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Yiqi Xiong,1,&ast; Wenying Qiao,2,3,&ast; Tingting Mei,1,&ast; Kang Li,4 Ronghua Jin,2,3 Yonghong Zhang1 1Interventional Therapy Center for Oncology, Beijing You’an Hospital, Capital Medical University, Beijing, 100069, People’s Republic of China; 2National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People’s Republic of China; 3Changping Laboratory, Beijing, 102206, People’s Republic of China; 4Research center for biomedical Resources, Beijing You’an Hospital, Capital Medical University, Beijing, 100069, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yonghong Zhang, Interventional therapy center for oncology; Beijing You’an Hospital, Capital Medical University, 8 Xitoutiao, Youanmenwai Street, Fengtai District, Beijing, Tel +86-13810108505, Email zhangyh@ccmu.edu.cn Ronghua Jin, National center for infectious diseases, Beijing Ditan Hospital, Capital Medical University, 8 Jingshundong Street, Chaoyang District, Beijing, Tel +86-13811611118, Email ronghuajin@ccmu.edu.cnPurpose: The aim of our study was to investigate the relationship between albumin-bilirubin (ALBI) grade and recurrence in patients who underwent TACE sequential ablation. We developed and validated a nomogram to predict low levels of ALBI patients’ recurrence.Patients and Methods: A total of 880 patients undergoing TACE combined ablation at Beijing Youan Hospital from January 2014 to December 2021 were retrospectively enrolled, including 415 patients with L-ALBI (≤-2.6) and 465 patients with high levels (>-2.6) of ALBI (H-ALBI). L-ALBI patients were randomized in a 7:3 ratio into the training cohort (N=289) and validation cohort (N=126). Multivariate Cox regression followed by random survival forest was carried out to identify independent risk factors for prediction nomogram construction. An examination of nomogram accuracy was performed using the C-index, receiver operating characteristic (ROC), calibration curves, and decision curve analysis (DCA) curves. According to the nomogram, the patients were divided into low-risk, intermediate-risk, and high-risk groups. Kaplan-Meier (KM) curves were applied to compare the difference in recurrence-free survival (RFS) among the three groups.Results: The median RFS in L-ALBI patients was significantly longer than the H-ALBI patients (40.8m vs 20.1m, HR:1.71, 95% CI:1.44– 2.04, P< 0.0001). The nomogram was composed of five variables, such as age, Barcelona Clinic Liver Cancer (BCLC) stage, globulin, gamma-glutamyl transferase to lymphocyte ratio (GLR), and international normalized ratio (INR). The C-index (0.722 and 0.731) and 1-, 3-, and 5-year AUCs (0.725, 0.803, 0.870, and 0.764, 0.816, 0.798) of the training and validation cohorts proved the good predictive performance of the nomogram. Calibration curves and DCA curves demonstrated good consistency and good clinical utility. There were significant differences in RFS between the low-risk, intermediate-risk, and high-risk groups (P< 0.0001).Conclusion: L-ALBI Patients who underwent TACE combined ablation had better recurrence-free survival than patients with H-ALBI. The nomogram developed and validated in our study had good predictive ability in recurrence for L-ALBI patients.Keywords: hepatocellular carcinoma, HCC, ablation, nomogram, recurrence, albumin-bilirubin, ALBI

Wei Xiao,1 Yanqiong Liu,2 Hua Tang,3 Qin Xie,2 Yanlan Luo,2 Tao Mei1 1Department of Neurosurgical Care Unit, Changde Hospital, Xiangya School of Medicine, Central South University, Changde, 415003, People’s Republic of China; 2Cardiovascular Medicine Department, Changde Hospital, Xiangya School of Medicine, Central South University, Changde, 415003, People’s Republic of China; 3Neurosurgery Department, Changde Hospital, Xiangya School of Medicine, Central South University, Changde, 415003, People’s Republic of ChinaCorrespondence: Tao Mei, Email yilan1008@sina.comBackground: Intracerebral hemorrhage (ICH) affects up to 1% of chronic oral anticoagulation (OAC) users per year. This study explored the knowledge, attitude and practice (KAP) towards ICH prevention among patients taking OACs.Methods: This multicenter cross-sectional survey was conducted at 4 hospitals from February to May 2023, and a self-administered questionnaire was developed to assess KAP toward ICH prevention among patients taking OACs. Structural equation modeling was used to assess the relationship between KAP.Results: A total of 536 valid questionnaires (67.25%) were analyzed, from 43.8% participants on Warfarin, 40.5% on Rivaroxaban and 15.7% on Dabigatran. The average knowledge, attitudes and practice scores were 9.22, 24.11, and 28.01 out of 16, 35 and 40, respectively. Participants who received Rivaroxaban had lower knowledge scores but higher attitude and practice store compared to those who received Warfarin or Dabigatran (all p < 0.001). According to Structure Equation Modeling, attitude had direct positive effect on practice (β = 0.694 [0.603– 0.804], p = 0.012), while knowledge had direct negative effect on attitude (β = − 2.077 [− 2.507– 1.651], p = 0.013), as well as negative effect on practice, both direct (β = − 0.450[− 0.689– 2.03], p=0.012), and indirect (β = − 1.441 [− 1.928– 1.192], p = 0.004).Conclusion: Patients taking OACs showed insufficient knowledge, negative attitude and proactive practice regarding ICH; practice scores were affected by age, type of anticoagulation medication, and attitude rather than knowledge.Keywords: cerebral hemorrhage, anticoagulants, warfarin, dabigatran, rivaroxaban, knowledge, attitude, practice

