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Solid strong base catalysts are highly attractive for diverse reactions owing to their advantages of neglectable corrosion, facile separation, and environmental friendliness. However, their widespread applications are impeded by basic components aggregation and low stability. In this work, we fabricate single calcium atoms on graphene (denoted as Ca1/G) by use of a redox strategy for the first time, producing solid strong base catalyst with high activity and stability. The precursor Ca(NO3)2 is first reduced to CaO at 400 °C by the support graphene, forming CaO/G with conventional basic sites, and the subsequent reduction at 850 °C results in the generation of Ca1/G with atomically dispersed Ca. Various characterizations reveal that Ca single atoms are anchored on graphene in tetra-coordination (Ca--C2--N2) where N is in situ doped from Ca(NO3)2. The atomically dispersed Ca, along with their anchoring on the support, endow Ca1/G with high activity and stability toward the transesterification reaction of ethylene carbonate with methanol. The turnover frequency value reaches 128.0 h-1 on Ca1/G, which is much higher than the traditional counterpart CaO/G and various reported solid strong bases (2.9-46.2 h-1). Moreover, the activity of Ca1/G is well maintained during 5 cycles, while 60% of activity is lost for the conventional analogue CaO/G due to the leaching of Ca. [ABSTRACT FROM AUTHOR]

Background: A personal review of the meaning in life can be important for sorting out the integrity of life for the elderly in long-term care facilities. Interactions, actions and responses through horticultural activities may trigger elderly to review the meaning of aspects of their lives during the process of participation. Purpose: The study aimed to examine whether participation in horticultural activities can promote a review of the meaning in life among elderly residents in long-term care facilities, and affirm their own experiences and efforts in the course of their life. Methods: Using convenient sampling, this qualitative research study recruited and interviewed nine participants from long-term care facilities in northeastern Taiwan. The interview content was analyzed with a phenomenological approach. Results: Of nine participants, six were female and three were male, with a mean age of 81.76 ( SD = 8.47). Four major themes emerged: (1) reviews of meaningful events in life experiences; (2) to be able to live well during the process of getting older; (3) the value of cooperation; (4) elderly still have the ability and responsibility to take care of others. Conclusions: Our findings provide evidence-based information about the effects of horticulture therapy on promoting review of the meaning in life among elderly in the long-term care facilities. [ABSTRACT FROM AUTHOR]

BACKGROUND: The long-term prognosis of patients with hepatocellular carcinoma (HCC) after surgery remains far from satisfactory, especially in patients with microvascular invasion (MVI). This study aimed to evaluate the potential survival benefit from adjuvant lenvatinib for patients with HCC and MVI. METHODS: Patients with HCC after curative hepatectomy were reviewed. All patients were divided into 2 groups according to adjuvant lenvatinib. Propensity score matching (PSM) analysis was used to reduce selection bias and make the results more robust. Survival curves are shown by the Kaplan-Meier (K-M) analysis and compared by the Log-rank test. Univariate and multivariate Cox regression analyses were performed to determine the independent risk factors. RESULTS: Of 179 patients enrolled in this study, 43 (24%) patients received adjuvant lenvatinib. After PSM analysis, 31 pairs of patients were enrolled for further analysis. Survival analysis before and after PSM analysis showed a better prognosis in the adjuvant lenvatinib group (all P < .05). The adverse events associated with oral lenvatinib were acceptable. Multivariate Cox regression analysis showed that adjuvant lenvatinib was an independent protective factor for improving overall survival (OS) (hazard ratio [HR] = 0.455, 95% confidence interval [CI] = 0.249-0.831, P = .001) and recurrence-free survival (RFS) (HR = 0.523, 95% CI = 0.308-0.886, P = .016). CONCLUSIONS: Postoperative adjuvant targeted therapy can improve the long-term prognosis of patients with HCC and MVI. Therefore, in clinical practice, oral lenvatinib should be recommended for patients with HCC and MVI to decrease tumor recurrence and improve long-term survival. [ABSTRACT FROM AUTHOR]

