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Objective: To investigate the 1 year mortality after hip fractures in super advanced age patients and summarize the death associated risk factors in order to provide basis for targeted intervention countermeasures., Methods: The clinical data of 332 super advanced age patients with femoral neck or intertrochanteric fractures treated by hip replacement or intramedullary femoral nail fixation from January 2015 to January 2023 were retrospectively analyzed. There were 128 males and 204 females with the mean age of (92.2±2.5) years ranging from 90 to 103 years old. Among them, 92 cases died within 1 year after surgery. Correlation with the occurrence of death on age, gender, body mass index, fracture type, treatment method, timing of operation, preoperative hemoglobin and serum albumin level, operation time, combined medical diseases, pre-injury mobilityand American Society of Anesthesiology(ASA) classification were analyzed. The risk factors of death within 1 year after operation were screened by univariate analysis. The results were entered into the multivariate Logistic regression analysis, screening the high risk factors for 1 year mortality after hip fractures., Results: The mortality of super advanced age patients with hip fracture within 1 year after surgery accounted for 27.7%(92/332). Univariate analysis showed high body mass index, long interval from injury to surgery, low preoperative serum albumin levels, inability to walk independently before injury, accompanied by heart failure, pulmonary infection, obstructive pulmonary disease, stroke, and a higher proportion of ASA grades Ⅲ-Ⅳ. Multivariate Logistic regression analysis showed preoperative serum albumin below 30g g·L -1 [ OR =2.973, 95% CI (2.461, 5.344), P =0.039], inability to walk independently before injury [ OR =3.519, 95% CI (2.224, 5.413), P =0.018], heart function grade C-D[ OR =4.213, 95% CI (2.952, 6.99), P =0.021], pulmonary infection[ OR =3.927, 95% CI (2.187, 7.731), P =0.016] and ASA Ⅲ-Ⅳ[ OR =5.124, 95% CI (3.092, 8.235), P =0.032] were the independent risk factors for death within 1 year in super advanced age patients with hip fractures., Conclusion: Preoperative serum albumin below 30g.L-1, poor preinjury activity, heart function grade C-D, pulmonary infection, and ASA grade Ⅲ-Ⅳ are independent risk factors for postoperative mortality in super advanced age patients with hip fractures.

Amidst the digital transformation of education, the essence of the human touch in online teaching remains pivotal. Despite growing literature, there remains a significant gap in understanding how the human element in online teaching directly influences student engagement and learning outcomes, especially in diverse educational contexts. This study develops a quantifiable index capturing the essence of humanized online teaching and investigates the determinants influencing this humanization. Additionally, an index encapsulating students' online learning experiences, as perceived by their instructors, has been constructed. Bridging these indices, the research unravels the intricate relationship between the humanization of online teaching and the resulting student experiences in the virtual realm. Sourced from a self-constructed questionnaire and encompassing responses from 152 instructors across 22 Malaysian institutions, the data revealed an average incorporation of 81.38% humanized online teaching elements. Key determinants, such as subject matter, teaching experience, Internet quality, and platform choices, emerged as significant influences. A regression model showed approximately 31.7% (R-squared = 0.317, p<0.001) of the variation in the dependent variable. A significant moderate positive correlation (r = 0.423, p<0.001) between the Humanized Online Teaching Index and the Students' Online Learning Experiences Index highlights the intertwined nature of humanized instructional methodologies and enhanced student engagement in online settings. Though contextualised during the coronavirus disease-2019 pandemic, the study's implications transcend the immediate circumstances, offering transformative insights for future online teaching methodologies and enhancing student experiences in the evolving digital age., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Chai et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

A structural mechanics and energy storage difunctional supercapacitor based on a geopolymer membrane injected with a 0.5 M Na 2 SO 4 electrolyte and a pseudocapacitive electrode Mn 7 O 13 is designed and assembled. The geopolymer membrane is prepared as a structural electrolyte with metakaolin and alkaline activator solution. The wide channels in the geopolymer matrix provide paths for ion movement. The Mn 7 O 13 electrode is prepared by different hydrothermal treatments at different temperatures and times, and assembled with activated carbon and a geopolymer with different moduli to form a difunctional supercapacitor. The results show that the electrode sample annealed at 300 °C for 45 min after hydrothermal treatment at 160 °C for 24 h exhibits the best comprehensive performance. The specific capacitance of the electrode is 175.5 F g -1 (2392.6 F m -2 ) at 1 A g -1 , and the specific capacitance of the difunctional structure supercapacitor assembled with a geopolymer with a modulus of 1.2 and cured for 28 days is 144.12 F g -1 (1960.0F m -2 ) at 1 A g -1 under 15 MPa.

