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While over 40 neonatal pain assessment scales have been published, owing to a lack of consensus and standardized metrics, there are more than 100 assessment indicators with varying descriptors and quality differences. This study aims to reach a consensus on optimal and comprehensive variables for neonatal pain assessment, leading to the development of a multidimensional neonatal pain response variable set. This study consisted of three phases: (1) A literature review was conducted to identify influencing factors and assessment indicators of neonatal pain response. (2) Panel meetings involving neonatal healthcare professionals evaluated and screened factors and indicators to develop an initial draft of the variable set. (3) Through two rounds of Delphi study achieved consensus, and determined the neonatal pain response variable set. Through a literature review and a panel meeting, the identified factors and indicators were categorized into contextual, physiological, and behavioral variables, forming an initial draft of the variable set. Sixteen professionals participated in two rounds of the Delphi study, with response rates exceeding 70%, and authority coefficients surpassing 0.7 in both rounds. The final iteration of the variable set includes 9 contextual variables, 2 physiological variables, and 5 behavioral variables.   Conclusion: Neonatal pain response variable set developed in this study is scientific, comprehensive, and multidimensional, aligning with the characteristics of neonatal pain response and clinically applicable. The inclusion of contextual variables enhances the ability to confront the complexity of clinical environments and individual differences. It can provide a practical and theoretical basis for clinical research on neonatal pain assessment. What is Known: • Neonatal pain assessment relies on scales used by healthcare professionals currently. But there is no "gold standard" for neonatal pain assessment. • While over 40 neonatal pain assessment scales have been published, owing to a lack of consensus and standardized metrics, there are more than 100 assessment indicators with varying descriptors and quality differences. Most of scales overlook the clinical environment complexity individual differences in pain responses, diminishing the accuracy and applicability. What is New: • In addition to the commonly used physiological and behavioral variables in the scales, we have incorporated contextual variables to better address the complexity of clinical environments and individual differences in pain responses. • Through an evidence-based approach, developed a neonatal pain response variable set comprising 9 contextual variables, 2 physiological variables, and 5 behavioral variables., (© 2024. The Author(s).)

Tandem amplification of carbapenemase genes increases gene copy number and enhances carbapenem resistance. These amplifications are often heterogeneous, transient, and located on plasmids, which also contribute to heteroresistance. Amplification of encoding genes is especially important for enzymes with low hydrolysis activity, which are often overlooked. Here, we reported an intrinsic oxacillinase oxaAb amplification flanked by ISAba1. The amplification is in the chromosome and contains up to 25 repeats. We provided genomic, transcriptomic, and proteomic evidence that the amplification resulted in oxacillinase overproduction. Notably, no point mutations of oxaAb were found during the amplification process. Strains of Acinetobacter baumannii with intrinsic amplified or external transformed ISAba1-oxaAb exhibited higher meropenem hydrolysis activity. Furthermore, the number of repeats in the amplification decreased gradually over a period of 21 d cultured with carbapenem withdrawal. However, upon re-exposure to meropenem, the ISAba1 flanked oxaAb responded rapidly, with repeat numbers reaching or exceeding pre-carbapenem withdrawal levels within 24 h. Taken together, these findings suggest that ISAba1-mediated gene amplification and overproduction of intrinsic low-activity oxacillinase oxaAb resulted in carbapenem resistance., (Copyright © 2024 Elsevier Ltd and International Society of Antimicrobial Chemotherapy. All rights reserved.)

Purpose: To compare the clinical outcomes of myopiacorrected with corneal-wavefront-guided (CWG) laser in situ keratomileusis (LASIK) with AMARIS 1050S (SCHWIND eye-tech-solutions GmbH & Co. KG) and corneal-topography-guided (CTG) LASIK with WaveLight EX500 (Alcon Laboratories, Fort Worth, TX)., Methods: In this prospective, pseudo-randomized expanded cohort study, a total of 266 patients were subjected to binocular LASIK surgery, either with WaveLight EX500 (WaveLight group) or Amaris 1050S (AMARIS group) platforms. Data related to right eyes were selected for analysis. Corneal higher-order aberration (HOA) was selected as the primary endpoint; while visual acuity and refraction were the secondary endpoints. All the endpoints were assessed at 3 months postoperatively., Results: There were 134 eyes in the AMARIS group and 132 eyes in the WaveLight group. After 3 months of postoperative follow-up, spherical and coma aberrations were significantly lower (P < 0.05) in the WaveLight group (spherical aberration: - 0.104 ± 0.199 µm; coma aberration: - 0.117 ± 0.202 µm) in comparison with the AMARIS group (spherical aberrations: 0.254 ± 0.146 µm; coma aberrations: 0.316 ± 0.297 µm). In the AMARIS group, 96.3% of the eyes achieved an uncorrected distance visual acuity (UDVA) of 20/20 while in the WaveLight group, 96.2% of the eyes achieved an UDVA of 20/20. Furthermore, the mean postoperative manifest refraction spherical equivalent (MRSE) was - 0.02 ± 0.28 in the AMARIS group and - 0.05 ± 0.21 in the WaveLight group (P = 0.34)., Conclusions: Both WaveLight EX500 and Amaris 1050S LASIK showed excellent refractive and visual outcomes. In addition, the WaveLight group showed minimal spherical and coma aberrations when compared to the AMARIS group., (© 2024. The Author(s).)

Purpose: To evaluate the characteristic of corrective epithelial thickness after femtosecond laser-assisted lenticule intrastromal keratoplasty (LIKE) to correct moderate-to-high hyperopia., Methods: The prospective case series study of the LIKE procedure was performed to correct moderate-to-high hyperopia. The epithelial thickness map was generated by anterior segment optical coherence tomography (AS-OCT) in the corneal central 9-mm zone. Keratometry and corneal higher order aberrations were analyzed by Pentacam (Oculus Optikgeräte GmbH) preoperatively and postoperatively., Results: In the 26 eyes of 13 participants who underwent the LIKE procedure for moderate-to-high hyperopia, the attempted spherical equivalence (SEQ) was +6.50 ± 1.09 diopters (D). Compared to the preoperative epithelial thickness maps, the postoperative epithelial thickness had become significantly thinner in the central 5-mm zone; the difference was 6 to 7 µm. The paracentral epithelium performed nonuniform remodeling; the thinnest epithelial thickness was located in the inferotemporal section, which has the greatest difference from the superonasal; the difference between these two was approximately 3 µm. Through correlation analysis, it was found that the sections with thinner epithelium were significantly related to corneal curvature and corneal vertical coma., Conclusions: The LIKE procedure can be used to correct moderate-to-high hyperopia. This study further indicated the epithelial remodeling characteristic after the LIKE procedure: the central and paracentral corneal epithelial thickness becomes thinner, and the epithelial thickness distributes non-uniformly, which may be the important factor of the postoperative curvature asymmetric distribution and induction of corneal vertical coma. [ J Refract Surg . 2024;40(5):e321-e327.] .

Cooperative vehicle-infrastructure system (CVIS) is an important part of the intelligent transport system (ITS). Autonomous vehicles have the potential to improve safety, efficiency, and energy saving through CVIS. Although a few CVIS studies have been conducted in the transportation field recently, a comprehensive analysis of CVIS is necessary, especially about how CVIS is applied in autonomous vehicles. In this paper, we overview the relevant architectures and components of CVIS. After that, state-of-the-art research and applications of CVIS in autonomous vehicles are reviewed from the perspective of improving vehicle safety, efficiency, and energy saving, including scenarios such as straight road segments, intersections, ramps, etc. In addition, the datasets and simulators used in CVIS-related studies are summarized. Finally, challenges and future directions are discussed to promote the development of CVIS and provide inspiration and reference for researchers in the field of ITS., Competing Interests: The authors declare no competing interests., (© 2024 The Author(s).)