Background: Human immunodeficiency virus type 1 (HIV-1) epidemic in China is featured by geographical diversity of epidemic patterns. Understanding the characteristics of regional HIV-1 epidemic allows carrying out targeted prevention and controlling measures. This seven-year cross-sectional study was conducted in Heilongjiang, one province of Northeast China, where newly diagnosed infection is fast increasing yearly, but temporal HIV-1 epidemic trend is largely unknown. Methods: Information of 1,006 newly diagnosed HIV-1-infected participants were collected before antiretroviral therapy during 2010–2016 in Heilongjiang province. HIV-1 genotype was identified based on the viral gag and env gene sequences. Recent infection was determined by Limiting-Antigen Avidity assays. Comparison analyses on the median ages, CD4 counts, proportions of stratified age groups and CD4 count groups, and rates of recent HIV-1 infection among different population and sampling times were performed to understand temporal HIV-1 epidemic features. Results: Homosexual contact among men who have sex with men (MSM) was the main transmission route and CRF01_AE was the most dominant HIV-1 genotype. During 2010–2016, the HIV-1 epidemic showed three new changes: the median age continued to decline, the cases with a CD4 count more than 500 cells/μl (CD4hi cases) disproportionally expanded, and the recent HIV-1 infection rate steadily increased. MSM cases determined the temporal trend of HIV-1 epidemic here. Increase of young MSM cases (aged <30 years) made the main contribution to the younger age trend of MSM cases. These young MSM exhibited a higher median CD4 count, a higher proportion of CD4hi cases, and a higher rate of recent HIV-1 infection than cases aged 30 years and more. MSM infected by CRF01_AE virus mostly affected HIV-1 epidemic patterns among MSM population. Conclusion: Young MSM have become a new hotspot and vulnerable group for HIV-1 transmission in Heilongjiang Province, Northeast China. The rapid increase in the number of young MSM cases, mainly those with CRF01_AE infection, changed temporal HIV-1 epidemic pattern here. Measures for prevention and control of HIV-1 infection among this population are urgently needed in the future. [ABSTRACT FROM AUTHOR]

Background & aims: The long-term prognosis of patients with metabolic syndrome (MS) and hepatitis B virus-related hepatocellular carcinoma (HBVHCC) after radical hepatectomy remains unclear. The purpose of this study was to elucidate the effect of MS on long-term survival for patients with HBVrelated HCC after hepatectomy. Methods: Patients with HBV-HCC after hepatectomy were included. Patients were stratified into MS-HBV-HCC and HBV-HCC groups. Clinical features and surgical outcomes were compared between the two groups, and COX regression analysis was used to determine independent risk factors associated with overall survival (OS) and recurrence-free survival (RFS). Result: 389 patients (MS-HBV-HCC group: n=50, HBV-HCC group: n=339) were enrolled for further analysis. Baseline characteristics showed that patients with MS-HBV-HCC were associated with a high rate of elderly patients, ASA score, and co-morbid illness, but a lower rate of anatomy hepatectomy. There were no significant differences in perioperative complications. After excluding patients who relapsed or died within 90 days after surgery, multivariate Cox regression analysis showed MS was an independent risk factor of OS (HR 1.68, 95% CI 1.05-2.70, P = 0.032) and RFS (HR 1.78, 95% CI 1.24-2.57, P = 0.002). Conclusion: MS is an independent risk factor for poor OS and RFS in HBVinfected HCC patients after radical hepatectomy. This suggests that we need to strengthen postoperative follow-up of the relevant population and encourage patients to develop a healthy lifestyle. [ABSTRACT FROM AUTHOR]

Background: The GALAD and ASAP scores are two well-recognized algorithms to estimate the risk of hepatocellular carcinoma (HCC) based on gender, age, alpha-fetoprotein (AFP), protein induced by vitamin K absence or Antagonist-II (PIVKA-II) and AFP-L3 (included in the GALAD score but not in the ASAP score). The current study sought to compare the diagnostic performance of each score to detect HCC among patients infected with hepatitis C virus (HCV). Methods: A multicenter case-control study was undertaken in which blood samples were collected from HCV infected patients with and without HCC. Using the area under the receiver operating characteristic curve (AUROC), ASAP and GALAD scores were compared relative to diagnostic performance to detect any stage HCV-HCC and early-stage HCV-HCC. Results: The analytic cohort included 168 HCV-HCC patients and a control group of 193 HCV-infected patients. The ASAP score had a higher AUROC to detect any stage HCV-HCC versus the GALAD score, both in the overall group (0.917 vs. 0.894, P=0.057) and in the cirrhosis subgroup (0.909 vs. 0.889, P=0.132). Similar results were noted relative to the detection of early-stage HCV-HCC, whether defined by BCLC staging (stage 0-A: 0.898 vs. 0.860, P=0.026) or 8th TNM staging (stage I: 0.899 vs. 0.870, P=0.070). In subgroup analysis to detect AFP-negative HCV-HCC, the ASAP score also demonstrated a higher AUROC than the GALAD score to detect any stage HCV-HCC in the AFP-negative subgroup (0.815 vs. 0.764, P=0.063). Conclusions: The ASAP score had better diagnostic performance for early detection of HCV-HCC compared with the GALAD score. The ASAP score may be preferrable to the GALAD score for HCC screening and surveillance among HCV-infected patients. [ABSTRACT FROM AUTHOR]

