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Introduction: This study comprehensively investigates the changes in healthcare utilization among chronic patients with regular outpatient visits to hospitals after the occurrence of Covid-19. The research examines whether patients altered their originally regular medical attendance frequencies due to the pandemic and explores potential negative impacts on the health conditions of those irregular attendees post-pandemic., Methods: Data for this study were sourced from a database at a medical center in Taiwan. The subjects were chronic patients with regular hospital outpatient visits before the Covid-19 outbreak. The study tracked medical utilization patterns from 2017 to 2022 for different patient characteristics and outpatient behaviors, employing statistical methods such as Repeated Measures ANOVA and Generalized Estimating Equation to analyze changes in healthcare utilization and health status during the post-pandemic period., Results: The results reveal that, compared to the regular group, chronic patients with irregular outpatient visits during the post-pandemic period exhibited a decrease of 5.85 annual outpatient visits, a reduction of NT$20,290.1 in annual medical expenses, and a significantly higher abnormality rate in average biochemical test results by 0.9%., Conclusions: The findings contribute to understanding the impact of the Covid-19 pandemic on healthcare utilization and health conditions among outpatient chronic disease populations. In response to the new medical landscape in the post-pandemic era, proactive suggestions are made, including providing telemedicine outpatient services and referral-based medical care to meet the needs of the target population, ensuring a continuous and reassuring healthcare model for chronic patients, and mitigating the operational impacts of public health emergencies on hospitals., (© 2024. The Author(s).)

Objective: To conduct a systematic review of external validation studies on the use of different Artificial Intelligence algorithms in breast cancer screening with mammography., Data Source: Our systematic review was conducted and reported following the PRISMA statement, using the PubMed, EMBASE, and Cochrane databases with the search terms "Artificial Intelligence," "Mammography," and their respective MeSH terms. We filtered publications from the past ten years (2014 - 2024) and in English., Study Selection: A total of 1,878 articles were found in the databases used in the research. After removing duplicates (373) and excluding those that did not address our PICO question (1,475), 30 studies were included in this work., Data Collection: The data from the studies were collected independently by five authors, and it was subsequently synthesized based on sample data, location, year, and their main results in terms of AUC, sensitivity, and specificity., Data Synthesis: It was demonstrated that the Area Under the ROC Curve (AUC) and sensitivity were similar to those of radiologists when using independent Artificial Intelligence. When used in conjunction with radiologists, statistically higher accuracy in mammogram evaluation was reported compared to the assessment by radiologists alone., Conclusion: AI algorithms have emerged as a means to complement and enhance the performance and accuracy of radiologists. They also assist less experienced professionals in detecting possible lesions. Furthermore, this tool can be used to complement and improve the analyses conducted by medical professionals., Competing Interests: Conflicts to interest: none to declare.

Introduction: Immunogenic cell death (ICD) is a unique cell death triggered by chemotherapy. However, studies elucidating the potential therapeutic role of ICD and the underlying mechanism in diabetic nephropathy (DN) are limited., Methods: WGCNA was conducted on the human kidney biopsy data linked to DN, analyzing gene sets associated with ICD. Gene Set Enrichment Analysis and Gene Set Variation Analysis were utilized to examine the discrepancy in biological function. We used Gene Ontology, the Kyoto Encyclopedia of Genes and Genomes, and the GeneMANIA database to investigate the function of the signature genes. An analysis using the receiver operating characteristic (ROC) was conducted to validate the diagnostic value of hub genes. Additionally, immune infiltration-related analyses were also performed. In conclusion, we examined the association between the glomerular filtration rate, serum creatinine, and hub genes. Hub genes were validated by immunohistochemistry using db/db mice kidneys., Results: WGCNA revealed that the targets in the turquoise unit (1674 genes) exhibited the highest positive correlation with ICD. Furthermore, 4222 statistically significant DEGs were identified when comparing the DN and healthy control groups. Significantly, the KEGG pathway enrichment analysis indicated a connection between ICD and the nuclear factor-kappa B signaling pathway and the synthesis of cytokines (tumor necrosis factor superfamily). ROC analysis revealed that 16 hub genes exhibited strong discriminatory potential as biomarkers for DN. Therefore, immunohistochemical validation, with the potential involvement of chemokines (CCL11, CCR2, CCR7, CX3CR1, CXCL10, CXCL12, and CXCR5) and immune cells (CD3G, CD5, and CD247) may be crucial for the diagnosis and therapy of DN., Conclusions: DKK3, NR4A1, NR4A2, VEGFA, and DUSP1 may be associated with the development of DN. The pathogenesis of DN may specifically involve chemokines (CCL11, CCR2, CCR7, CX3CR1, CXCL10, CXCL12, and CXCR5) and immune cells (CD3G, CD5, and CD247), with LCP2 playing a significant role., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Tannic acid (TA), a plant-derived polyphenol rich in hydroxyl groups, serves as both a reducing agent and stabilizer for synthesizing gold nanoparticles (TA-AuNPs). This study presents a groundbreaking method that utilizes TA to fabricate TA-AuNPs and develop two distinct colorimetric detection systems for mercury (Hg 2+ ) and iron (Fe 2+ ) ions. The first detection system leverages the interaction between TA-AuNPs and Hg 2+ to enhance the peroxidase-like activity of TA-AuNPs, facilitating the production of hydroxyl radicals upon reaction with hydrogen peroxide, which subsequently oxidizes 3,3',5,5'-tetramethylbenzidine (TMB) into a blue-colored product (ox-TMB). The second system capitalizes on TA-AuNPs to catalyze the Fenton reaction between Fe 2+ and hydrogen peroxide in the presence of 2, 6-pyridinedicarboxylic acid, boosting the generation of hydroxyl radicals that oxidize TMB into a blue-colored ox-TMB. Absorbance measurements at 650 nm display a linear relationship with Hg 2+ concentrations ranging from 0.40 to 0.60 μM (R 2 = 0.99) and Fe 2+ concentrations from 0.25 to 2.0 μM (R 2 = 0.98). The established detection limits for Hg 2+ and Fe 2+ are 18 nM and 96 nM, respectively. Applications to real-world samples achieved an excellent spiked recovery, spanning 101.6% to 108.0% for Hg 2+ and 90.0% to 112.5% for Fe 2+ , demonstrating the method's superior simplicity, speed, and cost-effectiveness for environmental monitoring of these ions compared to existing techniques., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

This study introduces a novel one-pot method employing tannic acid (TA) to synthesize stable gold nanoparticles (TA-AuNPs), which are characterized using transmission electron microscopy, X-ray powder diffraction, and Fourier transform infrared spectroscopy. We apply these TA-AuNPs in a newly developed colorimetric assay for hydrogen peroxide (H 2 O 2 ) detection that utilizes the oxidation of iodide (I - ) on TA-AuNPs, leading to a detectable yellow color change in the solution. The reaction kinetics are captured by the rate equation R = 0.217[KI] 0.61 [H 2 O 2 ] 0.69 . The possible sensing mechanism was proposed through density functional theory calculations. At the optimum conditions, the proposed TA-AuNPs/I - system demonstrated a linear relationship between H 2 O 2 concentration and absorbance intensity (λ = 350 nm) and achieved a limit of detection (LOD) of 7.33 μM. Furthermore, we expand the utility of this approach to glucose detection by integrating glucose oxidase into the system, resulting in a LOD of 10.0 μM. Application of this method to actual urine samples yielded spiked recovery rates ranging from 96.6-102.0% and relative standard deviations between 3.00-8.34%, underscoring its efficacy and potential for real-world bioanalytical challenges., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

This qualitative study aimed to investigate the effectiveness of community rehabilitation programs for children with developmental delays from the perspective of early intervention service providers in Taiwan. Adopting a single-case experimental design (ABM design), this study examined the immediate and sustained effects of interventions on individualized goals during baseline, intervention, and maintenance phases. Additionally, data from interviews with parents, special education teachers, and other participants were collected to understand the challenges and improvement strategies of community rehabilitation programs. Results revealed that community rehabilitation programs for children with developmental delays exhibited both immediate and sustained effectiveness. Challenges faced by parents and professionals differed, with parents having less contact and communication with administrative systems, while professionals experienced more pronounced implementation difficulties during interventions. Moreover, strategies for improving community rehabilitation programs for children with developmental delays should vary for parents and professionals to address inconsistencies in attitudes and strategies among parents and administrative obstacles encountered by professionals.

