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Background: The prevalence of depression among people with chronic pain remains unclear due to the heterogeneity of study samples and definitions of depression. We aimed to identify sources of variation in the prevalence of depression among people with chronic pain and generate clinical prediction models to estimate the probability of depression among individuals with chronic pain. Methods: Participants were from the UK Biobank. The primary outcome was a "lifetime" history of depression. The model's performance was evaluated using discrimination (optimism-corrected C statistic) and calibration (calibration plot). Results: Analyses included 24,405 patients with chronic pain (mean age 64.1 years). Among participants with chronic widespread pain, the prevalence of having a "lifetime" history of depression was 45.7% and varied (25.0–66.7%) depending on patient characteristics. The final clinical prediction model (optimism-corrected C statistic: 0.66; good calibration on the calibration plot) included age, BMI, smoking status, physical activity, socioeconomic status, gender, history of asthma, history of heart failure, and history of peripheral artery disease. Among participants with chronic regional pain, the prevalence of having a "lifetime" history of depression was 30.2% and varied (21.4–70.6%) depending on patient characteristics. The final clinical prediction model (optimism-corrected C statistic: 0.65; good calibration on the calibration plot) included age, gender, nature of pain, smoking status, regular opioid use, history of asthma, pain location that bothers you most, and BMI. Conclusions: There was substantial variability in the prevalence of depression among patients with chronic pain. Clinically relevant factors were selected to develop prediction models. Clinicians can use these models to assess patients' treatment needs. These predictors are convenient to collect during daily practice, making it easy for busy clinicians to use them. [ABSTRACT FROM AUTHOR]

Objective: To determine factors associated with hospital admissions from ED presentations for low back pain (LBP). Methods: This was a retrospective analysis of 147 ED centres in New South Wales (NSW), Australia, between 2005 and 2014. Data were accessed from the NSW Emergency Department Data Collection to determine patients who attended ED and whether or not they were admitted to hospital. Results: There were 1 388 078 ED visits for LBP across 147 different ED centres between 2005 and 2014. Between 2005 and 2013, hospital admission rates from ED visits for LBP increased annually by 5.1% (95% confidence interval [CI] 3.9–6.4) from 477 per 100 000 in 2005 to 730 per 100 000 in 2013. Patients who were under injured workers' insurance (i.e. workers compensation insurance) had significantly lower odds (odds ratio [OR] 0.42, 95% CI 0.40–0.43) of being admitted to hospital for LBP compared with those not on injured workers' insurance. Patients living in the highest socioeconomic areas were also more likely to be admitted to hospital from an ED visit, compared with those from the lowest socioeconomic areas (OR 1.26, 95% CI 1.24–1.29). Conclusion: Rates of hospitalisation following attendance to ED for LBP increased annually by 5% between 2005 and 2013. Hospital admission rates were lower among patients from the lowest socioeconomic areas or under injured workers' compensation insurance. [ABSTRACT FROM AUTHOR]

• Recombinant epitope protein rEP-PM contains some B cell epitopes and T cell epitopes of PRRSV-GP5, PRRSV-M, Mhp-P46 and Mhp-P65 protein. • rEP-PM could induce the production of high levels of antibodies. • rEP-PM could induce the Th1-dominant cellular immune response in mice. • rEP-PM has good immunoreactivity with anti-rEP-PM, anti-PRRSV and anti-Mhp antibodies. • Anti-rEP-PM antibody could specifically recognize proteins from PRRSV and Mhp. Porcine reproductive and respiratory syndrome virus (PRRSV) and Mycoplasma hyopneumoniae (M. hyopneumoniae , Mhp) are two of the most common pathogens involved in the porcine respiratory disease complex (PRDC) resulting in significant economic losses worldwide. Vaccination is the most effective approach to disease prevention. Since PRRSV and Mhp co-infections are very common, an efficient dual vaccine against these pathogens is required for the global swine industry. Compared with traditional vaccines, multi-epitope vaccines have several advantages, they are comparatively easy to produce and construct, are chemically stable, and do not have an infectious potential. In this study, to develop a safe and effective vaccine, B cell and T cell epitopes of PRRSV-GP5, PRRSV-M, Mhp-P46, and Mhp-P65 protein had been screened to construct a recombinant epitope protein rEP-PM that has good hydrophilicity, strong antigenicity, and high surface accessibility, and each epitope is independent and complete. After immunization in mice, rEP-PM could induce the production of high levels of antibodies, and it had good immunoreactivity with anti-rEP-PM, anti-PRRSV, and anti-Mhp antibodies. The anti-rEP-PM antibody specifically recognizes proteins from PRRSV and Mhp. Moreover, rEP-PM induced a Th1-dominant cellular immune response in mice. Our results showed that the rEP-PM protein could be a potential candidate for the development of a safe and effective multi-epitope peptide combined vaccine to control PRRSV and Mhp infections. [ABSTRACT FROM AUTHOR]

Objective More than one-half of pregnant women experience pregnancy-related low back pain (LBP). Pregnancy-related LBP greatly affects activities of daily life, and although many interventions have been proposed, the optimal treatment for pregnancy-related LBP remains unclear. The purpose of this study was to compare conservative care strategies on their efficacy and safety for women with pregnancy-related LBP through systematic review with pairwise meta-analysis and network meta-analysis. Methods MEDLINE, Embase, the Cochrane Library, AMED, CINAHL, PEDro, PsycINFO, and ClinicalTrials.gov were searched from inception to November 2019. Randomized controlled trials and observational controlled studies were included without restriction to language, sample size, or duration of follow-up. Two independent investigators extracted the data and assessed the risk of bias. The quality of evidence was evaluated through Grading of Recommendations Assessment, Development and Evaluation. Results Twenty-three studies were included in the qualitative synthesis (18 randomized controlled trials were included in the network meta-analysis). For women with LBP during pregnancy, progressive muscle relaxation therapy (mean difference = −3.96; 95% CI = −7.19 to −0.74; moderate-quality evidence) and Kinesio Taping (mean difference = −3.71; 95% CI = −6.55 to −0.87; low-quality evidence) reduced pain intensity (Visual Analog Scale, range = 0 to 10) compared with placebo. Moderate-quality evidence suggested that transcutaneous electrical nerve stimulation improved physical function (mean difference = −6.33; 95% CI = −10.61 to −2.05; Roland Morris Disability Questionnaire, range = 0–24) compared with placebo. Conclusion For patients with LBP during pregnancy, progressive muscle relaxation therapy and Kinesio Taping may help to decrease pain, and transcutaneous electrical nerve stimulation may improve physical function. Impact This review helps fill the gap in evidence regarding optimal treatment for pregnancy-related LBP. Lay Summary If you have LBP during pregnancy, your physical therapist has evidence to support the use of progressive muscle relaxation therapy and Kinesio Taping to help decrease pain and the use of transcutaneous electrical nerve stimulation to help improve physical function. [ABSTRACT FROM AUTHOR]

Background: Cytoplasmic linker-associated protein 2 (CLASP2) belongs to a family of microtubule plus-end tracking proteins that localize to the distal ends of microtubules and is involved in various microtubule-dependent processes. We previously showed that CLASP2 is involved in the epithelial-to-mesenchymal transition of bladder urothelial cancer. This research aimed to explore the significance of CLASP2 expression as a prognostic marker for muscle-invasive bladder urothelial cancer (MIBC) patients after radical cystectomy-pelvic lymph node dissection (RC-PLND).Methods: CLASP2 expression was analyzed in 76 benign bladder tissues and 160 MIBC tissues by tissue immunohistochemistry. Survival analysis and multiple regression analysis following propensity score matching were performed to investigate the correlation between high CLASP2 expression and MIBC patients' survival.Results: CLASP2 expression was increased in MIBC patients, especially those with high-stage tumors or lymph node metastasis. In the follow-up of MIBC patients after propensity score matching, whether MIBC patients received adjuvant chemotherapy after RC-PLND, high CLASP2 expression was significantly associated with a poor prognosis. MIBC patients with low CLASP2 expression who received adjuvant chemotherapy tended to have an improved survival prognosis.Conclusion: CLASP2 expression is correlated with malignant progression of MIBC. High CLASP2 expression predicted a poor prognosis for MIBC patients after RC-PLND. [ABSTRACT FROM AUTHOR]