Background and aims: Recently, the effectiveness of "textbook outcomes (TO)" in the evaluation of surgical quality has been recognized by more and more scholars. This study tended to examine the association between preoperative albumin-bilirubin (ALBI) grades and the incidence of achieving or not achieving TO (non-TO) in patients with hepatocellular carcinoma (HCC) undergoing laparoscopic hepatectomy. Methods: The patients were stratified into two groups: ALBI grade 1 (ALBI = -2.60) and ALBI grade 2/3 (ALBI > -2.60). The characteristics of patients and the incidence of non-TO were compared. Multivariate analyses were performed to determine whether ALBI grade was independently associated with TO. Results: In total, 378 patients were enrolled, including 194 patients (51.3%) in the ALBI grade 1 group and 184 patients (48.7%) in the ALBI grade 2/3 group. In the whole cohort, 198 patients (52.4%) did not achieve TO, and the incidence of non-TO in the ALBI grade 2/3 group was obviously higher than that in the ALBI grade 1 group (n = 112, 60.9% vs. n = 86, 44.3%, P = 0.001). The multivariate analyses showed that ALBI grade 2/3 was an independent risk factor for non-TO (OR: 1.95, 95%CI: 1.30-2.94, P = 0.023). Conclusions: More than half (52.4%) of the patients with hepatocellular carcinoma did not achieve TO after laparoscopic hepatectomy, and preoperative ALBI grade 2/3 was significantly associated with non-TO. Improving the liver function reserve of patients before operation, thereby reducing the ALBI grade, may increase the probability for patients to reach TO and enable patients to benefit more from surgery. [ABSTRACT FROM AUTHOR]

Chemotherapy drugs are high-risk medications, and medication and occupational safety are important indicators in the new method of hospital accreditation. Hyperthermic intraperitoneal chemotherapy (HIPEC) is a new approach in our unit that was established in 2015. The motivation for improvement was based on an analysis of the current status, in which the correctness of the cognition of administration of HIPEC is 55.2%, and the correctness of the safety of chemotherapy administration was only 50.4%. Solutions have been established to create a standard operation procedure for nursing care during HIPEC administration, including a splash prevention kit for chemotherapy treatment, an audit system, and in-service education training. After implementing this specific project for improvement, the correctness of the cognition was increased from 55.2% to 100%, and the correctness of the safety of chemotherapy administration improved from 50.4% to 100%, both of which reached the project's goal. This project is expected to increase the awareness of occupational safety during the administration of chemotherapy drugs in medical institutions. [ABSTRACT FROM AUTHOR]

Background: Salmonella derby (S. derby) is a Gram-negative diplococcus that is common in the digestive tract. Infected patients generally experience symptoms such as fever and diarrhea. Mild cases are mostly self-healing gastroenteritis, and severe cases can cause fatal typhoid fever. Clinical cases are more common in children. The most common form of S. derby infection is self-healing gastroenteritis, in which, fever lasts for about 2 d and diarrhea for < 7 d. S. derby can often cause bacterial conjunctivitis, pneumonia, endocarditis, peritonitis and urethritis. However, intracranial infections in infants caused by S. derby are rare in clinical practice and have not been reported before in China. Case summary: A 4-mo-old female infant had recurrent fever for 2 wk, with a maximum body temperature of around 39.4°C. Treatment for infectious fever in a local hospital was ineffective, and she was admitted to our hospital. Before admission, there was one sudden convulsion, characterized by unclear consciousness, limb twitching, gaze in both eyes, and slight cyanosis on the face. Cerebrospinal fluid (CSF) culture was positive for Gram-negative bacilli, which conformed to S. derby. After treatment with meropenem and ceftriaxone antibiotics, the patient was discharged home in a clinically stable state after 4 wk of treatment. Conclusion: We reported a rare case of S. derby cultured in CSF. S. derby enters the CSF through the blood-brain barrier, causing purulent meningitis. If not treated timeously, it can lead to serious, lifethreatening infection [ABSTRACT FROM AUTHOR]