This study presents a novel deep learning-based approach for the State of Charge (SOC) estimation of electric vehicle (EV) batteries, addressing critical challenges in battery management and enhancing EV efficiency. Unlike conventional methods, our research leverages a diverse dataset encompassing environmental factors (e.g., temperature, altitude), vehicle parameters (e.g., speed, throttle), and battery attributes (e.g., voltage, current, temperature) to train a sophisticated deep learning model. The key novelty of our approach lies in its integration of real-world driving data from a BMW i3 EV, enabling the model to capture the intricate dynamics affecting SOC with remarkable accuracy. We conducted 72 tests using actual driving trip data, which included 25 types of environmental variables, to validate the feasibility and effectiveness of our proposed model. The deep learning network, designed specifically for SOC estimation, outperformed traditional models by demonstrating superior accuracy and reliability in predicting SOC values. Our findings indicate a significant advancement in SOC estimation techniques, offering actionable insights for both policymakers and industry practitioners aimed at fostering energy conservation, carbon reduction, and the development of more efficient EVs. The study's major contribution is its demonstrated capability to improve SOC estimation accuracy by understanding the complex interrelationships among various influencing factors, thereby addressing a pivotal challenge in EV battery management. By employing cutting-edge deep learning techniques, this research not only marks a significant leap forward from traditional SOC estimation methods but also contributes to the broader goals of sustainable transportation and environmental protection., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Shih-Lin Lin reports financial support was provided by 10.13039/100020595National Science and Technology Council, Taiwan. Shih-Lin Lin reports financial support was provided by Ministry of Education's Teaching Practice Research Program, Taiwan. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author.)

In this study, the flexoelectric characteristics of 2D TiO 2 nanosheets are examined. The theoretical calculations and experimental results reveal an excellent strain-induced flexoelectric potential (flexopotential) by an effective defect engineering strategy, which suppresses the recombination of electron-hole pairs, thus substantially improving the catalytic activity of the TiO 2 nanosheets in the degradation of Rhodamine B dye and the hydrogen evolution reaction in a dark environment. The results indicate that strain-induced bandgap reduction enhances the catalytic activity of the TiO 2 nanosheets. In addition, the TiO 2 nanosheets degraded Rhodamine B, with k obs being ≈1.5 × 10 -2  min -1 in dark, while TiO 2 nanoparticles show only an adsorption effect. 2D TiO 2 nanosheets achieve a hydrogen production rate of 137.9 µmol g -1  h -1 under a dark environment, 197% higher than those of TiO 2 nanoparticles (70.1 µmol g -1  h -1 ). The flexopotential of the TiO 2 nanosheets is enhanced by increasing the bending moment, with excellent flexopotential along the y-axis. Density functional theory is used to identify the stress-induced bandgap reduction and oxygen vacancy formation, which results in the self-dissociation of H 2 O on the surface of the TiO in the dark. The present findings provide novel insights into the role of TiO 2 flexocatalysis in electrochemical reactions., (© 2024 Wiley‐VCH GmbH.)

This research introduces a novel approach using silver (Ag) nanostructures generated through electrochemical deposition and photo-reduction of Ag on fluorine-doped tin oxide glass substrates (denoted as X-Ag-Ag y FTO, where 'X' and 'y' represent the type of light source and number of deposited cycles, respectively) for surface-enhanced Raman spectroscopy (SERS). This study used malachite green (MG) as a Raman probe to evaluate the enhancement factors (EFs) in SERS-active substrates under varied fabrication conditions. For the substrates produced via electrochemical deposition, we determined a Raman EF of 6.15 × 10 4 for the Ag 2 FTO substrate. In photo-reduction, the impact of reductant concentration, light source, and light exposure duration were examined on X-Ag nanoparticle formation to achieve superior Raman EFs. Under optimal conditions (9.0 mM sodium citrate, 460 nm blue-LED at 10 W for 90 min), the combination of blue-LED-reduced Ag (B-Ag) and an Ag 2 FTO substrate (denoted as B-Ag-Ag 2 FTO) exhibited the best Raman EF of 2.79 × 10 5 . This substrate enabled MG detection within a linear range of 0.1 to 1.0 µM (R 2 = 0.98) and a detection limit of 0.02 µM. Additionally, the spiked recoveries in aquaculture water samples were between 90.0% and 110.0%, with relative standard deviations between 3.9% and 6.3%, indicating the substrate's potential for fungicide detection in aquaculture.

Background: Myopericytoma is a benign tumor that typically occurs within subcutaneous tissue and most often involves the distal extremities, followed by the proximal extremities, neck, thoracic vertebrae and oral cavity. Complete resection is often curative. Malignant myopericytoma is extremely rare and has a poor prognosis. Here, we report for the first time a case of malignant myopericytoma originating from the colon., Case Summary: A 69-year-old male was admitted to our hospital with right upper quadrant pain for five days. Imaging suggested a liver mass with hemorrhage. A malignant hepatic tumor was the initial diagnosis. Surgical resection was performed after a complete preoperative work up. Initial postoperative pathology suggested that the mass was a malignant myoblastoma unrelated to the liver. Four months after the first surgery, an enhanced computed tomography (CT) scan revealed a recurrence of the tumor. The diagnosis of malignant myopericytoma derived from the colon was confirmed on histopathological examination of the specimen from the second surgery. The patient did not return to the hospital regularly for surveillance. The first postoperative abdominal CT examination six months after the second surgery demonstrated multiple liver metastases. Survival time between the diagnosis of the tumor to death was approximately one year., Conclusion: Malignant myopericytoma is a rare cancer. Preoperative diagnosis may be difficult. Due to a lack of treatment options, prognosis is poor., Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Under Taiwan's National Health Insurance (NHI) system, it's crucial for all healthcare providers to accurately submit medical expense claims to the National Health Insurance Administration (NHIA) to avoid incorrect deductions. With changes in healthcare policies and adjustments in hospital management strategies, the complexity of claiming rules has resulted in hospitals expending significant manpower and time on the medical expense claims process. Therefore, this study utilizes the Lean Six Sigma DMAIC (Define, Measure, Analyze, Improve, Control) management approach to identify wasteful and non-value-added steps in the process. Simultaneously, it introduces Robotic Process Automation (RPA) tools to replace manual operations. After implementation, the study effectively reduces the process time by 380 min and enhances Process Cycle Efficiency (PCE) from 69.07 to 95.54%. This research validates a real-world case of Lean digital transformation in healthcare institutions. It enables human resources to be allocated to more valuable and creative tasks while assisting hospitals in providing more comprehensive and patient-centric services., (© 2024. The Author(s).)

Ethnopharmacological Relevance: Compound Jixuecao Decoction (CJD) is a traditional Chinese herbal medicine prescribed in China to treat chronic renal failure (CRF). Previous studies have shown that CJD affects cell apoptosis and proliferation. However, the mechanism of its renal protective action has not been characterized., Aim of the Study: To explore the mechanism(s) underlying the effect of CJD on endoplasmic reticulum stress (ERS) and apoptosis in the treatment of CRF using network pharmacology, molecular docking, molecular dynamics simulations, and in vivo studies., Materials and Methods: The compounds comprising CJD were extracted from the Traditional Chinese Medicine Systems Pharmacology Database. A Swiss target prediction database and similarity integration approach were employed to identify potential targets of these components. The GeneCards and DisGeNET databases were used to identify targets associated with CRF, apoptosis, and ERS. The STRING database was employed to analyze the protein-protein interactions (PPIs) associated with drug-disease crossover. A chemical composition-shared target network was established, and critical pathways were identified through gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses. The Protein Data Bank database was used to search key proteins, while molecular docking and dynamics simulations were performed between the top four CJD active ingredients and proteins involved in apoptosis and ERS in CRF. Subsequent in vivo studies using a 5/6 nephrectomy rat model of CRF were performed to verify the findings., Results: The 80 compounds identified in CJD yielded 875 target genes, of which 216 were potentially related to CRF. PPI network analysis revealed key targets via topology filtering. Enrichment analysis, molecular docking, and molecular dynamics simulation results suggested that CJD primarily targets mitofusin-2 (MFN2), B-cell lymphoma-2 (BCL2), BAX, protein kinase RNA-like ER kinase (PERK), and C/EBP homologous protein (CHOP) during CRF treatment. In vivo, CJD significantly increased the abundance of MFN2, BCL2, and significantly reduced the abundance of BAX, PERK, CHOP proteins in kidney tissues, indicating that CJD could improve apoptosis and ERS in CRF rats., Conclusions: This study provides evidence that CJD effectively delays CFR through modulation of the MFN2 and PERK-eIF2α-ATF4-CHOP signaling pathways., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