Combination of chemotherapy and small interfering RNA (siRNA)-based nanotherapeutics could cooperatively and effectively suppress multiple drug resistance in cancer development. Particularly, nano-delivery systems that efficiently encapsulate two or more therapeutic payloads to the tumor-targeted sites have been proven significantly. Here, we prepared a micellar nanoparticle formed by monomethoxy poly (ethylene glycol)–block–poly(ε-caprolactone)-block-poly(L-lysine)/cholesterol (mPEG-b-PCL-b-PLL/Chol, further abbr. as "P"). In this work, PCL as the hydrophobic core to encase doxorubicin and PLL as the cationic moiety to bind with negatively charged siRNA are used to achieve the co-delivery of therapies in one platform. The results showed that the micellar nanoparticle is capable of delivering siRNA and doxorubicin simultaneously to the same tumor cells, and consequently displays enhanced inhibition efficiency on MCF-7/ADR cells. Moreover, real-time polymerase chain reaction (RT-PCR) and Western blot experiments indicated that the co-delivery of micelleplex-delivering B-cell lymphoma 2 specific siRNA (siBcl) successfully down-regulated the expression of Bcl-2 protein, which triggers chemotherapy to be more sensitive to the cancer cells. Therefore, the strategy of co-delivering anticancer drug and siRNA showed promising potential in reversing drug resistance of tumor cells. [ABSTRACT FROM AUTHOR]

Graphical abstract Highlights • The triterpenoids from Ganoderma resinaceum were analyzed by using UPLC-QTOF-MS. • A strategy for identification of triterpenoids has been developed. • Total 55 triterpenoids were identified from G. resinaceum. Abstract The triterpenoids from Ganoderma resinaceum were investigated by using UPLC-QTOF-MS and their fragmentation behaviors are summarized in detail. Based on the fragmentation pathways, a strategy for identification of triterpenoids has been developed. The main triterpenoids in G. resinaceum can be classified into 6 types (type 1-1, 1-2, 2-1, 2-2, 3-1, 3-2) in three steps. Each step was controlled by the characteristic ions, which are summarized from fragmentation pathways of 34 reference compounds. Total 55 triterpenoids were identified from G. resinaceum. Thirty-four of them were identified by using reference standards. The other unknown compounds were tentatively identified by using the developed identification strategy. This work is helpful for phytochemical investigation of G. resinaceum as well as quality control of materials containing triterpenoids. [ABSTRACT FROM AUTHOR]

Inulin-type fructooligosaccharides (FOS) purified from Morinda Officinalis , with degrees of polymerization (DP) from 3 to 9, have been approved in China as an oral prescribed drug for mild and moderate depression episode, while the stability and oral absorption of this FOS mixtures are largely unknown. As the main active component and quality control marker for above FOS, DP5 was selected as the representative FOS in this study. Desalting method by ion exchange resin was developed to treat bio-sample, followed by separation and quantification by high performance liquid chromatography-charged aerosol detector. Results showed that the DP5 was stepwisely hydrolyzed in simulated gastric fluid and gut microbiota, while maintained stable in intestinal fluid. DP5 has poor permeability across Caco-2 monolayer with P app of 5.22 × 10 −7  cm/s, and very poor oral absorption with bioavailability of (0.50 ± 0.12)% in rat. In conclusion, FOS in Morinda Officinalis demonstrated poor chemical stability in simulated gastric fluid and human gut microbiota, and low oral absorption in rats. [ABSTRACT FROM AUTHOR]

Background The safety of front-line chemotherapies for the treatment of extensive stage small-cell lung cancer ( ED-SCLC) is uncertain. We carried out a network meta-analysis to compare the toxicity of different therapies for ED-SCLC. Methods We searched EMBASE, PubMed, CENTRAL and . We performed network meta-analysis on hematological (anemia, leukopenia, neutropenia, and thrombocytopenia) and non-hematological toxicities (diarrhea, infection, and nausea and vomiting). Results Nine studies with 2317 patients were included. Etoposide with carboplatin ( EC) was associated with a higher incidence of anemia (odds ratio [ OR] 2.02, 95% confidence interval [ CI] 1.13-3.63), leukopenia ( OR 2.67, 95% CI 1.25-5.72), neutropenia ( OR 12.08, 95% CI 2.13-68.66), and thrombocytopenia ( OR 2.73, 95% CI 1.27-5.85) compared with irinotecan with carboplatin ( IC). Similarly, etoposide with cisplatin ( EP) was associated with a higher incidence of anemia ( OR 1.70, 95% CI 1.13-2.56), leukopenia ( OR 2.65, 95% CI 1.34-5.28), neutropenia ( OR 5.70, 95% CI 2.93-11.10), and thrombocytopenia ( OR 3.26, 95% CI 1.66-6.38) compared with irinotecan with cisplatin ( IP). EC was associated with a lower incidence of diarrhea ( OR 0.26, 95% CI 0.10-0.68) compared with IC, and EP was associated with a lower incidence of diarrhea ( OR 0.09, 95% CI 0.03-0.25) and nausea and vomiting ( OR 0.53, 95% CI 0.33-0.84) than IP. Conclusions Hematological toxicities were most common in EC-treated patients, while the lowest incidence occurred with IP treatment. The IP regimen was associated with the highest incidence of toxicities of the digestive tract, while the lowest incidence occurred with EC treatment. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to investigate age- and sex-specific effects of obesity, metabolic syndrome (MetS) and its components on back pain in middle-aged and older English individuals.Methods: We used data from the English Longitudinal Study of Ageing, wave 2 (2004-2005). Body mass index (BMI) expressed the obesity, while MetS was defined according to revised Adult Treatment Panel (ATP) III criteria. We assessed associations between obesity, MetS and its components with presence and severity of back pain and provided estimates per strata, middle-aged (50-64years) and older (65-79years), women and men.Results: The study sample included 3328 participants, 1021 and 835 middle-aged women and men and 773 and 699 older women and men, respectively. We found that BMI (OR=1.07, 95% CI 1.05-1.09), MetS (OR=1.47, 95% CI 1.22-1.77), high waist circumference (WC), high triglycerides (TG), and high fasting blood glucose were associated with the presence of back pain. Effects of BMI were consistent across the strata. However, MetS was associated with back pain only in women, middle-aged (OR=1.59, 95% CI 1.14-2.21) and older (OR=1.43, 95% CI 1.01-2.05). The MetS component driving this association was high WC, supported by high TG in older women. Higher BMI, presence of MetS, high blood pressure and TG were associated with back pain severity.Conclusions: We found that obesity was associated with the presence and severity of back pain, irrespective of age and sex. However, we found women-specific effects of MetS driven by high WC, indicating that metabolic dysregulation contributes to back pain pathophysiology in women. [ABSTRACT FROM AUTHOR]

Objective The aim of this meta-analysis was to evaluate the postdural puncture headache after spinal anesthesia with Whitacre spinal needles compared with Quincke spine needles. Methods We searched several databases, including PubMed, Embase, ISI Web of Knowledge, and Cochrane Central Register of Controlled Trials until October 10th, 2014, for randomized controlled trials that compared spinal anesthesia with Whitacre spinal needles or Quincke spine needles for postdural puncture headache. Two reviewers independently screened the literature, assessed the risk for bias and extracted data. We used RevMan 5.3 software to perform the meta-analysis. Studies were included for the main end points if they addressed the following: frequency of postdural puncture headache, severity of postdural puncture headache as assessed by limitation of activities, and frequency of epidural blood patch. Results Nine randomized controlled trials were included for meta-analysis. The meta-analysis showed that spinal anesthesia with Whitacre spinal needles achieved lower incidence of postdural puncture headache(RR 0.34; 95% CI [0.22, 0.52]; P < .00001); in addition, the severity of postdural puncture headache was lower in the Whitacre spinal needle group (RR 0.32; 95% CI [0.16, 0.66]; P = .002). Furthermore, the frequency of an epidural blood patch in the Whitacre spinal needle group was lower compared with that in the Quincke spine needle group (RR 0.15; 95% CI [0.04, 0.51]; P = .002). Conclusion We suggest the Whitacre spinal needles as a superior choice for spinal anesthesia compared with Quincke spine needles. [ABSTRACT FROM AUTHOR]