Introduction Studies indicate that long-acting injectable antipsychotics (LAIAs) reduce the risk of relapse and hospitalization compared with oral antipsychotics (APs) in adults. Oral formulations of APs are well-studied in the pediatric population, but little is known regarding the off-label use of LAIAs in this population. Methods This retrospective chart review evaluated readmission rates for pediatric patients admitted to a psychiatric ward in a large academic hospital between January 1, 2015, and December 1, 2022, requiring AP therapy. The experimental group included patients initiated on LAIA therapy, and the control group included patients initiated on a new oral AP. Patients were matched by several clinical factors. Results Each group consisted of 38 patients. For the primary outcome, hospital readmission rates at 3 months, the LAIA group had a 13.2% readmission rate compared with 26.3% in the comparator group (p = .153). In months 4 through 6, there was a 5.3% versus 15.8% readmission rate, respectively (p = .139). In months 7 through 12, it was 7.9% versus 18.4% (p = .179). There were significantly fewer cumulative readmissions at the 1-year mark in the LAIA group (N = 9, 23.7%) compared with the oral AP group (N = 18, 47.4%) (p = .031). No statistically significant differences were seen in hospital length of stay although results numerically favored LAIA. Discussion In a pediatric population, the administration of an LAIA when compared with the oral equivalent resulted in numerically fewer hospital readmissions, decreased length of stay, and fewer adverse effects, but these effects were not statistically significant except for cumulative readmissions at 1 year.

Stimulant use disorder (SUD) is a public health problem in the United States that is associated with increased morbidity and mortality. Psychosocial interventions, such as cognitive behavioral therapy and contingency management, are the main treatment modality for SUDs and no pharmacotherapy is currently FDA approved for this indication. Although some medications show promising data for the treatment of SUD, the evidence remains inconsistent, and the clinical application is limited due to the heterogenicity of the population and the lack of studies in patients with various comorbidities. Selection of pharmacotherapy treatment for methamphetamine intoxication, persistent methamphetamine-associated psychosis with methamphetamine use disorder, and cocaine use disorder in patients with co-occurring OUD are discussed in 3 patient cases.

Minliang Wu,1,* Wenjun Le,2,* Tianxiao Mei,2 Yuchong Wang,1 Bingdi Chen,2 Zhongmin Liu,2 Chunyu Xue11Department of Plastic Surgery,Changhai Hospital, Second Military Medical University, Shanghai 200433, People’s Republic of China; 2Institute for Regenerative Medicine and Translational Nanomedicine, Shanghai East Hospital, The Institute for Biomedical Engineering & Nano Science, Tongji University School of Medicine, Shanghai 200092, People’s Republic of China*These authors contributed equally to this work Abstract: Targeted drug delivery by nanoparticles (NPs) is an essential technique to achieve the ideal therapeutic effect for cancer. However, it requires large amounts of work to imitate the biomarkers on the surface of the cell membrane and cannot fully retain the bio-function and interactions among cells. Cell membranes have been studied to form biomimetic NPs to achieve functions like immune escape, targeted drug delivery, and immune modulation, which inherit the ability to interact with the in vivo environments. Currently, erythrocyte, leukocyte, mesenchymal stem cell, cancer cell and platelet have been applied in coating photothermal agents and anti-cancer drugs to achieve increased photothermal conversion efficiency and decreased side effects in cancer ablation. In this review, we discuss the recent development of cell membrane-coated NPs in the application of photothermal therapy and cancer targeting. The underlying biomarkers of cell membrane-coated nanoparticles (CMNPs) are discussed, and future research directions are suggested.Keywords: cell membrane, nanoparticles, photothermal therapy, cancer targeting