This study delves into the green synthesis and multifaceted applications of three types of carbon quantum dots (CQDs), namely, CQDs-1, CQDs-2, and CQDs-3. These CQDs were innovatively produced through a gentle pyrolysis process from distinct plant-based precursors: genipin with glucose for CQDs-1, genipin with extracted gardenia seeds for CQDs-2, and genipin with whole gardenia seeds for CQDs-3. Advanced analytical techniques, including X-ray photoelectron spectroscopy (XPS) and Fourier-transform infrared spectroscopy (FT-IR), were employed to detail the CQDs' structural and surface characteristics, revealing their unique functional groups and surface chemistries. The study further explores the CQDs' bioimaging potential, where confocal fluorescence microscopy evidenced their swift uptake by Escherichia coli bacteria, indicating their suitability for bacterial imaging. These CQDs were also applied in the synthesis of gold nanoparticles (AuNPs), acting as reducing agents and stabilizers. Among these, CQD3-AuNPs were distinguished by their remarkable stability and catalytic efficiency, achieving a 99.7% reduction of 4-nitrophenol to 4-aminophenol in just 10 min and maintaining near-complete reduction efficiency (99.6%) after 60 days. This performance notably surpasses that of AuNPs synthesized using sodium citrate, underscoring the exceptional capabilities of CQD3-AuNPs. These insights pave the way for leveraging CQDs and CQD-stabilized AuNPs in bacterial imaging and catalysis, presenting valuable directions for future scientific inquiry and practical applications., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

This research investigates the control of thickness and weight in plastic extrusion vacuum-thermoforming products to identify optimal key parameters for cost reduction and energy savings. The initial step involves identifying crucial influencing factors. In this step, the Delphi technique was employed through a questionnaire administered to a panel of expert scholars to ensure minimal error and maximal reliability in determining key influencing factors. Consensus was sought to establish appropriateness and consistency. Subsequently, the Taguchi method was applied for quality design and planning of the extrusion vacuum-forming process. The experimental design parameters were selected using an L 18 (2 1 × 3 7 ) orthogonal array, and the desired quality characteristics were determined. Comparative analysis of quantitative production data from two consecutive experiments was conducted, and based on F-values and contribution analysis, the combination of control factors maximizing the Signal-to-Noise (S/N) ratio was identified. The objective is to seek optimal parameters for improving the quality of the plastic polypropylene (PP cup lid) manufacturing process, reducing process variability, and identifying the most robust production conditions. Through multiple actual production prediction experiments, it was determined that five control factors, "polypropylene new material ratio," "T-die lips adjustment thickness", "mirror wheel temperature stability", "molding vacuum pressure time", and "forming mold area design", contribute to the maximization of the S/N ratio, i.e., minimizing variability. Statistical validation confirms a significant improvement in product quality and weight control. Noteworthily, the quality control model and experimental design parameters established in this study are also applicable to other plastic products and bio-based materials, such as PET, HIPS, and biodegradable PLA lids with added calcium carbonate. The results of the experimental production demonstrate its ability to consistently control product weight within the range of 3.4 ± 0.1 g, approaching the specified tolerance limits. This capability results in approximately 2.6% cost savings in product weight, contributing significantly to achieving a company's KPI goals for environmental conservation, energy efficiency, and operational cost reduction. Therefore, the findings of this study represent a substantial and tangible contribution.

Purpose: This study investigated the mechanism of TSF in treating DN through network pharmacology, molecular docking, and experimental validation., Methods: To identify critical active ingredients, targets, and DN genes in TSF, multiple databases were utilized for screening purposes. The drug-compound-target network was constructed using Cytoscape 3.9.1 software for network topological analysis. The protein interaction relationship was analyzed using the String database platform. Metascape database conducted enrichment analysis on the key targets using Gene Ontology and the Kyoto Encyclopedia of Genes and Genomes. The renoprotective effect was evaluated using a mouse model of diabetic nephropathy (db/db mice) that occurred spontaneously. Validation of the associated targets and pathways was performed using Western Blot (WB), Polymerase Chain Reaction (PCR), and Immunohistochemical methods (IHC)., Results: The network analysis showed that the TSF pathway network targeted 24 important targets and 149 significant pathways. TSF might have an impact by focusing on essential objectives such as TP53, PTEN, AKT1, BCL2, BCL2L1, PINK-1, PARKIN, LC3B, and NFE2L2, along with various growth-inducing routes. Our findings demonstrated that TSF effectively repaired the structure of mitochondria in db/db mice. TSF greatly enhanced the mRNA levels of PINK-1. WB and IHC findings indicated that TSF had a notable impact on activating the PINK-1/PARKIN signaling pathway in db/db mice, significantly increasing LC3 and NRF2 expression., Conclusion: Our results indicate that TSF effectively addresses DN by activating the PINK-1/PARKIN signaling pathway and enhancing Mitochondrion structure in experimental diabetic nephropathy., Competing Interests: The authors report no conflicts of interest in this work., (© 2024 Chen et al.)

Transition metal dichalcogenides, by virtue of their two-dimensional structures, could provide the largest active surface for reactions with minimal materials consumed, which has long been pursued in the design of ideal catalysts. Nevertheless, their structurally perfect basal planes are typically inert; their surface defects, such as under-coordinated atoms at the surfaces or edges, can instead serve as catalytically active centers. Here we show a reaction probability > 90 % for adsorbed methanol (CH 3 OH) on under-coordinated Pt sites at surface Te vacancies, produced with Ar + bombardment, on layered PtTe 2 - approximately 60 % of the methanol decompose to surface intermediates CH x O (x = 2, 3) and 35 % to CH x (x = 1, 2), and an ultimate production of gaseous molecular hydrogen, methane, water and formaldehyde. The characteristic reactivity is attributed to both the triangular positioning and varied degrees of oxidation of the under-coordinated Pt at Te vacancies., (© 2024. The Author(s).)

A phytochemical research on the twigs of Dichapetalum longipetalum (Turcz.) Engl. Resulted in five undescribed dichapetalin-type triterpenoids 1-5. Their chemical structures were determined by spectroscopic analysis of HR-ESIMS and NMR spectra and the absolute configuration of compound 1 was completely elucidated by single crystal X-ray crystallography. Through preliminary anti-inflammatory activity assessment, compound 1 exhibited inhibitory effect on LPS-induced NO production in RAW264.7 murine macrophages with an IC 50 value of 2.09 μM., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper, (Copyright © 2023 Elsevier Ltd. All rights reserved.)

