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Abstract Background Carotid artery dissection is an important cause of stroke. However, the predictors of ischemic stroke in patients with carotid artery dissection are controversial. The study aimed to analyze the predictors of ischemic stroke in patients with carotid artery dissection through retrospective medical records. Methods Data of discharged patients diagnosed with carotid artery dissection during 2019–2023 were retrospectively collected. Based on the occurrence of ischemic stroke, the patients were divided into the ischemic stroke or non-ischemic stroke groups. Based on the results of univariate analyses, variables with an associated P value

Abstract Caffeine and halloysite nanoclay mineral that are bio-based compounds were utilized to synthesize a novel Lewis acid heterogeneous catalyst. To this aim, halloysite was functionalized with 2,4,6-trichloro-1,3,5-triazine and reacted with caffeine, which was then converted to ionic liquid via a reaction with ZnCl2. The catalyst was applied for promoting the dehydration of fructose to 5-hydroxymethylfurfural. To investigate the effects of the reaction variables, response surface methodology was used. The product was achieved in 98.5% in 100 min using a catalyst loading of 30 wt% at 100 °C. Moreover, the catalyst was recyclable up to six runs with slight zinc leaching. Comparison of the catalytic activity of the catalyst with that of halloysite and a control catalyst with one caffeine-based Lewis acid ionic liquid confirmed the superior activity of the former and the important role of 2,4,6-trichloro-1,3,5-triazine for increasing the number of the grafted caffeine and thus the acidic sites of the catalyst. A plausible reaction mechanism was proposed, and the activity of the catalyst for other carbohydrates was also studied. According to the results, this catalyst catalyzed the reaction of other substrates to furnish 5-hydroxymethylfurfural in low to moderate yields. According to the kinetic studies, the activation energy was estimated to be 22.85 kJ/mol.

Abstract Background Previous studies have highlighted several problems in the implementation of multidisciplinary treatment (MDT) from a managerial perspective. However, no study has addressed these issues from clinicians’ perspective. Therefore, this study aimed to identify and address the existing problems in MDT by investigating what clinicians know and think about the implementation of MDT. Methods A self-designed questionnaire was used to evaluate clinicians’ understanding of MDT in municipal public Class III Grade A hospitals in Western China using a cross-sectional questionnaire study. Results Overall, 70.56% of clinicians knew the scope of MDT, and 63.41% knew the process of MDT. Professional title (P = 0.001; OR: 2.984; 95% CI: 1.590–5.603), participated in MDT (P = 0.017; OR: 1.748; 95% CI: 1.103–2.770), and application for MDT (P = 0.000; OR: 2.442; 95% CI: 1.557–3.830) had an impact on clinicians’ understanding of the scope of MDT. Professional title (P = 0.002; OR:2.446; 95% CI: 1.399–4.277) and participation in MDT (P = 0.000; OR: 2.414; 95% CI: 1.581–3.684) influenced clinicians’ understanding of the scope of MDT. More than 70% of the respondents thought that MDT was important in medical care. However, less than half of the clinicians who had attended MDT were currently satisfied with the results of MDT. Conclusion Most clinicians agreed that MDT was crucial in clinical care. However, more than a third of clinicians did not fully understand the scope and process of MDT. Appropriate measures are necessary to improve the quality of MDT. Our study suggests that healthcare administration should strengthen MDT education, especially for new and young clinicians.

Abstract Introduction Patients with a single subcortical infarction (SSI) in the territory of the middle cerebral artery (MCA) often experience early neurological deterioration (END) despite receiving intravenous thrombolytic therapy (IVT). In this study, predictors of END were investigated in patients with SSI in the MCA after IVT. Methods Patients with SSI in the MCA territory who had received IVT between June 2020 and 2022 were included. END was defined as an increase in the total National Institutes of Health Stroke Scale (NIHSS) score by ≥2 or in the motor NIHSS score by ≥1 within the first 72 h of admission. Patients with proximal (pSSI) and distal SSI (dSSI) were analyzed to determine SSI type‐specific predictors for END. Results We evaluated 174 patients with SSI in the MCA territory who underwent IVT. Multivariable logistic regression analysis showed that pSSI (odds ratio [OR] = 0.242; 95% confidence interval [CI], 0.104–0.564; p = .001), lower high‐density lipoprotein cholesterol (HDL‐C) (OR = 0.150; 95% CI, 0.033–0.682; p = .014), higher blood glucose (OR = 0.858; 95% CI, 0.752–0.979; p = .023), and higher red blood cells count (OR = 1.966; 95% CI, 1.154–3.349; p = .013) were risk factors for END. In patients with pSSI, HDL‐C and blood glucose were associated with END. No variable related to END was found in the dSSI group. Conclusions The proportion of END in patients with SSI in the MCA territory after IVT was not low; therefore, pSSI, HDL‐C, blood glucose, and red blood cells should be monitored closely. The frequency and predictors of SSI in the MCA territory differed between pSSI and dSSI.