Cyclocarya paliurus (CP) extracts have been shown to lower sugar and lipid levels in blood, but the material basis is not clear. We analyzed CP aqueous extracts using high-performance liquid chromatography "fingerprinting", checked their pharmacological parameters using virtual screening, and undertook molecular docking and molecular dynamics simulations. Also, the inhibitory effects of CP components upon α-glucosidase in vitro were evaluated. Fingerprinting and virtual screening showed that the aqueous extract of CP contained the active components protocatechuic acid, chlorogenic acid, caffeic acid and rutin, which were safe and had no side effects in vivo. Molecular docking and molecular dynamics simulations showed that chlorogenic acid and rutin might have a potent inhibitory effect on α-glucosidase. An enzyme-activity assay in vitro showed that the half-maximal inhibitory values of chlorogenic acid and rutin were 398.9 and 351.8 μg/ml, respectively. Chlorogenic acid and rutin had an inhibitory effect on α-glucosidase. Cyclocarya paliurus could be developed as a natural α-glucosidase inhibitor., (© 2022 John Wiley & Sons Ltd.)

Objective: Subsequent microvascular decompression (MVD) might be affected by the previous two-isocentre gamma knife radiosurgery (GKS) due to the tissue changes caused by its higher dose radiation and larger treatment volume. This study aimed to evaluate the safety and efficacy of MVD as a second step treatment after two-isocentre GKS., Methods: Between December 2016 and May 2019, data from 19 consecutive trigeminal neuralgia (TN) patients who experienced MVD after failed two-isocentre GKS were collected. The clinical characteristics, intraoperative findings, surgical outcomes and complications were reviewed and compared with 158 patients who underwent MVD as an initial treatment., Results: Fifteen patients (78.9%) achieved complete pain relief (Barrow Neurological Institute, BNI class I) immediately after surgery and nine patients (47.4%) maintained complete pain relief at the last follow-up, which was similar to patients who underwent initial MVD. The median follow-up period was 36 months. The incidence of new or worsened facial numbness showed no statistical significance between the groups. During surgery, trigeminal nerve atrophy was noted in 9 patients (47.4%), thickened arachnoid in 3 patients (15.8%), atherosclerotic plaque in 3 patients (15.8%) and neurovascular adhesion in 1 patient (5.3%)., Conclusions: MVD remains an effective and safe rescue therapy for patients who elect the minimally invasive treatment with two-isocentre GKS for the first time, without an increased risk of facial numbness., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This study outlines and developed a multilayer perceptron (MLP) neural network model for adolescent hypertension classification focusing on the use of simple anthropometric and sociodemographic data collected from a cross-sectional research study in Sarawak, Malaysia. Among the 2,461 data collected, 741 were hypertensive (30.1%) and 1720 were normal (69.9%). During the data gathering process, eleven anthropometric measurements and sociodemographic data were collected. The variable selection procedure in the methodology proposed selected five parameters: weight, weight-to-height ratio (WHtR), age, sex, and ethnicity, as the input of the network model. The developed MLP model with a single hidden layer of 50 hidden neurons managed to achieve a sensitivity of 0.41, specificity of 0.91, precision of 0.65, F -score of 0.50, accuracy of 0.76, and Area Under the Receiver Operating Characteristic (ROC) Curve (AUC) of 0.75 using the imbalanced data set. Analyzing the performance metrics obtained from the training, validation and testing data sets show that the developed network model is well-generalized. Using Bayes' Theorem, an adolescent classified as hypertensive using this created model has a 66.2% likelihood of having hypertension in the Sarawak adolescent population, which has a hypertension prevalence of 30.1%. When the prevalence of hypertension in the Sarawak population was increased to 50%, the developed model could predict an adolescent having hypertension with an 82.0% chance, whereas when the prevalence of hypertension was reduced to 10%, the developed model could only predict true positive hypertension with a 33.6% chance. With the sensitivity of the model increasing to 65% and 90% while retaining a specificity of 91%, the true positivity of an adolescent being hypertension would be 75.7% and 81.2%, respectively, according to Bayes' Theorem. The findings show that simple anthropometric measurements paired with sociodemographic data are feasible to be used to classify hypertension in adolescents using the developed MLP model in Sarawak adolescent population with modest hypertension prevalence. However, a model with higher sensitivity and specificity is required for better positive hypertension predictive value when the prevalence is low. We conclude that the developed classification model could serve as a quick and easy preliminary warning tool for screening high-risk adolescents of developing hypertension., Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this paper., (Copyright © 2021 Soo See Chai et al.)