Ning Sun,1,2,* Dou Wang,3,* Guoqiang Yao,4 Xiaomei Li,1 Ting Mei,1 Xinke Zhou,1 Kwok-Yin Wong,2 Baishan Jiang,4 Zhiyuan Fang,11The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou 510500, People’s Republic of China; 2State Key Laboratory of Chemical Biology and Drug Discovery, and Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, People’s Republic of China; 3Department of Hepatobiliary and Pancreatic Surgery, Shenzhen People‘s Hospital, Second Clinical Medical College of Jinan University, Shenzhen 518020, People’s Republic of China; 4Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou 510530, People’s Republic of China*These authors contributed equally to this work Background: The intraoperative visualization of tumor cells is a powerful modality for surgical treatment of solid tumors. Since the completeness of tumor excision is closely correlated with the survival of patients, probes that can assist in distinguishing tumor cells are highly demanded.Purpose: In the present study, a fluorescent probe JF1 was synthesized for imaging of tumor cells by conjugating a substrate of cathepsin B (quenching moiety) to Oregon Green derivative JF2 using a self-immolative linker.Methods: JF1 was then loaded into the folate-PEG modified CaCO3 nanoparticles. The folate receptor-targeted, pH-dependent, and cathepsin B activable CaCO3 nanoprobe was test in vitro and in vivo for tumor imaging.Results: CaCO3 nanoprobe demonstrated good stability and fast lighting ability in tumors under low pH conditions. It also showed lower fluorescence background than the single cathepsin B dependent fluorescent probe. The pH-dependent and cathepsin B controlled “turn-on” property enables precise and fast indication of tumor in vitro and in vivo.Conclusion: This strategy of controlled drug delivery enables in vivo imaging of tumor nodules with a high signal-to-noise ratio, which has great potential in surgical tumor treatment.Keywords: cathepsin B, activable probe, fluorescent probe, CaCO3 nanoparticle, tumor imaging

Fang Liu,1,* Wenjun Le,2,* Tianxiao Mei,2 Tiegong Wang,1 Luguang Chen,1 Yi Lei,1 Shaobin Cui,2 Bingdi Chen,2 Zheng Cui,2,3 Chengwei Shao1 1Radiology Department of Changhai Hospital, Second Military Medical University, 2Shanghai East Hospital, The Institute for Biomedical Engineering & Nano Science, Tongji University School of Medicine, Shanghai, People’s Republic of China; 3Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA *These authors contributed equally to this work Abstract: Pancreatic cancer is a highly malignant disease with a 5-year survival rate ,5% mainly due to lack of early diagnosis and effective therapy. In an effort to improve the early diagnostic rate of pancreatic cancer, a nanoprobe Fe3O4@SiO2 modified with anti-mesothelin antibody (A-MFS) was prepared to target cells and tumor tissues highly expressing mesothelin in vitro (human pancreatic cancer cell line SW1990) and in vivo (subcutaneously transplanted tumors) studies. The A-MFS probe was successfully prepared and was spherical and uniform with a hydrodynamic diameter between 110 and 130 nm. Cell Counting Kit-8 testing indicated that A-MFS was nontoxic in vitro and in vivo studies. The in vitro study showed that the A-MFS probe specifically targeted SW1990 cells with high mesothelin expression. The in vivo study was conducted in Siemens 3.0 T magnetic resonance imaging. The average T2-weighted signal values of the xenografts were 966.533±31.56 before injecting A-MFS and 691.133±56.84 before injecting saline solution. After injection of 0.1 mL A-MFS via nude mouse caudal vein for 2.5 hours, the average T2-weighted signal of the xenograft decreased by 342.533±42.6. The signal value decreased by -61.233±33.9 and -58.7±19.4 after injection of the saline and Fe3O4@SiO2. The decrease of tumor signal by A-MFS was much more significant than that by saline and Fe3O4@SiO2 (P

