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Tracheostomy is a common surgical procedure for securing a patent airway. Anatomical variations of major vessels overlying the trachea may pose significant bleeding risk during the procedure. Hence, thorough preoperative assessment of the neck and surgeon’s intraoperative vigilance are essential. Open tracheostomy is a safer option than percutaneous dilatational tracheostomy. Extra caution with stoma wound care and change of tracheostomy tube are necessary postoperatively if any major vessel is detected in close proximity with the tracheal stoma.

Background: The etiology of systemic lupus erythematosus (SLE) is complex, and the disease is thus difficult to cure. In this regard, it has been established that SLE patients are characterized by differing levels of vitamin D-hydroxylation; however, the direct effects of vitamin D (VitD) in these patients remain unknown. Objective: Therefore, we investigated the effects and mechanisms of action of VitD in the context of SLE. Methods: The effects of VitD on MRL/LPR mice were studied by synthesizing glycogen synthase kinase-3β (GSK-3β)-interfering lentiviruses and transfecting with miR-126a-5p mimics. Changes in the body weight of mice were recorded for 6 weeks. Western blotting was performed to determine the levels of T-bet, GATA3, and GSK-3β protein expression, and qRT-PCR was performed to determine the levels of miR-126a-5p and GSK-3β mRNA expression. ELISA was performed to determine the levels of ANA, dsDNA, and snRNP/Sm in mice serum. Results: GSK-3β and miR-126a-5p were expressed at high and low levels, respectively, in MRL/LPR mice. VitD (30 ng/kg) was found to reduce the expression of GSK-3β and increase miR-126a-5p expression, which targets GSK-3β. T-bet and GATA3 were found to be positively regulated by miR-126a-5p and VitD and negatively regulated by GSK-3β. The body weight of mice was not altered by VitD. ANA, dsDNA, and snRNP/Sm were positively regulated by miR- 126a-5p and VitD and negatively regulated by GSK-3β. The effects of GSK-3β were enhanced in response to the inhibition of miR-126a-5p expression. Conclusion: VitD upregulated miR-126a-5p to target GSK-3β expression, thereby alleviating the SLE in MRL/LPR mice.

Acrobot, which is also called gymnastic robot, is a single input-multi output (SIMO) system which imitates motion of a barbell athlete. However, two links of this model are just equivalent to body and hand of athlete. To imitate better motion of athlete, three-linked acrobot- a complicated multi input-multi output (MIMO) under-actuated system – is developed. Parts of barbell athlete including leg, body and hand, are modelled well by this new system. In this paper, we present a method to apply an 81-rule fuzzy algorithm, which is popularly used for invert pendulum systems, to balance this model at upward equilibrium point. Instead of using a complicated 729-rule fuzzy controller which is set by knowledge of experts, we use more simple fuzzy structure. Through genetic algorithm (GA), the pre-processing and post-processing coefficients of fuzzy controller are chosen. With these suitable coefficients, our fuzzy controller is proved to work well through Matlab/Simulink simulation.

Corneal epithelial healing after refractive surgery is a clinically significant issue, especially for surface ablation procedures, and this can be monitored using optical coherence tomography (OCT). The aim of this work is to investigate the corneal epithelial thickness and irregularity by OCT after transepithelial photorefractive keratectomy (t-PRK) and analyse its correlation with visual and refractive outcomes. Patients aged ≥18 years with myopia, with or without astigmatism, who underwent t-PRK between May 2020 and August 2021 were included. All participants were subjected to complete ophthalmic examinations and OCT pachymetry at every follow-up visit. Patients were followed up at 1 week and 1, 3, and 6 months postoperatively. A total of 67 patients (126 eyes) were enrolled in this study. One month postoperatively, spherical equivalent refraction and visual acuity achieved preliminary stability. However, central corneal epithelial thickness (CCET) and standard deviation of the corneal epithelial thickness (SDcet) took 3–6 months to progressive recovery. Patients with higher baseline spherical equivalent refraction were associated with slower epithelial recovery. At every follow-up time point, a significant superior-inferior difference in the minimum corneal epithelial thickness area was observed. Higher stromal haze was correlated with higher spherical equivalent refraction (both baseline and residual) but had no relation with visual outcomes. There was a significant correlation between higher CCET with a better uncorrected distance visual acuity and lower corneal epithelial thickness irregularity. CCET and SDcet measured by OCT seem to be a good auxiliary indicator for reflecting the status of corneal wound recovery after t-PRK surgery. However, a well-designed randomised control study is needed to confirm the study results.

