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Migration and homing of immune cells are critical for immune surveillance. Trafficking is mediated by combinations of adhesion and chemokine receptors that guide immune cells, in response to chemokine signals, to specific locations within tissues and the lymphatic system to support tissue-localized immune reactions and systemic immunity1,2. Here we show that disruption of leukaemia inhibitory factor (LIF) production from group 2 innate lymphoid cells (ILC2s) prevents immune cells leaving the lungs to migrate to the lymph nodes (LNs). In the absence of LIF, viral infection leads to plasmacytoid dendritic cells (pDCs) becoming retained in the lungs where they improve tissue-localized, antiviral immunity, whereas chronic pulmonary allergen challenge leads to marked immune cell accumulation and the formation of tertiary lymphoid structures in the lung. In both cases immune cells fail to migrate to the lymphatics, leading to highly compromised LN reactions. Mechanistically, ILC2-derived LIF induces the production of the chemokine CCL21 from lymphatic endothelial cells lining the pulmonary lymphatic vessels, thus licensing the homing of CCR7+ immune cells (including dendritic cells) to LNs. Consequently, ILC2-derived LIF dictates the egress of immune cells from the lungs to regulate tissue-localized versus systemic immunity and the balance between allergen and viral responsiveness in the lungs.Disruption of leukaemia inhibitory factor production from group 2 innate lymphoid cells prevents immune cells leaving the lungs to migrate to lymph nodes, leading to plasmacytoid dendritic cells becoming retained in the lungs following viral infection. [ABSTRACT FROM AUTHOR]

Big data becomes the key for ubiquitous computing and intelligence, and Distributed Storage Systems (DSS) are widely used in large-scale data centers or in the cloud for efficient data management. However, the data on stored are likely to be unavailable due to hardware failures and cyberattacks, e.g. DDoS. Maximum Distance Separable (MDS) codes are commonly used for the recovery of faulty storage nodes or unavailable data. However, the recovery of data nodes usually involves access to multiple nodes, which introduces significant communication overheads to the DSS. In this paper, a new DSS based on the Redundant Residue Number System (RRNS) is proposed, where efficient recovery is enabled by applying the second version of Chinese Remainder Theorem (CRT-II). The complexity and network traffic of the proposed data protection scheme is analyzed theoretically and compared with that of traditional MDS based DSSs. Experimental results show that the proposed DSS achieves lower encoding complexity, lower recovery complexity and lower network traffic than the MDS based schemes. Although the proposed data protection scheme introduces computation overheads for the case on which there are no failing nodes, its complexity is still lower for scenarios with frequent data updates. In addition, the proposed scheme introduces additional advantages in terms of security and storage flexibility. [ABSTRACT FROM AUTHOR]

Fully targeted mRNA therapeutics necessitate simultaneous organ-specific accumulation and effective translation. Despite some progress, delivery systems are still unable to fully achieve this. Here, we reformulate lipid nanoparticles (LNPs) through adjustments in lipid material structures and compositions to systematically achieve the pulmonary and hepatic (respectively) targeted mRNA distribution and expression. A combinatorial library of degradable-core based ionizable cationic lipids is designed, following by optimisation of LNP compositions. Contrary to current LNP paradigms, our findings demonstrate that cholesterol and phospholipid are dispensable for LNP functionality. Specifically, cholesterol-removal addresses the persistent challenge of preventing nanoparticle accumulation in hepatic tissues. By modulating and simplifying intrinsic LNP components, concurrent mRNA accumulation and translation is achieved in the lung and liver, respectively. This targeting strategy is applicable to existing LNP systems with potential to expand the progress of precise mRNA therapy for diverse diseases. Targeted delivery of mRNA using lipid nanoparticles is currently a challenge. Here, the authors examine the composition of LNPs and report changes to the standard formulation can address issues with liver accumulation and allow for increased tissue specific targeting. [ABSTRACT FROM AUTHOR]

Piezo-photocatalysis has recently been regarded as a promising strategy in energy generation and environmental remediation. Herein, Na0.5Bi0.5TiO3 (NBT) nanoparticles were fabricated by solid-state method and heat-treated at various temperatures. A coupling effect between piezoelectricity and photoexcitation of NBT nanoparticles to enable a high piezo-photocatalytic performance was demonstrated. The NBT nanoparticles heat-treated at 700oC exhibit an optimum piezo-photocatalytic performance with a degradation rate of 0.078 min−1 for Rhodamine B, which is 4.2 and 7.4 times of the individual photocatalysis and piezocatalysis, respectively. The high piezo-photocatalytic performance is ascribed to the small grain size, narrow band gap, low fluorescence intensity, low charge transfer resistance and large remnant polarization. Moreover, the NBT nanoparticles exhibit a good durability and universality for the piezo-photocatalytic degradation. On the basis of the radical trapping experiment, a possible piezo-photocatalytic mechanism was proposed. The work provides a new insight into piezo-photocatalysis and a new guidance for the design of high-performance catalysts. [ABSTRACT FROM AUTHOR]