To investigate the associations between corneal curvature (CC) and other anterior segment biometrics in young myopic adults. In this retrospective multi-center study, 7893 young myopic adults were included. CC and other anterior segment biometrics were measured by Scheimpflug imaging (Pentacam). CC was defined as SimK at central 3 mm area, and other anterior segment biometrics included white-to-white corneal diameter (WTW), central corneal thickness (CCT), corneal volume (CV) at 3 mm, 5 mm, and 7 mm area, anterior corneal astigmatism (ACA), posterior corneal astigmatism (PCA), anterior corneal eccentricity (ACE) and asphericity (ACAP), posterior corneal eccentricity (PCE) and asphericity (PCAP), anterior chamber depth (ACD), and anterior chamber volume (ACV). Univariate regression analyses were used to assess the associations between CC and other anterior segment biometrics, and multivariate regression analyses were further performed to adjusted for age, gender and spherical equivalent. CC was higher in patients of female gender and higher myopia (all P < 0.05). Eyes in higher CC quartiles had lower WTW, thinner CCT, lower CV at 3 mm and 5 mm, lower ACD, and lower ACV (all P < 0.001), but had larger ACA, larger PCA, less PCE and less PCAP (all P < 0.001), compared to eyes in lower CC quartiles. The trends of CV at 7 mm, ACE and ACAP were inconsistent in different CC quartiles. After adjusting for age, gender and spherical equivalent with multivariate linear regression, CC was positively correlated to CV at 7 mm (β s  = 0.069), ACA (β s  = 0.194), PCA (β s  = 0.187), ACE (β s  = 0.072), PCAP (β s  = 0.087), and ACD (β s  = 0.027) (all P < 0.05), but was negatively correlated to WTW (β s  = - 0.432), CCT (β s  = - 0.087), CV-3 mm (β s  = - 0.066), ACAP (β s  = - 0.043), PCE (β s  = - 0.062), and ACV (β s  = - 0.188) (all P < 0.05). CC was associated with most of the other anterior segment biometrics in young myopic adults. These associations are important for better understanding of the interactions between different anterior segment structures in young myopic patients, and are also useful for the exploration of the pathogenesis of myopia., (© 2024. The Author(s).)

Recent progress in high-throughput sequencing technologies has dramatically increased availability of genome data for prokaryotes and eukaryotes. Dinoflagellates have distinct chromosomes and a huge genome size, which make their genomic analysis complicated. Here, we reviewed the nuclear genomes of core dinoflagellates, focusing on the genome and cell size. Till now, the genome sizes of several dinoflagellates (more than 25) have been measured by certain methods (e.g., flow cytometry), showing a range of 3-250 pg of genomic DNA per cell. In contrast to their relatively small cell size, their genomes are huge (about 1-80 times the human haploid genome). In the present study, we collected the genome and cell size data of dinoflagellates and compared their relationships. We found that dinoflagellate genome size exhibits a positive correlation with cell size. On the other hand, we recognized that the genome size is not correlated with phylogenetic relatedness. These may be caused by genome duplication, increased gene copy number, repetitive non-coding DNA, transposon expansion, horizontal gene transfer, organelle-to-nucleus gene transfer, and/or mRNA reintegration into the genome. Ultimate verification of these factors as potential causative mechanisms would require sequencing of more dinoflagellate genomes in the future., 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 GmbH. All rights reserved.)

The interactions between white-to-white corneal diameter (WTW) and other ocular biometrics are important for planning of refractive surgery and understanding of ocular structural changes in myopia, but such interactions are rarely investigated in young myopic adults. This is a retrospective study involving 7893 young myopic adults from five centers. WTW and other ocular biometrics were measured by Pentacam. The ocular biometrics included anterior corneal curvature (AK) and posterior corneal curvature (PK), central corneal thickness (CCT) and corneal volume (CV), anterior and corneal eccentricity and asphericity, anterior corneal astigmatism (ACA) and posterior corneal astigmatism, anterior chamber depth (ACD), and anterior chamber volume (ACV). The ocular biometrics were compared among eyes of different WTW quartiles. Multivariate linear regression was used to assess the linear associations between WTW and other ocular biometrics adjusting for age, gender and spherical equivalent. In eyes of different WTW quartiles, other ocular biometrics were also significantly different (all P < 0.05). After adjusting for age, gender and spherical equivalent, WTW was positively correlated to AK (β = 0.26 to 0.29), ACA (β = 0.13), anterior corneal asphericity (β = 0.05), PK (β = 0.33 to 0.34), posterior corneal asphericity (β = 0.13), ACD (β = 0.29), and ACV (β = 40.69), and was negatively correlated to CCT (β = - 6.83), CV (β = - 0.06 to - 0.78), anterior corneal eccentricity (β = - 0.035), and posterior corneal eccentricity (β = - 0.14) (all P < 0.001). In conclusion, we found that in young myopic adults, larger WTW was associated with thinner corneal thickness, flatter corneal curvature, more anterior corneal toricity, less corneal eccentricity and asphericity, and broader anterior chamber. Our findings may fill in the gap of literature, and help us better understand how the anterior segment structures interact with the WTW in myopia., (© 2024. The Author(s).)

Locating 3D objects from a single RGB image via Perspective-n-Point (PnP) is a long-standing problem in computer vision. Driven by end-to-end deep learning, recent studies suggest interpreting PnP as a differentiable layer, allowing for partial learning of 2D-3D point correspondences by backpropagating the gradients of pose loss. Yet, learning the entire correspondences from scratch is highly challenging, particularly for ambiguous pose solutions, where the globally optimal pose is theoretically non-differentiable w.r.t. the points. In this paper, we propose the EPro-PnP, a probabilistic PnP layer for general end-to-end pose estimation, which outputs a distribution of pose with differentiable probability density on the SE(3) manifold. The 2D-3D coordinates and corresponding weights are treated as intermediate variables learned by minimizing the KL divergence between the predicted and target pose distribution. The underlying principle generalizes previous approaches, and resembles the attention mechanism. EPro-PnP can enhance existing correspondence networks, closing the gap between PnP-based method and the task-specific leaders on the LineMOD 6DoF pose estimation benchmark. Furthermore, EPro-PnP helps to explore new possibilities of network design, as we demonstrate a novel deformable correspondence network with the state-of-the-art pose accuracy on the nuScenes 3D object detection benchmark. Our code is available at https://github.com/tjiiv-cprg/EPro-PnP-v2.

Background: Anxiety is a common preoperative symptom in children with simple congenital heart disease (SCHD). Music therapy shows potential as a non-drug intervention. However, it is unclear how it impacts the level of cooperation during the induction of anesthesia and preoperative anxiety, as well as the factors that influence its effectiveness. Therefore, we will conduct a comprehensive review and meta-analysis to assess the impact of music therapy on the level of cooperation during anesthesia induction and preoperative anxiety in children with SCHD., Methods: Electronic searches will be conducted through various databases including PubMed, Embase, Web of Science, Medline, and CNKI to gather randomized controlled trials (RCTs) examining the impact of music therapy on the level of cooperation during anesthesia induction and preoperative anxiety among children with SCHD. Two evaluators will independently review the literature, extract information, and assess the risk of bias in the included studies. Afterwards, data analysis will be conducted using Stata 14.0 software and Revman 5.4 software. The results will be based on random-effects models. The reliability and quality of evidence will be evaluated by using the Grading of Recommendations, Development, and Evaluation (GRADE) system. Heterogeneity will be examined by subgroup analysis stratified by age, gender ratio, type of surgery, drop-out rate, measurement tools, and country of origin. We will assess potential publication bias using funnel plot symmetrical and Begg's ang Egger's regression tests., Discussion: Given the multiple advantages that may be associated with music therapy, this therapy may be a desirable alternative to existing therapies for preoperative cooperation and anxiety issues in children with SCHD. We hope that this systematic review will guide clinical decision-making for future efforts related to coping with preoperative fit and anxiety in children with SCHD., Systematic Review Registration: PROSPERO registration number: CRD42023445313. https://www.crd.york.ac.uk/prospero/display&#95;record.php?ID=CRD42023445313., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Liu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