The N6-methyladenosine (m6A) modification is regulated by methylases, commonly referred to as "writers," and demethylases, known as "erasers," leading to a dynamic and reversible process. Changes in m6A levels have been implicated in a wide range of cellular processes, including nuclear RNA export, mRNA metabolism, protein translation, and RNA splicing, establishing a strong correlation with various diseases. Both physiologically and pathologically, m6A methylation plays a critical role in the initiation and progression of kidney disease. The methylation of m6A may also facilitate the early diagnosis and treatment of kidney diseases, according to accumulating research. This review aims to provide a comprehensive overview of the potential role and mechanism of m6A methylation in kidney diseases, as well as its potential application in the treatment of such diseases. There will be a thorough examination of m6A methylation mechanisms, paying particular attention to the interplay between m6A writers, m6A erasers, and m6A readers. Furthermore, this paper will elucidate the interplay between various kidney diseases and m6A methylation, summarize the expression patterns of m6A in pathological kidney tissues, and discuss the potential therapeutic benefits of targeting m6A in the context of kidney diseases., Competing Interests: Declaration of competing interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Many countries have allowed farmers to feed β-adrenergic receptor agonists, such as ractopamine (Rac), to animals to improve the quality of their meat. However, Rac consumption can cause health problems for humans; thus, detecting Rac in meat before its packaging is essential. Consequently, this study developed a simple and sensitive electrochemical sensor by modifying a glassy carbon electrode (GCE) with Nafion/silver nanoparticles (Nafion/AgNPs). When this electrochemical sensor is used to detect Rac, electrostatic interaction occurs between Nafion and Rac, and the AgNPs oxidize Rac; thus, the accumulation and electrochemical sensing of Rac are achieved. Differential pulse voltammetry indicated that the as-prepared Nafion/AgNP-GCE sensor exhibited suitable electrochemical sensing ability under optimum conditions (6.0 μL of 0.10% Nafion/AgNPs in a Britton-Robertson buffer solution with a pH of 1.8, an accumulation potential of -0.2 V, and a Rac accumulation duration of 300 s). Moreover, this sensor has an extremely low limit of detection and high sensitivity (1.60 × 10 -3 ppm and 2.14 μA/ppm, respectively) in the Rac concentration range 7.50 × 10 -3 -1.00 ppm. The as-prepared sensor also exhibits satisfactory reproducibility and storage stability, with the corresponding relative standard deviations (RSDs) being 4.27% ( n = 5) and 1.56% ( n = 10), respectively. The proposed electrochemical sensor was successfully used to determine the Rac content in pig liver samples, with spiked recoveries of 95.2-101.8% and RSDs of 0.55-4.83% being achieved., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

In this work, luminescent carbon dots with gardenia seeds as carbon precursors (GCDs) were synthesized using a one-step mild pyrolysis process and were then used as probes for imaging of bacterial ( Escherichia coli ). The GCDs showed a strong emission at 430 nm when excited at 370 nm. The relative fluorescence quantum yield of GCDs was found to be 1.13% in an aqueous medium. Rapid internalization of the GCDs by bacteria was confirmed by three colors (blue, green, and yellow) images that were obtained using confocal fluorescence microscopy. In addition, GCDs were noted to exhibit potent scavenging activities against DPPH˙, ˙OH, and ˙O 2 - free radicals. GCDs were also assayed as antioxidants in an oil sample by volumetric determination of the peroxide value. Thus, GCDs exhibited good antioxidant properties both in aqueous and oil media. In addition, a free fatty acid quantification kit in the presence of GCDs showed enhanced fluorescence detection of palmitic acid with a remarkably good limit of detection of 0.08 μM, which is lower than that in the absence of GCDs (0.76 μM). The proposed fluorescence method was then successfully used to determine the concentration of palmitic acid spiked in milk powder samples, with spiked recoveries of 82.6-109.6% and relative standard deviations of 0.9-4.6%., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

The aim of this study is to investigate the effects of Gynostemma pentaphyllum dried with two different methods(air drying and heating) on inflammation in acute lung injury(ALI) mice in vivo and in vitro. Lipopolysaccharide(LPS) was sprayed into the airway of wild type C57BL/6J male mice to establish the model, and the drug was injected into the tail vein 24 h after modeling. Lung function, lung tissue wet/dry weight(W/D) ratio, the total protein concentration, interleukin 6(IL-6), IL-1β, and tumor necrosis factor-α(TNF-α) in the bronchoalveolar lavage fluid(BALF), and pathological changes of the lung tissue were used to evaluate the effects of different gypenosides on ALI mice. The results showed that total gypenosides(YGGPs) and the gypenosides substituted with one or two glycosyl(GPs_(1-2)) in the air-dried sample improved the lung function, significantly lowered the levels of IL-1β and TNF-α in BALF, and alleviated the lung inflammation of ALI mice. Moreover, GPs_(1-2) had a more significant effect on inhibiting NO release in RAW264.7 cells. This study showed that different drying methods affected the anti-inflammatory activity of G. pentaphyllum, and the rare saponins in the air-dried sample without heating had better anti-inflammatory activity.

This study explored the mediation of mindfulness and perceived hope between perceived social support and mental health literacy in university students. Of 568 students (205 males, 363 females, average age 20.97) from 70 Taiwanese universities, tools like the Perceived Social Support Scale, General Health Questionnaire, Mindful Attention Awareness Scale, and State Hope Scale were used, adapted to Traditional Chinese through back-translation. Confirmatory factor analysis affirmed model validity. Hayes' PROCESS Model 6 analyzed the data. The results showed an indirect effect of social support on mental health literacy via mindfulness and hope (B = 0.091, 95 % CI: 0.0613 to 0.1258). Three mediation paths were: (1) mindfulness (B = 0.035); (2) hope (B = 0.052); and (3) a combined effect (B = 0.003). A direct effect of social support on mental health literacy was significant (B = 0.120). The model explained 33.9 % of the variance in mental health literacy. The research underscores the link between social support, mindfulness, hope, and mental health literacy, identifying mindfulness and hope as mediators. It stresses the mediation impact and suggests strategies to boost mental health literacy in university students. Future research should expand to cross-cultural studies, further examine the evolving dynamics of social support, and incorporate both qualitative and experimental methodologies. The inclusion of factors such as alienation, well-being, and resilience can enrich the theoretical framework., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

The purposes of this study were to describe the learning outcomes of students with disabilities in senior high school, to establish a model to explain the effects of personal, family, and school experience factors on the learning outcomes of students with disabilities, and to determine the relationship between post-school and in-school outcomes. There were 496 participants selected in the 2011 and 2012 academic year from the database of Special Needs Education Longitudinal Study. The survey data obtained from questionnaires for teachers, parents, and students were used to conduct secondary analysis. Descriptive statistics such as frequencies and percentages, a PLS structural equation model, and multiple regression were used in this study. The results of this study were as follows: (1) Students with disabilities had the best learning performances in school, and most parents were satisfied with their students' education in school; however, employment performance was the weakest upon leaving school. (2) School experience factors had the greatest influence on the school learning outcomes model, followed by student factors and family factors. (3) In-school outcomes effectively predicted postsecondary education, employment, social adaptation, and satisfaction after leaving school. In conclusion, the results of this study found that personal, family, and school factors have a significant impact on the learning outcomes of students with disabilities, and in-school outcomes can effectively predict postsecondary education, social adaptation, and satisfaction after leaving school.

The effects of clinically relevant concentrations of lidocaine on epithelial-mesenchymal transition (EMT) and associated lung cancer behaviors have rarely been investigated. The aim of the present study was to assess the impact of lidocaine on EMT and its related phenomena, including chemoresistance. Lung cancer cell lines (A549 and LLC.LG) were incubated with various concentrations of lidocaine, 5-fluorouracil (5-FU) or both to test their effects on cell viability. Subsequently, the effects of lidocaine on various cell behaviors were assessed in vitro and in vivo using Transwell migration, colony-formation and anoikis-resistant cell aggregation assays, and human tumor cell metastasis in a chorioallantoic membrane (CAM) model quantitated by PCR analysis. Prototypical EMT markers and their molecular switch were analyzed using western blotting. In addition, a conditioned metastasis pathway was generated through Ingenuity Pathway Analysis. Based on these measured proteins (slug, vimentin and E-cadherin), the molecules involved and the alteration of genes associated with metastasis were predicted. Of note, clinically relevant concentrations of lidocaine did not affect lung cancer cell viability or alter the effects of 5-FU on cell survival; however, at this dose range, lidocaine attenuated the 5-FU-induced inhibitory effect on cell migration and promoted EMT. The expression levels of vimentin and Slug were upregulated, whereas the expression of E-cadherin was downregulated. EMT-associated anoikis resistance was also induced by lidocaine administration. In addition, portions of the lower CAM with a dense distribution of blood vessels exhibited markedly increased Alu expression 24 h following the inoculation of lidocaine-treated A549 cells on the upper CAM. Thus, at clinically relevant concentrations, lidocaine has the potential to aggravate cancer behaviors in non-small cell lung cancer cells. The phenomena accompanying lidocaine-aggravated migration and metastasis included altered prototypical EMT markers, anoikis-resistant cell aggregation and attenuation of the 5-FU-induced inhibitory effect on cell migration., Competing Interests: The authors declare that they have no competing interests., (Copyright: © Hsieh et al.)

