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Objective: To compare the efficacy of several local antibiotic regimens in preventing surgical site infection (SSI) in clean surgical wounds., Data Sources: The authors searched CNKI (China National Knowledge Infrastructure), the VIP (VIP information resource integration service platform), Wanfang Data knowledge service platform (WANFANG), SinoMed, Cochrane Library, EMBASE, and PubMed., Study Selection: A total of 20 randomized controlled trials published between January 1, 2000 and April 1, 2021 were included in this meta-analysis., Data Extraction: Authors extracted the name of the first author, publication date, country, type of surgery, follow-up time, mean age of participants, sample size of each group, interventions, outcome indicators, and study type from each article., Data Synthesis: The overall effectiveness of eight local managements in reducing the incidence of the SSI effect were compared through the SUCRA (surface under the cumulative ranking curve) probabilities. The results of a network meta-analysis demonstrated that gentamicin ointment (odds ratio [OR], 0.16; 95% CI, 0.04-0.60), mupirocin ointment (OR, 0.44; 95% CI, 0.21-0.94), and gentamicin soaking of the graft (OR, 0.63; 95% CI, 0.44-0.91) significantly reduced the incidence of SSI compared with control. Further, vancomycin soaking of the graft (86.7%) ranked first, followed by gentamicin ointment (81.1%), gentamicin irrigation (79.9%), mupirocin ointment (56.8%), triple antibiotic ointment (47.8%), gentamicin soaking of the graft (42.3%), and vancomycin powder (22.1%); ampicillin powder (17.8%) was the least effective drug., Conclusions: The findings indicate that local antibiotics combined with conventional antibiotics in the wound before wound closure are effective in reducing the incidence of SSI in clean surgical wounds. Vancomycin inoculation of the graft exhibited the best effect., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Comparative adult guardianship law and other alternatives, especially in an Asian context, is an under-investigated area. This paper attempts to fill the gap in the literature by comparing the adult guardianship law and other alternatives from the perspectives of Singapore and Japan. The central argument of this paper is that in order for the law of adult guardianship to be widely adopted in Asian societies like Singapore and Japan - where much of adult guardianship related issues are governed by informal familial arrangements; this would require governments to do more than the mere enacting of adult guardianship legislation. To encourage widespread adoption, governments must embark on a robust public awareness campaign to promote the adult guardianship scheme, provide institutional support, and simplify the process for people wishing to sign up to the scheme and enact the appropriate safeguards against abuse. Such conditions are present in Singapore, whereas in Japan, these are lacking which explains the lower take-up rate with Japanese people preferring informal arrangements. Another key difference between Singapore and Japan is that the former relies primarily on family and relatives to act as adult guardians, while the court in the latter jurisdiction insists on the appointment of professionals like lawyers to act as adult guardians. It is surmised that this factor explains the lower take-up rate of formal adult guardianship in Japan as compared to Singapore due to the costs involved in engaging professional guardians. This paper also explores the alternatives to adult guardianship in both systems. Alternatives to formal adult guardianship is important because there will be a substantial portion of the population of older adults who would prefer these alternatives for various reasons.

Discovering patterns in co-occurrences data between objects and groups of concepts is a useful task in many domains, such as healthcare data analysis, information retrieval, and recommender systems. These relational representations come from objects' behaviors in different views, posing a challenging task of integrating information from these views to uncover the shared latent structures. The problem is further complicated by the high dimension of data and the large ratio of missing data. We propose a new paradigm of learning semantic relations using tensor factorization, by jointly factorizing multi-view tensors and searching for a consistent underlying semantic space across each views. We formulate the idea as an optimization problem and propose efficient optimization algorithms, with a special treatment of missing data as well as high-dimensional data. Experiments results show the potential and effectiveness of our algorithms.

Patients with certain clotting disorders or conditions have a greater risk of developing arterial or venous clots and downstream embolisms, strokes, and arterial insufficiency. These patients need prescription anticoagulant drugs to reduce the possibility of clot formation. However, historically, the clinical decision making workflow in determining the correct type and dosage of anticoagulant(s) is part science and part art. To address this problem, we developed Anticoagulation Manager, an intelligent clinical decision workflow management system on iOS-based mobile devices to help clinicians effectively choose the most appropriate and helpful follow-up clotting tests for patients with a common clotting profile. The app can provide physicians guidance to prescribe the most appropriate medication for patients in need of anticoagulant drugs. This intelligent app was jointly designed and developed by medical professionals in CDC and engineers at Georgia Tech, and will be evaluated by physicians for ease-of-use, robustness, flexibility, and scalability. Eventually, it will be deployed and shared in both physician community and developer community.

