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The plastid-encoded RNA polymerase serves as the principal transcription machinery within chloroplasts, transcribing over 80% of all primary plastid transcripts. This polymerase consists of a prokaryotic-like core enzyme known as the plastid-encoded RNA polymerase core, and is supplemented by newly evolved associated proteins known as PAPs. However, the architecture of the plastid-encoded RNA polymerase and the possible functions of PAPs remain unknown. Here, we present the cryo-electron microscopy structure of a 19-subunit plastid-encoded RNA polymerase complex derived from spinach (Spinacia oleracea). The structure shows that the plastid-encoded RNA polymerase core resembles bacterial RNA polymerase. Twelve PAPs and two additional proteins (FLN2 and pTAC18) bind at the periphery of the plastid-encoded RNA polymerase core, forming extensive interactions that may facilitate complex assembly and stability. PAPs may also protect the complex against oxidative damage and has potential functions in transcriptional regulation. This research offers a structural basis for future investigations into the functions and regulatory mechanisms governing the transcription of plastid genes. The plastid-encoded RNA polymerase serves as the principal transcription machinery within chloroplasts. Here, the authors present the cryo-electron microscopy structure of a 19-subunit plastid-encoded RNA polymerase complex derived from spinach. [ABSTRACT FROM AUTHOR]

Morphology of right ventricular outflow tract (RVOT) is potentially related to cardiovascular outcomes. However, this relationship still remains to be verified with direct evidence. We retrospectively reviewed cases from the autopsy specimen library in the Center of Forensic Medicine in Sun Yat-sen University from 2017 to 2023. Six RVOT morphological characteristics were measured and their association with cardiovascular diseases (CVDs), sudden cardiac death (SCD) and age at death was evaluated. Relationship between myocardial fibrosis in RVOT and CVDs was investigated. RVOT characteristics were recruited by machine learning algorithms for diagnosing CVDs. A total of 2370 cases were finally recruited. Perimeter of sub-valve plane (pSBV) in RVOT was positively associated with risk of CVDs and SCD (OR: 1.21, 95%CI: 1.07–1.37, p = 0.003; OR: 1.33, 95%CI: 1.16–1.52, p < 0.001). Compared with thickness of septum (tS) < 3.0 mm, tS ≥ 3.0 mm was associated with premature death in disease-dominant death (β=-0.16, 95%CI: -0.20 to -0.11, p < 0.001) and SCD (β=-0.15, 95%CI: -0.21 to -0.10, p < 0.001). Degree of myocardial fibrosis in the posterior septum was increased in coronary atherosclerosis (6.86%±2.48% vs. 4.91%±2.14%, p = 0.011) and cardiomyopathies (8.11%±3.24% vs. 4.88%±3.11%, p = 0.005). A logistic regression model, recruiting age, left and right ventricular wall thickness, pSBV, circumference of pulmonary annulus and aortic annulus, was elected as an optimal diagnostic model of CVDs, yielding AUC of 0.734 (95%CI: 0.705–0.763), 0.781 (0.740–0.821) and 0.763 (0.725-0.800) in training, validation and test sets. Increased pSBV significantly correlates with higher risk of CVDs and SCD. And tS ≥ 3.0 mm is an independent risk factor of premature death regardless of diseases. [ABSTRACT FROM AUTHOR]

The prevalence of extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E) and carbapenem-resistant Enterobacterales (CRE) has become a global public health problem. ESBL-E/CRE colonization can increase the risk of infection in patients and lead to poor disease prognosis. We conducted a systematic review and meta-analysis to evaluate current decolonization strategies regarding ESBL-E/CRE and their efficacy. A literature search was conducted until August 2023 on the five databases to review decolonization strategies associated with ESBL-E/CRE. A meta-analysis was conducted using RevMan 5.4 to compare differences in the decolonization strategy with placebo controls. The primary outcome was decolonization rates, with secondary outcomes of attributable death and adverse events. Quality of identified studies was determined using the Newcastle–Ottawa scale and cochrane risk assessment tool. Random and fixed effects meta-analyses were performed to calculate pooled value. A total of 25 studies were included. In five randomized controlled trial (RCT) studies, the decolonization effect of selective digestive decontamination(SDD) on ESBL-E/CRE at the end of treatment was significantly better in the experimental group than the controls [risk radio (RR): 3.30; 95% CI 1.78–6.14]. In three n-RCT studies, the decolonization effect in the experimental group was still better than the controls one month after SDD therapy [odds ratio (OR): 4.01; 95% CI 1.88–8.56]. The combined decolonization rates reported by six single-arm trial studies of SDD therapy ranged from 53.8 to 68.0%. Additionally, TSA analysis confirmed the effectiveness of SDD therapy. In studies on Faecal microbiota transplantation (FMT) therapy, the decolonization effect of the experimental group was significantly better than the controls 1 month after treatment (OR: 2.57; 95% CI 1.07–6.16). In studies without a control group and with varying follow-up times, the decolonization rates varied widely but indicated the effectiveness trend of FMT therapy (61.3–81.2%). Currently, research on the decolonization effect of probiotic therapy on ESBL-E/CRE is insufficient, and only a systematic review was conducted. SDD and FMT strategies have short-term benefits for ESBL-E/CRE decolonization, but long-term effects are unclear. The effect of probiotic therapy on ESBL-E/CRE decolonization is an interesting topic that still requires further investigation. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy, safety, and improvement of symptoms by ultrasound-guided microwave ablation (MWA) for patients with large benign thyroid nodules (BTNs). Methods: Eighty-seven patients with 87 BTNs (≥ 4 cm) treated with MWA between April 2015 and March 2021 were enrolled in this retrospective multicenter study, with clinical and ultrasound examinations performed at the 1st, 3rd, 6th, and 12th months. A multivariable linear mixed effects model was employed to explore the alterations in volume and volume reduction ratio (VRR), as well as the potential factors associated with VRR. Results: The mean age of the 87 patients was 45.69 ± 14.21 years (range 18–76 years), and the ratio of men to women was 1:4.8. The mean volumes were much decreased at the 12th month after ablation compared to the initial volumes (p <.001). The mean VRR was 76.09% at the 12th month. The technique efficacy (VRR > 50%) was 90.80% at the 12th month. A multivariate analysis revealed that VRR was related to the initial volume (p =.015), annular flow (p =.010), and nodule composition (p =.024). The mean symptomatic score decreased from 4.40 ± 0.28 to 0.26 ± 0.06 at the 12th month (p <.001). At the same time, the mean cosmetic score decreased from 3.22 ± 0.10 to 1.31 ± 0.08 (p <.001). Conclusion: MWA could serve as a safe and effective therapy for large BTNs, significantly reducing the volume of BTNs and significantly improving compressive symptoms and appearance problems. Clinical relevance statement: Microwave ablation could serve as a safe and effective therapy for large benign thyroid nodules, leading to significant volume reduction and satisfied symptom and cosmetic alleviation period. Key Points: • This multicenter study investigated the feasibility and safety of microwave ablation for large benign thyroid nodules. • After ablation, the nodule volume was significantly reduced, and patients' symptoms and appearance problems were significantly improved. • Microwave ablation is feasible for large benign thyroid nodules and has been a supplement treatment. [ABSTRACT FROM AUTHOR]