This study proposes the use of thiomalic acid-modified Au and Ag nanoparticle mixtures (TMA-Au/AgNP mixes) for the selective detection of tricyclazole. Upon the addition of tricyclazole, the color of TMA-Au/AgNP mixes solution changes from orange-red to lavender (red-shift). According to the density-functional theory calculations, tricyclazole-induced aggregation of TMA-Au/AgNP mixes through electron donor-acceptor interactions was proved. The sensitivity and selectivity of the proposed method are affected by the amount of TMA, volume ratio of TMA-AuNPs to TMA-AgNPs, pH value, and buffer concentration. The ratio of absorbance (A 654 /A 520 ) of TMA-Au/AgNP mixes solution is proportional to the concentration of tricyclazole over the range 0.1-0.5 ppm with a linear correlation (R 2 = 0.948). Moreover, the limit of detection was estimated at 0.028 ppm. The practicality of TMA-Au/AgNP mixes was validated for the determination of tricyclazole concentration in real samples (spiked recovery was 97.5%-105.2%), demonstrating its advantages of simplicity, selectivity, and sensitivity.

Background: Inflammation has a significant role in the onset and progression of inflammatory bowel disease (IBD). Increasing attention has been paid to the use of acupuncture in IBD patients; however, its regulatory effects on inflammatory factors in IBD still require validation. Here, we systematically evaluated the effects of acupuncture on inflammatory factors in IBD patients., Methods: Eight electronic databases were searched for studies that met the inclusion criteria. After evaluating the quality of the studies selected by two reviewers, the meta-analysis was performed to assess the efficacy of acupuncture in IBD patients and the impact on inflammatory factors (TNF-α, IL-1, IL-8 and IL-10)., Results: Four randomized controlled trials with a total of 228 patients satisfied the inclusion criteria. Acupuncture has a positive therapeutic impact on IBD (MD = 1.22, 95% CI [1.07, 1.39], P = 0.003). Moreover, it regulates the levels of TNF-α (MD =-60.58, 95% CI [-100.30, -20.89], P = 0.003), IL-8 (MD =-56.40, 95% CI [-60.02, -52.14], P < 0.00001) and IL-10 (MD =35.96, 95% CI [11.02, 60.91], P = 0.005) in IBD patients. However, the P value of meta-analysis in IL-1 great than 0.05.(MD =-27.90, 95% CI [-97.82, 42.02], P = 0.11)., Conclusion: Acupuncture has a positive therapeutic impact on IBD and can effectively regulate inflammatory factors in IBD patients. TNF-α, IL-8 and IL-10 are more appropriate inflammatory indicators for clinically evaluating the anti-inflammatory response in the blood of IBD patients by acupuncture., Competing Interests: Declaration of Competing Interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Previous studies found that Jinlida granules could significantly reduce blood glucose levels and enhance the low-glucose action of metformin. However, the role of Jinlida in the standard-reaching rate of blood glucose and improving clinical symptoms has yet to be studied. We aimed to elaborate on the efficacy of Jinlida in type 2 diabetes (T2D) patients who experience clinical symptoms based on secondary analysis of a randomized controlled trial., Methods: Data were analyzed from a 12-week, randomized, placebo-controlled study of Jinlida. The standard-reaching rate of blood glucose, the symptom disappearance rate, the symptom improvement rate, the efficacy of single symptoms, and the total symptom score were evaluated. The correlation between HbA1c and the improvement of clinical symptoms was analyzed., Results: For 12 weeks straight, 192 T2D patients were randomly assigned to receive either Jinlida or a placebo. The treatment group showed statistically significant differences in the standard-reaching rate of HbA1c < 6.5% ( p = 0.046) and 2hPG (< 10 mmol/L, 11.1 mmol/L) ( p < 0.001), compared with the control group. The standard-reaching rate of HbA1c < 7% ( p = 0.06) and FBG < 7.0 mmol/L ( p = 0.079) were not significantly different between the treatment and control groups. Five symptoms exhibited a statistical difference in symptom disappearance rate ( p < 0.05). All the symptoms exhibited a significant difference in symptom improvement rate ( p < 0.05). The mean change in total symptom score from baseline to week 12 was -5.45 ± 3.98 in the treatment group and -2.38 ± 3.11 in the control group, with statistically significant differences ( p < 0.001). No significant correlations were noted between symptom improvement and HbA1c after 12 weeks of continuous intervention with Jinlida granules or placebo., Conclusion: Jinlida granules can effectively improve the standard-reaching rate of blood glucose and clinical symptoms of T2D patients, including thirst, fatigue, increased eating with rapid hungering, polyuria, dry mouth, spontaneous sweating, night sweat, vexing heat in the chest, palms, and soles, and constipation. Jinlida granules can be used as an effective adjuvant treatment for T2D patients who experience those symptoms., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Kang, Sun, Duan, Zhang, An, Jin, Lian and Tong.)

The SnS/SnS 2 heterostructure was fabricated by the chemical vapor deposition method. The crystal structure properties of SnS 2 and SnS were characterized by X-ray diffraction (XRD) pattern, Raman spectroscopy, and field emission scanning electron microscopy (FESEM). The frequency dependence photoconductivity explores its carrier kinetic decay process. The SnS/SnS 2 heterostructure shows that the ratio of short time constant decay process reaches 0.729 with a time constant of 4.3 × 10 -4 s. The power-dependent photoresponsivity investigates the mechanism of electron-hole pair recombination. The results indicate that the photoresponsivity of the SnS/SnS 2 heterostructure has been increased to 7.31 × 10 -3 A/W, representing a significant enhancement of approximately 7 times that of the individual films. The results show the optical response speed has been improved by using the SnS/SnS 2 heterostructure. These results indicate an application potential of the layered SnS/SnS 2 heterostructure for photodetection. This research provides valuable insights into the preparation of the heterostructure composed of SnS and SnS 2 , and presents an approach for designing high-performance photodetection devices.

Driving can understand the importance of tire tread depth and air pressure, but most people are unaware of the safety risks of tire oxidation. Drivers must maintain vehicle tire quality to ensure performance, efficiency, and safety. In this study, a deep learning tire defect detection method was designed. This paper improves the traditional ShuffleNet and proposes an improved ShuffleNet method for tire image detection. The research results are compared with the five methods of GoogLeNet, traditional ShuffleNet, VGGNet, ResNet and improved ShuffleNet through tire database verification. The experiment found that the detection rate of tire debris defects was 94.7%. Tire defects can be effectively detected, which proves the robustness and effectiveness of the improved ShuffleNet, enabling drivers and tire manufacturers to save labor costs and greatly reduce tire defect detection time., (© 2023. The Author(s).)

Aims: To date, there is no distinct principle determining whether to use irrigation under negative-pressure wound therapy (NPWT). We developed a new economical device to manage difficult wounds, employing 1 of 2 techniques depending on the wound condition., Methods: This case series study was conducted in 12 patients with difficult wound, from 2017 to 2018. Four patients were treated with Type A bidirectional irrigation system (wound irrigation), while 8 patients were treated with Type B bidirectional irrigation system (wound irrigation combined with NPWT)., Results: In the Type A device group, inflammatory profiles in case I, case IV, and case VIII were not monitored due to the stability of their wound. The mean recovery period was 3.75 weeks (2-8 weeks), with decreases in 100% healing rate. In the Type B device group, we noted an average of 71% reduction in inflammatory profiles. All patients' infections were resolved or were healing, and 7 patients recovered satisfactorily. The recovery period ranged from 4 to 17 weeks, with a median value of 7 weeks., Conclusion: Bidirectional irrigation system decreases secondary infections and complications, and increases the healing rate in patients with difficult wound.