Background: Gliomas are the most intrinsic type of primary intracranial tumors. The protein encoded by The calponin 3 (CNN3) has been proven to be a member of the calponin family. Its relationships with cervical cancer, colorectal cancer, gastric cancer, and colon cancer have been emphasized by several studies. Our research aims to explore the prognosis value and immunotherapeutic targetability of CNN3 in glioma patients using bioinformatics approach., Methods: CNN3 expression in glioma was analyzed based on GEO and TCGA datasets. Gene expression profiling with clinical information was employed to investigate the correlation between clinicopathological features of glioma patients and relative CNN3 expression levels. Survival analysis was conducted using Kaplan-Meier analysis and the Cox proportional-hazards regression model. Gene set enrichment analysis was conducted to select the pathways significantly enriched for CNN3 associations. Correlations between inflammatory activities, immune checkpoint molecules and CNN3 were probed by gene set variation analysis, correlograms, and correlation analysis., Results: CNN3 was enriched in gliomas, and high expression of CNN3 correlated with worse clinicopathological features and prognosis. Associations between CNN3 and several immune-related pathways were confirmed using a bioinformatics approach. Correlation analysis revealed that CNN3 was associated with inflammatory and immune activities, tumor microenvironment, and immune checkpoint molecules., Conclusion: Our results indicate that high CNN3 expression levels predict poor prognosis, and CNN3 may be a promising immunotherapy target., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: The integration of palliative care into primary health care has been advocated to improve its accessibility and the continuity of care. Recent studies on such an approach have mainly focused on health care cost and utilization. This study aims to evaluate the effects of a community interdisciplinary palliative care program on the symptom experience of patients with advanced disease., Methods: A prospective cohort study was conducted. The Integrated Palliative Care Outcome Scale was used for monthly assessment to monitor their condition. Wilcoxon signed-rank test was used to examine changes in symptom experience across time., Results: Forty-eight patients with a predominance of cancer diagnoses, enrolled in the program. They reported anxiety, hardly feeling at peace, and neither receiving information as wanted nor being able to share their feeling with family/friends as more overwhelming than physical symptoms. Improvements in emotional symptoms was statistically significant at 1-month follow up (p < 0.001). Improvements in communication/practical issues were also significant at the 1-month (p < 0.001) and 2-month (p = 0.005) follow-up. However, changes in symptom experiences in the subsequent months were not apparent., Conclusions: This study reveals the overwhelming emotional, communication and information needs among patients with advanced diseases and provides empirical evidence of the community palliative care program in short term. Further work is needed to strengthen the medical-social partnership to support care in place albeit health deterioration., (© 2021. The Author(s).)

Transition metal chalcogenides (TMCs) have gained worldwide interest owing to their outstanding renewable energy conversion capability. However, the poor mechanical flexibility of most existing TMCs limits their practical commercial applications. Herein, triggered by the recent and imperative synthesis of highly ductile α-Ag 2 S, an effective approach based on evolutionary algorithm and ab initio total-energy calculations for determining stable, ductile phases of bulk and two-dimensional Ag x Se 1- x and Ag x Te 1- x compounds was implemented. The calculations correctly reproduced the global minimum bulk stoichiometric P 2 1 2 1 2 1 -Ag 8 Se 4 and P 2 1 / c -Ag 8 Te 4 structures. Recently reported metastable AgTe 3 was also revealed but it lacks dynamical stability. Further single-layered screening unveiled two new monolayer P 4/ nmm -Ag 4 Se 2 and C2-Ag 8 Te 4 phases. Orthorhombic Ag 8 Se 4 crystalline has a narrow, direct band gap of 0.26 eV that increases to 2.68 eV when transforms to tetragonal Ag 4 Se 2 monolayer. Interestingly, metallic P 2 1 / c -Ag 8 Te 4 changes to semiconductor when thinned down to monolayer, exhibiting a band gap of 1.60 eV. Present findings confirm their strong stability from mechanical and thermodynamic aspects, with reasonable Vickers hardness, bone-like Young's modulus ( E ) and high machinability observed in bulk phases. Detailed analysis of the dielectric functions ε(ω), absorption coefficient α(ω), power conversion efficiency (PCE) and refractive index n (ω) of monolayers are reported for the first time. Fine theoretical PCE (SLME method ∼11-28%), relatively high n (0) (1.59-1.93), and sizable α(ω) (10 4 -10 5 cm -1 ) that spans the infrared to visible regions indicate their prospects in optoelectronics and photoluminescence applications. Effective strategies to improve the temperature dependent power factor (PF) and figure of merit (ZT) are illustrated, including optimizing the carrier concentration. With decreasing thickness, ZT of p-doped Ag-Se was found to rise from approximately 0.15-0.90 at 300 K, leading to a record high theoretical conversion efficiency of ∼12.0%. The results presented foreshadow their potential application in a hybrid device that combines the photovoltaic and thermoelectric technologies.