Generalized pustular psoriasis (GPP) is a rare but severe form of psoriasis. However, the pathogenesis of GPP has not been fully elucidated. Although RNA-binding proteins (RBPs) and the alternative splicing (AS) process are essential for regulating post-transcriptional gene expression, their roles in GPP are still unclear. We aimed to elucidate the regulatory mechanisms to identify potential new therapeutic targets. Here, We analyzed an RNA sequencing (RNA-seq) dataset (GSE200977) of peripheral blood mononuclear cells (PBMCs) of 24 patients with GPP, psoriasis vulgaris (PV), and healthy controls (HCs) from the Gene Expression Omnibus (GEO) database. We found that the abnormal alternative splicing (AS) events associated with GPP were mainly “alt3p/alt5p”, and 15 AS genes were differentially expressed. Notably, the proportions of different immune cell types were correlated with the expression levels of regulatory alternatively spliced genes (RASGs): significant differences were observed in expression levels of DTD2, NDUFAF3, NBPF15, and FBLN7 in B cells and ARFIP1, IPO11, and RP11-326L24.9 in neutrophils in the GPP samples. Furthermore, We identified 32 differentially expressed RNA-binding proteins (RBPs) (18 up-regulated and 14 down-regulated). Co-expression networks between 14 pairs of differentially expressed RBPs and RASGs were subsequently constructed, demonstrating that these differentially expressed RBPs may affect the progression of GPP by regulating the AS of downstream immune/inflammatory-related genes such as LINC00989, ENC1 and MMP25-AS1. Our results were innovative in revealing the involvement of inflammation-related RBPs and RASGs in the development of GPP from the perspective of RBP-regulated AS. [ABSTRACT FROM AUTHOR]

The transfer of arsenic (As) from soil to plant could be significantly influenced by soil parameters through regulating soil As bioavailability. To distinguish the bioavailable As provided by soil and the As uptaken by plants, herein two different soil bioavailable were defined, namely potential soil bioavailable As (evaluated through the bioavailable fraction of As) and actual soil bioavailable As (assessed through plant bioaccumulation factor, BF, and BFavailable). To identify the dominant soil parameters for the two soil bioavailable As forms, soil and plant samples were collected from a former As mine site. The results showed that the potential bioavailable As only accounted for 1.77 to 11.43% in the sampled soils, while the BF and BFavailable in the sampled vegetables ranged from 0.00 to 1.01 and 0.01 to 17.87, respectively. Despite a similar proportion of As in the residual fraction, soil with higher pH and organic matter (OM) content and lower iron (Fe) content showed a higher potential soil bioavailable As. Correlation analysis indicated a relationship between the soil pH and potential soil bioavailable As (r = 0.543, p < 0.01) and between the soil Fe and actual soil bioavailable As (r = − 0.644, p < 0.05, r = − 0.594, p < 0.05). Stepwise multiple linear regression (SMLR) analysis was employed to identify the dominant soil parameters and showed that soil pH and phosphorus (P) content could be used to predict the potential soil bioavailable As (R2 = 0.69, p < 0.001). On the other hand, soil Fe and OM could be used to predict the actual soil bioavailable As (R2 = 0.18–0.86, p < 0.001–0.015, in different vegetables). These results suggest that different soil parameters affect potential and actual soil bioavailable As. Hence, soil Fe and OM are the most important parameters controlling As transfer from soil to plant in the investigated area. [ABSTRACT FROM AUTHOR]

Background: This study aims to establish a predictive model for assessing the risk of esophageal cancer lung metastasis using machine learning techniques. Methods: Data on esophageal cancer patients from 2010 to 2020 were extracted from the surveillance, epidemiology, and end results (SEER) database. Through univariate and multivariate logistic regression analyses, eight indicators related to the risk of lung metastasis were selected. These indicators were incorporated into six machine learning classifiers to develop corresponding predictive models. The performance of these models was evaluated and compared using metrics such as The area under curve (AUC), accuracy, sensitivity, specificity, and F1 score. Results: A total of 20,249 confirmed cases of esophageal cancer were included in this study. Among them, 14,174 cases (70%) were assigned to the training set while 6075 cases (30%) constituted the internal test set. Primary site location, tumor histology, tumor grade classification system T staging criteria N staging criteria brain metastasis bone metastasis liver metastasis emerged as independent risk factors for esophageal cancer with lung metastasis. Amongst the six constructed models, the GBM algorithm-based machine learning model demonstrated superior performance during internal dataset validation. AUC, accuracy, sensitivity, and specificity values achieved by this model stood at respectively at 0.803, 0.849, 0.604, and 0.867. Conclusion: We have developed an online calculator based on the GBM model ( aid clinical decision-making and treatment planning. [ABSTRACT FROM AUTHOR]

Versatile Video Coding (VVC) introduces various advanced coding techniques and tools, such as QuadTree with nested Multi-type Tree (QTMT) partition structure, and outperforms High Efficiency Video Coding (HEVC) in terms of coding performance. However, the improvement of coding performance leads to an increase in coding complexity. In this paper, we propose a multi-feature fusion framework that integrates the rate-distortion-complexity optimization theory with deep learning techniques to reduce the complexity of QTMT partition for VVC inter-prediction. Firstly, the proposed framework extracts features of luminance, motion, residuals, and quantization information from video frames and then performs feature fusion through a convolutional neural network to predict the minimum partition size of Coding Units (CUs). Next, a novel rate-distortion-complexity loss function is designed to balance computational complexity and compression performance. Then, through this loss function, we can adjust various distributions of rate-distortion-complexity costs. This adjustment impacts the prediction bias of the network and sets constraints on different block partition sizes to facilitate complexity adjustment. Compared to anchor VTM - 13.0, the proposed method saves the encoding time by 10.14% to 56.62%, with BDBR increase confined to a range of 0.31% to 6.70%. The proposed method achieves a broader range of complexity adjustments while ensuring coding performance, surpassing both traditional methods and deep learning-based methods. [ABSTRACT FROM AUTHOR]