Densities and viscosities of binary mixtures of 8-hydrogen-1,8-diazabicyclo[5,4,0]-undec-7-enium imidazolide ([HDBU]IM) and 8-butyl-1,8-diazabicyclo[5,4,0]-undec-7-enium imidazolide ([BDBU]IM) ionic liquids (ILs) with water were measured at temperatures from T = (293.15 to 313.15) K. Excess molar volumes V E and viscosity deviations Δ η of the mixtures were calculated to study the intermolecular interactions and structural factors between ILs and water. The results show that the V E values of the two mixtures are negative over the whole composition range, while the Δ η values have positive deviations, indicating that the hydrogen bonding interactions between IL and water are dominant in the mixtures. Moreover, the absolute values of V E (| V E |) of {[HDBU]IM (1) + H 2 O (2)} system are larger than those of {[BDBU]IM (1) + H 2 O (2)} system at the same condition, indicating that the hydrogen bonding interactions between [HDBU]IM and water are stronger than those between [BDBU]IM and water. Both | V E | and Δ η values of the mixtures decrease with the increasing temperature, resulting from the decreasing the hydrogen bonding interactions between IL and water. Other derived properties of the studied systems, such as the apparent molar volumes, partial molar volumes, excess partial molar volumes, Gibbs free energy of activation for viscous flow, and excess Gibbs free energy of activation for viscous flow were also calculated from the experimental values. [ABSTRACT FROM AUTHOR]

Densities and viscosities of the pure ionic liquid 1,1,3,3-tetramethylguanidine imidazole ([TMG]IM) and its binary mixtures with methanol, ethanol, 1-propanol, and 1-butanol were measured at temperatures from T = (293.15 to 313.15) K. The thermal expansion coefficient, molecular volume, standard entropy, and lattice energy of [TMG]IM were obtained from the experimental density value. The temperature dependence of the viscosity of [TMG]IM was fitted to the fluidity equation. Excess molar volumes V E and viscosity deviations Δ η of the binary mixtures were calculated and fitted to the Redlich–Kister equation with satisfactory results. The result shows that the V E values of the binary mixtures are negative over the whole composition range, while Δ η values have an S-shape deviation. Temperature has little effect on the V E of the systems, but it has significant effect on the Δ η . Furthermore, the absolute values of V E for {[TMG]IM (1) + alcohol (2)} systems at the same temperature decrease with increasing carbon alkyl chain of the primary alcohol. Other derived properties, such as the apparent molar volumes, partial molar volumes, excess partial molar volumes, Gibbs free energy of activation for viscous flow, and excess Gibbs free energy of activation for viscous flow of the above-mentioned systems were also calculated. [ABSTRACT FROM AUTHOR]

Highlights: [•] Synthesis of MIPs with novel functional monomer as a selective sorbent for extraction of gastrodin. [•] An environment-friendly material with water used in the loading and eluting process of molecularly imprinted solid phase extraction. [•] Application of the optimized protocol for the extraction of gastrodin from the aqueous extract of Gastrodia elata roots. [Copyright &y& Elsevier]

Abstract: Goethite (Gt) is an important iron mineral in soils and sediments. Conventional measurements cannot effectively identify it at the low concentrations typical of soils and sediments. In this paper we demonstrate that diffuse reflectance spectroscopy (DRS) in conjunction with thermal treatment provides a definitive technique for identifying Gt in soil and sediments. The DRS pattern of Gt exhibits diagnostic changes of the first derivative value (FDV) peaks after heating to 300°C, whereas hematite (Hm) displays no shift in peak wavelength after heating. The degree of thermal changes induced in a sample depends on the concentration of both Gt and Hm. Application of this technique to natural soils and sediments demonstrates that it can effectively detect Gt even at very low concentrations in soils and sediments. [Copyright &y& Elsevier]

• Three cell lines fishing and LC-MS analysis was developed. • Multiple targets selected based on modern medical principles. • Active compounds in a herbal formula for treatment of psoriasis were decoded. Chinese medicine formula (CMF) usually contains multiple herbs and its components are very complicated, which therapeutic effects are derived from the integrative activity of multiple components. Therefore, the screening of bioactive compounds in the formula is necessary, though it is very difficult, not only for elucidating the therapeutic components but also for developing the quality control method. In this work, three cell lines fishing combined with LC-MS analysis was developed for screening the potential bioactive compounds in Fuzhengzhiyanghefuzhiyang decoction (FZHFZY), a CMF for the treatment of psoriasis in clinic. Nineteen potential active compounds were discovered and thirteen of them were identified as rehmannioside D, melittoside or rehmannioside A, tufulingoside, neoastilbin, astilbin, neoisoastilbin, isoastilbin, engeletin, isoengeletin, spinosin, cnidimoside A, rutaevin and limonin, respectively. The effects of identified components were also analyzed in vitro. The results showed that IL-1β expression of RAW 264.7 cells treated with spinosin and melittoside as well as the TNF-α level of RAW 264.7 cells treated with rehmannioside D and melittoside were not significantly different compared with lipopolysaccharide (LPS)-treated cells. Though all identified potential active components had no apoptosis effect to HaCaT cells, rehmannioside D, rehmannioside A, astilbin and neoisoastilbin could significantly suppress HUVEC cells migration compared with control. These results indicated that the target cell fishing combined with LC-MS analysis is a useful tool for screening bioactive compounds from complicated CMF, and the identified active components may mainly contribute to the therapeutic effects of FZHFZY. [ABSTRACT FROM AUTHOR]

Nonheading Chinese cabbage is an important leafy vegetable, and quantitative identification and automated analysis of nonheading Chinese cabbage leaves are crucial for cultivating new varieties with higher quality, yield, and resistance. Traditional leaf phenotypic analysis relies mainly on phenotypic observation and the practical experience of breeders, leading to issues such as time consumption, labor intensity, and low precision, which result in low breeding efficiency. Considering these issues, a method for the extraction and analysis of phenotypes of nonheading Chinese cabbage leaves is proposed, targeting four qualitative traits and ten quantitative traits from 1500 samples, by integrating deep learning and OpenCV image processing technology. First, a leaf classification model is trained using YOLOv8 to infer the qualitative traits of the leaves, followed by the extraction and calculation of the quantitative traits of the leaves using OpenCV image processing technology. The results indicate that the model achieved an average accuracy of 95.25%, an average precision of 96.09%, an average recall rate of 96.31%, and an average F1 score of 0.9620 for the four qualitative traits. From the ten quantitative traits, the OpenCV-calculated values for the whole leaf length, leaf width, and total leaf area were compared with manually measured values, showing RMSEs of 0.19 cm, 0.1762 cm, and 0.2161 cm2, respectively. Bland–Altman analysis indicated that the error values were all within the 95% confidence intervals, and the average detection time per image was 269 ms. This method achieved good results in the extraction of phenotypic traits from nonheading Chinese cabbage leaves, significantly reducing the personpower and time costs associated with genetic resource analysis. This approach provides a new technique for the analysis of nonheading Chinese cabbage genetic resources that is high-throughput, precise, and automated. [ABSTRACT FROM AUTHOR]

Background: Studies have reported an increase in the prevalence of depression during the COVID-19 pandemic. The accuracy of screening tools may change with the prevalence and distribution of a disease in a population or sample: the "Spectrum Effect". Methods: First, we selected commonly used screening tools and developed search strategies for the inclusion of original studies during the pandemic. Second, we searched PsycINFO, EMBASE, and MEDLINE from March 2020 to September 2022 to obtain original studies that investigated the accuracy of depression screening tools during the pandemic. We then searched these databases to identify meta-analyses summarizing the accuracy of these tools conducted before the pandemic and compared the optimal cut-offs for depression screening tools during the pandemic with those before. Result: Four original studies evaluating the optimal cut-offs for four screening tools (Beck Depression Inventory [BDI-II], Hospital Anxiety and Depression Scale-Depression [HADS-D], Patient Health Questionnaire-9 [PHQ-9], and Geriatric Depression Scale-4 [GDS-4]) were published during the pandemic. Four meta-analyses summarizing these tools before the pandemic. We found that the optimal cut-off of BDI-II was 14 during the pandemic (23.8% depression prevalence, screening patients with Type 2 diabetes) and 14.5 before the pandemic (17.6% depression prevalence, screening psychiatric, primary care, and healthy populations); HADS-D was 10 during the pandemic (23.8% depression prevalence, screening patients with type 2 diabetes) and 7 before the pandemic (15.0% depression prevalence, screening medically ill patients); PHQ-9 was 11 during the pandemic (14.5% depression prevalence, screening university students) and 8 before the pandemic (10.9% depression prevalence, screening the unrestricted population), and GDS-4 was 1.8 during the pandemic (29.0% depression prevalence, screening adults seen in a memory clinic setting) and 3 before the pandemic (18.5% depression prevalence, screening older adults). Conclusion: The optimal cut-off for different screening tools may be sensitive to changes in study populations and reference standards. And potential spectrum effects that should be considered in post-COVID time which aiming to improve diagnostic accuracy. [ABSTRACT FROM AUTHOR]

