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Increasing literature suggests that palliative care and dermatology are closely intertwined; however, there are no documented palliative care curricula in dermatology residency. In this study, we developed a palliative care curriculum for Harvard dermatology residents, and assessed residents’ knowledge, skills and attitudes towards palliative care before and after the curriculum. We found that a palliative care curriculum increases residents’ knowledge and confidence in goals of care discussions and palliative care referrals, and that a palliative care curriculum is well received among dermatology residents.

Covid-19 is primarily spread through contact with the virus which may survive on surfaces with a lifespan of hours or even days if not sanitized. To curb its spread, it is hence of vital importance to detect those who have been in contact with the virus for a sustained period of time, the so-called close contacts. Most of the existing digital approaches for contact tracing focus only on direct face-to-face contacts. There has been little work on detecting indirect environmental contact, which is to detect people coming into a contaminated area with the live virus, i.e., an area last visited by an infected person within the virus lifespan. In this work, we study automatic IoT contact tracing when the virus has a lifespan which may depend on the disinfection frequency at a location. Leveraging the ubiquity of WiFi signals, we propose vContact, a novel, private, pervasive and fully distributed WiFi-based IoT contact tracing approach. Users carrying an IoT device (phone, wearable, dongle, etc.) continuously scan WiFi access points (APs) and store their hashed IDs. Given a confirmed case, the signals are then uploaded to a server for other users to match in their local IoT devices for virus exposure notification. vContact is not based on device pairing, and no information of other users is stored locally. The confirmed case does not need to have the device for it to work properly. As WiFi data are sampled sporadically and asynchronously, vContact uses novel and effective signal processing approaches and a similarity metric to align and match signals at any time. We conduct extensive indoor and outdoor experiments to validate vContact performance. Our results demonstrate that vContact is effective and accurate for contact detection. The precision, recall and F1-score of contact detection are high (up to 90%) for close contact proximity (2m). Its performance is robust against AP numbers, AP changes and phone heterogeneity. Having implemented vContact as an Android SDK and installed it on phones and smart watches, we present a case study to demonstrate the validity and implementability of our design in notifying its users about their exposure to the virus with a specific lifespan. IEEE

Microribonucleic acids (miRNAs) are small non-coding ribonucleic acids (ncRNAs), which can affect recognition of homologous sequences and interfere with transcription. It plays key roles in the initiation, development, resistance, metastasis or recurrence of cancers. Identifying circulatory indicators will positively improve the prognosis and quality of life of patients with early cancer. Previous studies have shown that miRNA is highly involved in cancer. In addition, miRNA derived from cancers can be encapsulated as exosomes and further extracted into circulatory systems to realize malignant functions. It indicates that circulating exosome-derived miRNAs have the potential to replace conventional biomarkers as cancer derived exosomes carrying miRNAs can be identified by specific markers and might be more stable and accurate for early diagnosis.

Strawberry seedlings from greenhouses in different districts of Beijing started showing symptoms of black root rot in 2014, and the diseased plants were collected between 2015 and 2017. Forty-six Dactylonectria isolates were obtained from the root samples, among which five representative isolates were further identified based on morphological characteristics and multi-locus sequence of four loci, internal transcribed spacer region of nuclear rDNA (ITS), β-tubulin (tub2), histone H3 (his3) and translation elongation factor 1-alpha (tef1). Amongst them, three isolates were identified as D. novozelandica, one was D. torresensis and one D. pauciseptata. Pathogenicity tests confirmed that all isolates were pathogenic to strawberry (cultivar Benihope) and produced black root rot symptoms. This study is the first report of Dactylonectria species causing black root rot of strawberries in China, as well as D. novozelandica and D. pauciseptata in the world.