Objective: Discrepancies in the definition of adductor canal block (ACB) lead to inconsistent results. To investigate the actual analgesic and motor-sparing effects of ACB by anatomically defining femoral triangle block (FTB), proximal ACB (p-ACB), and distal ACB (d-ACB), we re-classified the previously claimed ACB approaches according to the ultrasound findings or descriptions in the corresponding published articles. A meta-analysis with subsequent subgroup analyses based on these corrected results was performed to examine the true impact of ACB on its analgesic effect and motor function (quadriceps muscle strength or mobilization ability). An optimal ACB technique was also suggested based on an updated review of evidence and ultrasound anatomy., Materials and Methods: We systematically searched studies describing the use of ACB for knee surgery. Cochrane Library, PubMed, Web of Science, and Embase were searched with the exclusion of non-English articles from inception to 28 February 2022. The motor-sparing and analgesic aspects in true ACB were evaluated using meta-analyses with subsequent subgroup analyses according to the corrected classification system., Results: The meta-analysis includes 19 randomized controlled trials. Compared with the femoral nerve block group, the quadriceps muscle strength (standardized mean difference (SMD) = 0.33, 95%-CI [0.01; 0.65]) and mobilization ability (SMD = -22.44, 95%-CI [-35.37; -9.51]) are more preserved in the mixed ACB group at 24 h after knee surgery. Compared with the true ACB group, the FTB group (SMD = 5.59, 95%-CI [3.44; 8.46]) has a significantly decreased mobilization ability at 24 h after knee surgery., Conclusion: By using the corrected classification system, we proved the motor-sparing effect of true ACB compared to FTB. According to the updated ultrasound anatomy, we suggested proximal ACB to be the analgesic technique of choice for knee surgery. Although a single-shot ACB is limited in duration, it remains the candidate of the analgesic standard for knee surgery on postoperative day 1 or 2 because it induces analgesia with less motor involvement in the era of multimodal analgesia. Furthermore, data from the corrected classification system may provide the basis for future research.

The severe acute respiratory syndrome coronavirus - 2 (SARS - CoV - 2) was reported to cause the Wuhan outbreak of the corona virus disease 2019(COVID-19). To date, the COVID-19 has infected more than 600 million people gloabally. As a growing number of patients recover from acute infections and are discharged from hospitals, the proportion of patients in the recovery period is gradually increasing. Many of these individuals have been reported to experience multiple symptoms during the convalescence, such as fatigue, dyspnea and pain which are designated as "long-COVID", "post-COVID syndrome" or "recovery sequelae. We searched for recent articles published in PubMed on COVID-19 convalescence and found that the pathogenesis of COVID-19 convalescence is not yet well recognized. It may be associated with incomplete recovery of immune system, parenchymal organ damage (liver or lung), coagulation abnormalities, "second hit" caused by viral infection, and Phenomenon of Cell Senescence-Associated Secretory Phenotype (SASP). Some drugs and psychological factors of patients also play a non-negligible role in it. We also found that the effect of traditional Chinese medicine (TCM) is effective in the treatment of the COVID-19 recovery phase, which can not only relieve the corresponding symptoms, but also improve the indicators and pulmonary fibrosis. Bufei Huoxue Capsule, as the only drug explicitly mentioned for COVID-19 recovery period, can exert strong rehabilitative effects on physiological activity in patients recovering from COVID-19. In addition, in previous studies, traditional Chinese medicine has been confirmed to have the ability to resist cytokine storms, as well as improve coagulation and myocardial damage, which makes it have potential therapeutic advantages in targeting the hyperimmune response, coagulation abnormalities and myocardial damage existing in the recovery period. In conclusion, the clinical symptoms of patients convalescing from COVID-19 are complex, and its pathogenesis has not been elucidated. traditional Chinese medicine, as a traditional treatment, its specific action and mechanism need to be confirmed by more studies, so that it can play a better role., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Jiang, An, Duan, Lian, Jin, Zhang, Yang, Zhang, Kang and Sun.)

Diabetic kidney disease (DKD) is more prevalent with an increase in diabetes mellitus. Oxidative stress is a major factor in the occurrence and progression of DKD. Defending against oxidative stress and restoring antioxidant defense might be key to preventing and treating DKD. The purpose of this article is to provide an explanation of how oxidative stress affects DKD, conduct a systematic review and meta-analysis on DKD, and examine the effect of antioxidants on the disease. An analysis of 19 randomized controlled trials showed that the use of antioxidants could reduce UAE (albumin excretion rate) in patients with DKD (SMD: - 0.31; 95% CI [- 0.47, - 0.14], I 2  = 0%), UACR (urine albumin/creatinine ratio) (SMD: - 0.60; 95% CI [- 1.15, - 0.06], I 2  = 89%), glycosylated hemoglobin (hbA1c) (MD: - 0.61; 95% CI [- 1.00, - 0.21], I 2  = 93%) and MDA (malonaldehyde) (SMD:-1.05; 95% CI [- 1.87, - 0.23], I 2  = 94%), suggesting that antioxidants seemed to have therapeutic effects in patients with DKD, especially in reducing proteinuria and hbA1c. The purpose of this study is to provide new targets and ideas for drug research and clinical treatment of DKD., (© 2023. The Author(s).)

The 12-Year Basic Education Curricula not only follow the objectives of previous curriculum syllabus development, but they place more focus on competence-oriented instruction, which aims to emphasize the importance of combining the curriculum with life situations that are not solely based on learning knowledge and skills. This study aims to investigate the results of the students' learning effectiveness and learning engagement after adding competence-oriented instructional strategies into electrical engineering practical subjects offered by the Department of Electrical Engineering in skills-based senior high schools, and, at the same time, to figure out the difference in learning effectiveness using different instructional strategies. Two classes of students from the Department of Electrical Engineering major in electrical engineering practical subjects in one skills-based senior high school in Central Taiwan were chosen as the participants for this study. By way of pre-test-post-test research design and heterogeneous grouping, a 10-week instruction experiment consisting of two groups and occurring over the course of 30 classes was conducted, wherein competence-oriented instructional strategies were used in an experimental group, while traditional didactic instructional strategies were used in a control group. By analyzing the collection of quantitative and qualitative data through competence-oriented instructional strategies, the instruction effectiveness and feasibility of the basic electricity practical curriculum were developed as the study topic for understanding how competence-oriented instruction can be implemented into the practical curriculum of the electrical engineering and electronic engineering group. According to the research objective, the results were concluded as follows: (1) Students of the Department of Electrical Engineering have a slightly better learning effectiveness in electrical engineering practice under competence-oriented instructional strategies compared with those who learned under the traditional didactic instructional strategies; (2) there is a significant difference in the students' learning engagement in electrical engineering practice from the Department of Electrical Engineering under competence-oriented instructional strategies compared with those who learned under the traditional didactic instructional strategies. The conclusion of this study emphasizes designing questions based on life situations, thereby applying what students have learned to solve problems they encounter in their daily lives. Compared with traditional didactic instructional strategies, competence-oriented instructional strategies not only have a better learning effectiveness and provide flexibility for the students to solve problems and provide analysis for situations, they also have broader applicability and an increased number of positive benefits when it comes to students' group interactions and sharing.

Background: Piriformis syndrome (PS) is a painful musculoskeletal condition characterized by a deep gluteal pain that may radiate to the posterior thigh and leg. This study was designed to compare the effectiveness of ozone and BTX to lidocaine injection in treating piriformis syndrome that was resistant to medication and/or physical therapy. Study design: Between November 2018 and August 2019, we involved eighty-four subjects diagnosed with piriformis syndrome in a double-blinded, prospective, randomized comparative study to receive an ultrasound-guided injection of lidocaine (control group), botulinum toxin A, or local ozone (28 patients each group) in the belly of the piriformis muscle. Pain condition evaluated by the visual analog score (VAS) was used as a primary outcome, and the Oswestry Disability Index (ODI) as a secondary outcome, before, at one month, two months, three months, and six months following the injection. Results: The majority (58.3%) of patients were male, while (41.7%) were female. At one month, a highly significant decrease occurred in VAS and ODI in the lidocaine and ozone groups compared to the botulinum toxin group (p < 0.001). At six months, there was a highly significant decrease in VAS and ODI in the botulinum toxin group compared to the lidocaine and ozone groups (p < 0.001). Conclusion: Botulinum toxin may assist in the medium- and long-term management of piriformis syndrome, while lidocaine injection and ozone therapy may help short-term treatment in patients not responding to conservative treatment and physiotherapy.