Background WNT974 is a small molecule inhibitor of Wnt signaling that specifically inhibits porcupine O-acyltransferase. This phase Ib dose-­escalation study evaluated the maximum tolerated dose of WNT974 in combination with encorafenib and cetuximab in patients with BRAF V600E-mutant metastatic colorectal cancer with RNF43 mutations or RSPO fusions. Patients and Methods Patients received once-daily encorafenib and weekly cetuximab, in addition to once-daily WNT974, in sequential dosing cohorts. In the first cohort, patients received 10-mg WNT974 (COMBO10), which was reduced in subsequent cohorts to 7.5-mg (COMBO7.5) or 5-mg (COMBO5) after dose–limiting toxicities (DLTs) were observed. Primary endpoints were incidence of DLTs and exposure to WNT974 and encorafenib. Secondary endpoints were anti-tumor activity and safety. Results Twenty patients were enrolled (COMBO10, n = 4; COMBO7.5, n = 6; COMBO5, n = 10). DLTs were observed in 4 patients, including grade 3 hypercalcemia (COMBO10, n = 1; COMBO7.5, n = 1), grade 2 dysgeusia (COMBO10, n = 1), and lipase increased (COMBO10, n = 1). A high incidence of bone toxicities (n = 9) was reported, including rib fracture, spinal compression fracture, pathological fracture, foot fracture, hip fracture, and lumbar vertebral fracture. Serious adverse events were reported in 15 patients, most frequently bone fracture, hypercalcemia, and pleural effusion. The overall response rate was 10% and disease control rate 85%; most patients achieved stable disease as their best response. Conclusion Concerns surrounding the safety and lack of preliminary evidence of improved anti-tumor activity of WNT974 + encorafenib + cetuximab, compared with previous encorafenib + cetuximab data, ultimately led to study discontinuation. Phase II was not initiated. Trial registration ClinicalTrials.gov, NCT02278133

C84H78N4O28Dy2, triclinic, P 1 ‾ $P\overline{1}$ (no. 2), a = 12.3134(5) Å, b = 12.7705(5) Å, c = 14.5150(6) Å, α = 70.852(1)°, β = 80.298(1)°, γ = 65.726(1)°, V = 1964.05(14) Å3, Z = 1, R gt (F) = 0.0381, wR ref (F 2) = 0.0682, T = 296.15 K.

Spinal muscular atrophy (SMA) is a neurodegenerative disease characterized by the selective loss of spinal motor neurons (MNs) and concomitant muscle weakness. Mutation of SMN1 is known to cause SMA, and restoring SMN protein levels via antisense oligonucleotide treatment is effective for ameliorating symptoms. However, this approach is hindered by exorbitant costs, invasive procedures, and poor treatment responses of some patients. Here, we seek to circumvent these hurdles by identifying reliable biomarkers that could predict treatment efficacy. We uncovered that MiR34 exhibits consistent downregulation during SMA progression in both human and rodent contexts. Importantly, Mir34 family-knockout mice display axon swelling and reduced neuromuscular junction (NMJ) endplates, recapitulating SMA pathology. Introducing MiR34a via scAAV9 improved the motor ability of SMNΔ7 mice, possibly by restoring NMJ endplate size. Finally, we observed a consistent decreasing trend in MiR34 family expression in the cerebrospinal fluid (CSF) of type I SMA patients during the loading phase of nusinersen treatment. Baseline CSF MiR34 levels before nusinersen injection proved predictive of patient motor skills 1 year later. Thus, we propose that MiR34 may serve as a biomarker of SMA since it is associated with the pathology and can help evaluate the therapeutic effects of nusinersen.