Aim: The high proportion of plumage polymorphism in raptor species presents exciting research potential. Unfortunately, fundamental knowledge gaps remain that limit our ability to fully understand the development and role of plumage polymorphism in this group and extend those insights to vertebrates as a whole. We report data that fills one such knowledge gap in the red‐tailed hawk (Buteo jamaicensis) that will enable investigations to uncover factors that influence the biogeography of plumage polymorphism in the species and raptors more generally. Location: North America. Taxon: Buteo jamaicensis (red‐tailed hawk). Methods: We captured and outfitted four dark and 22 light morphs with GPS/GSM satellite transmitters during the non‐breeding season in the Great Lakes region of North America to assess their breeding provenance and behaviours. We calculated 95% AKDE nesting home ranges during an 80‐day period meant to capture the incubation and brood‐rearing periods and compared home ranges by age and sex to contextualise movements. Results: Our results indicate that dark types nest in eastern Canada and belong to the same breeding population as the light individuals tagged in our study, extending the known distribution of plumage polymorphism in the species approximately 1500 km eastward into eastern Canada. Main Conclusions: This revised distribution of plumage polymorphism is a critical first step for understanding the biogeography of plumage polymorphism and assessing drivers of within‐population trait diversity in this species, and predatory vertebrates more generally. [ABSTRACT FROM AUTHOR]

This paper presents an in-depth analysis of steering and guidance problems of independently rotating wheels (IRWs) in railway vehicles and provides an engineering insight into the possibilities for passive and/or semi-active control possibilities that do not require expensive full-active systems. The theoretical development is then supported in the study by carrying out a comprehensive performance evaluation in comparison with a full active control. The study demonstrates that the independently rotating wheelset may be effectively controlled via semi-active approaches to provide the wheelsets with the necessary steering on curves and self-centring ability on a straight track with irregularities with performance comparable with full active systems. [ABSTRACT FROM AUTHOR]

Author(s): Ali Poyan Mehr [sup.1] , Mei T. Tran [sup.1] , Kenneth M. Ralto [sup.1] [sup.2] [sup.3] , David E. Leaf [sup.4] , Vaughan Washco [sup.1] , Joseph Messmer [sup.1] [...], Nicotinamide adenine dinucleotide (NAD.sup.+) extends longevity in experimental organisms, raising interest in its impact on human health. De novo NAD.sup.+ biosynthesis from tryptophan is evolutionarily conserved yet considered supplanted among higher species by biosynthesis from nicotinamide (NAM). Here we show that a bottleneck enzyme in de novo biosynthesis, quinolinate phosphoribosyltransferase (QPRT), defends renal NAD.sup.+ and mediates resistance to acute kidney injury (AKI). Following murine AKI, renal NAD.sup.+ fell, quinolinate rose, and QPRT declined. QPRT.sup.+/- mice exhibited higher quinolinate, lower NAD.sup.+, and higher AKI susceptibility. Metabolomics suggested an elevated urinary quinolinate/tryptophan ratio (uQ/T) as an indicator of reduced QPRT. Elevated uQ/T predicted AKI and other adverse outcomes in critically ill patients. A phase 1 placebo-controlled study of oral NAM demonstrated a dose-related increase in circulating NAD.sup.+ metabolites. NAM was well tolerated and was associated with less AKI. Therefore, impaired NAD.sup.+ biosynthesis may be a feature of high-risk hospitalizations for which NAD.sup.+ augmentation could be beneficial. Impaired NAD.sup.+ biosynthesis may be a common feature of high-risk hospitalizations for which NAD.sup.+ augmentation could improve therapeutic outcome.

To scientifically and effectively determine the layout of stability control systems， accurately identify partition interfaces， and enhance the operational security of large-scale power grids， this paper proposes a power grid partitioning method based on complex network coupling matrices. First， a complex network coupling matrix is constructed using grid power flow and reactive power-voltage sensitivity to represent active operation and voltage control features for dual-weight quantification of active and reactive power. Next， quality evaluation metrics for grid partitioning are developed to quantify partition structure strength， source-load matching， and voltage regulation effects， forming a structural and functional evaluation framework for grid partitioning. Finally， considering the grid’s operational characteristics and topological features， the local expansion method of complex network theory is adaptively improved to achieve non-overlapping optimal grid partitioning. Case analysis validates the superiority and accuracy of the proposed method.

Abstract Purpose The aim of this study is to convert low-dose PET (L-PET) images to full-dose PET (F-PET) images based on our Diffused Multi-scale Generative Adversarial Network (DMGAN) to offer a potential balance between reducing radiation exposure and maintaining diagnostic performance. Methods The proposed method includes two modules: the diffusion generator and the u-net discriminator. The goal of the first module is to get different information from different levels, enhancing the generalization ability of the generator to the image and improving the stability of the training. Generated images are inputted into the u-net discriminator, extracting details from both overall and specific perspectives to enhance the quality of the generated F-PET images. We conducted evaluations encompassing both qualitative assessments and quantitative measures. In terms of quantitative comparisons, we employed two metrics, structure similarity index measure (SSIM) and peak signal-to-noise ratio (PSNR) to evaluate the performance of diverse methods. Results Our proposed method achieved the highest PSNR and SSIM scores among the compared methods, which improved PSNR by at least 6.2% compared to the other methods. Compared to other methods, the synthesized full-dose PET image generated by our method exhibits a more accurate voxel-wise metabolic intensity distribution, resulting in a clearer depiction of the epilepsy focus. Conclusions The proposed method demonstrates improved restoration of original details from low-dose PET images compared to other models trained on the same datasets. This method offers a potential balance between minimizing radiation exposure and preserving diagnostic performance.