Spinal cord injury (SCI) is a global health problem with a heavy economic burden. Surgery is considered as the cornerstone of SCI treatment. Although various organizations have formulated different guidelines on surgical treatment for SCI, the methodological quality of these guidelines has still not been critically appraised. We aim to systematically review and appraise the current guidelines on surgical treatments of SCI and summarize the related recommendations with the quality evaluation of supporting evidence. Systematic review. Medline, Cochrane library, Web of Science, Embase, Google Scholar, and online guideline databases were searched from January 2000 to January 2022. The most updated and recent guidelines containing evidence-based or consensus-based recommendations and established by authoritative associations were included. The Appraisal of Guidelines for Research and Evaluation, 2nd edition instrument containing 6 domains (eg, applicability) was used to appraise the included guidelines. An evidence-grading scale (ie, level of evidence, LOE) was utilized to evaluate the quality of supporting evidence. The supporting evidence was categorized as A (the best quality), B, C, and D (the worst quality). Ten guidelines from 2008 to 2020 were included, however, all of them acquired the lowest scores in the domain of applicability among all the six domains. Fourteen recommendations (eight evidence-based recommendations and six consensus-based recommendations) were totally involved. The SCI types of the population and timing of surgery were studied. Regarding the SCI types of the population, eight guidelines (8/10, 80%), two guidelines (2/10, 20%), and three guidelines (3/10, 30%) recommended surgical treatment for patients with SCI without further clarification of characteristics, incomplete SCI, and traumatic central cord syndrome (TCCS), respectively. Besides, one guideline (1/10, 10%) recommended against surgery for patients with SCI without radiographic abnormality. Regarding the timing of surgery, there were eight guidelines (8/10, 80%), two guidelines (2/10, 20%), and two guidelines (2/10, 20%) with recommendations for patients with SCI without further clarification of characteristics, incomplete SCI, and TCCS, respectively. For patients with SCI without further clarification of characteristics, all eight guidelines (8/8, 100%) recommended for early surgery and five guidelines (5/8, 62.5%) recommended for the specific timing, which ranged from within 8 hours to within 48 hours. For patients with incomplete SCI, two guidelines (2/2, 100%) recommended for early surgery, without specific time thresholds. For patients with TCCS, one guideline (1/2, 50%) recommended for surgery within 24 hours, and another guideline (1/2, 50%) simply recommended for early surgery. The LOE was B in eight recommendations, C in three recommendations, and D in three recommendations. We remind the reader that even the highest quality guidelines often have significant flaws (eg, poor applicability), and some of the conclusions are based on consensus recommendations which is certainly less than ideal. With these caveats, we found most included guidelines (8/10, 80%) recommended early surgical treatment for patients after SCI, which was consistent between evidence-based recommendations and consensus-based recommendations. Regarding the specific timing of surgery, the recommended time threshold did vary, but it was usually within 8 to 48 hours, where the LOE was B to D. [ABSTRACT FROM AUTHOR]

Spinal cord injury (SCI) is a serious health problem which carries a heavy economic burden. Imaging technologies play an important role in the diagnosis of SCI. Although several organizations have developed guidelines for diagnostic imaging of SCI, their quality has not yet been systematically assessed. We aim to conduct a systematic review to appraise SCI guidelines and summarize their recommendations for diagnostic imaging of SCI. Systematic review. We searched Embase, Medline, Web of Science, Cochrane, some guideline-specific databases (eg, Scottish Intercollegiate Guidelines Network) and Google Scholar from January 2000 to January 2022. We included guidelines developed by nationally recognized organizations. If multiple versions could be obtained, we included the latest one. We appraised included guidelines using the Appraisal of Guidelines for Research and Evaluation, 2nd edition instrument which contains six domains (eg, scope and purpose). We also extracted recommendations and assessed their supporting evidence using levels of evidence (LOE). The evidence was categorized as A (the best quality), B, C, and D (the worst quality). Seven guidelines (2008–2020) were included. They all received the lowest scores in the domain of applicability. All guidelines (7/7, 100%) recommended magnetic resonance imaging (MRI) in patients with SCI or SCI without radiographic abnormality (SCIWORA). A total of 12 recommendations involving patient age (eg, adult and child patients), timing of MRI (eg, as soon as possible and in the acute period), symptoms indicated for MRI (eg, a stiff spine and midline tenderness, suspected disc and posterior ligamentous complex injury, and neurological deficit), and types of MRI (eg, T2-weighted imaging and diffusion tensor imaging) were extracted. Among them, the LOE was C in nine (75%) recommendations and D in three (25%) recommendations. Seven guidelines were included in the present systematic review, and all of them showed the worst applicability scores in the Appraisal of Guidelines for Research and Evaluation, 2nd edition instrument. They all weakly recommended MRI for patients with suspected SCI or SCIWORA based on a low LOE. [ABSTRACT FROM AUTHOR]

Abstract In order to investigate the transfer and accumulation pathways of heavy metals in cropland ecosystems, an investigation of the geochemical behaviors of heavy metals in soil and rice plants was carried out in the Yangtze River Delta. Soil is one of the biggest reservoirs of heavy metals and affects food safety at the beginning of the food chain. The results of this study demonstrate that heavy metal levels in soil decreased with increasing soil pH, while rice shoots accumulated heavy metals more readily under low soil pH conditions. The non-carcinogenic hazard quotients (HQ) of heavy metals show that health risks for humans were primarily due to Pb and As. Furthermore, cancer risk (Risk) results suggested that ~76% and ~15.7% of cancer risk was caused by Cd and As levels, respectively. Decreasing soil pH enhanced the non-carcinogenic and carcinogenic health risks for the human body. Through exponential change between transfer factor (TF grain/soil) and soil metals, HQ, a direct monitoring method for rice plants, was built using regression curves. It is proposed that besides condition of soil with high heavy metal concentration, for rice grown with surface soil metals, the safety of the rice product should be monitored when soil metals are under the following levels after harvest: non-carcinogenic risk, As < 20 mg/kg, Pb < 100 mg/kg, Cd < 0.07–0.68 mg/kg and Cu 7.56–30.87 mg/kg; and cancer risk, As < 20 mg/kg, Cd < 4 mg/kg and Cr < 200 mg/kg. Highlights • Spatial distribution of heavy metals in soil and rice in area with little mine-impact • Significant discrepancy of metal levels and transfer under different soil pH • Exponential and linear relationships between transfer from soil to rice and soil, rice metals • Non-carcinogenic and cancer health risk assessment for heavy metal in rice • Low observation values of soil metals for possible high health risk samples [ABSTRACT FROM AUTHOR]

• Systematically reviewed and appraised guidelines through the AGREE II instrument. • Focused on pressure sores, pulmonary infection, urinary tract infection, and venous thromboembolism. • Extracted relevant recommendations and assessed the quality of their supporting evidence. • The quality of supporting evidence ranged from poor to fair. • For venous thromboembolism, recommendations on unfractionated heparin was controversial. Complications such as pressure sores, pulmonary infection, urinary tract infection (UTI), and venous thromboembolism (VTE) are common after spinal cord injury (SCI). These have serious consequences for patients' physical, social, and vocational well-being. Several authoritative organizations have developed guidelines for managing these complications after SCI. We aim to systematically review and appraise guidelines on the management of four common complications (pressure sores, pulmonary infection, UTI, and VTE) after SCI as well as to summarize relevant recommendations and assess the quality of their supporting evidence. Systematic review. We searched Medline, Embase, Cochrane, and Web of Science, as well as guideline-specific databases (eg, National Guideline Clearinghouse) and Google Scholar, from January 2000 to January 2022. We included the most updated guidelines developed by specific authoritative organizations. We evaluated the included guidelines using the Appraisal of Guidelines for Research and Evaluation 2nd edition instrument, which measures six domains (eg, applicability). Recommendations extracted from guidelines were categorized as for, against, or neither for nor against. An evidence assessment was adopted to classify the quality of supporting evidence as poor, fair, or good. Eleven guidelines from 2005 to 2020 were included, all of which, among the six domains, scored lowest in the domain of applicability. For pressure sores, guidelines recommended for skin inspection, repositioning, and the use of pressure reduction equipment as preventive measures and dressings, debridement, and surgery as treatment measures. For pulmonary infection, guidelines recommended for physical (eg, the use of an insufflation–exsufflation device) and pharmacological measures (eg, the use of bronchodilators). For UTI, guidelines recommended for antibiotics as a treatment measure but recommended against cranberries, methenamine salts, and acidification or alkalinization agents as preventive measures. For VTE prophylaxis, five guidelines recommended for low molecular weight heparin (LMWH). Three guidelines recommended against unfractionated heparin, whereas one guideline recommended for it. Most of the supporting evidence was of poor quality (130/139), and the rest was of fair quality (9/139). For pressure sores, pulmonary infection, and UTI, evidence of poor to fair quality indicated consistent recommendations for prevention and treatment measures. For VTE, LMWH was consistently recommended, whereas recommendations on the use of unfractionated heparin were controversial. [ABSTRACT FROM AUTHOR]