Abstract In an attempt to prepare a low-cost and efficient acidic heterogeneous catalyst for the conversion of fructose to 5-hydroxymethylfurfural under mild reaction conditions, the acidity of halloysite was improved by covalent grafting of an acidic polyionic liquid. More precisely, halloysite was first vinyl functionalized and then polymerized with vinyl imidazole and 2-acrylamido-2-methylpropanesulfonic acid. The tangling imidazole rings were further converted to acidic ionic liquids by treating them with chlorosulfuric acid. UV–Vis spectroscopy and Hammett equation confirmed that conjugation of acid polyionic liquid resulted in the increase of the acidity of halloysite. Investigation of the efficiency of the catalyst for the synthesis of 5-hydroxymethylfurfural and optimization of reaction variables showed that 5-hydroxymethylfurfural was yielded in 97.8% after 30 min under the optimum conditions, i.e. catalyst loading of 20 wt% at 70 °C. Notably, the catalyst was highly reusable and it could be reused for at least seven reaction runs with insignificant loss of its activity. Furthermore, this catalyst could also promote the conversion of sucrose and maltose to give moderate yields of 5-hydroxymethylfurfural.

Abstract Background The mastery and application of the “Plan-Do-Check-Act” (PDCA) cycle by hospital clinical department managers are essential for hospitals to carry out total quality management and continuously improve medical quality. This study investigated the degree of cognition of the PDCA cycle by clinical department managers and the factors affecting their cognition. Methods A self-designed questionnaire was used to evaluate the cognition of clinical department managers regarding the PDCA cycle in 11 municipal public Class III Grade A hospitals in Western China. Results More than 25% of clinical department managers in the surveyed hospitals are unaware or partially aware of the PDCA cycle. Logistic regression analysis showed that sex (P = 0.049), education (P

Plasma lipidomics has been commonly used for biomarker discovery. Studies in cancer have suggested a significant alteration of circulating metabolite profiles which is correlated with cancer characteristics and treatment outcome. However, the lipidomics characteristics of nasopharyngeal carcinoma (NPC) have rarely been studied. We previously described the phenomenon of lipid droplet accumulation in NPC cells and showed that such accumulation could be regulated by latent infection of Epstein–Barr virus (EBV). Here, we compared the plasma lipidome of NPC patients to that of healthy controls by liquid chromatography-tandem mass spectrometry (LC–MS/MS). We found 19 lipids (e.g., phosphatidylinositols 18:0/20:4 and 18:0/18:2 and free fatty acid 22:6) to be remarkably decreased, whereas 2 lipids (i.e., diacylglycerols 16:0/16:1 and 16:0/20:3) to be increased, in the plasma of NPC patients, compared with controls. Different lipid profiles were also observed between patients with different titers of EBV antibodies (e.g., EA-IgA and VCA-IgA) as well as between patients with and without lymph node or distant organ metastasis. In conclusion, plasma lipidomics might help to differentiate NPC cases from controls, whereas EBV infection might influence the risk and prognosis of NPC through modulating lipid metabolism in both tumor cells and peripheral blood.

Abstract Background The high morbidity, mortality, and disability rates of stroke constitute a heavy burden to the society. The level of understanding about stroke warning symptoms and first aid systems among community residents was generally low. The aim of our work is to investigate stroke-related knowledge in community residents of Jinjiang district of Chengdu and to raise public awareness about stroke through an intensive educational program. Methods Nine communities in Jinjiang district were sampled and a questionnaire about stroke-related knowledge was applied before and after stroke educational activities. We analyzed the impact of such activities in stroke recognition and management. Results We collected 1685 valid questionnaires. The awareness about stroke risk before educational activities was 11.4%. The recognition of stroke warning signs among community residents was 29.8–59.5%. Among them, the recognition of major signs, such as limb weakness, language disorder, and imbalance was more than 50%. When faced with five stroke warning signs, the proportion of participants who chose to make an emergency call was 41.5%. Less than 10% of the participants chose to consult a doctor, take medicine, or wait. After strengthening publicity and educational activities regarding stroke, there was a significant improvement in the identification of stroke risk factors, warning signs, and stroke management. The percentage of participants who chose to make an emergency call increased from 53.2 to 82.7%. Conclusions The knowledge about stroke among community residents in Jinjiang District of Chengdu was low. Strengthening publicity and educational activities may raise awareness about stroke prioritizing call emergency after the onset of stroke signs.