To compare the predictability of different formulas in the postoperative vault of an implantable collamer lens (ICL) surgery and assist physicians for formula selection in ICL implantation. This is a retrospective study. Patients who underwent ICL implantation between August 31, 2021 and October 29, 2021 at our clinic were reviewed. The clinical data, predicted ICL sizes and vaults, actual ICL size implanted and vaults at 1 month after surgery, and corresponding prediction formulas used were collected and analyzed. This study included 140 eyes from 72 patients (15 males and 57 females). Differences between ICL sizes recommended by the Visian ICL Online Calculation & Ordering System (OCOS) and NK formula (Version. 3) or KS formula (Version. 4) were statistically significant (P < .0001), except for the recommended ICL sizes between the NK and KS formulas (P > .05). Better consistency between predicted ICL vaults and achieved ICL vaults was observed when using the KS formula compared to the NK formula. The actual ICL vaults were 250 to 750 μm at 1 month after surgery in 66.4%, 76.5%, and 80.5% eyes of the OCOS, NK, and KS groups, respectively. There was significant difference between the OCOS and KS groups (P < .05), especially in the 12.6 mm ICL group. The KS formula is the most accurate formula for recommending an ICL size and vault prediction when compared to the NK formula and OCOS. Further studies for a more accurate formula are warranted., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Invasive infection caused by hypervirulent Klebsiella pneumoniae (HvKP) has been reported worldwide. Most of the patients are community population, related to diabetes mellitus (DM), chronic liver disease and other basic diseases, which prone to systemic migratory infection. In this study, we collected 377 patients with community acquired Klebsiella pneumoniae liver abscess in our hospital from January 2013 to December 2018, 65.8% of whom were male, and 49.6% had DM. Patients with DM are prone to eye and central nervous system (CNS) infection, which need continuous local abscess drainage during treatment. Among them, patients with poor blood glucose control have a higher rate of blood stream infections (BSI). 219 strains of HvKP were obtained, with K1/K2 Serotype accounted for 81.7%. The incidence of BSI in K2 patients was higher than that in K1 patients. The PCR results indicate that the carrying rate of virulence genes (rmpA、areo、kfu、allS、iroN、magA、uge、wcaG) in K1/K2 type strains is significantly higher than that in non K1/K2 type strains. ST23 and ST65 are the most common multilocus sequence typing (MLST), which belong to K1 and K2 Serotype respectively. All of HvKP strains showed high sensitivity to commonly used clinical antibiotics other than ampicillin, with 54.3% of the strains exhibiting high viscosity characteristics. Meanwhile, 35 classic Klebsiella pneumoniae (cKP) strains were collected, and their serum typing is mainly non K1/K2. The carrying rate of virulence genes and viscosity degree in HvKP are significantly higher than those in cKP. Primary liver abscess caused by HvKP is prone to multiple tissue and organ infections, but it shows higher sensitivity to most commonly used antibiotics in clinical practice except for ampicillin. After effective treatment, the overall prognosis of patients is better. This study analyzes the pathogenic characteristics of HvKP and elaborates on the clinical characteristics of patients, which can provide reference for clinical and scientific research work.

Background: The efficacy of traditional Chinese exercise (TCE)-based interventions in the improvement of sleep quality is controversial. In this systematic review, we aimed to summarize randomized controlled trials (RCTs) that outline the effects of TCE on sleep quality., Methods: Five databases (Web of Science, Embase, PubMed, Medline, and China National Knowledge Infrastructure) were searched for literature published before July 2022. RCTs examining TCE interventions were included. The treatment effects were estimated using a random-effect meta-analysis model with mean differences (MDs). There were 2 outcome scales for sleep quality; however, because they were extremely contrastive to be analyzed by standard MD, the scales were analyzed separately to ensure the accuracy of the results. This review was registered in the International Prospective Register of Systematic Reviews (identifier CRD42023421314)., Results: Twenty studies were included for analysis at last. The outcome was calculated using the Verran and Snyder-Halpern Sleep Scale (MD: 344.17, 95% confidence interval: 316.95 to 371.39, P < .00001) and Pittsburgh Sleep Quality Index to measure sleep quality (MD: -2.24, 95% confidence interval: -3.05 to -1.43, P < .00001), both showed improvement effect. In subgroup analysis, for patients with fibromyalgia, normal older adults, and non-Hodgkin lymphoma, chronic fatigue syndrome-like illness, knee osteoarthritis, nasopharyngeal carcinoma, pausimenia, insomnia, TCE could improve sleep quality. However, there was no significant improvement in stroke patients, breast cancer patients, normal college students, and episodic migraine patients. Tai Chi had greater effects in improving sleep quality than Qigong. In addition, the participants practice site, duration, and age did not influence the effects of TCE., Conclusion: TCE can improve sleep quality in specific populations in specific populations clinical applications. Tai chi should be considered first to improve sleep quality. However, further extensive trials and rigorous study designs should be conducted to strengthen the findings of this study. In addition, considering the large heterogeneity, the findings of our study should be interpreted cautiously., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Toxin-antitoxin systems are highly variable, even among strains of the same bacterial species. The MazEF toxin-antitoxin system is found in many bacteria and plays important roles in various biological processes such as antibiotic tolerance and phage defense. However, no interplay of MazEF systems between different species was reported., Materials and Methods: MazEF toxin-antitoxin system of Helicobacter macacae was examined in three Escherichia coli strains with and without endogenous MazEF knockout. In vivo toxicity, antibiotic tolerance, and live/dead staining followed by flowcytometry analysis were performed to evaluate the functionality and interplay of the toxin-antitoxin system between the two species., Results: Controlled ectopic expression of MazF of H. macacae (MazFhm) in E. coli did not affect its growth. However, in endogenous MazEF knockout E. coli strains, MazFhm expression caused a sharp growth arrest. The toxicity of MazFhm could be neutralized by both the antitoxin of MazE homolog of H.macacae and the antitoxin of MazE of E. coli, indicating interplay of MazEF toxin-antitoxin systems between the two species. Induced expression of MazFhm enhanced tolerance to a lethal dose of levofloxacin, suggesting enhanced persister formation, which was further confirmed by live/dead cell staining., Conclusions: The MazEF toxin-antitoxin system of H. macace enhances persister formation and thus antibiotic tolerance in E. coli. Our findings reveal an interplay between the MazEF systems of H. macacae and E. coli, emphasizing the need to consider this interaction while evaluating the toxicity and functionality of MazF homologs from different species in future studies., (© 2023 The Authors. Helicobacter published by John Wiley & Sons Ltd.)

Pulmonary drug delivery via microspheres has gained growing interest as a noninvasive method for therapy. However, drug delivery through the lungs via inhalation faces great challenges due to the natural defense mechanisms of the respiratory tract, such as the removal or deactivation of drugs. This study aims to develop a natural polymer-based microsphere system with a diameter of around 3 μm for encapsulating pulmonary drugs and facilitating their delivery to the deep lungs. Pectin was chosen as the foundational material due to its biocompatibility and degradability in physiological environments. Electrospray was used to produce the pectin-based hydrogel microspheres, and Design-Expert software was used to optimize the production process for microsphere size and uniformity. The optimized conditions were determined to be as follows: pectin/PEO ratio of 3:1, voltage of 14.4 kV, distance of 18.2 cm, and flow rate of 0.95 mL/h. The stability and responsiveness of the pectin-based hydrogel microspheres can be altered through coatings such as gelatin. Furthermore, the potential of the microspheres for pulmonary drug delivery (i.e., their responsiveness to the deep lung environment) was investigated. Successfully coated microspheres with 0.75% gelatin in 0.3 M mannitol exhibited improved stability while retaining high responsiveness in the simulated lung fluid (Gamble's solution). A gelatin-coated pectin-based microsphere system was developed, which could potentially be used for targeted drug delivery to reach the deep lungs and rapid release of the drug.

Background: Numerous studies have suggested that Baduanjin, a traditional Chinese exercise, can alleviate fatigue symptoms in patients with various illnesses. The aim of this review was to evaluate the efficacy of Baduanjin in reducing fatigue symptoms., Methods: A comprehensive literature search was conducted using several databases, including PubMed, Web of Science, Embase, Medline, China Biology Medicine disc, China National Knowledge Infrastructure, and Wanfang, from inception to June 2023. Relevant studies reporting on the effects of Baduanjin on fatigue symptoms were included. A random-effects meta-analysis model with standardized mean differences was used to estimate the treatment effects. Moderator analyses were conducted using continuous variables and meta-regression. This review was registered in the International Prospective Register of Systematic Reviews (identifier CRD42023411532). Grading of recommendations, assessment, development and evaluations framework was used to assess the certainty of evidence., Results: Ten randomized controlled trials with patients diagnosed with 9 different diseases were included in the meta-analysis. The Baduanjin intervention groups showed significant improvements in total fatigue intensity (standard mean difference = -0.49, 95% confidence interval = -0.69 to -0.30, P = .000; I2 = 56%, P = .009). The statistically significant differences in the subgroup analyses, including intervention durations, age of participants, fatigue types, and practice location, remained unchanged. Meta-regression showed that practice place might have significant effect on the results. The certainty of the evidence was moderate for participants 55-year younger or in hospital training. However, fatigue, different groups, participants 55-year or older, training at home, and different fatigue types had lower evidence certainty., Conclusion: Baduanjin can effectively alleviate fatigue symptoms with relatively flexible requirements. However, studies investigating the same disease types and including non-Chinese populations are scarce. Therefore, further studies with long-term interventions, larger sample sizes, and well-designed methodologies are warranted., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: To characterize the quality of vision after SMILE, FS-LASIK, and ICL implantation and evaluate the related factors., Methods: 131 eyes of 131 myopic patients (90 female, 41 male) who underwent refractive surgeries including SMILE (35 patients), FS-LASIK (73 patients), and ICL implantation (23 patients) were analyzed. The Quality of Vision questionnaires were completed 3 months after surgery, and the results were characterized and analyzed with baseline characteristics, treatment parameters, and postoperative refractive outcomes using logistic regression analysis to find out predicted factors., Results: Mean age was 26.5 ± 4.6 years (range: 18 to 39 years) and mean preoperative spherical equivalent was - 4.95 ± 2.04 diopters (D) (range: -1.5 to -13.5). Safety and efficacy index was comparable between different techniques: the safety index was 1.21 ± 0.18, 1.22 ± 0.18, and 1.22 ± 0.16 and the efficacy index were 1.18 ± 0.20, 1.15 ± 0.17, 1.17 ± 0.15 for SMILE, FS-LASIK and ICL respectively. The mean overall QoV score was 13.40 ± 9.11, with mean frequency, severity, and bothersome score of 5.40 ± 3.29, 4.53 ± 3.04, and 3.48 ± 3.18 respectively, and there was no significant difference between different techniques. Overall, the symptom with the highest scores was glare, following fluctuation in vision and halos. Only the scores of halos were significantly different among different techniques (P < 0.000). Using ordinal regression analysis, mesopic pupil size was identified as a risk factor (OR = 1.63, P = 0.037), while postoperative UDVA was a protective factor (OR = 0.036, P = 0.037) for overall QoV scores. Using binary logistic regression analysis, we found that patients with larger mesopic pupil size had an increased risk to experience glare postoperatively; compared to ICL, patients who underwent SMILE or FS-LASIK tended to report fewer halos; patients with better postoperative UDVA were less likely to report blurred vision and focusing difficulty; with larger residual myopic sphere postoperatively, patients experienced focusing difficulties and difficulty judging distance or depth perception more frequently., Conclusions: SMILE, FS-LASIK, and ICL had comparable visual outcomes. Overall, glare, fluctuation in vision, and halos were the most frequently experienced visual symptoms 3 months postoperatively. Patients with ICL implanted tended to report halos more frequently compared with SMILE and FS-LASIK. Mesopic pupil size, postoperative UDVA, and postoperative residual myopic sphere were predicted factors for reported visual symptoms., (© 2023. The Author(s).)