Background: There are debates in acupuncture related systematic reviews and meta-analyses on whether searching Chinese databases to get more Chinese-language studies may increase the risk of bias and overestimate the effect size, and whether the treatment effects of acupuncture differ between Chinese and non-Chinese populations. Methods: In this meta-epidemiological study, we searched the Cochrane library from its inception until December 2021, and identified systematic reviews and meta-analyses with acupuncture as one of the interventions. Paired reviewers independently screened the reviews and extracted the information. We repeated the meta-analysis of the selected outcomes to separately pool the results of Chinese- and non-Chinese-language acupuncture studies and presented the pooled estimates as odds ratios (OR) with 95% confidence interval (CI). We calculated the Ratio of ORs (ROR) by dividing the OR of the Chinese-language trials by the OR of the non-Chinese-language trials, and the ROR by dividing the OR of trials addressing Chinese population by the OR of trials addressing non-Chinese population. We explored whether the impact of a high risk of bias on the effect size differed between studies published in Chinese- and in non-Chinese-language, and whether the treatment effects of acupuncture differed between Chinese and non-Chinese population. Results: We identified 84 Cochrane acupuncture reviews involving 33 Cochrane groups, of which 31 reviews (37%) searched Chinese databases. Searching versus not searching Chinese databases significantly increased the contribution of Chinese-language literature both to the total number of included trials (54% vs. 15%) and the sample size (40% vs. 15%). When compared with non-Chinese-language trials, Chinese-language trials were associated with a larger effect size (pooled ROR 0.51, 95% CI 0.29 to 0.91). We also observed a higher risk of bias in Chinese-language trials in blinding of participants and personnel (97% vs. 51%) and blinding of outcome assessment (93% vs. 47%). The higher risk of bias was associated with a larger effect estimate in both Chinese-language (allocation concealment: high/unclear risk vs. low risk, ROR 0.43, 95% CI 0.21 to 0.87) and non-Chinese-language studies (blinding of participants and personnel: high/unclear risk vs. low risk, ROR 0.41, 95% CI 0.23 to 0.74). However, we found no evidence that the higher risk of bias would increase the effect size of acupuncture in Chinese-language studies more often than in non-Chinese-language studies (the confidence intervals of all ROR in the high-risk group included 1, Table 3). We further found acupuncture appeared to be more effective in Chinese than in non-Chinese population (Table 4). Conclusions: The findings of this study suggest the higher risk of bias may lead to an overestimation of the treatment effects of acupuncture but would not increase the treatment effects in Chinese-language studies more often than in other language studies. The difference in treatment effects of acupuncture was probably associated with differences in population characteristics. Trial registration: We registered our protocol on the Open Science Framework (OSF) (https://doi.org/10.17605/OSF.IO/PZ6XR). [ABSTRACT FROM AUTHOR]

As solvent-based coatings are gradually phasing out in China, the volatile organic compounds (VOCs) emission characteristics of surface-coating industries have changed rapidly. Sector-based field measurements were conducted to build VOCs emission factors and source profiles of surface-coating industries in Jiangsu Province. A VOCs emission inventory was developed, and the projections for 2020 to 2030 were set. It was found that VOCs content in water-based coatings is 50.8% of solvent-based coatings on average. VOCs emission factors of solvent-based coatings ranged from 0.40 to 0.51 kg kg−1, while those of water-based coatings ranged from 0.14 to 0.24 kg kg−1. Compared to solvent-based coatings, the proportion of aromatics emitted from water-based coatings was 44.2% lower, while the proportion of oxygenated VOCs (OVOCs) was 11.6% higher. The results showed that VOCs emissions were about 134 Gg in Jiangsu Province in 2020, of which the solvent-based coating sources contributed 79.6% of the total. Aromatics were the main species contributing 52.9% of VOCs emissions and 85.9% of ozone formation potential (OFP). According to emission prediction results of four scenarios, the emission reduction of implementing low-content VOCs coating substitution is 8.7% higher than that of adopting the best available end-of-pipe treatment measures by 2030. [ABSTRACT FROM AUTHOR]

Spinal cord injury brings devastating consequences and huge economic burden. Different authoritative organizations have developed different guidelines for pharmacological treatments of spinal cord injury, but there is a lack of a critical appraisal of them. To systematically review and appraise guidelines regarding their recommendations for pharmacological treatments for spinal cord injury. Systematic review. We searched Medline, Embase, Cochrane, and Web of Science from January 2000 to January 2022 as well as guideline-specific databases (eg, Congress of Neurological Surgeons) and Google Scholar. We included the most updated guideline containing evidence-based recommendations or consensus-based recommendations developed by specific authoritative organizations if multiple versions were available. We appraised guidelines through the Appraisal of Guidelines for Research and Evaluation, 2nd edition instrument consisting of six domains (eg, applicability). With supporting evidence, recommendations were classified as: for, against, neither for nor against. We utilized an evidence assessment system to categorize the quality of supporting evidence as poor, fair, or good. Eight guidelines developed from 2008 to 2020 were included, but all of them scored lowest in the domain of applicability among all six domains. Twelve pharmacological agents (eg, methylprednisolone) were studied. For methylprednisolone, three guidelines (3/8=37.5%) recommended for (one evidence-based and two consensus-based), three (3/8=37.5%) recommended against (all evidence-based), and two (2/8=25%) recommended neither for nor against. For monosialotetrahexosylganglioside (GM-1), one guideline (1/4=25%) recommended for (consensus-based), one (1/4=25%) recommended against (evidence-based), and two (2/4=50%) recommended neither for nor against. For other agents (eg, minocycline), most guidelines (3/5=60%) recommended neither for nor against, one (1/5=20%) recommended against naloxone (evidence-based) and nimodipine (evidence-based), and one (1/5=20%) recommended for neural growth factor (consensus-based). The quality of most of the supporting evidence was poor, and the rest was fair. There were inconsistencies among recommendations for methylprednisolone and GM-1. Evidence-based recommendations tended to recommend against, whereas consensus-based recommendations tended to recommend for. [ABSTRACT FROM AUTHOR]

Eyelid tumors are tumors that occur in the eye and its appendages, affecting vision and appearance, causing blindness and disability, and some having a high lethality rate. Pathological images of eyelid tumors are characterized by large pixels, multiple scales, and similar features. Solving the problem of difficult and time-consuming fine-grained classification of pathological images is important to improve the efficiency and quality of pathological diagnosis. The morphology of Basal Cell Carcinoma (BCC), Meibomian Gland Carcinoma (MGC), and Cutaneous Melanoma (CM) in eyelid tumors are very similar, and it is easy to be misdiagnosed among each category. In addition, the diseased area, which is decisive for the diagnosis of the disease, usually occupies only a relatively minor portion of the entire pathology section, and screening the area of interest is a tedious and time-consuming task. In this paper, deep learning techniques to investigate the pathological images of eyelid tumors. Inspired by the knowledge distillation process, we propose the Multiscale-Attention-Crop-ResNet (MAC-ResNet) network model to achieve the automatic classification of three malignant tumors and the automatic localization of whole slide imaging (WSI) lesion regions using U-Net. The final accuracy rates of the three classification problems of eyelid tumors on MAC-ResNet were 96.8%, 94.6%, and 90.8%, respectively. [ABSTRACT FROM AUTHOR]