Background and Purpose: In ischemic stroke, intravenous tenecteplase is noninferior to alteplase in selected patients and has some practical advantages. Several stroke centers in New Zealand changed to routine off-label intravenous tenecteplase due to improved early recanalization in large vessel occlusion, inconsistent access to thrombectomy within stroke networks, and for consistency in treatment protocols between patients with and without large vessel occlusion. We report the feasibility and safety outcomes in tenecteplase-treated patients. Methods: We performed a retrospective analysis of consecutive patients thrombolyzed with intravenous tenecteplase at 1 comprehensive and 2 regional stroke centers from July 14, 2018, to February 29, 2020. We report the baseline clinical characteristics, rates of symptomatic intracranial hemorrhage, and angioedema. These were then compared with patient outcomes with those treated with intravenous alteplase at 2 other comprehensive stroke centers. Multivariable mixed-effects logistic regression models were performed assessing the association of tenecteplase with symptomatic intracranial hemorrhage and independent outcome (modified Rankin Scale score, 0–2) at day 90. Results: There were 165 patients treated with tenecteplase and 254 with alteplase. Age (75 versus 74 years), sex (56% versus 60% male), National Institutes of Health Stroke Scale scores (8 versus 10), median door-to-needle times (47 versus 48 minutes), or onset-to-needle time (129 versus 130 minutes) were similar between the groups. Symptomatic intracranial hemorrhage occurred in 3 (1.8% [95% CI, 0.4–5.3]) tenecteplase patients compared with 7 (2.7% [95% CI, 1.1–5.7]) alteplase patients ( P =0.75). There were no differences between tenecteplase and alteplase in the rates of angioedema (4 [2.4%; 95% CI, 0.7–6.2] versus 1 [0.4%; 95% CI, 0.01–2.2], P =0.08) or 90-day functional independence (100 [61%] versus 140 [57%], P =0.47), respectively. In mixed-effects logistic regression models, there was no significant association between thrombolytic choice and symptomatic intracranial hemorrhage (odds ratio tenecteplase, 0.62 [95% CI, 0.14–2.80], P =0.53) or functional independence (odds ratio tenecteplase, 1.20 [95% CI, 0.74–1.95], P =0.46). Conclusions: Routine use of tenecteplase for stroke thrombolysis was feasible and had comparable safety profile and outcome to alteplase.

The native gold in the Woxi Au–Sb–W deposit is characterized by remarkably high purities (99.9%), called as super-pure native gold. The deposit can thus be used as the suitable application example for analyzing ore-forming conditions by using the thermodynamic calculation of AuxAg1 – x-fluid equilibria. According to experimental results of minerals and fluid inclusions, some physicochemical conditions are assumed in the thermodynamic calculation of the fluids equilibrated with Au–Ag solid solutions of XAu = 0.999. Calculated results in log fO2-pH diagrams show dissolved gold and silver concentrations, as well as stability fields of pyrite and sericite associated with the super-pure native gold. On the other hand, LA-ICP-MS analysis indicates that both Au and Ag concentration are determined in the fluid inclusions of scheelite, showing varied Au/Ag ratios with different homogenization temperatures. The calculated results assumed by different data of inclusions in scheelite, indicate two fluid inclusions showing higher homogenization temperatures (303°C and 356°C) and higher Au/Ag ratios are possible for precipitation of the super-pure native gold coexisting with pyrite and sericite, whereas one fluid inclusion showing a lower homogenization temperature (198°C) and a lower Au/Ag ratio is impossible for the super-pure native gold. Therefore, the super-pure native gold in the Woxi deposit was probably formed by the hydrothermal fluid with higher Au/Ag ratios and high temperatures in the mineralization stage of scheelite.

For end-stage renal disease (ESRD), patients receiving kidney transplantation, peritoneal dialysis (PD) and hemodialysis (HD) are both appropriate modes of pre-transplant dialysis. The aim of this review is to assess the impact of pre-transplant PD compared to HD on kidney transplant outcomes in ESRD patients.A comprehensive search in digital databases, like PubMed, SCOPUS and EMBASE and a manual search were conducted to identify cohort studies comparing the kidney transplant outcomes of both pre-transplant dialysis modalities. The data were subjected to both qualitative and quantitative analysis. A meta-analysis was carried out to calculate the effect estimate for patient survival, graft survival and delayed graft function, death-censored graft survival, acute rejection-free graft survival, graft vessel thrombosis, urological complications, surgical complications, any infections, and onset of diabetes after transplantation. The qualities of the included studies were judged by the New-castle Ottawa scale.The overall patient survival is shown to be better with patients who underwent pre-transplant PD compared to HD with OR 1.34 95% CI [1.11, 1.61], p = 0.002. Delayed graft function was found to be highly associated with HD compared to PD with OR 0.60 [0.52, 0.70], p0.0001 with moderate heterogeneity (i2 = 48%). However, no difference was observed in terms of graft survival, complications, infections, and new onset of diabetes mellitus compared to patients undergoing pre-transplant HD.Within the limitations of the review, it can be concluded that ESRD patients undergoing pre-transplant PD were found to have better patient survival and lower incidence of delayed graft function.

With the development of microecology in recent years, the relationship between intestinal bacteria and inflammatory bowel disease (IBD) has attracted considerable attention. Accumulating evidence suggests that dysbiotic microbiota plays an active role in triggering or worsening the inflammatory process in IBD and that fecal microbiota transplantation (FMT) is an attractive therapeutic strategy since transferring a healthy microbiota to IBD patient could restore the appropriate host-microbiota communication. However, the molecular mechanisms are unclear, and the efficacy of FMT has not been very well established. Thus, further studies in animal models of IBD are necessary. In this method, we applied FMT from wild-type C57BL/6J mice to IL-10 deficient mice, a widely used mouse model of colitis. The study elaborates on collecting fecal pellets from the donor mice, making the fecal solution/suspension, administering the fecal solution, and monitoring the disease. We found that FMT significantly mitigated the cardiac impairment in IL-10 knockout mice, underlining its therapeutic potential for IBD management.