Objective: To investigate the occurrence and the risk factors of stroke complicated by venous thromboembolism., Methods: A total of 2709 stroke patients who received treatment at our hospital between January 2018 and June 2021 were selected. The incidence of stroke complicated by venous thromboembolism was analyzed and the risk factors of stroke complicated by venous thromboembolism were investigated by logistic regression., Results: Among the 2709 stroke patients, 390 had venous thromboembolism, resulting in 14.39% incidence of venous thromboembolism. Among them, 383 patients (14.14%) had deep venous thrombosis (DVT), 4 patients (0.15%) had pulmonary thromboembolism (PTE), and 3 cases (0.11%) had DVT combined with PTE. According to the analysis of unconditional multivariate logistic regression model, age>60 years, concomitant hypertension, concomitant diabetes, bedrest time after admission≥3 days, D-dimer (D-D)≥0.95 mg/mL, triglyceride (TG)≥1.83 mmol/L, Barthel Index (BI) score≤9 points, and Padua score>4 points after admission were independent risk factors for stroke complicated by venous thromboembolism ( P <0.05), while anticoagulation therapy was a protective factor ( P <0.05)., Conclusion: Stroke complicated by venous thromboembolism is associated, to some degree, with age, concomitant hypertension, concomitant diabetes, bedrest time, D-D, TG, BI score, Padua score, and whether anticoagulant therapy is administered or not. Interventions in line with relevant risk factors should be strengthened to effectively reduce the risk of stroke complicated by venous thromboembolism., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Sciences).)

Alzheimer's disease (AD) is the most common cause of dementia worldwide. Our previous study revealed that bone morphogenetic protein 9 (BMP9) could ameliorate the amyloid pathology and cognitive impairments in a transgenic model of AD. However, the mechanisms underlying the protective effect of BMP9 against amyloid pathology remain unknown. Low-density lipoprotein receptor-related protein 1 (LRP1) plays an essential role in the clearance of amyloid beta. Here, we demonstrated that intranasal BMP9 significantly enhanced the expression of LRP1 in the brains of APP/PS1 mice. Importantly, silencing LRP1 significantly promoted the amyloid plaques accumulation and facilitated the neuroinflammation in the brains of BMP9-treated APP/PS1 mice. Furthermore, silencing LRP1 significantly impaired the learning and memory functions of BMP9-treated APP/PS1 mice. Our results suggest that BMP9 ameliorate the amyloid pathology and cognitive dysfunction in APP/PS1 mice by promoting the expression of LRP1., 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 B.V. All rights reserved.)

Aging slows down the mechanisms behind skeletal muscle weakening and mobility. Increases in inflammation brought on by aging may contribute to some characteristics of sarcopenia. As a result of population aging worldwide, sarcopenia, an age-related disease, has become a huge burden on both individuals and society as a whole. The study of the morbidity mechanism and available sarcopenia treatments has received more attention. The inflammatory response may be one of the most important methods behind the pathophysiology of sarcopenia in the aged, according to the background of the study. This anti-inflammatory cytokine inhibits the ability of human monocytes and macrophages to induce inflammation as well as the production of cytokines like IL-6. Here, we investigate the association between sarcopenia and interleukin-17 (IL-17), an inflammatory cytokine in the aged. There were 262 subjects aged 61-90 years who were screened for sarcopenia in Hainan General Hospital. The subjects were divided into 45 males and 60 females aged 65-79 years (average age: 72.00 ± 4.31 years). 105 patients without sarcopenia were randomly selected among 157 participants. It included 50 males and 55 females, aged 61-76 years (mean age: 69.10 ± 4.55 years) as per the standard definition of the Asian Working Group for Sarcopenia (AWGS). The "skeletal muscle index" (SMI), "hand grip strength" (HGS), "gait speed" (GS), "biochemical indexes," "serum IL-17 level," nutritional status, and past medical history of the two groups were evaluated and compared. Compared with the participants without sarcopenia, sarcopenia patients had higher average age; less physical exercise; lower total scores of BMI, pre-ALB, IL-17, and SPPB; and a higher proportion of malnutrition risk (all P < 0.05). By "ROC curve analysis," the best critical point was IL-17 in the growth of sarcopenia. The area that comes under ROC (AUROC) value was 0.627 (95% CI = 0.552, 0.702, P = 0.002). The ideal threshold value for IL-17 to estimate sarcopenia was 18.5 pg/mL. In the unadjusted model, IL-17 was considerably linked to sarcopenia (OR = 1.123, 95% CI = 1.037-1.215, P = 0.004). After the covariate adjustment observed in the complete adjustment model (OR = 1.111, 95% CI = 1.004-1.229, P = 0.002), this significance still exists. The results of this study suggest a strong relationship between sarcopenia and IL-17. This study will look at IL-17's potential to serve as a key sarcopenia indicator. This trial is registered with ChiCTR2200022590., Competing Interests: As declared by the authors, there was no conflict of interest regarding this research work., (Copyright © 2023 Lu Xiong et al.)

Mycoplasma pneumoniae, an obligate parasitic pathogen without cell wall, can cause severe upper and lower respiratory tract symptoms. It is the pathogen of human bronchitis and walking pneumonia, and named community-acquired pneumonia. In addition to severe respiratory symptoms, there are clinical extrapulmonary manifestations in the skin, brain, kidney, musculoskeletal, digestive system, and even blood system after M. pneumoniae infection. Hereby, we comprehensively summarized and reviewed the intrapulmonary and extrapulmonary pathogenesis of M. pneumoniae infection. The pathogenesis of related respiratory symptoms caused by M. pneumoniae is mainly adhesion damage, direct damage including nutrient predation, invasion and toxin, cytokine induced inflammation damage and immune evasion effect. The pathogenesis of extrapulmonary manifestations includes direct damage mediated by invasion and inflammatory factors, indirect damage caused by host immune response, and vascular occlusion. The intrapulmonary and extrapulmonary pathogenic mechanisms of M. pneumoniae infection are independent and interrelated, and have certain commonalities. In fact, the pathogenic mechanisms of M. pneumoniae are complicated, and the specific content is still not completely clear, further researches are necessary for determining the detailed pathogenesis of M. pneumoniae. This review can provide certain guidance for the effective prevention and treatment of M. pneumoniae infection., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objectives: The purpose is to analyze existing studies related to the field of demoralization through bibliometrics., Methodology: Relevant literature on demoralization was searched from PubMed, Web of Science, the Cochrane Library, and CINAHL Complete. Bibliometric analysis was performed using GraphPad Prisma 8.2.1, VOSviewer 1.6.18 and R software. Research publication trends, author-country collaboration, research hotspots and future trends were explored by generating network relationship maps., Results: A total of 1,035 publications related to the field of demoralization were identified. The earliest relevant studies have been published since 1974, and the studies have grown faster since 2000. Psyche-oncology and Psychother Psychosom had the highest number of publications ( n  = 25). The United States, Italy and Australia have made outstanding contributions to the field and there was an active collaboration among leading scholars. Major research hotspots include the multiple ways of assessing demoralization, the specificity of various demographics and psychological disorders in different disease contexts, and the association and distinction of diverse clinical psychological abnormalities. The impact of COVID-19 on demoralization and subsequent interventions and psychological care may become a future research direction., Conclusion: There has been a significant increase in research in the field of demoralization after 2000. The United States provided the most publications. There is overall active collaboration between authors, countries, and institutions. In future research, more attention will be paid to the effects of COVID-19 on demoralization and intervention care for this psychology., 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 Zheng, Xiong, Li, Liu, Xu and Luo.)