Background and Objective: Although paracetamol (acetaminophen) combined with other analgesics can reduce pain intensity in some pain conditions, its effectiveness in managing low back pain and osteoarthritis is unclear. This systematic review investigated whether paracetamol combination therapy is more effective and safer than monotherapy or placebo in low back pain and osteoarthritis.Online database searches were conducted for randomised trials that evaluated paracetamol combined with another analgesic compared to a placebo or the non-paracetamol ingredient in the combination (monotherapy) in low back pain and osteoarthritis. The primary outcome was a change in pain. Secondary outcomes were (serious) adverse events, changes in disability and quality of life. Follow-up was immediate (≤ 2 weeks), short (> 2 weeks but ≤ 3 months), intermediate (> 3 months but < 12 months) or long term (≥ 12 months). A random-effects meta-analysis was conducted. Risk of bias was assessed using the original Cochrane tool, and quality of evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE).Twenty-two studies were included. Pain was reduced with oral paracetamol plus a non-steroidal anti-inflammatory drug (NSAID) at immediate term in low back pain (paracetamol plus ibuprofen vs ibuprofen [mean difference (MD) − 6.2, 95% confidence interval (CI) −10.4 to −2.0, moderate evidence]) and in osteoarthritis (paracetamol plus aceclofenac vs aceclofenac [MD − 4.7, 95% CI − 8.3 to − 1.2, moderate certainty evidence] and paracetamol plus etodolac vs etodolac [MD − 15.1, 95% CI − 18.5 to − 11.8; moderate certainty evidence]). Paracetamol plus oral tramadol reduced pain compared with placebo at intermediate term for low back pain (MD − 11.7, 95% CI − 19.2 to − 4.3; very low certainty evidence) and osteoarthritis (MD − 6.8, 95% CI − 12.7 to −0.9; moderate certainty evidence). Disability scores improved in half the comparisons. Quality of life was infrequently measured. All paracetamol plus NSAID combinations did not increase the risk of adverse events compared to NSAID monotherapy.Low-to-moderate quality evidence supports the oral use of some paracetamol plus NSAID combinations for short-term pain relief with no increased risk of harm for low back pain and osteoarthritis compared to its non-paracetamol monotherapy comparator.Methods: Although paracetamol (acetaminophen) combined with other analgesics can reduce pain intensity in some pain conditions, its effectiveness in managing low back pain and osteoarthritis is unclear. This systematic review investigated whether paracetamol combination therapy is more effective and safer than monotherapy or placebo in low back pain and osteoarthritis.Online database searches were conducted for randomised trials that evaluated paracetamol combined with another analgesic compared to a placebo or the non-paracetamol ingredient in the combination (monotherapy) in low back pain and osteoarthritis. The primary outcome was a change in pain. Secondary outcomes were (serious) adverse events, changes in disability and quality of life. Follow-up was immediate (≤ 2 weeks), short (> 2 weeks but ≤ 3 months), intermediate (> 3 months but < 12 months) or long term (≥ 12 months). A random-effects meta-analysis was conducted. Risk of bias was assessed using the original Cochrane tool, and quality of evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE).Twenty-two studies were included. Pain was reduced with oral paracetamol plus a non-steroidal anti-inflammatory drug (NSAID) at immediate term in low back pain (paracetamol plus ibuprofen vs ibuprofen [mean difference (MD) − 6.2, 95% confidence interval (CI) −10.4 to −2.0, moderate evidence]) and in osteoarthritis (paracetamol plus aceclofenac vs aceclofenac [MD − 4.7, 95% CI − 8.3 to − 1.2, moderate certainty evidence] and paracetamol plus etodolac vs etodolac [MD − 15.1, 95% CI − 18.5 to − 11.8; moderate certainty evidence]). Paracetamol plus oral tramadol reduced pain compared with placebo at intermediate term for low back pain (MD − 11.7, 95% CI − 19.2 to − 4.3; very low certainty evidence) and osteoarthritis (MD − 6.8, 95% CI − 12.7 to −0.9; moderate certainty evidence). Disability scores improved in half the comparisons. Quality of life was infrequently measured. All paracetamol plus NSAID combinations did not increase the risk of adverse events compared to NSAID monotherapy.Low-to-moderate quality evidence supports the oral use of some paracetamol plus NSAID combinations for short-term pain relief with no increased risk of harm for low back pain and osteoarthritis compared to its non-paracetamol monotherapy comparator.Results: Although paracetamol (acetaminophen) combined with other analgesics can reduce pain intensity in some pain conditions, its effectiveness in managing low back pain and osteoarthritis is unclear. This systematic review investigated whether paracetamol combination therapy is more effective and safer than monotherapy or placebo in low back pain and osteoarthritis.Online database searches were conducted for randomised trials that evaluated paracetamol combined with another analgesic compared to a placebo or the non-paracetamol ingredient in the combination (monotherapy) in low back pain and osteoarthritis. The primary outcome was a change in pain. Secondary outcomes were (serious) adverse events, changes in disability and quality of life. Follow-up was immediate (≤ 2 weeks), short (> 2 weeks but ≤ 3 months), intermediate (> 3 months but < 12 months) or long term (≥ 12 months). A random-effects meta-analysis was conducted. Risk of bias was assessed using the original Cochrane tool, and quality of evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE).Twenty-two studies were included. Pain was reduced with oral paracetamol plus a non-steroidal anti-inflammatory drug (NSAID) at immediate term in low back pain (paracetamol plus ibuprofen vs ibuprofen [mean difference (MD) − 6.2, 95% confidence interval (CI) −10.4 to −2.0, moderate evidence]) and in osteoarthritis (paracetamol plus aceclofenac vs aceclofenac [MD − 4.7, 95% CI − 8.3 to − 1.2, moderate certainty evidence] and paracetamol plus etodolac vs etodolac [MD − 15.1, 95% CI − 18.5 to − 11.8; moderate certainty evidence]). Paracetamol plus oral tramadol reduced pain compared with placebo at intermediate term for low back pain (MD − 11.7, 95% CI − 19.2 to − 4.3; very low certainty evidence) and osteoarthritis (MD − 6.8, 95% CI − 12.7 to −0.9; moderate certainty evidence). Disability scores improved in half the comparisons. Quality of life was infrequently measured. All paracetamol plus NSAID combinations did not increase the risk of adverse events compared to NSAID monotherapy.Low-to-moderate quality evidence supports the oral use of some paracetamol plus NSAID combinations for short-term pain relief with no increased risk of harm for low back pain and osteoarthritis compared to its non-paracetamol monotherapy comparator.Conclusions: Although paracetamol (acetaminophen) combined with other analgesics can reduce pain intensity in some pain conditions, its effectiveness in managing low back pain and osteoarthritis is unclear. This systematic review investigated whether paracetamol combination therapy is more effective and safer than monotherapy or placebo in low back pain and osteoarthritis.Online database searches were conducted for randomised trials that evaluated paracetamol combined with another analgesic compared to a placebo or the non-paracetamol ingredient in the combination (monotherapy) in low back pain and osteoarthritis. The primary outcome was a change in pain. Secondary outcomes were (serious) adverse events, changes in disability and quality of life. Follow-up was immediate (≤ 2 weeks), short (> 2 weeks but ≤ 3 months), intermediate (> 3 months but < 12 months) or long term (≥ 12 months). A random-effects meta-analysis was conducted. Risk of bias was assessed using the original Cochrane tool, and quality of evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE).Twenty-two studies were included. Pain was reduced with oral paracetamol plus a non-steroidal anti-inflammatory drug (NSAID) at immediate term in low back pain (paracetamol plus ibuprofen vs ibuprofen [mean difference (MD) − 6.2, 95% confidence interval (CI) −10.4 to −2.0, moderate evidence]) and in osteoarthritis (paracetamol plus aceclofenac vs aceclofenac [MD − 4.7, 95% CI − 8.3 to − 1.2, moderate certainty evidence] and paracetamol plus etodolac vs etodolac [MD − 15.1, 95% CI − 18.5 to − 11.8; moderate certainty evidence]). Paracetamol plus oral tramadol reduced pain compared with placebo at intermediate term for low back pain (MD − 11.7, 95% CI − 19.2 to − 4.3; very low certainty evidence) and osteoarthritis (MD − 6.8, 95% CI − 12.7 to −0.9; moderate certainty evidence). Disability scores improved in half the comparisons. Quality of life was infrequently measured. All paracetamol plus NSAID combinations did not increase the risk of adverse events compared to NSAID monotherapy.Low-to-moderate quality evidence supports the oral use of some paracetamol plus NSAID combinations for short-term pain relief with no increased risk of harm for low back pain and osteoarthritis compared to its non-paracetamol monotherapy comparator. [ABSTRACT FROM AUTHOR]