Postpartum body pain is one of the common postpartum diseases, the damage to the patient’s physical and mental health can not be ignored. The recognition and treatment of postpartum body pain in traditional Chinese medicine mainly take qi and blood, Zang-fu organs and ying wei as the main points of syndrome differentiation. Its main etiology and pathogenesis are postpartum deficiency of qi and blood, wind-cold and dampness evil invading human body, the dysfunction of each viscera and the disharmony of camp and health. According to the cause, the treatment can be summarized as supplementing qi and blood, harmonizing Yingwei, dispelling wind and dispersing cold, activating collages and relieving pain, regulating zang fu organs and so on. TCM treatment focuses on the holistic view, and its systematic treatment through early intervention, multiple means and multiple approaches has the advantages of high safety, significant efficacy and low recurrence rate. Clinical syndrome differentiation is not limited to one of the above types, but this article can provide treatment ideas for this disease.

Aims: To evaluate the nutritional status of patients before thyroid surgery at the Thyroid Surgery Department, National Hospital of Endocrinology in 2022. Methods: This was a cross-sectional study on 163 patients before thyroid surgery. Nutritional status of the patients was investigated using body mass index (BMI), mid-upper arm circumference (MUAC), and subjective global assessment (SGA). Results: The rates of malnutrition according to SGA and BMI were 31.3 and 7.4%, respectively. The rate of overweight according to BMI was 10.4%. The rate of obesity was 1.8% according to BMI, while it was 0% by MUAC classification. Conclusion: High rate of malnutrition was presented in the patients before thyroid surgery. It is important to use SGA to evaluate the patients and give an approptiate intervention of nutrition to prevent severe effects of malnutrition on surgical patients.

For a company, it is important to know which products to launch to the market that may get the maximal profit. To achieve this goal, companies not only need to consider these products’ features, but also need to analyze how customers make their purchase decisions. For most customers, the price of a product is the most important purchase factor. If the price of a product can be adjusted, the purchase decision of a customer may change. With different price settings, we can speculate on the expected number of customers and the profit of the products. Motivated by this, we want to find the most profitable products among the candidates for the company. A distance-based adoption model can be used to evaluate the expected customers for products at different prices. The computational cost is high in two parts. One is the computational cost of obtaining the most profitable information on each set of candidate products. Another part is that many candidate product combinations need to be calculated. To tackle the computation problem, we propose two strategies. One is to avoid considering all possible price settings. The other is to avoid processing all possible subsets of the candidate products. Experimental results reveal the efficiency of our strategies.

Background: The association between poor oral health and the risk of incident dementia remains unclear. Objective: To investigate the associations of poor oral health with incident dementia, cognitive decline, and brain structure in a large population-based cohort study. Methods: A total of 425,183 participants free of dementia at baseline were included from the UK Biobank study. The associations between oral health problems (mouth ulcers, painful gums, bleeding gums, loose teeth, toothaches, and dentures) and incident dementia were examined using Cox proportional hazards models. Mixed linear models were used to investigate whether oral health problems were associated with prospective cognitive decline. We examined the associations between oral health problems and regional cortical surface area using linear regression models. We further explored the potential mediating effects underlying the relationships between oral health problems and dementia. Results: Painful gums (HR = 1.47, 95% CI [1.317–1.647], p < 0.001), toothaches (HR = 1.38, 95% CI [1.244–1.538], p < 0.001), and dentures (HR = 1.28, 95% CI [1.223–1.349], p < 0.001) were associated with increased risk of incident dementia. Dentures were associated with a faster decline in cognitive functions, including longer reaction time, worse numeric memory, and worse prospective memory. Participants with dentures had smaller surface areas of the inferior temporal cortex, inferior parietal cortex, and middle temporal cortex. Brain structural changes, smoking, alcohol drinking, and diabetes may mediate the associations between oral health problems and incident dementia. Conclusion: Poor oral health is associated with a higher risk of incident dementia. Dentures may predict accelerated cognitive decline and are associated with regional cortical surface area changes. Improvement of oral health care could be beneficial for the prevention of dementia.