The circadian clock generates rhythms in biological processes including plant development and metabolism. Light synchronizes the circadian clock with the day and night cycle and also triggers developmental transitions such as germination, or flowering. The circadian and light signaling pathways are closely interconnected and understanding their mechanisms of action and regulation requires the integration of both pathways in their complexity. Here, we provide a glimpse into how chromatin remodeling lies at the interface of the circadian and light signaling regulation. We focus on histone acetylation/deacetylation and the generation of permissive or repressive states for transcription. Several chromatin remodelers intervene in both pathways, suggesting that interaction with specific transcription factors might specify the proper timing or light-dependent responses. Deciphering the repertoire of chromatin remodelers and their interacting transcription factors will provide a view on the circadian and light-dependent epigenetic landscape amenable for mechanistic studies and timely regulation of transcription in plants., 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 © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: In recent years, the concept of living systematic review (LSR) has attracted the attention of many scholars and institutions. A growing number of studies have been conducted based on LSR methodology, but their focus direction is unclear. The objective of this study was to provide a comprehensive review of existing LSR-related studies and to analyse their whole picture and future trends with bibliometrics., Methods: A comprehensive search strategy was used to construct a representative dataset of LSRs up to October 2021. GraphPad V.8.2.1 and Mindmaster Pro presented the basic information of the included studies and the timeline of LSR development, respectively. The author and country cooperation network, hotspot distribution clustering, historical citation network and future development trend prediction related to LSR were visualised by VOSviewer V.1.6.16 and R-Studio V.1.4., Results: A total of 213 studies were eventually included. The concept of LSR was first proposed in 2014, and the number of studies has proliferated since 2020. There was a closer collaboration between author teams and more frequent LSR research development and collaboration in Europe, North America and Australia. Numerous LSR studies have been published in high-impact journals. COVID-19 is the predominant disease of concern at this stage, and the rehabilitation of its patients and virological studies are possible directions of research in LSR for a long time to come. A review of existing studies found that more than half of the LSR series had not yet been updated and that the method needed to be more standardised in practice., Conclusion: Although LSR has a relatively short history, it has received much attention and currently has a high overall acceptance. The LSR methodology was further practised in COVID-19, and we look forward to seeing it applied in more areas., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: This study aimed to examine changes in miRNAs expression profile of COPD patients., Methods: Thirty-six COPD patients as well as thirty-three healthy volunteers were recruited. Total RNAs were collected from the plasma of each participant. The differentially expressed miRNAs in COPD were screened from the GEO database. RT-qPCR was carried out to detect miRNA expression., Results: In total, 9 out of 55 miRNAs were expressed differentially in COPD patients. Confirmed by RT-qPCR validation, 6 miRNAs increased while 3 miRNAs decreased. Further analysis of miR-423-5p, which has not been reported in COPD, showed that AUC for the diagnosis of COPD was 0.9651, and miR-423-5p levels was inversely correlated with the duration of smoking., Conclusion: The present study demonstrates that miR-423-5p is a potential marker for identifying COPD patients., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2022 HCFMUSP. Published by Elsevier España, S.L.U. All rights reserved.)

To systematically review the clinical practice guidelines (CPGs) for the treatment of patients with coronavirus disease 2019 (COVID-19) using Chinese herbal medicine (CHM), assess the methodological quality as well as clinical credibility and implementability of specific recommendations, and summarize key recommendations., Methods: As of April 2022, we conducted a comprehensive search on major electronic databases, guideline websites, academic society websites, and government websites to assess the methodological quality and clinical applicability of the included CPGs using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool and Evaluation-Recommendations EXcellence (AGREE-REX) instructions, respectively., Results: The search yielded 61 CPGs, which were mostly published in 2020; moreover, 98.4% of the CPGs were published in China. Only five CPGs achieved a high-quality AGREE II rating; further, six CPGs could be directly recommended, with most of the CPGs still showing much room for improvement. CPGs had a low overall score in the AGREE-REX evaluation, with the domains of clinical applicability, values and preferences, and implementability being standardized in 21.80% ± 12.56%, 16.00% ± 11.81%, and 31.33% ± 14.55% of the CPGs, respectively. Five high-quality CPGs mentioned 56 Chinese herbal formulas. Half of the recommendations had moderate or strong evidence level in the GRADE evaluation. The most frequently recommended herbal medicines were Lianhua Qingwen granule/capsule and Jinhua Qinggan granule; however, the strength of recommendation for each prescription varied across CPGs and populations., Conclusions: The overall quality of current CPGs for COVID-19 for CHM still needs to be improved; moreover, the strength of the evidence remains to be standardized across CPGs., Graphical Abstract: http://links.lww.com/AHM/A34., Competing Interests: The authors declare no conflict of interest., (Copyright © 2022 Tianjin University of Traditional Chinese Medicine.)

COVID-19 vaccines have become an important hope for slowing down or stopping the pandemic. As the population ages, older adults will comprise a greater proportion of the vaccinated population. We aimed to assess influencing factors of COVID-19 vaccine hesitancy in older adults. For this aim, We conducted a cross-sectional study on a questionnaire survey of the elderly over 65 years living in the community of Haikou City from August 1st to September 30th, 2021. Univariate and multivariate Logistic regression analyses were performed to identify factors related to vaccine hesitancy. We analyzed completed questionnaires from 225 respondents (42.2% women, mean age 73.4±6.2 years). There were 99 people in the vaccine hesitation group and 126 people in the vaccine acceptance group, the incidence of vaccine hesitation in the elderly population is about44%（99/225）. The incidence of frailty in the vaccine hesitation group was much higher than that in the vaccine trust group (62.63 vs. 30.95%, P＜0.001). The risk factors of vaccine hesitancy in the elderly aged 70-75years and over 75 years were 2.987 times and 3.587 times higher than that in the population aged 65-70 years (OR=2.987,95%CI: 1.424-6.265, P＜0.001; OR=3.587,95% CI:1.804-7.131, P＜0.001). Frailty is also an independent risk factor of vaccine hesitancy in the elderly population (OR=2.624,95%CI: 1.447-4.757, P＜0.001). Then the vaccination rate of the COVID-19 vaccine is far from reaching the requirements of herd immunity, and more flexible and comprehensive efforts are needed to increase the vaccination willingness of the frail elderly.

The electrochemical oxidation of sensitive propargylic benzylic alcohols having varying substituents is reported. We describe the preparation and characterization of N -hydroxytetrafluorophthalimide (TFNHPI) and pseudo-high-throughput development of a green electrochemical oxidation protocol for sensitive propargylic benzylic alcohols that employs TFNHPI as a stable electrochemical mediator. The electrochemical oxidation of propargylic benzylic alcohols was leveraged to develop short synthetic pathways for preparing gram quantities of resveratrol natural products such as pauciflorols.

Background: Chronic obstructive pulmonary disease (COPD) is a chronic lung disease and the third leading cause of death in the world. Dexmedetomidine has been reported to effectively inhibit histamine-induced bronchoconstriction. However, the molecular mechanism of dexmedetomidine in COPD has not been found., Objective: To explore the role and mechanism of dexmedetomidine in COPD, and to provide theoretical basis for clinical treatment of COPD., Methods: The expression of miR-146a was regulated by mimics or inhibitor and the relative expression of apoptotic proteins p53, Bax and Bcl-2 in human bronchial epithelial 16HBE cells was determined by real-time PCR and Western blot. Dexmedetomidine was treated for 16HBE cells and alveolar epithelial type II cells (AEC2), the cell apoptosis was detected by TUNEL and Hoechst33342 staining. A COPD rat model was established by smoking to test the effects of dexmedetomidine on the progression of COPD. The levels of IL-6, IL-1β and TNF-α in serum were measured by ELISA and the protein concentration of bronchoalveolar lavage fluid (BALF) was also detected in dexmedetomidine treated COPD rat model., Results: miR-146a promoted 16HBE cell apoptosis and reduced cell proliferation. Additionally, dexmedetomidine was showed to reduce the 16HBEL cell apoptosis through reducing the expression of miR-146a. Moreover, dexmedetomidine regulated cell apoptosis and cell apoptosis through miR-146a in AEC2 cells. More importantly, dexmedetomidine attenuated the morphology and pathology of COPD rat model., Conclusion: Dexmedetomidine reduced 16HBE cells and AEC2 cell apoptosis and attenuated COPD by down-regulating miR-146a., (© 2021. The Genetics Society of Korea.)