The recent increasing trend of “warm Arctic, cold continents” has attracted much attention, but it remains debatable as to what forces are behind this phenomenon. Here, we revisited surface temperature variability over the Arctic and the Eurasian continent by applying the self-organizing-map (SOM) technique to gridded daily surface temperature data. Nearly 40 % of the surface temperature trends are explained by the nine SOM patterns that depict the switch to the current warm Arctic–cold Eurasia pattern at the beginning of this century from the reversed pattern that dominated the 1980s and 1990s. Further, no cause–effect relationship is found between the Arctic sea ice loss and the cold spells in the high-latitude to midlatitude Eurasian continent suggested by earlier studies. Instead, the increasing trend in warm Arctic–cold Eurasia pattern appears to be related to the anomalous atmospheric circulations associated with two Rossby wave trains triggered by rising sea surface temperature (SST) over the central North Pacific and the North Atlantic oceans. On interdecadal timescale, the recent increase in the occurrences of the warm Arctic–cold Eurasia pattern is a fragment of the interdecadal variability of SST over the Atlantic Ocean as represented by the Atlantic Multidecadal Oscillation (AMO) and over the central Pacific Ocean.

OBJECTIVE: To compare the clinical efficacy of combined application of glycine powder air-polishing and mechanical submucosal debridement in non-surgical treatment of peri-implant diseases. METHODS: A randomized controlled clinical study was carried out on patients diagnosed with peri-implant diseases in the Department of Periodontology, Peking University School and Hospital of Stomatology, between May of 2020 and June of 2021.Twenty-eight patients with totally sixty-two implants were enrolled.The patients were randomly divided into the test group and control group. The patients in the test group (13 subjects/32 implants) received mechanical submucosal debridement using titanium curettes combined with application of glycine powder air-polishing, while the control group (15 subjects/30 implants) received mechanical submucosal debridement using titanium only. Clinical parameters, such as plaque index (PLI), pocket probing depth (PPD), bleeding index (BI) and the percentage of suppuration on probing on implants' level (SoP%) were measured at baseline and 8 weeks after non-surgical intervention. Changes and group differences of clinical parameters of the implants before and 8 weeks after non-surgical intervention were compared. RESULTS: Mean PLI, PPD, BI of both the test group and control group significantly reduced 8 weeks after non-surgical intervention (P < 0.05). Compared with the control group, the test group achieved lower BI (2.7±0.8 vs. 2.2±0.7, P < 0.05), more reduction of BI (0.6±0.7 vs. 1.1±0.6, P < 0.01) and more reduction of SoP% (21.9% vs. 10%, P < 0.05) after non-surgical intervention. Both the control and test groups exhibited comparable PLI and PPD reductions (P>0.05). For the implants diagnosed with peri-implant mucositis, the test group revealed more signi-ficant reduction in BI and SoP% than the control group (1.0±0.7 vs. 0.4±0.7, P=0.02; 6.3% vs. 0, P=0.012). There was no significant difference existing in PLI and PD improvement between the control group and test group (P>0.05). For the implants diagnosed with peri-implantitis, there was no significant difference existing in PLI, PPD, BI and SoP% improvement values between the test and control groups (P>0.05). No complications or discomforts were reported during the study. CONCLUSION: Both treatment procedures could relieve the inflammation of peri-implant soft tissue. Non-surgical mechanical submucosal debridement combined application of glycine powder air-polishing is associated with significant reduction of soft tissue bleeding and suppuration on probing especially in the implants diagnosed with peri-implant mucositis.

Aim Quinoline is a recalcitrant pollutant in coking wastewater which has been broadly investigated with many isolates possessing aerobic quinoline-degrading ability. However, studies on anaerobic degradation and the corresponding bacteria are very scarce. This study attempted to investigate the role of diverse functional members and the redundancy of quinoline degradation in a lab-scale quinoline denitrifying bioreactor. Methods and results Antibiotics were added to the batch culture under denitrifying conditions to disturb the microbial community of the quinoline-degrading bioreactor. According to the results, the nitrate removal rate remained stable, and the quinoline removal rate increased by 9·7% after treatment with streptomycin. However, PCoA analysis of 16S rRNA gene sequencing data of these samples indicated a significant shift in microbial community structures. Specifically, 12 operational taxonomic units (OTUs), including OTU1 (Pseudomonas) and OTU2 (Achromobacter), were significantly enriched. OTU1 replaced OTU8 (Thauera) as the most predominant denitrifying quinoline-degrading member. However, OTU8 and other predominant OTUs (Comamonas and Pseudoxanthomonas), which were hypothesized to contribute essentially to quinoline degradation in the origin bioreactor, became almost undetectable. Conclusion Functional redundancy due to high biological diversity allowed the role reversal of predominant quinoline-degrading bacteria and other rare bacteria when disturbed by antibiotic stress. Although the abundance of OTU1 was much lower initially, it replaced the essential role of the predominant member OTU8 in the bioreactor community for quinoline degradation once the environmental condition changed. Significance and impact of the study This study indicated that the high biological diversity in a wastewater treatment bacterial community is crucial for maintaining the degrading function of organic pollutants, especially in a changing environment due to external disturbance or stress.