The macroscopic mechanical behavior of granular materials is closely related to the fabric anisotropy and contact force anisotropy. In order to investigate the microevolution of fabric and force anisotropy of rock masses containing non-coplanar intermittent joints under direct shear loading, this paper establishes a numerical model using the particle flow code (PFC) based on the distinct element method (DEM) and investigates the effects of non-coplanar intermittent joints on the evolutions in the fabric and force anisotropy and the distributions of contact forces of rock specimens by setting up specimens with different ligament angles of joints. Meanwhile, the shear strength, deformation characteristics and failure mode, energy dissipation were analyzed to deepen the understanding of the macroscopic mechanical behavior of the specimens from the microscopic mechanism. Three anisotropic tensors a ij c , a ij n and a ij t are defined to characterize the anisotropic behavior of the granular materials which can show the evolution law of fabric and mechanical anisotropy of the system under direct shear load. The findings indicate that the degree of fabric anisotropy increases with increasing ligament, and the length of the load side significantly influences the initial mechanical anisotropy of the specimen. Concurrently, a rise in the ligament angle impedes the progression of anisotropy within the specimen, leading to a substantial reduction in the macroscopic mechanical strength of the rock. [ABSTRACT FROM AUTHOR]

Background: There has been a growing interest in characterizing factors influencing teaching decisions of science, technology, engineering, and mathematics (STEM) instructors in order to address the slow uptake of evidence-based instructional practices (EBIPs). This growing body of research has identified contextual factors (e.g., classroom layout, departmental norms) as primary influencers of STEM instructors' decision to implement EBIPs in their courses. However, models of influences on instructional practices indicate that context is only one type of factor to consider. Other factors fall at the individual level such as instructors' past teaching experience and their views on learning. Few studies have been able to explore in depth the role of these individual factors on the adoption of EBIPs since it is challenging to control for contextual features when studying current instructors. Moreover, most studies exploring adoption of EBIPs do not take into account the distinctive features of each EBIP and the influence these features may have on the decision to adopt the EBIP. Rather, studies typically explore barriers and drivers to the implementation of EBIPs in general. In this study, we address these gaps in the literature by conducting an in-depth exploration of individual factors and EBIPs' features that influence nine future STEM instructors' decisions to incorporate a selected set of EBIPs in their teaching. Results: We had hypothesized that the future instructors would have different reasoning to support their decisions to adopt or not Peer Instruction and the 5E Model as the two EBIPs have distinctive features. However, our results demonstrate that instructors based their decisions on similar factors. In particular, we found that the main drivers of their decisions were (1) the compatibility of the EBIP with their past experiences as students and instructors as well as teaching values and (2) experiences provided in the pedagogical course they were enrolled in. Conclusions: This study demonstrates that when considering the adoption of EBIPs, there is a need to look beyond solely contextual influences on instructor's decisions to innovate in their courses and explore individual factors. Moreover, professional development programs should leverage their participants past experiences as students and instructors and provide an opportunity for instructors to experience new EBIPs as learners and instructors. [ABSTRACT FROM AUTHOR]

Tripartite motif–containing 29 (TRIM29), also known as the ataxia telangiectasia group D-complementing (ATDC) gene, has been reported to play an oncogenic or tumor suppressive role in developing different tumors. So far, its expression and biological functions in hepatocellular carcinoma (HCC) remain unclear. We investigated TRIM29 expression pattern in human HCC samples using quantitative RT-PCR and immunohistochemistry. Relationships between TRIM29 expression level, clinical prognostic indicators, overall survival (OS), and disease-free survival (DFS) were evaluated by Kaplan–Meier analysis and Cox proportional hazards model. A series of in vitro experiments and a xenograft tumor model were conducted to detect the functions of TRIM29 in HCC cells. RNA sequencing, western blotting, and immunochemical staining were performed to assess the molecular regulation of TRIM29 in HCC. We found that the mRNA and protein levels of TRIM29 were significantly reduced in HCC samples, compared with adjacent noncancerous tissues, and were negatively correlated with poor differentiation of HCC tissues. Survival analysis confirmed that lower TRIM29 expression significantly correlated with shorter OS and DFS of HCC patients. TRIM29 overexpression remarkably inhibited cell proliferation, migration, and EMT in HCC cells, whereas knockdown of TRIM29 reversed these effects. Moreover, deactivation of the PTEN/AKT/mTOR and JAK2/STAT3 pathways might be involved in the tumor suppressive role of TRIM29 in HCC. Our findings indicate that TRIM29 in HCC exerts its tumor suppressive effects through inhibition of the PTEN/AKT/mTOR and JAK2/STAT3 signaling pathways and may be used as a potential biomarker for survival in patients with HCC. [ABSTRACT FROM AUTHOR]