Background: The impact of bile leakage (BL) on the long-term prognosis in patients with primary liver cancers after hepatectomy remains unclear., Methods: One thousand nine hundred and seventy-one consecutive patients with primary liver cancers who underwent curative hepatectomy were enrolled. 75 patients encountered BL, including 34 long-time BL (LTBL) and 41 short-time BL (STBL) according to 4-weeks demarcation. Variables associated with BL were identified using multiple logistic regression analysis. 75 patients without BL were enrolled into the Non-BL group using a one-to-one propensity score matched analysis before assessing the impact of BL on the long-term prognosis. The levels of interleukin-6 (IL-6) and C-reactive protein (CRP) in the serum and drain fluid were detected and compared., Results: The tumor size, type of liver cancer, operation time, blood loss and blood transfusion were independent risk factors for BL. The long-term survival showed no difference between the patients with and without BL (p > 0.05), while the LTBL was a significant predictor of poor long-term prognosis (p < 0.001). Compared with the patients without BL, the patients with BL had a higher level of IL-6 from postoperative day (POD) 1 to POD 60, and a higher level of CRP from POD 7 to POD 60. By POD 60, the levels of IL-6 and CRP hadn't restored to the normal level in the LTBL group., Conclusions: The LTBL has a negative impact on the long-term prognosis of patients with primary liver cancers after hepatectomy, in which the inflammatory responses may play a pivotal role., (Copyright © 2019. Published by Elsevier Taiwan LLC.)

Background: Laparoscopic Spiegel lobectomy is difficult due to its deep location and being surrounded by gross vessels. Extrahepatic Glissonean pedicle transection method has been proposed by Takasaki during open liver resections. This approach can be successfully performed during laparoscopic anatomic hepatectomy. Here we describe pure laparoscopic Spiegel lobectomy using the extrahepatic Glissonean approach., Methods: The patient was a 25-year-old male with a background of hepatitis B. A 1.5 cm×1.7 cm mass was detected in liver Spiegel lobe and highly suspected to be an hepatocellular carcinoma. The liver function was normal (Child-pugh 5), and alpha-fetoprotein was within the normal ranges. Laparoscopic Spiegel lobectomy using extrahepatic Glissonean approach was proposed. The hilar plate was partly detached from liver parenchyma, and 2 Glissonean pedicles of the Spiegel lobe were dissected, clamped and divided. Liver parenchymal transection was performed using the harmonic scalpel., Results: The operation time was 196 minutes without Pringle's maneuver. Estimated blood loss was <50 mL, and no blood transfusion was required. The patient recovered well and was discharged on postoperative day 6. There was no complication. Pathologic findings support the diagnosis of hepatocellular carcinoma., Conclusions: Laparoscopic Spiegel lobectomy using the extrahepatic Glissonean approach is safe and feasible.

We demonstrate generation of 0.2 mJ terahertz (THz) pulses in lithium niobate driven by Ti:sapphire laser pulses at room temperature. Employing tilted pulse front technique, the 800 nm-to-THz energy conversion efficiency has been optimized to 0.3% through chirping the sub-50 fs pump laser pulses to overcome multi-photon absorption and to extend effective interaction length for phase matching. Our approach paves the way for mJ-level THz generation via optical rectification using existing Ti:sapphire laser systems which can deliver Joule-level pulse energy with sub-50 fs pulse duration.

