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Background: This study investigates the precision of nurse practitioners (NPs) in measuring intracranial lesion volumes using the ABC/2 method, a simple yet widely used technique in neurosurgical practices. Amidst physician workforce shortages, the role of NPs in clinical practice, including specialized tasks like lesion volume estimation, is gaining importance., Methods: We conducted a retrospective study involving patients treated for intracranial meningiomas. NPs estimated tumor volumes using the ABC/2 method, which was then compared with automated ABC/2 estimations considered as the gold standard. Statistical analyses, including paired sample t-tests, Bland-Altman analysis, and Intraclass Correlation Coefficient (ICC) analysis, were employed to assess measurement accuracy and consistency., Results: Among the 265 meningioma patients included, NPs measured the average tumor volume as 36.95 ml, generally underestimating it compared to the 39.57 ml average obtained by the automated ABC/2 method. This underestimation, however, was clinically modest, indicated by an average percentage difference of 6.59% and a Cohen's d value of 0.08. Consistency in measurements, assessed using Bland-Altman and ICC analyses, demonstrated a high level of agreement between NPs measurements and the automated method. Additionally, no significant differences in measurement accuracy were observed either among different NPs or across NPs with varying levels of work experience., Conclusions: Nurse practitioners can effectively employ the ABC/2 method for estimating intracranial lesion volumes with reasonable accuracy and consistency, irrespective of their work experience. This finding is pivotal in enhancing the role of NPs in neurosurgical practices and could be significant in alleviating the strain caused by the global shortage of physicians. Future research may explore extending NPs' roles in other clinical diagnostic and therapeutic tasks., (© 2024. The Author(s).)

In our previous work, epitaxial Ba(Zr 0.2 Ti 0.8 )O 3 thick films (~1-2 μm) showed an excellent energy storage performance with a large recyclable energy density (~58 J/cc) and a high energy efficiency (~92%), which was attributed to a nanoscale entangled heterophase polydomain structure. Here, we propose a detailed analysis of the structure-property relationship in these film materials, using an annealing process to illustrate the effect of nanodomain entanglement on the energy storage performance. It is revealed that an annealing-induced stress relaxation led to the segregation of the nanodomains (via detailed XRD analyses), and a degraded energy storage performance (via polarization-electric field analysis). These results confirm that a nanophase entanglement is an origin of the high-energy storage performance in the Ba(Zr 0.2 Ti 0.8 )O 3 thick films.

To investigate the cholesterol-lowering effects of alfalfa saponin extract (ASE) and its regulation mechanism on some key genes involved in cholesterol metabolism, 40 healthy 7 weeks old male Sprague Dawley (SD) rats were randomly divided into four groups with 10 rats in each group: control group, hyperlipidemic group, ASE treatment group, ASE prevention group. The body weight gain, relative liver weight and serum lipid 1evels of rats were determined. Total cholesterol (TC) and total bile acids (TBA) levels in liver and feces were also measured. Furthermore, the activity and mRNA expressions of Hmgcr, Acat2, Cyp7a1 and Ldlr were investigated. The results showed the following: (1) The abnormal serum lipid levels in hyperlipidemic rats were ameliorated by ASE administration (both ASE prevention group and treatment group) (P<0.05). (2) Both ASE administration to hyperlipidemic rats significantly reduced liver TC and increased liver TBA level (P<0.05). TC and TBA levels in feces of hyperlipidemic rats were remarkably elevated by both ASE administration (P<0.05). (3) mRNA expressions of Hmgcr and Acat2 in the liver of hyperlipidemic rats were remarkably down-regulated (P<0.05), as well as mRNA expressions of Cyp7a1 and Ldlr were dramatically up-regulated by both ASE administration (P<0.05). The activities of these enzymes also paralleled the observed changes in mRNA levels. (4) There was no significant difference between ASE treatment and ASE prevention group for most parameters evaluated. Our present study indicated that ASE had cholesterol-lowering effects. The possible mechanism could be attributed to (1) the down-regulation of Hmgcr and Acat2, as well as up-regulation of Cyp7a1 and Ldlr in the liver of hyperlipidemic rats, which was involved in cholesterol biosynthesis, uptake, and efflux pathway; (2) the increase in excretion of cholesterol. The findings in our study suggested ASE had great potential usefulness as a natural agent for treating hyperlipidemia.