The West Lake is a World Heritage site in the West Lake watershed in eastern China. In this study, the hydrogeological and dual isotopic approaches were integrated to evaluate the seasonal and spatial variations of nitrate (NO 3 − ) in the West Lake watershed, and to characterize NO 3 − sources and transformations. The results revealed that the geochemical facies of the water samples were dominated by Ca 2 + + Na + –HCO 3 − + SO 4 2 − in the surface water and transfer water, Ca 2 + + Na + –HCO 3 − and Ca 2 + + Na + –SO 4 2 − in the groundwater, which most likely reflect natural reactions and anthropogenic inputs. About 13% of the groundwater samples containing NO 3 − exceeded the World Health Organization (WHO) standard of 10 mg N L − 1 . NO 3 − was the dominant form of total nitrogen (TN) and was the main surface water contaminant in the West Lake watershed. The δ 15 N NO 3 and δ 18 O NO 3 values indicated that the dominant NO 3 − sources in surface water were soil nitrogen (soil N) and chemical fertilizers, while the main NO 3 − sources in groundwater were soil N from the forest, chemical fertilizers and manure in the tea garden, domestic sewage from the small, old residential area in the forest as well as urban areas. The distribution of NO 3 − in groundwater was strongly influenced by land use. Results also suggest that there was significant nitrification in surface water and groundwater in the West Lake watershed, and that there were also denitrification processes in groundwater. The annual net fluxes of TN, NO 3 − , and NH 4 + into the West Lake were 2.0 × 10 4 , 4.0 × 10 3 , and 1.31 × 10 4 kg as N, respectively. [ABSTRACT FROM AUTHOR]

In this work, dummy molecularly imprinted polymers with high selectivity and affinity to capsaicin and dihydrocapsaicin are designed using N-vanillylnonanamide as a dummy template. The performance of dummy molecularly imprinted polymers and nonimprinted polymers was evaluated using adsorption isotherms, adsorption kinetics, and selective recognition capacity. Dummy molecularly imprinted polymers were found to exhibit good site accessibility, taking just 20 min to achieve adsorption equilibrium; they were also highly selective toward capsaicin and dihydrocapsaicin. We successfully used dummy molecularly imprinted polymers as a specific sorbent for selectively enriching capsaicin and dihydrocapsaicin from chili pepper samples. In a scaled-up experiment, the selective recovery of capsaicinoids was calculated to be 77.8% using solid-phase extraction. To the best of our knowledge, this is the first example of the use of N-vanillylnonanamide as a dummy template in molecularly imprinted polymers to simultaneously enrich capsaicin and dihydrocapsaicin. [ABSTRACT FROM AUTHOR]

Abstract: Very few studies of F in soil and wheat grain, straw and root under actual field conditions have been reported. In order to study F concentration (contamination) in wheat and its relationship to soil F and other elements, the present study collected and analyzed 150 pairs of topsoil and wheat samples (root, straw and grain) from the Yangtze River delta region, China. Compared with the Chinese maximum permissible concentration in wheat grain for F, 36.7% of wheat grain samples in the present study area are contaminated with F. The concentrations of F in different wheat tissues generally decreased in the order of root>straw>grain. Fluorine in wheat tissues showed significant correlations with Fe, S, P and heavy metals. The soil total F and water soluble F concentrations in the present study area range from 0.29 to 0.79gkg−1 and 2.28 to 30.11μgg−1, respectively. The soil total F and water soluble F exhibits no significant correlations with wheat root F or grain F. It is inferred that the major source of F in wheat is not from the soil, whereas F in wheat grain may mainly derive from the atmosphere. [Copyright &y& Elsevier]

Salmonella, as a zoonotic pathogen, has attracted widespread attention worldwide, especially in the transmission between household pets and humans. Therefore, we investigated the epidemic distribution of dog Salmonella from pet hospitals and breeding base in Xuzhou, Jiangsu Province, China, and used multilocus sequence typing (MLST) and clustered regularly interspaced short palindromic repeats (CRISPRs) to subtype Salmonella isolates. From April 2018 to November 2019, a total of 469 samples were collected from pet hospitals and breeding base, including 339 dog samples and 60 cat samples. S. Kentucky (40.74%) was the most prevalent serotype, but other, such as S. Typhimurium (18.52%) and S. Indiana (18.52%), were also widespread. Eight different sequence type (ST) patterns were identified by MLST and ST198 was the highest proportion of these isolates. CRISPRs analysis showed that 9 different Kentucky CRISPR types (KCTs) was identified from ST198. 48 spacers including 29 (6 News) for CRISPR1 and 19 (4 News) for CRISPR2 that proved the polymorphic of Salmonella genes in samples from different sources. The analysis demonstrated that the common serotypes were widely present in pet hosts in the same area. This analysis shows that CRISPR genes have better recognition ability in the same serotype, which has a positive effect on the traceability of Salmonella and the prevention and treatment of salmonellosis. [ABSTRACT FROM AUTHOR]

Accurate measurements of ophthalmic parameters and postoperative appearance prediction are essential for the diagnosis and treatment of many ophthalmic diseases. Nevertheless, it remains challenging due to (1) inconsistent ophthalmic image sampling standards, including ocular-camera distance, facial angle, and patient number, (2) complicated ocular morphology, such as subconjunctival hemorrhage, ocular movements, lighting effects, and morphological aging. It is difficult for a model to measure parameters and make predictions in variable sampling methods and morphology conditions. Therefore, the Global attention-based Ophthalmic Image Measurement and Postoperative Appearance Prediction System (GOMPS) is proposed, which quantifies ophthalmic image parameters to diagnose disease and simultaneously predict postoperative appearance of blepharoptosis. By perceiving the global structure of the ophthalmic image, GOMPS makes logical inference predictions of the sclera and cornea morphology, to overcome the above difficulties. Concretely, a global attention unit (GAU) and a novel global attention structure-aware network (GASA-Net) are designed to enhance GOMPS's global structure awareness ability to perform logical reasoning. Extensive experimental results on our collected ophthalmic dataset for diagnosis & prediction (OD2P) demonstrate that GOMPS surpasses the state-of-the-art methods in segmentation accuracy and achieves the current optimal performance in measurement and postoperative prediction under many clinical scenes. • Showcased GOMPS, the initial ophthalmic measurement & post-op look prediction system. • Presented the largest Ophthalmic Dataset for Diagnosis and Prediction OD2P. • Presented GASA-Net for accurate, robust segmentation in difficult ophthalmic images. • Investigated medial canthi & upper eyelid invariance in blepharoptosis treatment. • Realized in-depth ophthalmic surgery simulation using structural information. [ABSTRACT FROM AUTHOR]

Purpose: To compare the perioperative and functional outcomes of holmium laser enucleation of the prostate (HoLEP) and thulium laser enucleation of the prostate (ThuLEP) for the treatment of large-volume benign prostatic hyperplasia (BPH) (> 80 ml). Methods: A total of 116 consecutive patients with BPH were randomized to be treated surgically with either HoLEP (n = 58) or ThuLEP (n = 58), following the classical three-lobe enucleation technique. Follow-up was assessed at 1, 3, 6, 12 and 18 months after surgery. Results: At 18 months, the lower urinary tract symptom index was improved significantly in both groups compared with the baseline values. The operative time (78.4 ± 8.0 vs. 71.4 ± 6.4 min) and enucleation time (61.2 ± 5.4 vs. 56.4 ± 8.4 min) were significantly shorter for ThuLEP compared to HoLEP (both p < 0.001). There were no significant differences between the two groups regarding morcellation time, resected weight, hemoglobin decrease, catheter time and hospital stay (p > 0.05). The HoLEP and ThuLEP groups had equivalent International Prostate Symptom Scores (3 [3–3] vs. 3 [3–3], p = 0.776), quality of life (1 [1–2] vs. 2 [1–2], p = 0.809), Qmax (25.3 ± 4.8 ml/s vs. 24.7 ± 4.4 ml/s, p = 0.470), postvoid residual urine (PVR) (6.1 [2.6–20.8] vs. 7.7 [3.1–22.8] ml, p = 0.449) and PSA (0.84 ± 0.32 vs. 0.90 ± 0.34 ml, p = 0.309) at 18 months postoperatively. Conclusion: Both HoLEP and ThuLEP relieve lower urinary tract symptoms in a comparable way with high efficacy and safety. ThuLEP was statistically superior to HoLEP in operation time and enucleation time, although the differences were clinically negligible. [ABSTRACT FROM AUTHOR]