Background: Adequate reduction and stabilization of the syndesmosis are significant to prevent early degeneration of the ankle joint and get better clinical outcomes. However, the routine surgical methods have diffierent limitations. The purpose of this study was to develop a novel double Endobutton fixation to treat the distal tibiofibular syndesmotic injuries, and determine whether the novel double Endobutton fixation demonstrates a better biomechanical property compare with the intact syndesmosis, the screw fixation and the Tightrope fixation., Methods: Twenty-four normal fresh-frozen ankle specimens with a mean age of 42 ± 8 (range, 28-62) years were randomly divided equally into four groups: (1) the intact group, (2) the screw group, (3) the Tightrope group, (4) the Endobutton group. 3D printer technology was used to establish the personalized distal tibiofibular syndesmotic navigation modules to determine the accurate bone tunnel. Axial loading was applied in five ankle positions: neutral position, dorsiflexion, plantar flexion, varus and valgus. Rotation torque was applied in two ankle rotation of the neutral position: internal and external., Results: In most situations, the displacements of the intact group were larger than the screw group, the Tightrope group and the Endobutton group (P < .05), and the displacements of the screw group were smaller than other three groups (P < .05). The displacements of the double Endobutton group were slightly larger than the Tightrope group but no significant differences were found between these two groups except in the dorsiflexion position of axial loading experiments (P < .05). The novel double Endobutton fixation was steadier than intact syndesmosis and more micromotional than screw fixation., Conclusion: Our study demonstrated that the novel double Endobutton can be considered as the better fixation in treatment of distal tibiofibular syndesmotic injuries., Level of Evidence: Level III, retrospective comparative study., (Copyright © 2021. Published by Elsevier Ltd.)

Purpose: To describe the results of a relifting flap enhancement procedure for correction of residual refractive error after primary lenticule intrastromal keratoplasty (LIKE)., Methods: Case report., Results: One year after a LIKE procedure in the left eye, the patient (uncorrected distance visual acuity [UDVA]: 20/25; corrected distance visual acuity [CDVA]: 20/20; manifest refraction: -1.00 +1.00 × 105°) underwent flap relifting. The WaveLight EX500 excimer laser platform (Alcon Laboratories, Inc) was used for the topography-guided enhancement procedure to correct the residual refractive error and corneal irregularities. During the 1-year follow-up period, the cornea remained clear, the UDVA increased to 20/20 (reaching the level of preoperative CDVA), and manifest refraction was -0.25 +0.75 × 90°., Conclusions: The enhancement procedure described in this case report was effective for correction of residual refractive error and improvement of visual acuity following the LIKE procedure. The enhancement was stable for at least 15 months after the procedure. [ J Refract Surg . 2021;37(10):715-719.] .

Purpose: To compare differences in visual, refractive, and ablating outcomes between corneal topography-guided laser in situ keratomileusis (LASIK) by SCHWIND AMARIS and WaveLight Contoura for myopia and myopic astigmatism correction., Setting: Department of Refractive Surgery, Guangzhou Aier Eye Hospital, Guangzhou, China., Design: Prospective nonrandomized study., Methods: Patients treated with LASIK to correct ametropia and corneal higher-order aberrations (HOAs) with 6.5 mm of plan optical zone were recruited. In the AMARIS platform, there were 2 centration strategies: the symmetric (AA) and asymmetric (AS) offset modes. In the WaveLight platform, there was only symmetric offset (ES) mode. HOAs, contrast sensitivity, effective optical zone (EOZ), ablation depth, and ablating center were evaluated 3 months after the operation., Results: The study included 138 eyes. At 3 months after operation, the postoperative manifest refractive spherical equivalent was 0.04 ± 0.34 diopters (D), 0.06 ± 0.25 D, and -0.09 ± 0.21 D in AS, AA, and ES groups, respectively (P = .018). The EOZs of the AS and AA groups were 5.01 mm and 4.96 mm, and both were larger than 4.88 mm in the ES group (P = .04 and .03, respectively). The ablation depth of the AS group was 103.6 μm, which were larger than 86.6 μm in the AA group and 91.2 μm in the ES group., Conclusions: The SCHWIND AMARIS and WaveLight EX500 corneal topography-guided LASIK achieved comparable and excellent visual and refractive outcomes. The EX500 Contoura LASIK ablated less corneal tissue because of the smaller EOZ compared with the AMARIS, with a similar plan optical zone., (Copyright © 2021 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.)

Background: Ewing sarcoma (ES) of bone is accounting for the second most common type of primary bone cancer in children and adolescents. However, the patterns of distant metastasis (DM) and the effect of the sites of DM on survival outcomes were not investigated., Aims: This study aimed to investigate the patterns of DM and the prognostic factors related to outcomes in primary metastatic ES of the bone., Methods: Patients who were diagnosed with primary metastatic ES between 2010 and 2018 were identified from the Surveillance, Epidemiology, and End Results database. Kaplan-Meier analysis, log-rank tests, and Cox proportional-hazards regression models were used for statistical analyses., Results: We identified 277 patients in this study and 95.3% of them (n = 264) receiving chemotherapy. A total of 371 sites of DM were observed. Lung was the most common distant metastatic site (n = 182, 49.1%), followed by bone (n = 139, 37.5%), distant lymph node (n = 26, 7.0%), liver (n = 14, 3.8%), and brain (n = 10, 2.7%). Three-year cause-specific survival (CSS) was 56.1% in the entire cohort. Older age (hazard ratio [HR] 2.210, P < 0.001) and bone metastasis (HR 1.903, P = 0.002) were the independent prognostic factors associated with inferior CSS. Similar results were found in those with bone-only metastasis (n = 80) or lung-only metastasis (n = 117), which showed that patients with bone-only metastasis had an inferior CSS compared to those with metastases only to the lung (HR 1.926, P = 0.005)., Conclusions: Lung and bone are the most frequently distant metastatic sites in patients with primary metastatic ES of bone. Bone metastasis is an independent risk factor for inferior survival., Competing Interests: 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., (© 2021 The Author(s).)

Tuberculosis (TB), an infectious disease caused by Mycobacterium tuberculosis ( M. tuberculosis ), is an important public health issue. Current first-line drugs administered to TB patients have been in use for over 40 years, whereas second-line drugs display strong side effects and poor compliance. Additionally, designing effective regimens to treat patients infected with multi- and extremely-drug-resistant (MDR and XDR) strains of TB is challenging. In this report, we screened our compound library and identified compound 1 with antituberculosis activity and a minimal inhibitory concentration (MIC) against M. tuberculosis of 20 μg mL -1 . Structure optimization and the structure-activity relationship of 1 as the lead compound enabled the design and synthesis of a series of quinolone derivatives, 6a1-6a2, 6b1-6b36, 6c1, 6d1-6d14, 7a1-7a2, 7b1-7b2, 7c1, 8a1-8a5, 9a1-9a4 and 10a1-10a6. These compounds were evaluated in vitro for anti-tubercular activity against the M. tuberculosis H 37 Rv strain. Among them, compounds 6b6, 6b12 and 6b21 exhibited MIC values in the range of 1.2-3 μg mL -1 and showed excellent activity against the tested MDR-TB strain (MIC: 3, 2.9 and 0.9 μg mL -1 , respectively). All three compounds were non-toxic toward A549 and Vero cells (>100 and >50 μg mL -1 , respectively). In addition, an antibacterial spectrum test carried out using compound 6b21 showed that this compound specifically inhibits M. tuberculosis . These can serve as a new starting point for the development of anti-TB agents with therapeutic potential., Competing Interests: We declare that we do not have any commercial or associative interest that represents a conflict of interest in connection with the manuscript submitted., (This journal is © The Royal Society of Chemistry.)