We described the diagnosis and treatment of a patient with autoinflammatory disease, named "Deficiency in ELF4, X-linked (DEX)". A novel ELF4 variant was discovered and its pathogenic mechanism was elucidated. The data about clinical, laboratory and endoscopic features, treatment, and follow-up of a patient with DEX were analyzed. Whole exome sequencing and Sanger sequencing were performed to identify potential pathogenic variants. The mRNA and protein levels of ELF4 were analyzed by qPCR and Western blotting, respectively. The association of ELF4 frameshift variant with nonsense-mediated mRNA decay (NMD) in the pathogenesis DEX was examined. Moreover, RNA-seq was performed to identify the key molecular events triggered by ELF4 variant. The relationship between ELF4 and IFN-β activity was validated using a dual-luciferase reporter assay and a ChIP-qPCR assay. An 11-year-old boy presented with a Behçet's-like phenotype. The laboratory abnormality was the most obvious in elevated inflammatory indicators. Endoscopy revealed multiple ileocecal ulcers. Intestinal histopathology showed inflammatory cell infiltrations. The patient was treated with long-term immunosuppressant and TNF-α blocker (adalimumab), which reaped an excellent response over 16 months of follow-up. Genetic analysis identified a maternal hemizygote frameshift variant (c.1022del, p.Q341Rfs*30) in ELF4 gene in the proband. The novel variant decreased the mRNA level of ELF4 via the NMD pathway. Mechanistically, insufficient expression of ELF4 disturbed the immune system, leading to immunological disorders and pathogen susceptibility, and disrupted ELF4-activating IFN-β responses. This analysis detailed the clinical characteristics of a Chinese patient with DEX who harbored a novel ELF4 frameshift variant. For the first time, we used patient-derived cells and carried out transcriptomic analysis to delve into the mechanism of ELF4 variant in DEX. [ABSTRACT FROM AUTHOR]

Educational chatbots are gaining momentum due to their distinctive affordances of interactivity, immediacy, ease of use, and individualized experience. However, a fairly limited body of literature discusses how a chatbot can facilitate collaborative learning among peers in extensive reading contexts to encourage more vibrant interactions supporting further interest development. Therefore, this research aimed to analyze the affordances and limitations of a chatbot to facilitate human–human interactions by incorporating the refined Academically Productive Talk framework for nurturing a learning community, forming accurate knowledge, fostering rigorous thinking, and encouraging affective responses for elementary school learners. Specifically, the purpose of the research was to observe the situational interest of the learners, their interaction patterns, and their social learning behaviors. This research developed a chatbot stored with 64 children's storybooks to initiate and facilitate peer dialogues. A group of 30 learners were paired up to conduct two chatbot-facilitated dialogic reading activities. A total of 30 discourse logs and students' feedback on a survey of situational interest were analyzed. The discourse analysis of this research supports the affordances of the chatbot acting as an effective dialogue initiator and discussion facilitator to support both human-chatbot and human–human social learning. The chatbot encourages a diverse interactive dialogic climate, and four interaction patterns were identified. The situational interest of the initial encounter with the chatbot was boosted; however, their interest was unable to be sustained. The implications for the affordances and limitations of educational chatbots are discussed. [ABSTRACT FROM AUTHOR]

Reduced-toxicity conditioning (RIC) regimens are used for allogeneic hematopoietic stem cell transplantation in older patients. However, successful outcomes are hindered by graft-versus-host disease (GVHD), treatment-related mortality, and relapse, particularly after haploidentical donor hematopoietic stem cell transplantation (HID-HSCT). The aim of this study was to evaluate the effectiveness of an RIC conditioning regimen that included a combination of cyclosporin A, methotrexate (on day + 1), mycophenolate, lower doses of post-transplantation PTCy (40 mg/kg on day + 3), and ATG (7.5 mg/kg) as GVHD prophylaxis prior to haplo-stem cell transplantation (haplo-SCT) in older patients. Methods: We retrospectively analyzed outcomes in 55 patients ≥ 55 years of age with hematologic malignancies treated with fludarabine, cytarabine, busulfan, and low-dose cyclophosphamide as the conditioning regimen between January 1, 2019, and November 30, 2023. Results: Neutrophil engraftment was successful in all patients within 28 days, with 54 patients (98.2%) achieving complete donor chimerism. The cumulative incidence of non-relapse mortality was 0% at 30 days, 7.5% at 100 days, and 19% at 1 year. The cumulative incidence of grade II–IV acute graft-versus-host disease (aGVHD) was 25% (95%CI, 15−38%), whereas that of grade III–IV aGVHD was 9.1% (95% CI, 3.3−19%). The cumulative incidence of extensive chronic graft-versus-host disease at 1 year was 3.6% (95%CI, 0.66–11%). The cumulative incidences of relapse, overall survival, and GVHD-free/relapse-free survival at 1 year were 9.0%, 71.6%, and 67.1%, respectively. Conclusions: An RIC conditioning regimen, including a combination of lower PTCy/ATG as GVHD prophylaxis, followed by haplo-SCT, might be a promising option for appropriately selected older patients. [ABSTRACT FROM AUTHOR]

A stable DNA signal amplification sensor was developed on account of rolling circle amplification (RCA). This sensor includes target DNA-controlled rolling circle amplification technology and locking probe DNA replacement technology, which can be used to detect DNA fragments with genetic information, thus constructing a biosensor for universal detection of DNA. This study takes the homologous DNA of human immunodeficiency virus (HIV) and let-7a as examples to describe this biosensor. The padlock probe is first cyclized by T4 DNA ligase in response to the target's reaction with it. Then, rolling cycle amplification is initiated by Phi29 DNA polymerase, resulting in the formation of a lengthy chain with several triggers. These triggers can open the locked probe LP1 with the fluorescence signal turned off, so that it can continue to react with H2 to form a stable H1-H2 double strand. This regulates the distance between B-DNA modified by the quenching group and H1 modified by fluorescent group, and the fluorescence signal is recovered. [ABSTRACT FROM AUTHOR]

Numerous studies have compared outcomes of liver resection (LR) of patients with non-alcoholic fatty liver disease (NAFLD)-related hepatocellular carcinoma (HCC) to those of patients with non-NAFLD-related HCC. However, results have been inconsistent. We aim to clarify this issue. We enrolled 801 patients with hepatitis B virus (HBV)-related HCC, 433 patients with hepatitis C virus (HCV)-related HCC, and 128 patients with NAFLD-related HCC undergoing LR. Overall survival (OS) and disease-free survival (DFS) of patients with different etiologies of chronic liver disease was compared using the Kaplan–Meier estimator and log-rank test after propensity score matching (PSM). After PSM, 83 patients remained in each group. The groups did not differ significantly in age, sex, the proportion of patients with pathological American Joint Committee on Cancer stage 1, tumor size > 50 mm, receipt of major resection, alpha-fetoprotein (AFP) ≥ 20 ng/ml, presence of cirrhosis, model for end-stage liver disease (MELD) score, and American Society of Anesthesiologists (ASA) classification. The five-year OS of patients with HBV-, HCV-, and NAFLD-related HCC was 78%, 75%, and 78%, respectively (p = 0.789). The five-year DFS of the HBV, HCV, and NAFLD groups was 60%, 45%, and 54%, respectively (p = 0.159). Perioperative morbidity was noted in 17 (20.5%) in the HBV group, 22 (26.5%) in the HCV group, and 15 (18.1%) in the NAFLD group (p = 0.398). The five-year OS, DFS, and perioperative morbidity of patients undergoing LR for NAFLD-related HCC and those for viral hepatitis-related HCC was similar. [ABSTRACT FROM AUTHOR]