Eye-tracking technology is found effective in revealing the specific visual preference of Autism Spectrum Disorder (ASD) which can be characterized by high systemizing and low empathizing abilities. Early diagnosis is vital for ASD’s subsequent treatment. However, existing eye-tracking-based methods suffer from long diagnostic times and low diagnostic accuracy due to the lack of awareness of gaze preference derived from individual differences. Moreover, there is only one publicly available eye-tracking dataset that employs a simple image free-viewing paradigm to collect the gaze patterns of ASD and typically developed (TD) subjects with an average age of 8 years, thus can not effectively support the early diagnosis for preschool children. To tackle the difficulties, in this paper, we first propose an Uncertainty-inspired ASD Screening Network (UASN) that dynamically estimates the contribution of each stimulus viewed by different subjects, and secondly, we design a contrastive image-viewing paradigm and further collect eye movement data from preschool children to reveal the visual behaviors of ASD children accordingly. Specifically, in UASN, we estimate the uncertainty of each stimulus and use it for more efficient model training and a more simplified personalized diagnosis procedure. Besides, by synthesizing two images with the opposite semantic representations and recruiting ASD and TD subjects aged 2-6, we construct a new CI4ASD dataset, which offers a novel contrastive image-viewing paradigm for better diagnosis of ASD in children. Comprehensive experiments are conducted and results have evidenced the effectiveness of the proposed UASN and eye-tracking paradigm.

Abstract Background Infectious episodes contribute to morbidity and mortality in patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Renal involvement, also known as ANCA-associated glomerulonephritis (AGN), is frequently observed in AAV. Little is known about whether co-infection at initial diagnosis is associated with renal outcome and prognosis in children with AGN. Methods Clinical and prognostic data for children admitted to our center with AAV from January 2001 to August 2023 were analyzed retrospectively. We compared the incidence of end-stage renal disease (ESRD) and mortality according to infection status at initial diagnosis. Results A total of 33 children with AGN were included in this study, 22 had an infection at the time of AGN diagnosis. A trend toward higher levels of proteinuria in the infected group than in the non-infected group was observed (p = 0.42). Patients in the infected group had higher creatinine and lower eGFR values than those in the non-infected group (p = 0.09). A significant decrease in HGB was observed in the infected group (p

Introduction: The subjective and objective benefits of an opioid‐related disorders simulation lab have not been well established in pharmacy student education. Opioid‐related disorders are extremely prevalent, and education of pharmacy students should develop as the role of the pharmacist progresses. Objective: To enhance knowledge, affective skills, and empathy in the management of opioid‐related disorders for third professional‐year student pharmacists using simulation. Methods: Third‐year student pharmacists participated in a three‐part opioid‐related disorders activity. Students first completed a patient case in groups, then presented as the patient to a simulated retail pharmacy to obtain a buprenorphine‐naloxone prescription, and lastly, provided counseling to a simulated patient for naloxone nasal spray. Knowledge was assessed with a multiple‐choice survey, and affective skills and empathy were assessed with an opinion‐based survey. The surveys were administered pre‐class, post‐class, and 1 month following the class. The surveys were not validated but were based on curriculum goals. All of the surveys were completed online, and the pre‐class and post‐class surveys were completed on computers during class. Results: A total of 150 students completed the pre‐class survey, 144 completed the post‐class survey, and 90 completed the survey 1 month later. The experience was reported as valuable by 100% of participants. Knowledge significantly improved from the pre‐class survey (85.6%) to the post‐class survey (94.3%) (p < 0.001) and remained improved 1 month following the activity (92.4%) (p = 0.002). Based on the opinion‐based survey, empathy toward patients with opioid‐related disorders was significantly improved for three survey items following the activity and 1 month after the activity. Conclusion: This three‐part simulation demonstrated improvement in empathy and knowledge in the ability to provide care for patients with opioid‐related disorders among student pharmacists. [ABSTRACT FROM AUTHOR]