This paper proposes an optimized trajectory planner and motion planner framework, which aim to deal with obstacle avoidance along a reference road for autonomous driving in unstructured environments. The trajectory planning problem is decomposed into lateral and longitudinal planning sub-tasks along the reference road. First, a vehicle kinematic model with road coordinates is established to describe the lateral movement of the vehicle. Then, nonlinear optimization based on a vehicle kinematic model in the space domain is employed to smooth the reference road. Second, a multilayered search algorithm is applied in the lateral-space domain to deal with obstacles and find a suitable path boundary. Then, the optimized path planner calculates the optimal path by considering the distance to the reference road and the curvature constraints. Furthermore, the optimized speed planner takes into account the speed boundary in the space domain and the constraints on vehicle acceleration. The optimal speed profile is obtained by using a numerical optimization method. Furthermore, a motion controller based on a kinematic error model is proposed to follow the desired trajectory. Finally, the experimental results show the effectiveness of the proposed trajectory planner and motion controller framework in handling typical scenarios and avoiding obstacles safely and smoothly on the reference road and in unstructured environments.

Objective: This study aimed to investigate the effectiveness of risk scoring for predicting stroke recurrence after percutaneous patent foramen ovale (PFO) closure or medication therapy in patients with PFO and a history of cryptogenic stroke., Methods: This study included 559 patients with PFO and cryptogenic stroke who were treated in our hospital from January 2013 to January 2018 and were followed up for 15-72 months. After calculating the risk scores for stroke recurrence, we randomly divided the patients into two groups (ratio, 1:1): Patients in one group underwent PFO closure and those in the other received drug therapy., Results: Patients in the PFO closure group had a lower risk of recurrent stroke than those in the drug therapy group (1.1% vs. 4.2%). Moreover, serious bleeding was less frequent in the PFO closure group than in the drug therapy group (0% vs. 3.2%), although the incidence of atrial fibrillation or flutter did not significantly differ between the groups (p = 0.67). Interestingly, a subgroup analysis revealed no inter-treatment group difference in the rate of cryptogenic stroke recurrence among patients with risk scores of 0-1. By contrast, PFO closure yielded superior outcomes among patients with risk scores of ≥2., Conclusion: Compared with drug therapy, PFO closure reduced the risk of recurrent stroke among patients with a risk score of ≥2 and reduced the incidence of serious bleeding without increasing the risk of new-onset atrial fibrillation or atrial flutter.

Background: Xihuang pill has been widely applied as a promising adjunctive drug for gastric cance. However, the exact effects and safety of Xihuang pill have yet to be systematically investigated. We aimed to summarize the effificacy and safety of Xihuang pill for the treatment of advanced GC through the meta-analysis, in order to provide scientific reference for the design of future clinical trials., Methods: The protocol followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. Relevant randomized controlled trials were searched from PubMed, the Cochrane Library, Embase, the China National Knowledge Infrastructure, Wanfang Database, Chinese Science and echnology Periodical Database, and Chinese Biomedical Literature Database. Papers in English or Chinese published from their inception to October 2020 will be included without any restrictions. Cochrane Risk of Bias tool will be used to assess the risk of bias of included studies. The RevMan 5.4 and Stata 16.0 software will be applied for statistical analyses. Statistical heterogeneity will be computed by I2 tests. Sensitivity analysis will be conducted to evaluate the stability of the results. The publication bias will be evaluated by funnel plots and Egger test. The quality of evidence will be assessed by the Grading of Recommendations Assessment, Development and Evaluate system., Results: The results of our research will be published in a peer-reviewed journal., Conclusion: The conclusion of this study will provide helpful evidence of the effect and safety of Xihuang pill for the treatment of GC in clinical practice., Osf Registration Number: 10.17605/OSF.IO/VFJAK., Competing Interests: The authors have no conflicts of interests to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Tripartite motif (TRIM) proteins are RING E3 ubiquitin ligases defined by a shared domain structure. Several of them are implicated in rare genetic diseases, and mutations in TRIM32 and TRIM-like malin are associated with Limb-Girdle Muscular Dystrophy R8 and Lafora disease, respectively. These two proteins are evolutionary related, share a common ancestor, and both display NHL repeats at their C-terminus. Here, we revmniew the function of these two related E3 ubiquitin ligases discussing their intrinsic and possible common pathophysiological pathways.

It is essential to know the normal range of the interocular symmetry of the cornea (ISC) for keratoconus diagnosis and corneal substitutes design. In the present study we investigated the interocular symmetry of corneal biometrics in 6,644 Chinese myopic patients from multiple ophthalmic centers. Corneal biometrics of both eyes were exported from the Pentacam instrument. Interocular symmetry of the corneal biometrics was analyzed by Spearman's correlation test, intraclass correlation coefficient (ICC) analysis and Bland-Altman plot. Significantly strong interocular correlations were found in anterior and posterior corneal curvatures, corneal diameter, corneal thickness, corneal volume, corneal eccentricity, and corneal asphericity (r = 0.87-0.98, all P < 0.001). Moderate interocular correlations were observed in whole corneal astigmatism (r = 0.78) and posterior corneal astigmatism (r = 0.73). ICC between the right and left eyes was 0.94-0.98 for anterior and posterior corneal curvatures, corneal diameter, corneal thickness and corneal volume, 0.80-0.88 for corneal eccentricity and asphericity, and 0.73-0.79 for corneal astigmatism (all P < 0.001). Bland-Altman plot showed that the 95% limit of agreement between both eyes was narrow and symmetric in most of the corneal biometrics, suggesting strong interocular agreements in these corneal biometrics. In conclusion, significant interocular symmetry of corneal biometrics is observed in Chinese myopia patients. Extra attention should be paid to patients with interocular corneal asymmetry.

Abstract: To compare the safety and efficiency of simple corneal topography-guided (T-CAT) photorefractive keratectomy (PRK) and T-CAT PRK combined with crosslinking (CXL) to correct myopia with borderline suspicious tomography.Eyes with suspicious tomography (not classified as forme fruste keratoconus) underwent PRK combined with CXL. The suspicious tomography showed irregular posterior corneal morphology or maximum elevation value of the central 6 mm zone of the posterior surface (MEL) >15 μm, or Belin/Ambrósio Enhanced Ectasia Index (BAD-D) was >1.6. The PRK group was generated and matched within 2 μm for MEL, 0.3 for BAD-D value, and 0.5 D for manifest refractive spherical equivalent (MRSE) compared with the PRK-CXL group.PRK-CXL exhibited a larger MRSE (0.09 ± 0.22 D vs -0.03 ± 0.24 D, P = .02) and a larger sphere (0.14 ± 0.22 D vs 0.01 ± 0.21 D, P = .002) compared with PRK alone at 18 months postoperatively. The magnitude change and relative change rate of stiffness parameter A1 in the PRK-CXL were smaller than in the PRK group (-15.72 ± 14.56 vs -19.95 ± 14.37, P = .04, for magnitude change and -0.16 ± 0.15 vs -0.20 ± 0.14, P = .02, for relative change rate). In the PRK-CXL and PRK groups, 4.8% and 6.9% of eyes suffered grade 0.5 haze at postoperative 18-month. No cases of ectasia were reported in either group.PRK in combination with prophylactic crosslinking showed comparable safety and efficacy, but higher biomechanical stability compared to PRK alone, thus, the additional CXL plays a measurable role in reducing the change in corneal biomechanical properties after PRK in suspicious eyes., Competing Interests: The authors have no financial conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Perception of road structures especially the traffic intersections by visual sensors is an essential task for automated driving. However, compared with intersection detection or visual place recognition, intersection re-identification (intersection re-ID) strongly affects driving behavior decisions with given routes, yet has long been neglected by researchers. This paper strives to explore intersection re-ID by a monocular camera sensor. We propose a Hybrid Double-Level re-identification approach which exploits two branches of Deep Convolutional Neural Network to accomplish multi-task including classification of intersection and its fine attributes, and global localization in topological maps. Furthermore, we propose a mixed loss training for the network to learn the similarity of two intersection images. As no public datasets are available for the intersection re-ID task, based on the work of RobotCar, we propose a new dataset with carefully-labeled intersection attributes, which is called "RobotCar Intersection" and covers more than 30,000 images of eight intersections in different seasons and day time. Additionally, we provide another dataset, called "Campus Intersection" consisting of panoramic images of eight intersections in a university campus to verify our updating strategy of topology map. Experimental results demonstrate that our proposed approach can achieve promising results in re-ID of both coarse road intersections and its global pose, and is well suited for updating and completion of topological maps.