The iliopsoas plane (IP) is a fascial plane deep to the iliopsoas complex and is the target of several novel ultrasound-guided analgesic interventions for hip. Currently, limited information is known about its parameters. From the pelvic magnetic resonance (MR) images of an adult Eastern Asian population (n = 49), the IP width, depth, and needle-beam angle in the axial plane immediately caudal to the level of indirect tendon of rectus femoris (RF) were found to be 10.7 ± 1.6 mm, 48.5 ± 15.5 mm, and 84.2 ± 8.2 degrees, respectively. There was a statistically significant difference in the age categories for IP width, and older patients seemed to have wider IP. Our data may provide applications for the technical modification of ultrasound-guided iliopsoas plane block (IPB) in acute hip pain management and the future development of ultrasound-guided single-needle-entry radiofrequency neuroablation in chronic hip pain management.

In terms of treatment, a particularly targeted drug is needed to combat the COVID-19 pandemic. Although there are currently no specific drugs for COVID-19, traditional Chinese medicine(TCM) is clearly effective. It is recommended that through data analysis and mining of TCM cases (expert experience) and population evidence (RCT and cohort studies), core prescriptions for various efficacy can be obtained. Starting from a multidimensional model of regulating immunity, improving inflammation, and protecting multiple organs, this paper constructs a multidimensional model of targeted drug discovery, integrating molecular, cellular, and animal efficacy evaluation. Through functional activity testing, biophysical detection of compound binding to target proteins, multidimensional pharmacodynamic evaluation systems of cells (Vero E6, Vero, Vero81, Huh7, and caca2) and animals (mice infected with the new coronavirus, rhesus macaques, and hamsters), the effectiveness of effective preparations was evaluated, and various efficacy effects including lung moisturizing, dehumidification and detoxification were obtained. Using modern technology, it is now possible to understand how the immune system is controlled, how inflammation is reduced, and how various organs are protected. Complete early drug characterization and finally obtain effective targeted TCM. This article provides a demonstration resource for the development of new drugs specifically for TCM., Competing Interests: The authors declare no competing interests., (© 2022 The Author(s).)

The Hippo signaling pathway is involved in cell growth, proliferation, and apoptosis, and it plays a key role in regulating organ size, tissue regeneration, and tumor development. The Hippo signaling pathway also participates in the occurrence and development of various human diseases. Recently, many studies have shown that the Hippo pathway is closely related to renal diseases, including renal cancer, cystic kidney disease, diabetic nephropathy, and renal fibrosis, and it promotes the transformation of acute kidney disease to chronic kidney disease (CKD). The present paper summarizes and analyzes the research status of the Hippo signaling pathway in different kidney diseases, and it also summarizes the expression of Hippo signaling pathway components in pathological tissues of kidney diseases. In addition, the present paper discusses the positive therapeutic significance of traditional Chinese medicine (TCM) in regulating the Hippo signaling pathway for treating kidney diseases. This article introduces new targets and ideas for drug development, clinical diagnosis, and treatment of kidney diseases., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Sun, Jin, Zhang, Jin, Xue, Duan, Zhang, Kang and Lian.)

Introduction: Diabetic kidney disease (DKD) is a severe and growing health problem, associated with a worse prognosis and higher overall mortality rates than non-diabetic renal disease. Chinese herbs possess promising clinical benefits in alleviating the progression of DKD due to their multi-target effect. This real-world retrospective cohort trial aimed to investigate the efficacy and safety of Naoxintong (NXT) capsules in the treatment of DKD. Our study is the first real-world study (RWS) of NXT in the treatment of DKD based on a large database, providing a basis for clinical application and promotion., Methods: The data was collected from Tianjin Healthcare and Medical Big Data Platform. Patients with DKD were enrolled from January 1, 2011, to March 31, 2021. NXT administration was defined as the exposure. The primary outcome was the change in estimated glomerular filtration rate (eGFR). We employed the propensity score matching (PSM) method to deal with confounding factors., Results: A total of 1,798 patients were enrolled after PSM, including 899 NXT users (exposed group) and 899 non-users (control group). The eGFR changes from baseline to the end of the study were significantly different in the exposed group compared to the control group (-1.46 ± 21.94 vs -5.82 ± 19.8 mL/(min·1.73m 2 ), P< 0.01). Patients in the NXT group had a lower risk of composite renal outcome event (HR, 0.71; 95%CI, 0.55 to 0.92; P = 0.009) and deterioration of renal function (HR, 0.74; 95% CI, 0.56 to 0.99; P = 0.039)., Conclusion: NXT can significantly slow the decline of eGFR and reduce the risk of renal outcomes. However, large cohort studies and RCTs are needed to further confirm our results., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zhang, Zhang, Yang, Duan, Jiang, Jin, Lian and Tong.)

This study contributes to the under-researched area of culture in institutional care for people with intellectual disabilities in an East Asian context. Drawing upon in-depth interviews with 20 women frontline care workers for institutionalized people with intellectual disabilities in Taiwan, we examined culture-specific caring relations such as the fictive kinships of Confucian care ethics (i.e., respect for elders and affection for the young), the charity paradigm, and religious compassion, which can induce attentive and respectful care in institutional spaces but also relegate residents to stigmatized subordination in a hierarchy of caring relations and legitimatize the voluntary exploitation of women workers. In situating the relational nature of care and the dis-enabling potentials of culture at the disability-care-place intersection, we promote an ethics of engagement that values and dignifies both recipients and providers of care., Competing Interests: Declaration of competing interest None., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

(1) Introduction: The aim was to describe the anesthetic and surgical technique of eversion carotid endarterectomy performed under intermediate-deep cervical block with sedation, and to analyze the intraoperative and postoperative results. (2) Material and Methods: Thirty cases of unilateral eversion carotid endarterectomy (n = 30), performed between 2019-2020 in a tertiary center under intermediate-deep ultrasound-guided cervical plexus block and sedation, were prospectively observed and analyzed. Hemodynamic (blood pressure, heart rate) and neurological (cerebral oximetry) variables were measured in four intraoperative phases: at the beginning of the operation, prior to carotid clamping, after unclamping and at the end of the operation. We assessed acute postoperative pain in a numerical rating scale at 6, 12 and 24 h, early and 30-day complications, and length of stay. (3) Results: Baseline mean arterial pressure values were 100.4 ± 18 mmHg, pre-clamping 95.8 ± 14 mmHg, post-clamping 94.9 ± 11 mmHg, and at the end of the operation 102.4 ± 16 mmHg. Cerebral oximetry values were 61.7 ± 7/62.7 ± 8, 68.5 ± 9.6/69.1 ± 11.7 and 68.1 ± 10/68.1 ± 10 for the left and right hemispheres at baseline, pre- and post-clamping, respectively. The pain assessment showed a score less than or equal to 3. The incidence of residual nerve block, early complications, and major complications in the first 30 days was 40%, 16.7% and 3.3%, respectively. (4) Conclusions: The combination of intermediate-deep cervical plexus block and low-dose sedation is an effective and safe alternative in awake eversion carotid endarterectomy.