Nanofibers are attractive supporting matrices for catalytically active metallic catalysts. Herein, palladium species were successfully incorporated into the modified chitosan/poly(ethylene oxide)/maleic acid nanofibers by electrospinning. Then, the hybrid nanofibers were thermally cross-linked at elevated temperature to improve stable behavior in solution. X-ray diffraction and transmission electron microscopy characterizations show that the palladium nanoparticles are dispersed uniformly inside the hybrid nanofibers. This novel hybrid nanofiber mat displayed high catalytic activity for the Sonogashira coupling reaction of phenyl acetylene with aromatic iodides under copper free condition with moderate to excellent yields. Moreover, this nanofiber mat could be reused 10 times with little activity loss. Thus, we have proposed a facile way to prepare highly active and stable heterogeneous palladium catalyst.

Human-induced disturbances, including grazing and clipping, that cause defoliation are common in natural grasslands. Plant functional type differences in the ability to compensate for this tissue loss may influence interspecific competition. To explore the effects of different intensities of clipping and nitrogen (N) addition on compensatory growth and interspecific competition, we measured accumulated aboveground biomass (AGB), belowground biomass (BGB), tiller number, non-structural carbohydrates concentrations and leaf gas exchange parameters in two locally co-occurring species (the C3 grass Leymus chinensis and the C4 grass Hemarthria altissima) growing in monoculture and in mixture. For both grasses, the clipping treatment had significant impacts on the accumulated AGB, and the 40% clipping treatment had the largest effect. BGB gradually decreased with increasing defoliation intensity. Severe defoliation caused a significant increase in tiller number. Stored carbohydrates in the belowground biomass were mobilised and transported aboveground for the growth of new leaves to compensate for clipping-induced injury. The net CO2 assimilation rate (A) of the remaining leaves increased with clipping intensity and peaked under clipping intensities of 20% or 40%. Nitrogen addition, at a rate of 10 g·N·m-2 ·year-1 , enhanced A of the remaining leaves and non-structural carbohydrate concentrations, which benefited plant compensatory growth, especially for the C3 grass. Under the mixed planting conditions, the clipping and N addition treatments lowered the competitive advantage of the C4 grass. The results suggest that a combination of defoliation and N deposition have the potential to benefit the coexistence of C3 and C4 grasses.

The standardized training of specialist doctors is an important part of medical education after graduation and it is the only way to train clinicians to diagnose and treat the specialist diseases independently by using a standardized and high-quality way. The prevalence of periodontal disease and the proportion of patienets with severe and advanced periodontitis in our country are high and the diagnosis and treatment process for the periodontal disease are complicated. There is an urgent need to expand the team of periodontal specialists capable of the specialized treatment. The training of periodontal specialists in our country has just started. The present article summarizes the exploration and practice of periodontal specialist training in Peking University School and Hospital of Stomatology in the past five years, including the establishment of training bases, formulation of clear training goals, strict implementation of training rules, strengthening of process quality control to ensure the trainees could reach the expected standard of periodontal specialist after training. Through the summary of the previous stage practice, the authors hope to explore and establish a periodontal specialist training system in line with our country's national conditions and further to promote and accelerate the pace of nationwide periodontal specialist training system.专科医师规范化培训作为毕业后医学教育的重要组成部分，是培养能够独立、规范、高质量从事专科疾病诊疗工作临床医师的必由之路。我国牙周病患病率高，重度和晚期牙周炎比例高，诊疗过程复杂。亟需扩大能胜任此类治疗的牙周专科医师队伍。目前我国牙周专科医师培训刚刚起步。本文总结了近5年北京大学口腔医学院·口腔医院牙周专科医师培训的探索实践过程，从建立培训基地、制订明确的培训目标，到严格执行培训细则、加强过程质量控制，以确保学员经过培训后达到牙周专科医师的预期水平。通过阶段实践总结，探索符合我国国情的牙周专科医师培训体系，加快我国牙周专科医师的培训进程。.