Mammals exhibit different rates of cancer, with long-lived species generally showing greater resistance. Although bats have been suggested to be resistant to cancer due to their longevity, this has yet to be systematically examined. Here, we investigate cancer resistance across seven bat species by activating oncogenic genes in their primary cells. Both in vitro and in vivo experiments suggest that Myotis pilosus (MPI) is particularly resistant to cancer. The transcriptomic and functional analyses reveal that the downregulation of three genes (HIF1A, COPS5, and RPS3) largely contributes to cancer resistance in MPI. Further, we identify the loss of a potential enhancer containing the HIF1A binding site upstream of COPS5 in MPI, resulting in the downregulation of COPS5. These findings not only provide direct experimental evidence for cancer resistance in a bat species but also offer insights into the natural mechanisms of cancer resistance in mammals. Bats have been suggested to be resistant to cancer due to mechanisms related to their evolved longevity, but the associated molecular drivers are still understudied. Here, the authors examine cancer resistance mechanisms across seven bat species using in vitro and in vivo models, and identify HIF1A, COPS5, and RPS3 as related genes. [ABSTRACT FROM AUTHOR]

This study aimed to reveal harm of exposure to indoor air pollution to cognitive function through "gut-brain-axis" among rural elderly residents. There were 120 participants recruited in rural villages of northwest China from December 2021 to February 2022. The cognitive level was assessed by eight-item ascertain dementia (AD) questionnaire, and indoor air pollution exposure was measured by air quality sensor. Inflammatory cytokines and oxidative stress-related index were detected in blood serum. Fecal samples were collected for gut microbiota analysis. The 120 participants were divided into impaired cognition (AD8) (81/67.5%) and cognition normal (NG) (39/32.5%). And there had more female in AD8 (FAD) (55/67.9%) than NG (FNG) (18/46.2%) (P = 0.003). Exposure of air pollution in FAD was higher than FNG (PM1, PM2.5, PM10, P < 0.001; NO2, P < 0.001; CO, P = 0.014; O3, P = 0.002). The risk of cognitive impairment increases 6.8%, 3.6%, 2.6%, 11%, and 2.4% in female for every 1 μg/m3 increased in exposure of PM1, PM2.5, PM10, NO2, and O3, separately. And GSH-Px and T-SOD in FAD were significantly lower than the FNG group (P = 0.011, P = 0.019). Gut microbiota in FAD is disordered with lower richness and diversity. Relative abundance of core bacteria Faecalibacterium (top 1 genus) in FAD was reduced (13.65% vs 19.81%, P = 0.0235), while Escherichia_Shigella and Akkermansia was increased. Correlation analysis showed Faecalibacterium was negatively correlated with age, and exposure of O3, PM1, PM2.5, and PM10; Akkermansia and Monoglobus were positively correlated with exposure of PM1, PM2.5 and PM10; Escherichia_Shigella was significantly positively correlated with NO2. Indoor air pollution exposure impaired cognitive function in elderly people, especially female, which may cause systemic inflammation, dysbiosis of the gut microbiota, and ultimately leading to early cognitive impairment through the gut-brain axis. [ABSTRACT FROM AUTHOR]

A patented strain of Bacillus amyloliquefaciens C-1 in our laboratory could produce functional sodium selenite (Na2SeO3) under optimized fermentation conditions. With the strong stress resistance and abundant secondary metabolites, C-1 showed potential to be developed as selenium-enriched postbiotics. C-1 has the ability to synthesize SeNPs when incubated with 100 μg/ml Na2SeO3 for 30 h at 30 °C aerobically with 10% seeds-culture. The transformation rate from Na2SeO3 into SeNPs reached to 55.51%. After selenium enrichment, there were no significant morphology changes in C-1 cells but obvious SeNPs accumulated inside of cells, observed by scanning electron microscope and transmission electron microscope, verified by energy dispersive X-ray spectroscopy and X-ray photoelectron spectroscopy. SeNPs had antioxidant activity in radical scavenge of superoxide (O2−), Hydroxyl radical (OH−) and 1,1-diphenyl-2-picryl-hydrazine (DPPH), where scavenging ability of OH− is the highest. Selenium-enriched C-1 had obvious anti-inflammatory effect in protecting integrity of Caco-2 cell membrane destroyed by S. typhimurium; it could preventing inflammatory damage in Caco-2 stressed by 200 μM H2O2 for 4 h, with significantly reduced expression of IL-8 (1.687 vs. 3.487, P = 0.01), IL-1β (1.031 vs. 5.000, P < 0.001), TNF-α (2.677 vs. 9.331, P < 0.001), increased Claudin-1 (0.971 vs. 0.611, P < 0.001) and Occludin (0.750 vs. 0.307, P < 0.001). Transcriptome data analysis showed that there were 381 differential genes in the vegetative growth stage and 1674 differential genes in the sporulation stage of C-1 with and without selenium-enrichment. A total of 22 ABC transporter protein-related genes at vegetative stage and 70 ABC transporter protein-related genes at sporulation stage were founded. Genes encoding MsrA, thiol, glutathione and thioredoxin reduction were significantly up-regulated; genes related to ATP synthase such as atpA and atpD genes showed down-regulated during vegetative stage; the flagellar-related genes (flgG, fliM, fliL, and fliJ) showed down-regulated during sporulation stage. The motility, chemotaxis and colonization ability were weakened along with synthesized SeNPs accumulated intracellular at sporulation stage. B. amyloliquefaciens C-1 could convert extracellular selenite into intracellular SeNPs through the oxidation–reduction pathway, with strong selenium-enriched metabolism. The SeNPs and selenium-enriched cells had potential to be developed as nano-selenium biomaterials and selenium-enriched postbiotics. [ABSTRACT FROM AUTHOR]