Objective. Clavicle fracture fixation is commonly performed under general anesthesia due to the complex sensory innervation in this region which poses a challenge for anesthesiologists applying regional anesthetic (RA) techniques. In part 1 of this two-part study, we summarized the current literature describing various RA approaches in clavicle fractures and surgery. In our earlier scoping review, we surmised that a superficial or intermediate cervical plexus block (CPB) may provide analgesia for this procedure and, when combined with an interscalene brachial plexus block (ISB), can provide anesthesia to the clavicular region for surgical fixation. We performed a retrospective study, consolidating assumptions that were based on the results of our earlier scoping review. Methods. A retrospective study was conducted on 168 consecutive patients who underwent clavicle fixation surgery at a tertiary healthcare system in Singapore. We used a standardized pro forma to collate perioperative data from the electronic health records of both hospitals, including anesthetic technique, analgesic requirements, pain scores, and adverse events, up to the second postoperative day or up until discharge. Results. In our study, patients who received RA had significantly reduced pain scores and opioid requirements, compared to general anesthesia (GA) alone. Through subgroup analysis, differences were found in postoperative pain scores and opioid requirements in the following order: GA alone > GA with local infiltration analgesia > CPB > CPB plus ISB. All patients who received combined CPB and ISB had upper limb weakness in recovery, compared to none with CPB alone (p < 0.001). Of those who received an ISB either in isolation or combined with a CPB, four (9.3%) were reported to have dyspnea (within 24 h) and motor weakness that persisted beyond 12 h, compared to none for patients that received CPB alone. Conclusions. Addition of a CPB to GA for clavicle fracture fixation surgery is associated with reduced pain scores in the early postoperative period, with a lower opioid requirement compared to GA alone. In patients undergoing GA, the combination of a CPB with an ISB was associated with a small, although statistically significant, reduction in pain scores and opioid requirements compared to a CPB alone.

Modaomen Waterway is the main outlet of the Pear River system and an important water source for Zhuhai and Macao. The water quality of 13 sampling sites in Modaomen Waterway, phytoplankton, and environmental factors were investigated at 21 sampling sites in 4 drinking water source groups, which transport water from Modaomen Waterway and connect with each other, in August and October of 2021. A total of 73 genera of phytoplankton in eight phyla were identified, with a total of 150 species, most of them belonging to Cyanophyta, Chlorophyta, and Bacillariophyta . The relative abundance of Cyanophyta was higher than 90% in the DJS and YL reservoirs during flood and dry seasons; Cyanophyta, Chlorophyta, and Bacillariophyta were dominant phyla during different seasons; and their distribution was balanced in the ZXD and ZY reservoirs. The Shannon-Wiener index, Pielous uniformity index, and Margalef richness index showed that the ZY reservoir had the most abundant biodiversity, which indicated the best water quality, followed by the ZXD and YL reservoirs. Conversely, the DJS was the least diverse reservoir for phytoplankton. The PCoA analysis indicated significant differences in plankton structures in ZXD and ZY with the other two reservoirs ( P <0.05), respectively. Redundancy analysis (RDA) showed that the main environmental factors affecting the distribution of the phytoplankton community were NO 3 - , TOC, TP, Cl - , and NH 4 + -N. These results indicated that the phytoplankton community of the four reservoirs were greatly affected by the nutrient salt caused by water transport, which suggested that the water quality of Modaomen Waterway should be improved to increase reservoir water nutrition to ensure the safety of drinking water sources.

Objective: To explore the action mechanisms of lycopene in the treatment of chronic prostatitis / chronic pelvic pain syndrome (CP/CPPS) based on network pharmacology and molecular docking., Methods: We obtained the drug targets of lycopene from the databases TCMSP and PharmMapper, the therapeutic targets of CP/CPPS from OMIM, Disgenet and Genecards, and the common targets of lycopene and CP/CPPS with the Venny software. We constructed a protein-protein interaction (PPI) network of lycopene acting on CP/CPPS using the STRING database, screened the core targets with the Cytoscape software, followed by GO functional analysis and KEGG pathway analysis with the R software and molecular docking of lycopene and the core targets using AutoDock Tools, Vina and Pymol., Results: A total of 187 drug targets, 1 557 disease targets and 46 common targets were screened out. PPI network analysis showed that ALB, IGF1, EGFR, SRC, CASP3 and ESR1 were the core targets of lycopene in the treatment of CP/CPPS. GO functional analysis showed the common targets to be involved in the reproductive structure development, extrinsic apoptotic signaling pathway, and response to reactive oxygen species. KEGG pathway analysis indicated the association of Ras, PI3K-Akt, Rap1, FoxO and MAPK signaling pathways with the mechanism of lycopene acting on CP/CPPS. Molecular docking exhibited a great affinity of lycopene to all the core targets., Conclusion: This study revealed the potential targets and signaling pathways of lycopene in the treatment of CP/CPPS and its action mechanisms from the perspective of network pharmacology and molecular docking, which has provided some reference for future studies.

Diabetic kidney disease (DKD) is one of the major public health problems in society today. It is a renal complication caused by diabetes mellitus with predominantly microangiopathy and is a major cause of end-stage renal disease (ESRD). Autophagy is a metabolic pathway for the intracellular degradation of cytoplasmic products and damaged organelles and plays a vital role in maintaining homeostasis and function of the renal cells. The dysregulation of autophagy in the hyperglycaemic state of diabetes mellitus can lead to the progression of DKD, and the activation or restoration of autophagy through drugs is beneficial to the recovery of renal function. This review summarizes the physiological process of autophagy, illustrates the close link between DKD and autophagy, and discusses the effects of drugs on autophagy and the signaling pathways involved from the perspective of podocytes, renal tubular epithelial cells, and mesangial cells, in the hope that this will be useful for clinical treatment., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zhang, Sun, Xue, Jin, Li, Zhao, Lian, Qi and Tong.)

Iliopsoas plane (IP) is a fascial plane deep to the iliopsoas complex that can serve as a potential space for the injection of local anesthetics to selectively block the articular branches of femoral nerve and accessory obturator nerve to the anterior hip capsule. Two highly similar ultrasound-guided interfascial plane blocks that target the IP, pericapsular nerve group (PENG) block and iliopsoas plane block (IPB), were both designed to achieve motor-sparing sensory block to the anterior hip capsule. However, the most recent evidence shows that PENG block can cause 25% or more of quadriceps weakness, while IPB remains the hip block that can preserve quadriceps strength. In this scoping review of quadriceps weakness after PENG block and IPB, we first performed a focused review on the complicated anatomy surrounding the anterior hip capsule. Then, we systematically searched for all currently available cadaveric and clinical studies utilizing PENG block and IPB, with a focus on quadriceps weakness and its potential mechanism from the perspectives of fascial plane spread along and outside of the IP. We conclude that quadriceps weakness after PENG block, which places its needle tip directly deep to iliopsoas tendon (IT), may be the result of iliopectineal bursal injection. The incidental bursal injection, which can be observed on ultrasound as a medial fascial plane spread, can cause bursal rupture/puncture and an anteromedial extra-IP spread to involve the femoral nerve proper within fascia iliaca compartment (FIC). In comparison, IPB places its needle tip lateral to IT and injects just one-fourth of the volume of PENG block. The current evidence, albeit still limited, supports IPB as the true motor-sparing hip block. To avoid quadriceps weakness after PENG block, a more laterally placed needle tip, away from the undersurface of IT, and a reduction in injection volume should be considered. Future studies should focus on comparing the analgesic effects and quadriceps function impairment between PENG block and IPB.

Objective. Clavicle fractures are common injuries potentially associated with significant perioperative pain. However, this region's complex sensory innervation poses a challenge for regional anesthetic or analgesic (RA) techniques. We conducted this scoping review to summarize the current literature, particularly with regards to motor-sparing techniques. Methods. A scoping review was carried out in accordance with the Joanna Briggs Institute's framework. All articles describing the use of RA for clavicle fractures or surgery were included. PubMed ® , Ovid MEDLINE ® , EMBASE ® , Scopus ® , CINAHL ® , and the Cochrane database were searched without language restrictions. Results. Database searches identified 845 articles, 44 of which were included in this review, with a combined patient total of 3161. We included all peer-reviewed publications containing clinical data and summarized the findings. Conclusions. Current evidence of RA techniques in clavicle surgery is heterogeneous, with different approaches used to overcome the overlapping sensory innervation. The literature largely comprises case reports/series, with several randomized controlled trials. Intermediate cervical plexus block is the regional technique of choice for clavicle surgery, and can provide reliable surgical anesthesia when combined with an interscalene block. Cervical plexus block can provide motor-sparing analgesia following clavicle surgery. Promising alternatives include the clavipectoral block, which is a novel motor-sparing regional technique. Further studies are required to determine the efficacy and safety of various techniques.