system showed 100 % concordance with real-time PCR. Therefore, this novel superparamagnetic LFIA system could be used as a rapid, sensitive, and specific method for the detection of L. monocytogenes.

The adsorption dynamics of perfluoroisobutene (PFIB) on fixed bed activated carbon under various humidity conditions was studied, and the granular activated carbon was treated using a microwave. Th...

A simple but effective approach was developed to synthesize amino functionalized fluorescein isothiocyanate-doped silica nanoparticles based upon polycondensation of tetraethoxysilane. Organic dye molecule (fluorescein isothiocyanate) coupled with a silane coupling agent, 3-aminopropyltriethoxysilane, was incorporated into silica sphere through controlled hydrolysis and polymerization of tetraethoxysilane. The dye was connected with silica sphere through 3-aminopropyltriethoxysilane, which avoided the leakage of the dye. The cohydrolysis and polymerization of tetraethoxysilane and 3-aminopropyltriethoxysilane outside the surface of the silica sphere formed another thin silica shell with the functionalized amino groups on the surface. With amino groups on the surface, the nanoparticle surface was affluent in positive charges. The amino-functionalized nanoparticles were linked with mouse monoclonal antibody against hepatitis B virus surface antigen through electrostatic interaction to form fluorescence probes, which were tested by immunochromatographic assay using immunochromatography test strip. It was indicated that the fluorescence probe was suitable for immunoassay.

The common denominator of a unique disseminated multi-focal miliary myocardial hyaline necrosis and fibrosis in Keshan disease (KSD) and cystic fibrosis (CF) and a commonality of the affected age groups of fetuses and preschool children led to the review of existing KSD autopsy material to search for pancreatic and hepatic lesions considered pathognomonic for CF. Pancreatic lesions considered pathognomonic for CF were found in 595, or 35% of 1700 documented cases of KSD. The pancreatic lesions were limited to tissues of fetuses and preschool children. Adults dying of KSD had diagnostic lesions limited to the cardiovascular system, liver, and skeletal muscle. Varying degrees of focal biliary cirrhosis were identified in 850, or 50% of the KSD autopsies, and 85, or 5% developed severe lobular cirrhosis. The common denominator in CF and KSD appears to be a primary or induced secondary selenium deficiency in age-susceptible humans, prenatally at or around 22 wk of fetal life, during early postnatal life, or during the rapid-growth preschool years. The basic difference between the natural history of CF and KSD is that the selenium deficiency is totally environmental in KSD and appears to be the result of a maternal malabsorptive syndrome or an abnormality of selenium transfer in CF.

The rat femoral vein has become a standard model for microvascular anastomosis practice as well as for research investigations into various manipulative influences upon venous patency. Although vein grafts to the rat artery are the focus of many experimental studies, few reports have investigated vein-to-vein grafts. This study examines the short-term patency (1-3 days) of vein grafts interpositioned to the rat femoral vein. Several factors are studied for their ability to alter the patency rate. The results indicate that patency is difficult to achieve following the creation of a second serial anastomosis (construction of a vein-to-vein graft). Systemic heparin consistently improves patency rates, and trends toward increased patency are seen for reduction in longitudinal tension of the repaired vessel. It is also implied that a deeper understanding of venous hemodynamics and thrombotic events may lead to improved methodologies in the clinical applications of microvenous repairs. These results indicate that rat vein-to-vein grafts may provide a challenging microvascular training model, while introducing the novice microsurgeon to some of the complicating factors encountered with microvascular grafting.

An experimental model was developed combining arterial trauma with island flap creation using the rat groin flap system. Flap arteries were subjected to crush/avulsion injuries with subsequent microvascular repair. A second series involved resection 4 hr after thrombosis of injured flap arteries and interpositional vein grafting to reestablish circulation. A single bolus of systemic heparin was administered to half of the animals from each series on a blinded, randomized basis. Arterial patency at 7 days correlated with flap survival. There was no case of partial flap loss. Patencies improved in the first series from 31% to 71% with heparin administration (P less than 0.05) and from 58% to 90% in the second (not significantly different). A third series involving immediate resection of traumatized vessel and vein graft replacement achieved a patency of 92% (without heparinization). These results support the value of replacement of all traumatized arterial tissue with vein grafts and indicate the efficacy of systemic heparin (in single bolus) for enhancing the likelihood of maintaining patency. Furthermore, it is suggested that the occurrence of a thrombogenic site in the arterial inflow to a region of dependent tissue does not lead to partial tissue loss, and thus thromboembolic events may not be responsible for this clinical phenomenon.