Epigenetic mechanisms bridge genetic and environmental factors that contribute to the pathogenesis of major depression disorder (MDD). However, the cellular specificity and sensitivity of environmental stress on brain epitranscriptomics and its impact on depression remain unclear. Here, we found that ALKBH5, an RNA demethylase of N6-methyladenosine (m6A), was increased in MDD patients' blood and depression models. ALKBH5 in astrocytes was more sensitive to stress than that in neurons and endothelial cells. Selective deletion of ALKBH5 in astrocytes, but not in neurons and endothelial cells, produced antidepressant-like behaviors. Astrocytic ALKBH5 in the mPFC regulated depression-related behaviors bidirectionally. Meanwhile, ALKBH5 modulated glutamate transporter-1 (GLT-1) m6A modification and increased the expression of GLT-1 in astrocytes. ALKBH5 astrocyte-specific knockout preserved stress-induced disruption of glutamatergic synaptic transmission, neuronal atrophy and defective Ca2+ activity. Moreover, enhanced m6A modification with S-adenosylmethionine (SAMe) produced antidepressant-like effects. Our findings indicate that astrocytic epitranscriptomics contribute to depressive-like behaviors and that astrocytic ALKBH5 may be a therapeutic target for depression. The regulatory mechanism and function of astrocytic epigenetic effects on depression remain to be explored. Here, the authors show astrocytic ALKBH5 contributes to depressive-like behaviors via the m6A RNA methylation of GLT-1. [ABSTRACT FROM AUTHOR]

Background: Aberrant iron metabolism is commonly observed in multiple tumor types, including hepatocellular carcinoma (HCC). However, as the key regulator of iron metabolism involved in iron absorption, the role of transferrin receptor (TFRC) in HCC remains elusive. Methods: The mRNA and protein expression of TFRC were evaluated in paired HCC and adjacent non-tumor specimens. The correlation between TFRC level and clinicopathological features or prognostic significance was also analyzed. The role of TFRC on biological functions was finally studied in vitro and in vivo. Results: The TFRC level was remarkably upregulated in HCC tissues compared to paired peritumor tissues. Overexpressed TFRC positively correlated with serum alpha-fetoprotein, carcinoembryonic antigen, and poor tumor differentiation. Multivariate analysis demonstrated that upregulated TFRC was an independent predictive marker for poorer overall survival and disease-free survival in HCC patients. Loss of TFRC markedly impaired cell proliferation and migration in vitro and notably suppressed HCC growth and metastasis in vivo, while overexpression of TFRC performed an opposite effect. Mechanistically, the mTOR signaling pathway was downregulated with TFRC knockdown, and the mTOR agonist MHY1485 completely reversed the biological inhibition in HCC cells caused by TFRC knockdown. Furthermore, exogenous ferric citrate (FAC) or iron chelator reversed the changed biological functions and signaling pathway expression of HCC cells caused by TFRC knockdown or overexpression, respectively. Conclusions: Our study indicates that TFRC exerts an oncogenic role in HCC and may become a promising therapeutic target to restrain HCC progression. [ABSTRACT FROM AUTHOR]

Computer-simulated experiments have been gaining popularity over hands-on experiments in science education, given the availability of technology and the trend of distance learning. Past studies have focused primarily on comparing the learning outcomes and user experiences of the two experiment modes. In this study, we used an eye tracker to investigate the learning processes involved in manipulating hands-on and computer-simulated experiments, and the effect of prior knowledge and experiment mode on eye movements. A total of 105 undergraduates completed either mode of experiment to learn about pulley mechanics. Participants were asked to read relevant concepts before conducting the experiments to ensure they had basic knowledge about the subject matter. Results showed that the learning outcome of experimentation was affected by prior knowledge but not experiment mode. As for eye movements, the two experiment workstations were divided into nine functional regions. The findings revealed that eye movements in most regions were affected by the experiment mode, but not prior knowledge. The simulation group had shorter total fixation durations and smaller pupil sizes than the hands-on group, implying a lower cognitive load in learning in computer-simulated experiments. Lag sequential analysis and entropy analysis were conducted on cross-regional fixation transitions. The results revealed that participants in hands-on experiments tended to make more diversified fixation transitions across regions, whereas those in simulated experiments showed a higher level of concentration in the spatial pattern of fixation transitions. While sequential analysis offers insights into important fixation transitions on a regional level, entropy analysis allows for a more macro perspective on the overall transition distribution and facilitates conventional statistical modeling that takes individual differences into account. [ABSTRACT FROM AUTHOR]

Purpose This study seeks to build a normative database for the vessel density of the superficial retina (SVD) and evaluate how changes and trends in the retinal microvasculature may be influenced by age and axial length (AL) in non-glaucomatous eyes, as measured with optical coherence tomography angiography (OCTA). Methods We included 500 eyes of 290 healthy subjects visiting a county hospital. Each participant underwent comprehensive ophthalmological examinations and OCTA to measure the SVD and thickness of the macular and peripapillary areas. To analyze correlations between SVD and age or AL, multivariable linear regression models with generalized estimating equations were applied. Results Age was negatively correlated with the SVD of the superior, central, and inferior macular areas and the superior peripapillary area, with a decrease rate of 1.06%, 1.36%, 0.84%, and 0.66% per decade, respectively. However, inferior peripapillary SVD showed no significant correlation with age. AL was negatively correlated with the SVD of the inferior macular area and the superior and inferior peripapillary areas, with coefficients of -0.522%/mm, -0.733%/mm, and -0.664%/mm, respectively. AL was also negatively correlated with the thickness of the retinal nerve fiber layer and inferior ganglion cell complex (p = 0.004). Conclusion Age and AL were the two main factors affecting changes in SVD. Furthermore, AL, a relative term to represent the degree of myopia, had a greater effect than age and showed a more significant effect on thickness than on SVD. This relationship has important implications because myopia is a significant issue in modern cities. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) was a new interdiscipline of computer technology, mathematic, cybernetics and determinism. These years, AI had obtained a significant development by the improvement of core technology Machine Learning and Deep Learning. With the assistance of AI, profound changes had been brought into the traditional orthopedics. In this paper, we narratively reviewed the latest applications of AI in orthopedic diseases, including the severity evaluation, triage, diagnosis, treatment and rehabilitation. The research point, relevant advantages and disadvantages of the orthopedic AI was also discussed combined with our own research experiences. We aimed to summarize the past achievements and appeal for more attentions and effective applications of AI in the field of orthopedics. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate alterations of outer retinal reflectivity on spectral-domain optical coherence tomography (OCT) in diabetic patients without clinically detectable retinopathy (NDR). Methods: In this retrospective study, 64 NDR patients and 71 controls were included. Relative reflectivity (RR) of the ellipsoid zone (EZ), photoreceptor outer segment (OS) and inner segment (IS), and outer nuclear layer (ONL) at the foveola and at 500 μm, 1000 μm, and 2000 μm nasal (N), temporal (T), superior (S), and inferior (I) to the foveola was measured by cross-line OCT and ImageJ. Retinal vessel densities (VD) in fovea, parafovea, and perifovea areas were detected by OCT angiography (OCTA). Results: EZ RR in most retinal locations was significantly lower in NDR eyes compared to controls (all P < 0.05), except the foveola. Compared with controls, NDR eyes also displayed lower RR at N2000, T2000, S1000, and I1000 of OS, at S500 and I500 of IS, and at I500 of ONL (all P < 0.05). Negative correlations could be observed between retinal RR and diabetes duration, HbA1c, and best-corrected visual acuity (BCVA) (r = − 0.303 to − 0.452). Compared to controls, EZ, OS, and IS RR of the NDR eyes showed lower correlation coefficients with whole image SCP and DCP VD of parafovea and perifovea regions. Conclusion: Outer retinal reflectivity, along with the coefficients between retinal reflectivity and VD, is reduced in NDR patients and is correlated with diabetes duration, HbA1c, and BCVA. The reduction of outer retinal reflectivity may be a potential biomarker of early retinal alterations in diabetic patients. [ABSTRACT FROM AUTHOR]