Purpose: To describe the visual outcomes of correcting moderate to high hyperopia after two different surgical procedures of lenticular implantation., Methods: This prospective small case series study used epikeratophakia combined with transepithelial phototherapeutic keratectomy (PTK-EP) and femtosecond laser-assisted lenticule intrastromal keratoplasty (LIKE) using myopic small incision lenticule extraction (SMILE)-derived refractive lenticule for correcting hyperopia ranging from +3.00 to +10.00 diopters (D). The implanted refractive lenticule was matched with the recipient's manifest refraction. The visual, refractive, corneal tomographic, and epithelial thickness outcomes were analyzed after surgery., Results: Four eyes underwent PTK-EP and 6 eyes underwent LIKE. At the last postoperative visit, 6 of 10 eyes had uncorrected distance visual acuity equal to or better than the preoperative corrected distance visual acuity (CDVA). No eyes lost one line or more of CDVA postoperatively. Postoperative spherical equivalent was within ±0.50 D of the target for 9 of 10 eyes. Posterior corneal curvature slightly steepened for PTK-EP and LIKE. Postoperative epithelial thickness demonstrated the expected doughnut pattern in both groups characterized by epithelium in the central zone (5 mm) thinner than that in the peripheral zone (5 to 7 mm)., Conclusions: Visual outcomes, refraction, posterior corneal surface changes, and epithelial remodeling after PTKEP or LIKE show a potentially useful modality for correcting moderate to high hyperopia. [J Refract Surg. 2020;36(11):772-779.]., (Copyright 2020, SLACK Incorporated.)

Ochratoxin A (OTA) is a toxic secondary metabolite produced mainly by Penicillium spp. and Aspergillus spp. and commonly found in foodstuffs and feedstuffs. Carboxypeptidase A (CPA) can hydrolyze OTA into the non-toxic product ochratoxin α, with great potential to realize industrialized production and detoxify OTA in contaminated foods and feeds. This study constructed a P. pastoris expression vector of mature CPA (M-CPA) without propeptide and signal peptide. The results showed that the degradation rate of OTA by M-CPA was up to 93.36%. Its optimum pH was 8, the optimum temperature was 40 °C, the value of K m was 0.126 mmol/L, and the maximum reaction rate was 0.0219 mol/min. Compared with commercial CPA (S-CPA), the recombinant M-CPA had an improve stability, for which its optimum temperature increased by 10 °C and stability at a wide range pH, especially at pH 3-4 and pH 11. M-CPA could effectively degrade OTA in red wine. M-CPA has the potential for industrial applications, such as can be used as a detoxification additive for foods and feeds.

As one of the core issues of autonomous vehicles, vehicle motion control directly affects vehicle safety and user experience. Therefore, it is expected to design a simple, reliable, and robust path following the controller that can handle complex situations. To deal with the longitudinal motion control problem, a speed tracking controller based on sliding mode control with nonlinear conditional integrator is proposed, and its stability is proved by the Lyapunov theory. Then, a linear parameter varying model predictive control (LPV-MPC) based lateral controller is formulated that the optimization problem is solved by CVXGEN. The nonlinear active disturbance rejection control (ADRC) method is applied to the second lateral controller that is easy to be implemented and robust to parametric uncertainties and disturbances, and the pure pursuit algorithm serves as a benchmark. Simulation results in different scenarios demonstrate the effectiveness of the proposed control schemes, and a comparison is made to highlight the advantages and drawbacks. It can be concluded that the LPV-MPC has some trouble to handle uncertainties while the nonlinear ADRC performs slight worse tracking but has strong robustness. With the parallel development of the control theory and computing power, robust MPC may be the future direction.

Background: Xihuang pill, a famous traditional Chinese medicine formulation, is a broad-spectrum anti-tumor drug and has been widely used for the treatment of lung cancer in China. The aim of this study is to systematically investigate the efficacy and safety of Xihuang pill for the treatment of lung cancer., Methods: We will perform the comprehensive literature search in the following databases from their inceptions to August 2020 for data extraction: PubMed, the Cochrane Library, Embase, the China National Knowledge Infrastructure, Wanfang Database, Chinese Science and Technology Periodical Database, and Chinese Biomedical Literature Database. Cochrane Risk of Bias tool will be used to assess the risk of bias of included studies. The RevMan 5.4 and Stata 16.0 software will be applied for statistical analyses. Statistical heterogeneity will be computed by I tests. Sensitivity analysis will be conducted to evaluate the stability of the results. The publication bias will be evaluated by funnel plots and Egger test. The quality of evidence will be assessed by the Grading of Recommendations Assessment, Development and Evaluate system (GRADE) system., Results: The results of our research will be published in a peer-reviewed journal., Conclusion: The conclusion of this study will provide evidence to show whether Xihuang pill is an effective intervention for patient with lung cancer., Osf Registration Number: 10.17605/OSF.IO/W2GHN.

Including posterior corneal astigmatism (PCA) into consideration may increase the accuracy of astigmatism correction after corneal refractive surgery. In the present study we aim to investigate the distribution pattern of PCA in a large number of myopic patients from multiple ophthalmic centers. There were 7829 eyes retrospectively included in the study. Pentacam data of the eyes were retrieved from the machine and only results with image quality labelled with 'OK' were included. Distribution of PCA was slightly positively skewed (Skewness = 0.419, Kurtosis = 0.435, KS P < 0.0001). Mean PCA was 0.34 ± 0.14 D (range: 0.00 D-0.99 D). PCA was ≥ 0.25 D in 74.91% of the eyes and was ≥ 0.50 D in 11.61% of the eyes. In 97.55% of the eyes the steep meridian of PCA was vertical (SMV). PCA magnitude was significantly higher in eyes with SMV PCA (P < 0.0001) or high manifest astigmatism (MA, P < 0.0001). There was a significant correlation between anterior corneal astigmatism (ACA) magnitude and PCA magnitude in all of the eyes (r = 0.704, P < 0.0001). There was also a trend of decreasing frequency and magnitude of SMV PCA with aging (both P < 0.0001). In conclusion, PCA is present in myopic patients having corneal refractive surgery and PCA magnitude is increased with higher MA or ACA. Consideration of the impact of PCA on laser astigmatism correction may be necessary.

The fate of mesenchymal stem cells (MSCs) is regulated by biological, physical and chemical signals. Developments in biotechnology and materials science promoted the occurrence of bioactive materials which can provide physical and chemical signals for MSCs to regulate their fate. In order to design and synthesize materials that can precisely regulate the fate of MSCs, the relationship between the properties of materials and the fate of mesenchymal stem cells need to be clarified, in which the detection of the fate of mesenchymal stem cells plays an important role. In the past 30 years, a series of detection technologies have been developed to detect the fate of MSCs regulated by bioactive materials, among which high-throughput technology has shown great advantages due to its ability to detect large amounts of data at one time. In this review, the latest research progresses of detecting the fate of MSCs regulated by bone bioactive materials (BBMs) are systematically reviewed from traditional technology to high-throughput technology which is emphasized especially. Moreover, current problems and the future development direction of detection technologies of the MSCs fate regulated by BBMs are prospected. The aim of this review is to provide a detection technical framework for researchers to establish the relationship between the properties of BMMs and the fate of MSCs, so as to help researchers to design and synthesize BBMs better which can precisely regulate the fate of MSCs., Competing Interests: No conflict of interest exsits., (© 2020 [The Author/The Authors].)

Objectives: This study aimed to evaluate the predictive validity of the day-1 PELOD-2 and day-1 "quick" PELOD-2 (qPELOD-2) scores for in-hospital mortality in children with sepsis in a pediatric intensive care unit (PICU) of a developing country., Methods: The data of 516 children diagnosed as sepsis were retrospectively analyzed. The children were divided into survival group and non-survival group, according to the clinical outcome 28 days after admission. Day-1 PELOD-2, day-1 qPELOD-2, pediatric SOFA (pSOFA), and P-MODS were collected and scored. Receiver operating characteristic (ROC) curves were plotted, and the efficiency of the day-1 PELOD-2, day-1 qPELOD-2 score, pSOFA, and P-MODS for predicting death were evaluated by the area under the ROC curve (AUC)., Results: The day-1 PELOD-2 score, day-1 qPELOD-2 score, pSOFA, and P-MODS in the non-survivor group were significantly higher than those in the survivor group. ROC curve analysis showed that the AUCs of the day-1 PELOD-2 score, day-1 qPELOD-2 score, pSOFA, and P-MODS for predicting the prognosis of children with sepsis in the PICU were 0.916, 0.802, 0.937, and 0.761, respectively (all p < 0.05)., Conclusions: Both the day-1 PELOD-2 score and day-1 qPELOD-2 score were effective and able to assess the prognosis of children with sepsis in a PICU of a developing country. Additionally, the day-1 PELOD-2 score was superior to the day-1 qPELOD-2 score. Further studies are needed to verify the usefulness of the day-1 qPELOD-2 score, particularly outside of the PICU., (Copyright © 2019 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.)