Background/Aims: Sepsis is a severe and complicated syndrome that is characterized by dysregulation of host inflammatory responses and organ failure. Cystathionine-γ-lyase (CSE)/ hydrogen sulfide (H2S) has potential anti-inflammatory activities in a variety of inflammatory diseases. NADPH oxidase 4 (Nox4), a member of the NADPH oxidases, is the major source of reactive oxygen species (ROS) and its expression is increased in sepsis, but its function in CSE-mediated anti-inflammatory activities remains unknown. Methods: Macrophages were either transfected with CSE, Nox4 siRNA or transduced with lentiviral vector encoding CSE or Nox4, and then stimulated with lipopolysaccharide (LPS). The expression of inflammatory mediators and signaling pathway activation were measured by quantitative PCR (qPCR), ELISA, and immunoblotting. LPS-induced shock severity in WT, Nox4 knockdown and CSE knockout (CSE-/-) mice was assessed. Results: Here we showed that CSE and Nox4 were upregulated in macrophage and mouse in response to LPS. After LPS stimulation, the inflammatory responses were significantly ameliorated by lentiviral Nox4 shRNA knockdown, but were exacerbated by lentiviral overexpressing Nox4. Furthermore, Nox4 mediated inflammation through PI3K/Akt and p-p38 mitogen-activated protein kinase signal pathway. Notably, CSE knockout served to amplify the inflammatory cascade by increasing Nox4-ROS signaling activation in septic mice and macrophage. Similarly, the enhanced production of inflammatory mediators by macrophages was reduced by CSE overexpression. Conclusion: Thus, we demonstrated that CSE/H2S attenuated LPS-induced sepsis against oxidative stress and inflammation damage probably largely through mediated Nox4 pathway. [ABSTRACT FROM AUTHOR]

The Stenus flammeus group is proposed and twelve new species of the group are described: S. corniculus sp. n., S. daicongchaoi sp. n., S. jiajinshanus sp. n., S. jindingianus sp. n., S. paraflammeus sp. n., S. pengzhongi sp. n., S. pseudoflammeus sp. n., S. punctidorsus sp. n., S. tuyueyei sp. n., S. xilingmontis sp. n., and S. zhoudeyaoi sp. n. from Sichuan Province, and S. dabashanus sp. n. from Shaanxi Province. Their diagnostic characters are illustrated and a key to species of the group is provided. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to explore the resting-state functional connectivity (FC) differences between the paired default mode network (DMN) subregions in patients with primary insomnia (PIs). Methods: Forty-two PIs and forty-two age- and sex-matched good sleepers (GSs) were recruited. All subjects underwent the resting-state functional magnetic resonance imaging scans. The seed-based region-to-region FC method was used to evaluate the abnormal connectivity within the DMN subregions between the PIs and the GSs. Pearson correlation analysis was used to investigate the relationships between the abnormal FC strength within the paired DMN subregions and the clinical features in PIs. Results: Compared with the GSs, the PIs showed higher Pittsburgh Sleep Quality Index score, Hamilton Anxiety Rating Scale score, Hamilton Depression Rating Scale score, Self-Rating Depression Scale score, Self Rating Anxiety Scale score, Self-Rating Scale of Sleep score, and Profile of Mood States score (P,0.001). Compared with the GSs, the PIs showed significant decreased region-to-region FC between the medial prefrontal cortex and the right medial temporal lobe (t=-2.275, P=0.026), and between the left medial temporal lobe and the left inferior parietal cortices (t=-3.32, P=0.001). The abnormal FC strengths between the DMN subregions did not correlate with the clinical features. Conclusion: PIs showed disrupted FC within the DMN subregions. [ABSTRACT FROM AUTHOR]

The article reports on a study which suggests that decreased expression of methyl methansulfonate and ultraviolet-sensitive gene clone (Mus81) is associated with a poor prognosis in patients with hepatocellular carcinoma (HCC). Reverse transcriptase-polymerase chain reaction and Western blot analyses were used to identify Mus81 expression levels in the subjects. It found that Mus81 expression was an independent prognostic factor for HCC patients.

In this work we report that after single-walled carbon nanotubes (SWNTs) are sheared with a pair of titanium scissors, the magnetization becomes larger than that of the corresponding pristine ones. The magnetization increases proportionally with the number of SWNTs with sheared ends, suggesting that there exist magnetic moments at the sheared ends of SWNTs. By using the coefficient of this linear relation, the average magnetic moment is estimated to be 41.5 ± 9.8 μB (Bohr magneton) per carbon atom in the edge state at temperature of 300.0 K, suggesting that ultrahigh magnetic fields can be produced. The dangling sigma and pi bonds of the carbon atoms at sheared ends play important roles in determining the unexpectedly high magnetic moments, which may have great potential applications. [ABSTRACT FROM AUTHOR]