Background: Whether patients with advanced non-small cell lung cancer (NSCLC) should choose an immune-combination therapy regimen after EGFR-tyrosine kinase inhibitors (EGFR-TKIs) resistance is currently unclear. Methods: We evaluated 118 NSCLC patients treated by immune checkpoint inhibitors (ICIs) + chemotherapy (I + C), ICIs + chemotherapy + antiangiogenic therapy (I + C + A), chemotherapy + antiangiogenic therapy (C + A) after inefficacy of EGFR-TKIs. We assessed the objective remission rate (ORR), disease control rate (DCR), and progression-free survival (PFS) of these treatments. Results: The ORR was 26.1% vs 38.2% vs 16.3% in the three groups (P = 0.093). The divergence in DCR was also statistically significant (65.2% vs 85.3% vs 74.4%, P = 0.209). The median PFS was no statistically significant difference in PFS (3.09 vs 6.31 vs 5.91 months, P = 0.809), but the Kaplan–Meier survival curve of 12-month-PFS indicated an apparent survival advantage in the I + C + A group (P = 0.001). In addition, the I + C/I + C + A group showed higher median PFS than the C + A group in patients with brain metastases (median PFS, 6.44 vs 4.21 months, P = 0.022). The divergence in ORR of patients in the brain group was also statistically significant (P = 0.045). The I + C + A group showed superior efficacy in patients with liver metastases (median PFS, 0.95 vs 6.44 vs 3.48 months, P < 0.0001). The Cox proportional hazard modeling analysis suggested that the age, brain metastases, and liver metastases were all connected with the prognosis. Conclusions: This study suggests that advanced NSCLC patients after resistance to EGFR-TKIs may achieve better outcomes from triple therapy. Patients with brain metastases favor ICIs-related combination therapies and patients with liver metastases prefer I + C + A therapy. [ABSTRACT FROM AUTHOR]

Accessing urban parks is important for promoting physical activities and improving public health. In this study, we propose the use of Google Maps crowdsourcing data and the incorporation of park attractiveness to model urban park accessibility in the complex urban environments of Hong Kong. The difference between using geometric and route distance, the effect of park attractiveness in measuring accessibility, and the benefits gained from using walk time compared to distance are investigated. Our result shows that (1) route and geometric distances have a strong correlation with a conversion factor of about 1.5; (2) the common assumption that park size can be a proxy for describing attractiveness may not be correct. Instead, park attractiveness should be explicitly considered for a more effective accessibility modeling; and (3) estimation by walking time shows that there are non-negligible impacts from street conditions and traffic on urban park accessibility. Moreover, district hotspots short of park accessibility or attractiveness can be explicitly detected. Overall, this developed approach provides a flexible and informative approach to model the accessibility to urban parks. The outputs will help city planners, health professionals, and policymakers to evaluate and improve urban park planning and equity in accessibility in high-density cities. [ABSTRACT FROM AUTHOR]

Slowing the decline in walking mobility in the elderly is critical for maintaining the quality of life. Wearable assistive devices may 1 day facilitate mobility in older adults; however, we need to ensure that such devices do not impair stability in this population that is predisposed to fall-related injuries. This study sought to quantify the effects of untethered ankle exoskeleton assistance on measures of stability, whole-body dynamics, and strategies to maintain balance during normal and perturbed walking in older adults. Eight healthy participants (69–84 years) completed a treadmill-based walking protocol that included perturbations from unexpected belt accelerations while participants walked with and without ankle exoskeleton assistance. Exoskeleton assistance increased frontal plane range of angular momentum (8–14%, p ≤ 0.007), step width (18–34%, p ≤ 0.006), and ankle co-contraction (21–29%, p ≤ 0.039), and decreased biological ankle moment (16–27%, p ≤ 0.001) during unperturbed and perturbed walking; it did not affect the anteroposterior margin-of-stability, step length, trunk variability, or soleus activity during unperturbed and perturbed walking. Our finding that ankle exoskeleton assistance did not affect the anteroposterior margin-of-stability supports additional investigation of assistive exoskeletons for walking assistance in the elderly. [ABSTRACT FROM AUTHOR]

Background: Good quality of care for inflammatory bowel disease (IBD) depends on high-standard management and facility in the IBD center. Yet, there are no clear measures or criteria for evaluating pediatric IBD (PIBD) center in China. The aim of this study was to develop a comprehensive set of quality indicators (QIs) for evaluating PIBD center in China. Methods: A modified Delphi consensus-based approach was used to identify a set of QIs of structure, process, and outcomes for defining the criteria. The process included an exhaustive search using complementary approaches to identify potential QIs, and two web-based voting rounds to select the QIs defining the criteria for PIBD center. Results: A total of 101 QIs (35 structures, 48 processes and 18 outcomes) were included in this consensus. Structure QIs focused on the composition of multidisciplinary team, facilities and services that PIBD center should provide. Process QIs highlight core requirements in diagnosing, evaluating, treating PIBD, and disease follow-up. Outcome QIs mainly included criteria evaluating effectiveness of various interventions in PIBD centers. Conclusion: The present Delphi consensus developed a set of main QIs that may be useful for managing a PIBD center. -ZGREExbZZNYrtdkZM8DcG Video Abstract [ABSTRACT FROM AUTHOR]