A new Zn(II) complex of 4-acetylbenzoic acid, namely [ZnL2(H2O)2] (1) (HL = 4-acetylbenzoic acid) has been synthesized in water-ethanol (v:v = 1:2) solution using zinc acetate dihydrate, 4-acetylbenzoic acid, and NaOH as reactants. The structure of complex (1) has been characterized by IR and X-ray single-crystal diffraction. X-ray diffraction analysis of complex (1) reveals that the Zn(II) ion is six-coordinated in a distorted octahedral coordination geometry with four carboxylic O atoms from two different bidentate 4-acetylbenzoic acid ligands (O1, O2, O1a, O2a) and two O atoms from two coordinated water molecules (O4 and O4a). Complex (1) forms 1D chained structure by the intermolecular and intramolecular O-H···O hydrogen bonds, and further forms a three-dimensional network structure by the π-π interaction of benzene rings and intermolecular O-H···O hydrogen bonds. The singlet ground-state geometry of the complex (1) were optimized using the PBE0 functional. The intermolecular interactions of complex (1) were quantitatively analysed by 3D Hirschfeld surface analysis and associated 2D fingerprint plots. The catalytic activity of complex (1) has been tested for the oxidation of benzyl alcohol under O2 atmosphere. Copyright © 2023 by Authors, Published by BCREC Group. This is an open access article under the CC BY-SA License (https://creativecommons.org/licenses/by-sa/4.0).

Lian Gong,1 Ming Zhong,2 Kai Gong,3 Zhanwang Wang,1 Yong Zhong,4 Yi Jin,1 Haotian Chen,1 Panpan Tai,1 Xinyu Chen,1 Aiyan Chen,1 Ke Cao1 1Department of Oncology, Third Xiangya Hospital, Central South University, Changsha, 410013, People’s Republic of China; 2Department of Nephrology, Center of Kidney and Urology, the Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, People’s Republic of China; 3Department of Clinical Medicine, Xiangnan University, Chenzhou, People’s Republic of China; 4Department of Clinical Medicine, Hubei Enshi College, Enshi, People’s Republic of ChinaCorrespondence: Ke Cao, Email csucaoke@163.comBackground: Chaperonin-containing TCP1 subunit 8 (CCT8) has been proved to be involved in the occurrence and development of some cancers. However, no study has reported the potential role of CCT8 in a pan-cancer manner.Methods: TIMER2.0, GEPIA2, UALCAN and Sangerbox were used to explore the expression, prognosis and methylation of CCT8. We used cBioPortal, TISIDB, SangerBox, TIMER2.0 and TISMO to investigate the genetic alteration of CCT8 and the relationship of CCT8 with molecular subtype, immune subtype, immune infiltration and immunotherapy response. CCT8-related genes were screened out through GEPIA and STRING for Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. CCK-8, the colony formation assay, the wound healing assay and the Transwell assay were performed to explore the influence of CCT8 on proliferation and migration.Results: CCT8 was highly expressed in most cancers with a poor prognosis. The expression level of CCT8, which was affected by the promoter region methylation and genetic alteration, was related to the molecular and immune subtype of cancers. Interestingly, CCT8 was positively associated with the activated CD4 T cells and type 2 T-helper cells. CCT8 played a vital role in the cell cycle and RNA transport of cancers, and it significantly inhibited the proliferation and migration of lung adenocarcinoma cells when it was knocked down.Conclusion: CCT8 plays an indispensable role in promoting the proliferation and migration of many cancers. CCT8 might be a biomarker of T-helper type 2 (Th2) cell infiltration and a promising therapeutic target for T-helper type 1(Th1)/Th2 imbalance.Keywords: CCT8, survival, immune infiltration, biomarker, pan-cancer