Insulin-dependent diabetes mellitus causes microangiopathic changes in many tissues, including skin and muscle. It is not known if such changes are detrimental to free flap transfer, particularly after extended ischemia. To address this issue, we used an experimental design by using a syngeneic rat strain (Lewis) for free groin flap and muscle flap transplantations from streptozotocin-induced diabetic rats (2 month's duration of symptoms) to normal rats. Flaps from age-matched normal donors were transplanted to normal recipients for control comparisons. Groin flaps were stored ischemically for 12 or 18 hours at room temperature, or for 48 hours in the cold (4 degrees C) before transplantation. Flap survival and vascular patency were assessed at 7 days. Cutaneous maximus muscle flaps were transplanted to the groins of recipients after 6 hours of room temperature ischemia. Vascular patency, muscle viability, flap weight change (edema), and dehydrogenase activity were assessed after 2 days of reperfusion. Seventy percent, 67%, and 73% of diabetic groin flaps survived after 12, 18, or 48 (cold) hours of ischemia, respectively, in comparison with 90%, 73%, and 87% of normal flaps undergoing the same respective ischemia periods. The differences were not significant, even when the data were pooled (p greater than 0.1). Muscle flaps also showed no significant differences for the parameters studied. These results support the use of microvascular reconstructive surgery in diabetic patients, suggesting that moderate ischemic challenges do not compromise free flap transfer or extremity replantation.

Thrombosis following microvascular anastomosis requires further surgical intervention, involving anastomotic resection and reanastomosis or interpositional vein grafting. This study was undertaken to investigate different methods of salvaging thrombosed vessels, using a rat-vein model of error-induced thrombosis. Vessels were reconstructed 4 hr after the onset of thrombosis, using one of three methods: Group 1--removal of the erroneously placed stitch; Group 2--anastomotic resection and re-anastomosis; and Group 3--resection and replacement with a vein graft. Adjuvant antithrombotic therapy was simultaneously evaluated, assessing the influence of systemic Iloprost or heparin. Patency rates at one day postoperatively were 0 percent, 12.5 percent and 37.5 percent for Groups 1, 2, and 3, respectively. Following Iloprost infusion, these rates increased to 25 percent, 25 percent, and 56.3 percent, respectively and, following heparin administration, to 50 percent, 68.8 percent, and 81.8 percent, respectively. Significant increases were found for vein grafting (Group 3), and for the heparin-treated subgroups using all three methods. Effective levels of both Iloprost and heparin were confirmed by increases noted in rat-tail bleeding times. Significant rates of recanalization by three days following one-day occlusion were found in Groups 1 and 2. These results support the application of vein-graft replacement for thrombosed veins, concurrently with systemic heparinization. This study further confirms the high rate of recanalization seen in thrombosed rat femoral veins.

Technological advances have made CO2 laser-assisted microvascular anastomoses (LAMA) feasible. This study seeks to compare results of LAMA versus CSMA (conventional suture microsurgical anastomosis) in traumatized vessels. Using a rat model, femoral arteries and veins were either crushed and transected or divided by avulsion and then repaired by either LAMA or CSMA. LAMA resulted in higher patency rates than CSMA at early postoperative observation periods. With time, the patency rates improved in both groups and, by the end of the study, the patency rates were equivalent. These findings indicate that the laser technique may be a better option when working with traumatized vessels because of the critical nature of early patency rates. The improved results may be due to a reduction of suture material at the anastomotic site when using the laser technique. Some physiologic aspects of vessel thrombosis, recanalization, and the role of collateral circulation are discussed.

A simple method of performing the laser-assisted end-to-side microvascular anastomosis was devised. This technique was tested on 150 Sprague-Dawley rats in two separate series of experiments. In the first, end-to-side anastomoses were performed on the iliac artery under the normal tension due to the elastic recoil of severed vessels. Four stay sutures were placed 90 degrees apart, and the intervals were "spot welded" with a low-wattage CO2 microsurgical laser unit. The patency rate (96 percent) was equivalent to that found in a control group utilizing the conventional all-suture method (92 percent), but there was a significantly higher aneurysm rate (44 versus 11 percent). In a second model, an arterial bypass with very low anastomotic tension was performed around an obstruction created in the carotid artery. This model resulted in turbulent flow but low anastomotic tension. Here the laser-anastomosis patency rate was 98 percent, versus 42 percent for the conventional all-suture method. The placement of fewer sutures in association with turbulent flow in this model may account for the improved patency rate. The avoidance of excessive tension at the anastomotic site reduced the incidence of aneurysms to a negligible level.

Iliac artery end-to-end anastomoses were performed in 42 Sprague-Dawley rats, divided into seven groups, to determine the welding effects of CO2 laser radiation in microvascular anastomoses. Conventional suture techniques were performed on right iliac arteries, and left iliac arteries were anastomosed with a laser-assisted technique. Bursting strength and diameters of the anastomotic sites were measured at different intervals (from one day to five weeks) post surgery. The anastomotic patency rate was 100 percent in both groups, and the aneurysm rate was only 2 percent in the laser group. Bursting strength was low at one and three days post surgery in both groups; then, it increased gradually until both groups could withstand higher than physiologic pressures. Results of high patency rates, low aneurysm formation, and the ability to withstand pressures higher than physiologic, suggest that the laser-assisted anastomotic technique can play an important role in microvascular surgery.