Introduction: Lung cancer is one of primary cancer type with high incidence and mortality, non-small cell lung cancer (NSCLC) is the most common type of lung cncer. For advanced lung cancer, traditional chemotherapy and targeted therapy become difficult to solve the dilemma of further progress. In recent years, with the clinical application of immunotherapy, the therapeutic strategy of lung cancer has changed dramatically. At present, immunotherapy has shown conspicuous efficacy in NSCLC patients with high expression of programmed death-ligand 1 (PD-L1) and high tumor mutational burden (TMB). The discovery of driver mutations brings delightful hope for targeted cancer therapy. However, it remains controversial whether immunotherapy can be used in NSCLC patients with these specific driver mutations. Method: This article summarized the latest research progresses of immunotherapy in advanced NSCLC. We paid close attention to the relevance of various driver mutations and immunotherapy in NSCLC patients, and summarized the predictive effects of several driver mutations and immunotherapy. Results: The mutations of KRAS, KRAS+TP53, EPHA (especially EPHA5), ZFHX3, ZFHX3+TP53, NOTCH, BRAF and LRP1B+FAT3 have potential to be used as biomarkers to predict the positive effectiveness of immunotherapy. ZFHX3, ZFHX3+TP53, STKII/LKB1+KEAP1+SMARCA4+PBRM1 mutations in LUAD patients get more positive effect in immunotherapy. While the mutations of EGFR, KEAP1, STKII/LKB1+KRAS, EML4-ALK, MET exon 14 skipping mutation, PBRM1, STKII/LKB1+KEAP1+SMARCA4+PBRM1, ERBB2, PIK3CA and RET often indicate poor benefit from immunotherapy. Conclusion: Many gene mutations have been shown to be associated with immunotherapy efficacy. Gene mutations should be combined with PD-L1, TMB, etc. to predict the effect of immunotherapy. [ABSTRACT FROM AUTHOR]

Emerging multimedia technologies significantly enhance the naturalness and immersion of human computer interaction. Currently, research on kinesthetic information has gained increasing attentions of multimedia community. However, effective interaction between kinesthetic and other multimedia signals remains a challenging task. In this paper, we propose a visual-kinesthetic interaction in Virtual Reality (VR) and real-world control tasks. First, we model the correlation between user's visual attention and kinesthetic positions under different tasks. Second, we utilize an attention-based Long Short-Term Memory network to predict the kinesthetic positions. Third, we build a VR system with robotic car control, which validates our model in VR interaction and control tasks. With a high task achievement rate, we envision the implementation of kinesthetic information in a more natural interaction system. The VR interaction system based on the proposed model can also provide guidance for the design of immersive robot teleoperation systems. [ABSTRACT FROM AUTHOR]

Purpose: In most clinical trials, intracardiac echocardiography (ICE) has provided fewer views than the four standard views provided by transesophageal echocardiography (TEE) when assessing left atrial appendage closure (LAAC) devices. This study aimed to determine if ICE guided by the CartoSound system achieve adequate high-quality views and similar clinical outcomes as TEE during LAAC. Methods: This study prospectively enrolled 202 patients who underwent LAAC using either ICE (n = 69), TEE (n = 121), or a combination of ICE and TEE (n = 12) as the procedural imaging under local anesthesia. A novel multi-angled "FLAVOR" approach was used for assessment in the ICE group. Results: ICE allowed visualization of the implanted devices in all patients at all proposed angles with long-axis views while two-dimensional (2D) TEE showed short-axis views in 1 or 2 angles in 24.2% of cases, which was more prevalent when the pulmonary ridge was covered by the occluder. In the combined ICE-TEE cohort, 2D-TEE failed to detect peri-device leak in 1 patient. The complication rates were similar between the ICE and TEE groups. Shorter fluoroscopy time, lower radiation dose and contrast usage were founded in the ICE group. At first TEE follow-up, the rate and degree of peri-device leak were similar between the ICE and TEE groups. Conclusion: A systematic ICE protocol using a CartoSound module to guide LAAC was reliable for comprehensive long-axis imaging assessment compared with 2D/3D TEE under local anesthesia with a shorter fluoroscopy time, lower radiation dose, and less use of contrast. [ABSTRACT FROM AUTHOR]

To evaluate the diagnostic accuracy of improved fluoroscopy-guided biopsies for indeterminate biliary strictures (IBDS). A multi-center retrospective study was performed. Patients with IBDS who underwent digital single-operator cholangioscopy (DSOC) and improved fluoroscopy-guided biopsies procedures were included. The individual sensitivity, specificity, and accuracy were analyzed. A total of 67 patients were enrolled in this multi-center retrospective study. The DSOC and improved fluoroscopy-guided biopsies procedures were successfully performed in all cases (100%). The sensitivity, specificity, and accuracy values were 83.3%, 89.5%, and 85.1% for DSOC visual impression; 95.8%, 94.7%, and 95.5% for improved fluoroscopy-guided biopsies procedures, respectively. The sensitivity and accuracy of improved fluoroscopy-guided biopsies were significantly higher compared with DSOC visual impression. Four patients (6.0%, 4/67) occurred adverse events after the procedures. Improved fluoroscopy-guided biopsies had a high diagnostic accuracy of IBDS diagnosis. [ABSTRACT FROM AUTHOR]

In this study, reduced graphene oxide (RGO) with good water dispersibility and excellent adsorption performance was successfully prepared using sodium borohydride (NaBH4) as reductant, and their characterization and adsorption performance for Basic Red13 (BR13) and Cu2+ were analyzed. The results showed that RGO had an obvious graphene-like structure with the C/O ratio of 3.19, while the C/O ratio of graphene oxide (GO) was only 1.81. The reason for the good water dispersibility of RGO was the retention of partial oxygen-containing groups, especially carboxyl groups. The adsorption of RGO for BR13 and Cu2+ was typical monolayer physisorption, which could be well-described by pseudo-first-order and Langmuir isotherm models. The maximum adsorption capacities of RGO were 1674.01 mg/g for BR13 at pH = 13 and 164.72 mg/g for Cu2+ at pH = 6, which much higher than the corresponding values of 1258.65 mg/g and 123.14 mg/g for GO. In particular, the adsorption capacity of RGO for BR13 was the highest value reported so far. Moreover, no significant loss of adsorption performance was observed even after five cycles. This work suggested that reduced graphene oxide was an efficient adsorbent for the removal of organic dyes and heavy metal ions from water, which had great potential in pollution control applications. [ABSTRACT FROM AUTHOR]