The authors would like to call the reader's attention to the fact that unfortunately during a recent cross-check of the experimental record, they found that the positions of intercept and slope were reversed in Table 1 in the original manuscript. The authors apologize for the mistake.

A highly sensitive method was developed for the simultaneous separation and determination of organic and inorganic selenium species in rice by ion-pairing reversed-phase chromatography combined with inductively coupled plasma tandem mass spectrometry. To achieve a good separation of these species, a comparison between anion-exchange chromatography and ion-pairing reversed-phase chromatography was performed. The results indicated that ion-pairing reversed-phase chromatography was more suitable due to better separation and higher sensitivity for all analytes. In this case, a StableBond C18 column proved to be more robust or to have a better resolution than other C18 columns, when 0.5 mM tetrabutylammonium hydroxide and 10 mM ammonium acetate at pH 5.5 were used as the mobile phase. Moreover, an excellent sensitivity was obtained in terms of interferences by means of tandem mass spectrometry in the hydrogen mode. The detection limits were 0.02-0.12 μg/L, and recoveries of five selenium species were 75-114%, with relative standard deviations ≤ 9.4%. This method was successfully applied to the analysis of rice samples. Compared with previous studies, the proposed method not only gave comparable results when used for measuring selenium-enriched rice, but it can provide greater sensitivity for the detection of low concentrations of selenium species in rice., (© 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

A novel method has been developed for the direct, sensitive, and rapid detection of bronopol in rice using a simple solid-phase extraction (SPE) procedure followed by liquid chromatography-tandem mass spectrometry (LC-MS/MS), with electrospray ionization (ESI). Bronopol was stable under acidic conditions, and an acidic environment was thus needed before sample loading to ensure the stability of bronopol. Rice extracts containing bronopol were pretreated using a hydrophilic-lipophilic balanced (Bond Elut Plexa) cartridge to reduce the matrix effect. An XDB-C18 column (150 mm × 2.1 mm, 3.5 μm) was used for chromatographic separations, with a mobile phase comprising methanol and aqueous ammonium formate (5 mM). The linearity of the method was satisfactory with regression coefficient (R 2 ) = 0.9992. The limit of quantification was 3.3 μg kg -1 . Three spiked levels (25, 125 and 625 μg kg -1 ) were used to determine the recovery of bronopol, which was found to be 73.3-96.7%, with relative standard deviations (RSD) in the range 1.2-7.9%. The RSD for intra-day precision (n = 7) was 7.6% and the RSD for inter-day precision (n = 15) was 8.3%. The newly developed analytical method was successfully used to quantify bronopol in rice samples.

Selenium (Se) is an important trace element to the human being. The effects of selenium on contraction and cell membrane potential of coronary arterial smooth muscle were studied in guinea pig by isometric force development of strips and intracellular recording method. It was showed that Se caused vascular smooth muscle relaxation and depolarization of the cells in a dose dependent manner. Inhibitory effect of Se on KCl- or ACh-induced contraction could be quantitatively assessed by a rightward shift of the concentration-response curve. Furthermore, Se increased KCl-induced depolarization and decreased ACh-induced hyperpolarization.

Considerable controversy exists concerning the possible role of lead in the etiology of human hypertension. In animal studies, there is convincing evidence that lead alters cardiovascular responsiveness; rats drinking water containing 100 ppm lead develop a chronic, significant 15 to 20 mm Hg elevation in systolic blood pressure. Pressor responsiveness to catecholamines is enhanced in animals chronically exposed to lead, and the responsiveness of isolated vascular smooth muscle to adrenergic agonists is increased in rats with lead-induced hypertension. Experimental evidence suggests that alterations in the cellular mechanisms that regulate intracellular calcium concentration may contribute to the abnormal vascular function in lead-induced hypertension. Recent work in our laboratory indicates that increased vascular reactivity in genetic hypertension is associated with altered activity of the protein kinase C branch of the calcium messenger system. Contractile responses to lead in rabbit mesenteric artery are potentiated by activators (phorbol esters) of this enzyme complex, and a selective inhibitor of protein kinase C inhibited contractions induced by lead. Based on these results, it is proposed that a cellular component of the action of lead to increase vascular reactivity may relate to the role of protein kinase C in smooth muscle contraction.