Despite that some approved drugs and genetically engineered vaccines against hepatitis B virus (HBV) are available for HBV patients, HBV infection is still a severe public health problem in the world. All the approved therapeutic drugs (including interferon-alpha and nucleoside analogues) have their limitations. No drugs or therapeutic methods can cure hepatitis B so far. Therefore, it is urgently needed to discover and develop new anti-HBV drugs, especially non-nucleoside agents. Naturally originated compounds with enormous molecular complexity and diversity offer a great opportunity to find novel anti-HBV lead compounds with specific antiviral mechanisms. In this review, the natural products against HBV are discussed according to their chemical classes such as terpenes, lignans, phenolic acids, polyphenols, lactones, alkaloids and flavonoids. Furthermore, novel mode of action or new targets of some representative anti-HBV natural products are also discussed. The aim of this review is to report new discoveries and updates pertaining to anti-HBV natural products in the last 20 years, especially novel skeletons and mode of action. Although many natural products with various skeletons have been reported to exhibit potent anti-HBV effects to date, scarcely any of them are found in the list of conventional anti-HBV drugs worldwide. Additionly, in anti-HBV mechanism of action, only a few references reported new targets or novel mode of action of anti-HBV natural products.

Histopathological whole-slide images (WSIs) have emerged as an objective and quantitative means for image-based disease diagnosis. However, WSIs may contain acquisition artifacts that affect downstream image feature extraction and quantitative disease diagnosis. We develop a method for detecting blur artifacts in WSIs using distributions of local blur metrics. As features, these distributions enable accurate classification of WSI regions as sharp or blurry. We evaluate our method using over 1000 portions of an endomyocardial biopsy (EMB) WSI. Results indicate that local blur metrics accurately detect blurry image regions.

The problem of missing data has made it difficult to analyze Electronic Health Records (EHR). In EHR data, the "missingness" often results from the low-rank property: each patient is considered a mixture of prototypical patients, and certain types of patients will have similar missing entries in their records. However, most existing methods to deal with missing data fail to capture this low-rank property of missing data. Hence we propose to use matrix factorization and matrix completion methods to perform prediction in the presence of missing data. We validated our methods in the task of post-surgical complication prediction and experimental results show that our method can improve the prediction accuracy significantly.

Background: Few useful patient-reported outcomes scales for functional dyspepsia exist in China., Aims: The purpose of this work was to translate and cross-culturally adapt the Functional Digestive Disorders Quality of Life Questionnaire (FDDQL) from the English version to Chinese (in Mandarin)., Methods: The following steps were performed: forward translations, synthesis of the translations, backward translations, pre-testing and field testing of FDDQL. Reliability, validity, responsiveness, confirmatory factor analysis, item response theory and differential item functioning of the scale were analyzed., Results: A total of 300 functional dyspepsia patients and 100 healthy people were included. The total Cronbach's alpha was 0.932, and split-half reliability coefficient was 0.823 with all test-retest coefficients greater than 0.9 except Coping With Disease domain. In construct validity analysis, every item correlated higher with its own domain than others. The comparative fit index of FDDQL was 0.902 and root mean square error of approximation was 0.076. Functional dyspepsia patients and healthy people had significant differences in all domains. After treatment, all domains had significant improvements except diet. Item response theory analysis showed the Person separation index of 0.920 and the threshold estimator of items was normally distributed with a mean of 0 and standard deviation of 1.27. The residuals of each item were between -2.5 and 2.5, without statistical significance. Differential item functioning analysis found that items had neither uniform nor non-uniform differential item functioning in different genders and age groups., Conclusions: The Chinese version of FDDQL has good psychometric properties and is suitable for measuring the health status of Chinese patients with functional dyspepsia.

Context: Adrenomedullin (ADM) has been found expressed in the mouse oviduct and might play a role in reproduction., Objective: The objective of the study was to demonstrate the expression of ADM in the human oviduct, investigate its regulation by steroidal hormones and spermatozoa contact, and study its effect on ciliary beat frequency (CBF) in the human oviduct. DESIGN, SETTING, PATIENTS, AND INTERVENTIONS: Oviducts from women undergoing hysterectomy for benign diseases in a university hospital were collected. The oviducts were treated with estradiol and/or progesterone to simulate different phases of the ovarian cycle. ADM expression was studied at the peptide and mRNA levels by immunohistochemistry and RT-PCR, respectively. CBF was measured after treatment with graded concentrations of ADM and its antagonists. Cells from OE-E6/E7, an immortalized oviductal cell line, as well as oviductal tissue were cocultured with and without direct contact with capacitated human spermatozoa to compare oviductal cell ADM expression levels. CBF was also analyzed in oviductal tissue after spermatozoa-oviduct coincubation., Results: ADM expression was the highest in the isthmic region and in a hormonal environment simulating the early luteal phase. CBF was increased by ADM in a dose-dependent manner, which was blocked by ADM and calcitonin-gene-related peptide receptor antagonists. Direct contact with spermatozoa in coculture resulted in higher ADM expression in OE-E6/E7 cell line and oviductal tissue and higher CBF in oviductal epithelium., Conclusions: ADM expression in the human oviduct is hormone dependent and is up-regulated by sperm contact. ADM stimulates ciliary motility of the human oviduct.