Deep eutectic solvent (DES)-based gels, with their biocompatibility, non-volatility, low cost, and electrochemical stability, have attracted widespread interest as novel solid-state ionic conductor for flexible devices. However, fabrication of tough and stretchable DES gels is challenging due to the insufficient understanding of the interactions between polymers and DES. The development of tough DES gels based on hydrogen bonding is attractive but also challenging due to the possible competitive hydrogen bonds between the hydrogen bond-rich choline chloride-based polar DES and polymers. Herein, tough copolymer-supported DES gels with dual-cross-linked dissipative network were fabricated through copolymerization of methacrylic acid and N, N-dimethylacrylamide monomers with good and poor compatibility with DES to promote the formation of stable hydrogen bonds between polymers in the DES. The resulting DES gels were stiff, tough, stretchable, and self-recoverable, with tensile strength, breaking strain, Young's modulus, toughness, and recovery ratio being 2.08 MPa, 792%, 1.76 MPa, 12.88 MJ m−3, and 76%, respectively. The mechanical properties of DES gels could be widely tuned by varying the monomer ratio and solvent structure changes. The carbon-based supercapacitor based on the DES gel shows stable voltage window to 2 V and exhibits the specific capacitance of 93.25 F g−1 at 2 A g−1. An ultratough and stretchable copolymer-supported DES gel ionic conductor with high tensile strength of 2.08 Mpa, high toughness of 12.88 MJ m−3, stretchability of 792%, and excellent recovery properties are facile fabricated for flexible electronics through copolymerization of two monomer pairs of methacrylic acid and N, N-dimethylacrylamide that can form stable hydrogen bonds in the DES environment with a small amount of chemical cross-linker to form a dual-crosslinked dissipative network. [ABSTRACT FROM AUTHOR]

Flexible and stretchable neural electrodes are promising tools for high-fidelity interfacing with soft and curvilinear brain surface. Here, we describe a flexible and stretchable neural electrode array that consists of polyacrylonitrile (PAN) nanofiber network reinforced gold (Au) film electrodes. Under stretching, the interweaving PAN nanofibers effectively terminate the formation of propagating cracks in the Au films and thus enable the formation of a dynamically stable electrode-tissue interface. Moreover, the PAN nanofibers increase the surface roughness and active surface areas of the Au electrodes, leading to reduced electrochemical impedance and improved signal-to-noise ratio. As a result, PAN nanofiber network reinforced Au electrode arrays can allow for reliable in vivo multichannel recording of epileptiform activities in rats. [ABSTRACT FROM AUTHOR]

Background: Difficult biliary cannulation and unintended pancreatic cannulation exist in biliary interventions during endoscopic retrograde cholangiopancreatography. Wire-guided cannulation over a pancreatic stent (PS-WGC) and needle-knife precut over a pancreatic stent (PS-NKP) may facilitate biliary cannulation. This study aimed to compare the outcomes of PS-NKP and PS-WGC following guidewire passage into the pancreatic duct. Methods: A total of 304 patients who inserted a pancreatic stent and continued cannulation using wire-guided (PS-WGC) or needle-knife precut (PS-NKP) from October 2018 to November 2021 in three centers were ultimately enrolled in this study. The success rate of cannulation and incidence of complications were compared between the two groups. Results: Results of the success rate of cannulation in the PS-NKP (n = 98) group were significantly higher compared with the PS-WGC (n = 206) group (96.9% vs. 89.8%; P < 0.05). The overall adverse events were 10.2% (31/304), and PS-NKP had lower (PEP) rates compared with the PS-WGC (3.1% vs. 10.7%, P < 0.05). Conclusion: The PS-NKP group is superior to the PS-WGC group in terms of the effectiveness and safety of continued cannulation. Using needle-knife precut, especially early use, over the pancreatic stent to continue cannulation reduced PEP compared with PS-WGC. [ABSTRACT FROM AUTHOR]

This study was performed to observe the effects of water on photosynthesis and water-related physiology in dominant shrubs in shell sand habitats. Four-year-old Periploca sepium seedlings were used as model species. A gradient of 12 water levels was established by artificially supplying the shell sand with water up to saturation and then allowing natural evapotranspiration to occur. The photosynthetic, chlorophyll fluorescence and stem sap flow parameters of P. sepium were measured under a range of water conditions. The different soil water conditions were classified according to the responses of these parameters. (1) With the increase in the relative water content (RWC) of the shell sand, the parameters of leaf photosynthesis, chlorophyll fluorescence and water-related physiology in P. sepium showed significant critical responses. The net photosynthetic rate (Pn), transpiration rate (Tr), instantaneous water use efficiency (WUE), potential water use efficiency (WUEi), maximum photochemical efficiency (Fv/Fm), actual photochemical efficiency (ΦPSII) and daily accumulation of stem sap flow all increased first and then decreased with increasing RWC, but the corresponding water conditions associated with their maximum values were not the same. An RWC of 69.40% was determined to be the optimal water condition for photosynthesis and water-related physiological activity in P. sepium. At an RWC of 36.61%, the mechanism of photosynthetic inhibition in P. sepium changed from stomatal limitation to nonstomatal limitation; this was also the minimum water requirement for maintaining normal photosynthetic processes. An RWC of 50.27% resulted in the highest WUE in P. sepium, indicating that moderate drought stress increased WUE. (2) Based on the quantitative relationship between the photosynthetic parameters of P. sepium and the shell sand water gradient, the soil water availability was classified into 6 water grades. The RWC range for maintaining strong photosynthesis and high WUE in P. sepium was 63.22–69.98%. (3) Gas exchange in P. sepium was inhibited under drought and waterlogging stresses. Under these conditions, the photosynthetic electron transport chain was blocked, and the dissipation of light energy as heat increased, which ultimately led to a decline in photosynthetic productivity; moreover, transpiration and dissipation were aggravated, and water transmission and utilization processes in P. sepium were hindered. A significant negative feedback regulation mechanism in the photosynthetic and water-related physiological processes of P. sepium was observed; this mechanism allowed P. sepium growing in shell sand to be highly adaptable to water stress. [ABSTRACT FROM AUTHOR]

To test the patterns of the root morphology and architecture indexes of Tamarix chinensis in response to water and salt changes in the two media of the groundwater and soil, three-year-old T. chinensis seedlings were chosen as the research object. Groundwater with four salinity levels was created, and three groundwater level (GL) were applied for each salinity treatment to measure the root growth and architecture indexes. In the fresh water and brackish water treatments, the topological index (TI) of the T. chinensis roots was close to 0.5, and the root architecture was close to a dichotomous branching pattern. In the saline water and saltwater treatments, the TI of the T. chinensis roots was large and close to 1.0, and the root architecture was close to a herringbone-like branching pattern. Under different GLs and salinities, the total root length was significantly greater than the internal link length, the external link length was greater than the internal link length, and the root system showed an outward expansion strategy. The treatment with fresh water and a GL of 1.5 m was the most suitable for T. chinensis root growth, while the root growth of T. chinensis was the worst in the treatment with saline water and a GL of 0.3 m. T. chinensis can adapt to the changes in soil water and salt by regulating the growth and morphological characteristics of the root system. T. chinensis can adapt to high-salt environments by reducing its root branching and to water deficiencies by expanding the distribution and absorption area of the root system. [ABSTRACT FROM AUTHOR]