Lipid is the building block and an important source of energy, contributing to the malignant behavior of tumor cells. Recent studies suggested that lipid droplets (LDs) accumulations were associated with nasopharyngeal carcinoma (NPC) progression. Solute carrier family 27 member 6 (SLC27A6) mediates the cellular uptake of long-chain fatty acid (LCFA), a necessary lipid component. However, the functions of SLC27A6 in NPC remain unknown. Here, we found a significant reduction of SLC27A6 mRNA in NPC tissues compared with normal nasopharyngeal epithelia (NNE). The promoter methylation ratio of SLC27A6 was greater in NPC than in non-cancerous tissues. The demethylation reagent 5-aza-2’-deoxycytidine (5-aza-dC) remarkably restored the mRNA expression of SLC27A6, suggesting that this gene was downregulated in NPC owing to DNA promoter hypermethylation. Furthermore, SLC27A6 overexpression level in NPC cell lines led to significant suppression of cell proliferation, clonogenicity in vitro, and tumorigenesis in vivo. Higher SLC27A6 expression, on the other hand, promoted NPC cell migration and invasion. In particular, re-expression of SLC27A6 faciliated epithelial-mesenchymal transition (EMT) signals in xenograft tumors. Furthermore, we observed that SLC27A6 enhanced the intracellular amount of triglyceride (TG) and total cholesterol (T-CHO) in NPC cells, contributing to lipid biosynthesis and increasing metastatic potential. Notably, the mRNA level of SLC27A6 was positively correlated with cancer stem cell (CSC) markers, CD24 and CD44. In summary, DNA promoter hypermethylation downregulated the expression of SLC27A6. Furthermore, re-expression of SLC27A6 inhibited the growth capacity of NPC cells but strengthened the CSC markers. Our findings revealed the dual role of SLC27A6 in NPC and shed novel light on the link between lipid metabolism and CSC maintenance.

The dysregulation of epigenetic modification and energy metabolism cooperatively contribute to the tumorigenesis of nasopharyngeal carcinoma (NPC). However, the detailed mechanisms underlying their joint contribution to NPC development and progression remain unclear. Here, we investigate the role of Acy1 Coenzyme A Acyltransferases1 (ACAT1), a key enzyme in the metabolic pathway of ketone bodies, in the proliferation and metastasis of NPC and to elucidate the underlying molecular mechanisms. Ketogenesis, plays a critical role in tumorigenesis. Previously, we reported two enzymes involved in ketone body metabolism mediate epigenetic silencing and act as tumor suppressor genes in NPC. Here, we identify another key enzyme, Acetyl-CoA acetyltransferase 1 (ACAT1), and show that its transcriptional inactivation in NPC is due to promoter hypermethylation. Ectopic overexpression of ACAT1 significantly suppressed the proliferation and colony formation of NPC cells in vitro. The migratory and invasive capacity of NPC cells was inhibited by ACAT1. The tumorigenesis of NPC cells overexpressing ACAT1 was decreased in vivo. Elevated ACAT1 in NPC cells was accompanied by an elevated expression of CDH1 and a reduced expression of vimentin and SPARC, strongly indicating that ACAT1 is involved in regulating epithelial-mesenchymal transition (EMT). We also found that ACAT1 contributes to increased intracellular levels of β-hydroxybutyrate (β-HB). Exogenously supplied β-HB significantly inhibits the growth of NPC cells in a dose-dependent manner. In summary, ACAT1 may function as a tumor suppressor via modulation of ketogenesis and could thus serve as a potential therapeutic target in NPC. In summary, our data suggest that regulation of ketogenesis may serve as adjuvant therapy in NPC.

In the machine tool, geometric errors would largely influence the machining accuracy. The geometric errors include the Position Dependent Geometric Errors (PDGEs) and the Position Independent Geometric Errors (PIGEs), and the squareness errors are important PIGEs influencing the volumetric error largely. The measurement of the squareness errors are usually with low accuracy considering the overall error modeling and compensation. The other PDGEs such as the straightness errors and angle errors of corresponding axes are coupled with squareness errors or the Abbe errors are integrated in the measurement process of squareness errors, which is usually ignored in the overall error compensation. New method to obtain the accurate value of squareness errors to improve the volumetric accuracy is investigated considering the aspects. This paper proposes a new method to measure and identify the squareness errors of machine tools considering the volumetric accuracy based on the volumetric error model. The volumetric error model based on screw theory is proposed and then the identification method for the squareness errors is deduced in theory considering a 3-axis horizontal machine tool. Experiments with the measuring method and other traditional measuring methods have verified that the 3 identified squareness errors are in accordance with the measured square- ness within the accuracy range. Moreover, the 6 face diagonal errors are calculated with the identified squareness errors and other squareness errors in different methods, which are compared with the measured face diagonal errors. It shows that compared with the traditional measurement of squareness errors, the proposed method shows more ef- fective in the volumetric error evaluation process. [ABSTRACT FROM AUTHOR]

Large multi-axis propeller-measuring machines have two types of geometric error, position-independent geometric errors (PIGEs) and position-dependent geometric errors (PDGEs), which both have significant effects on the volumetric error of the measuring tool relative to the worktable. This paper focuses on modeling, identifying and compensating for the volumetric error of the measuring machine. A volumetric error model in the base coordinate system is established based on screw theory considering all the geometric errors. In order to fully identify all the geometric error parameters, a new method for systematic measurement and identification is proposed. All the PIGEs of adjacent axes and the six PDGEs of the linear axes are identified with a laser tracker using the proposed model. Finally, a volumetric error compensation strategy is presented and an inverse kinematic solution for compensation is proposed. The final measuring and compensation experiments have further verified the efficiency and effectiveness of the measuring and identification method, indicating that the method can be used in volumetric error compensation for large machine tools. [ABSTRACT FROM AUTHOR]