Studies on chronic total occlusion (CTO) treatment strategy in stable patients have reported conflicting results. We focused on stable diabetic patients with a single CTO (other vessels have been successfully treated before). We attempted to identify which strategy (percutaneous coronary intervention [PCI] or medical therapy [MT]) is optimal; 545 patients were selected from a total of 39 952 patients. Based on the initial treatment strategy, we assigned patients to either the PCI or MT group. The primary end point was a major adverse cardiac event (MACE). After a median follow-up of 45 months (interquartile range: 25.7-79.2 months), we observed (1) no difference in MACE and myocardial infarction between groups, (2) multivariate analysis showed that PCI group was superior to MT group in cardiac death (hazard ratio: 4.758 (1.698-13.334); P =.003) and all-cause death (2.767 [1.157-6.618]; P =.022). The superiority was consistent in propensity score–matched analysis, and (3) a failed PCI group was not associated with higher risks in the clinical end points, except for target vessel revascularization, compared with MT. We concluded that for stable patients with diabetes and one single CTO, initial PCI strategy tended to offer patients survival benefits compared with MT. [ABSTRACT FROM AUTHOR]

In this work, densities and viscosities of aqueous solution of 1,1,3,3-tetramethylguanidine imidazolide ([TMG]IM) ionic liquid were measured at temperatures from T = (293.15 to 313.15) K. Volumetric properties including excess molar volumes V E , apparent molar volumes, partial molar volumes, and excess partial molar volumes were calculated from the experimental density. Viscosity deviations Δ η , Gibbs energy and excess Gibbs energy of activation for viscous flow were deduced from the viscosity. Moreover, electrical conductivities κ and refractive indices of binary mixtures of [TMG]IM with water and alcohols were determined at 298.15 K. The results show that V E values of {[TMG]IM (1) + water (2)} mixture are negative over the whole composition range, while Δ η and refractive index deviations Δ n D values exhibit positive deviations, indicating that the hydrogen bonding interaction between [TMG]IM and water is dominant. The absolute values of V E and Δ η of the mixture decrease with the increasing temperature. The V E , Δ η , and Δ n D can be fitted by the Redlich–Kister equation with satisfactory results. The concentration-dependent κ of the studied systems are fitted to Casteel–Amis equation, showing that the κ values of {[TMG]IM (1) + water (2)} mixture are much higher than those of {[TMG]IM (1) + ethanol (2)} mixture. [ABSTRACT FROM AUTHOR]

Dummy molecularly imprinted polymers (DMIPs) for simultaneously selective removal and enrichment of ginkgolic acids (GAs) during the processing of Ginkgo biloba leaves have been prepared. Two dummy template molecule with similar structural skeleton to GAs, 6-methoxysalicylic acid (MOSA, DT-1) and 6-hexadecyloxysalicylic acid (HOSA, DT-2), have been designed and synthesized. The performance of the DMIPs and NIPs were evaluated including selective recognition capacity, adsorption isotherm, and adsorption kinetics. The selective recognition capacity of the three GAs with four analogues on the sorbents illustrated that the DMIPs sorbents have high specificity for GAs. An efficient method based on DMIP-HOSA coupled with solid-phase extraction (SPE) was developed for simultaneously selective removal and enrichment of ginkgolic acids (GAs) during the processing of Ginkgo biloba leaves. The method showed excellent recoveries (82.5–88.7%) and precision (RSD 0.5–2.6%, n = 5) for licorice extracts, Gastrodia elata extracts and pepper extracts spiked at three concentration levels each (50, 100, 200 μg mL −1 ). The results indicated that GAs and standardized Ginkgo biloba leaves extracts could be obtained simultaneously through the DMIP-SPE. [ABSTRACT FROM AUTHOR]

Objectives: Machine learning (ML) has been increasingly used in clinical medicine including studies focused on Clostridioides difficile infection (CDI) to inform to clinical decision making. We aimed to summarize ML choices in studies that used ML to predict CDI or CDI outcomes.Methods: We searched Ovid MEDLINE, Ovid EMBASE, Web of Science, medRxiv, bioRxiv and arXiv from inception to March 18, 2021. We included fully published studies that used ML where CDI constituted the study population, exposure or outcome. Two reviewers independently identified studies and abstracted outcomes. We summarized study characteristics and approaches to CDI definition and ML-specific modelling.Results: Forty-three studies of prediction (n = 21), classification (n = 17) or inference (n = 5) were included. Approaches to defining CDI were labelling during a clinical study or chart review (n = 21), electronic phenotyping (n = 13) or not specified (n = 9). None of the studies using an electronic phenotype described phenotype validation. Almost all studies (n = 41, 95%) conducted supervised ML and the most common ML algorithms were penalized logistic regression (n = 20, 47%) and classification tree (n = 17, 40%). Approaches to feature selection and dimension reduction were heterogeneous. Metrics were evaluated in a held-out test set in 16 (37%) studies; only seven used a time-based split. In terms of reporting quality assessment, the most poorly reported items were data leakage prevention (n = 0, 0%), code availability (n = 8, 19%) and class imbalance management (n = 12, 43%).Conclusions: While many studies have used ML to investigate CDI or CDI outcomes, electronic phenotyping of CDI was uncommon and phenotype validation was not reported in any study. Methodological approaches were heterogeneous. Validating CDI electronic phenotypes, evaluating performances of CDI models during a silent trial and deploying a CDI classifier to guide clinical practice are important future goals. [ABSTRACT FROM AUTHOR]

Abstract: A regional scale survey investigated accumulation of Cu and Zn in wheat and agricultural soil from the Yangtze River delta region, China. A total of 126 pairs of topsoil and wheat samples were collected to analyze Cu, Zn and relevant parameters. 7.9% and 21.4% of the wheat grain samples exceed Chinese maximum permitted concentrations of Cu and Zn in wheat grain (Cu: 10mgkg−1, Zn: 50mgkg−1), respectively. Cu had the highest accumulation in wheat straw, whereas Zn showed the highest accumulation in grain. The translocation from root to straw was the key link in the whole Cu transfer process in the soil–wheat system, and the average transfer coefficient was 1.244. For the whole Zn transfer process, the key link was the translocation from straw to grain, and the average transfer coefficient was 1.764. The spatial distributions of Cu and Zn accumulation in wheat grain did not exactly correspond to those in the soil. Among the soil parameters, soil pH was the most important factor in grain Cu or Zn accumulation apart from the concentrations of the heavy metal themselves. S and Fe had significant influences on Cu and Zn accumulation in the wheat grain. Besides Cu, Zn and co-transporter (S and Fe) imported from the soil, S present in atmosphere may also play an important role in wheat grain Cu and Zn accumulation, as S can provide conjunct ions and co-transporters for Cu and Zn in the soil–wheat system. [Copyright &y& Elsevier]

The accurate source tracing of volatile organic compounds (VOCs) in complicated source environments is challenging to perform, as similar pollutants may be emitted from different chemical processes. An emission profile-based source tracing method, based on comparing similarities between source profiles and ambient air profiles, was evaluated, and was found to improve the tracing efficiency. Emission profiles were acquired from a typical chemical industrial park in the Yangtze River Delta, China. A total of 30 process-based emission profiles comprising 107 VOC species were investigated and similarities among them were calculated. This analysis demonstrated that the similarities between emissions from various chemical processes are universal. Source tracing was then conducted for six air pollution episodes, based on the emission profile-based source tracing method combined with wind speed and direction data. The results showed that the proposed approach represents an efficient method for source tracing. This study enriches the database of source profiles for petroleum-related industries. The emission profiles from references and the air pollution episodes augment the emission profile database, especially under abnormal emission conditions. The database will more effectively serve future source-tracing cases, creating a virtuous circle that improves source tracing efficiency. Unlabelled Image • Emission profiles were acquired from a typical chemical industrial park. • The similarities between profiles were quantified and compared. • Emissions from particular chemical processes were proven to be similar. • Source tracing was performed using an emission profile-based method. • The database of source profiles for petroleum-related industries was augmented. [ABSTRACT FROM AUTHOR]