To provide a basis for further optimization of the polio sequential immunization schedule, this study evaluated the effectiveness of booster immunization with one dose of bivalent oral poliovirus vaccine (bOPV) at 48 months of age after different primary polio immunization schedules. At 48 months of age, one dose of bOPV was administered, and their poliovirus types 1–3 (PV1, PV2, and PV3, respectively)-specific neutralizing antibody levels were determined. Participants found to be negative for any type of PV-specific neutralizing antibody at 24, 36, or 48 months of age were re-vaccinated with inactivated polio vaccine (IPV). The 439 subjects who received a bOPV booster immunization at the age of 48 months had lower PV2-specific antibody levels compared with those who received IPV. One dose of IPV during basic polio immunization induced the lowest PV2-specific antibody levels. On the basis of our findings, to ensure that no less than 70% of the vaccinated have protection efficiency, we recommend the following: if basic immunization was conducted with 1IPV + 2bOPV (especially Sabin strain-based IPV), a booster immunization with IPV is recommended at 36 months of age, whereas if basic immunization was conducted with 2IPV + 1bOPV, a booster immunization with IPV is recommended at 48 months of age. A sequential immunization schedule of 2IPV + 1bOPV + 1IPV can not only maintain high levels of antibody against PV1 and PV3 but also increases immunity to PV2 and induces early intestinal mucosal immunity, with relatively good safety. Thus, this may be the best sequential immunization schedule for polio in countries or regions at high risk for polio. [ABSTRACT FROM AUTHOR]

Kink model is developed to analyze the data where the regression function is two-stage piecewise linear with respect to the threshold covariate but continuous at an unknown kink point. In quantile regression for longitudinal data, kink point where the kink effect happens is often assumed to be heterogeneous across different quantiles. However, the kink point tends to be the same across different quantiles, especially in a region of neighboring quantile levels. Incorporating such homogeneity information could increase the estimation efficiency of the common kink point. In this paper, we propose a composite quantile estimation approach for the common kink point by combining information from multiple neighboring quantiles. Asymptotic normality of the proposed estimator is studied. In addition, we also develop a sup-likelihood-ratio test to check the existence of the kink effect at a given quantile level. A test-inversion confidence interval for the common kink point is also developed based on the quantile rank score test. The simulation studies show that the proposed composite kink estimator is more efficient than the single quantile regression estimator. We also illustrate the proposed method via an application to a longitudinal data set on blood pressure and body mass index. [ABSTRACT FROM AUTHOR]

Purpose: The 8th edition of the American Joint Committee on Cancer (AJCC) staging system for hepatocellular carcinoma (HCC) has been used since 2018. However, whether any significant difference in overall survival (OS) exists between patients with T1a and T1b HCC who undergo resection has been controversial. We aim to clarify this issue. Methods: We consecutively enrolled newly diagnosed HCC patients who underwent liver resection (LR) from 2010 to 2020 at our institution. OS was estimated using the Kaplan–Meier method and compared using log-rank tests. Prognostic factors for OS were identified by multivariate analysis. Results: This study enrolled 1250 newly diagnosed HCC patients who underwent LR. No significant differences in OS were identified between patients with T1a and T1b tumors among all patients (p = 0.694), cirrhotic patients (p = 0.753), non-cirrhotic patients (p = 0.146), patients with alpha-fetoprotein (AFP) > 20 ng/ml (p = 0.562), patients with AFP ≤ 20 ng/ml (p = 0.967), patients with Edmondson grade 1 or 2 (p = 0.615), patients with Edmondson grade 3 or 4 (p = 0.825), patients positive for hepatitis B surface antigen (HBsAg; p = 0.308), in patients positive for anti-hepatitis C virus (HCV) antibody (p = 0.781), or patients negative for both HBsAg and anti-HCV antibody (p = 0.125). Using T1a as the reference, multivariate analysis showed that T1b is not a significant predictive factor for OS (hazard ratio (HR): 1.338; 95% confidence interval (CI):0.737–2.431; p = 0.339). Conclusion: No significant difference in OS was observed between patients who underwent LR to treat T1a and T1b HCC tumors. [ABSTRACT FROM AUTHOR]

This study investigated the knowledge, thoughts, and attitudes of oncology nurses in China regarding fertility preservation for male cancer patients of childbearing age, and for offering counseling or oncofertility services for the men in their care. Data was collected from 18 oncology nurses in Southwest China through voluntary self-report and in-depth interviews. The qualitative interview data were analyzed using a descriptive phenomenology method based on the lived experience of the nurses. The interviewees commonly reported 6 main concerns regarding fertility preservation (FP): their insufficient knowledge and inadequate nursing education; the importance of offering such services to cancer patients; legal vulnerability if FP information is withheld from patients; the role of the nurse in counseling; and barriers to discussing FP in practice. Nurses had a positive attitude toward FP, but most had no practical role in routinely informing male patients of their options, and the nurses believed that discussion of FP was outside their scope of practice. This study offers insight into the perceptions of oncology nurses in a developing country regarding the provision of FP services for adult male cancer patients. These results lead us to recommend that local fertility nurses should be given new training regarding FP. Furthermore, nurse-led clinics are desirable. Future research should focus on the effectiveness of nurse participation in FP counseling and referral, and how to improve the professional confidence of oncology nurses for addressing FP issues. [ABSTRACT FROM AUTHOR]

Over the past few decades, molecular dynamics simulations and first-principles calculations have become two major approaches to predict the lattice thermal conductivity (κL), which are however limited by insufficient accuracy and high computational cost, respectively. To overcome such inherent disadvantages, machine learning (ML) has been successfully used to accurately predict κL in a high-throughput style. In this review, we give some introductions of recent ML works on the direct and indirect prediction of κL, where the derivations and applications of data-driven models are discussed in details. A brief summary of current works and future perspectives are given in the end. [ABSTRACT FROM AUTHOR]

Neural probes are among the most widely applied tools for studying neural circuit functions and treating neurological disorders. Given the complexity of the nervous system, it is highly desirable to monitor and modulate neural activities simultaneously at the cellular scale. In this review, we provide an overview of recent developments in multifunctional neural probes that allow simultaneous neural activity recording and modulation through different modalities, including chemical, electrical, and optical stimulation. We will focus on the material and structural design of multifunctional neural probes and their interfaces with neural tissues. Finally, future challenges and prospects of multifunctional neural probes will be discussed. [ABSTRACT FROM AUTHOR]

Bars: 25 m. (e,f) The corresponding parameter of TRAP and the serum bone resorption marker detected by enzyme-linked immunosorbent assay (ELISA) showed that miR-21 deficiency blocked age-related osteoclastogenesis and bone resorption. (d) Enzyme-linked immunosorbent assay (ELISA) detection of the serum bone resorption marker of 3-month WT and miR-21-/- mice. miR-21 deficiency inhibited the bone resorption rate. [Extracted from the article]