Nucleic acid lateral flow assay (NALFA) with gold nanoparticles (AuNPs) as colorimetric probes have been extensively adopted for point-of-care testing (POCT). However, the sensitivity of NALFA still needs to be improved. Herein, DNA-gold nanoaggregate (DNA-AuNA) was assembled as a signal amplification probe of NALFA for sensitive detection of tumor marker TK1 mRNA. Four functional oligonucleotides with complementary pairs were assembled to form DNA-AuNA that coupled more AuNPs to improve sensitivity. Thus, the limit of detection (LOD) was 0.36 pM, which is lower than that of conventional AuNPs-based NALFA. Moreover, the bioassay showed good reproducibility, stability, and specificity for detecting TK1 mRNA. The detection of TK1 mRNA in human serum was also satisfactory. Therefore, DNA-AuNA-based NALFA provides a sensitive method for portable detection of TK1 mRNA. [ABSTRACT FROM AUTHOR]

Purpose: Studies have demonstrated correlations between frailty and comorbidity scores with adverse outcomes in total knee replacement (TKR). However, there is a lack of consensus on the most suitable pre-operative assessment tool. This study aims to compare Clinical Frailty Scale (CFS), Modified Frailty Index (MFI), and Charlson Comorbidity Index (CCI) in predicting adverse post-operative complications and functional outcomes following a unilateral TKR. Methods: In total, 811 unilateral TKR patients from a tertiary hospital were identified. Pre-operative variables were age, gender, body mass index (BMI), American Society of Anesthesiologists (ASA) class, CFS, MFI, and CCI. Binary logistic regression analysis was performed to ascertain odd ratios of pre-operative variables on adverse post-operative complications (length of stay < LOS >, complications, ICU/HD admission, discharge location, 30-day readmission, 2-year reoperation). Multiple linear regression analyses were used to estimate the standardized effects of pre-operative variables on the Knee Society Functional Score (KSFS), Knee Society Knee Score (KSKS), Oxford Knee Score (OKS), and 36-Item Short Form Survey (SF-36). Results: CFS is a strong predictor for LOS (OR 1.876, p < 0.001), complications (OR 1.83–4.97, p < 0.05), discharge location (OR 1.84, p < 0.001), and 2-year reoperation rate (OR 1.98, p <.001). ASA and MFI were predictors for ICU/HD admission (OR:4.04, p = 0.002; OR 1.58, p = 0.022, respectively). None of the scores was predictive for 30-day readmission. A higher CFS was associated with a worse outcome for 6-month KSS, 2-year KSS, 6-month OKS, 2-year OKS, and 6-month SF-36. Conclusion: CFS is a superior predictor for post-operative complications and functional outcomes than MFI and CCI in unilateral TKR patients. This suggests the importance of assessing pre-operative functional status when planning for TKR. Level of evidence: Diagnostic, II. [ABSTRACT FROM AUTHOR]

Objective: We aimed to assess the association between meditation practice and cognitive function over time among middle-aged and older adults. Method: We included Health and Retirement Study (HRS) participants assessed for meditation practice in the year 2000 as part of the HRS alternative medicine module (n = 1,160) and were followed up for outcomes over 2000–2016 period. We examined the association between meditation ≥ twice a week vs none/less frequent practice and changes in the outcomes of recall, global cognitive function, and quantitative reasoning using generalized linear regression models. Stratified analyses among persons with/without self-reported baseline depressive symptoms were conducted to assess the link between meditation and cognitive outcomes. Results: Among our full study sample, meditation ≥ twice a week was not significantly associated with total recall [β = -0.20; 95% CI: -0.97, 0.57; p = 0.61], global cognitive function [β = 0.05; 95% CI: -1.01, 1.12; p = 0.92], and quantitative reasoning [β = -11.48; 95% CI: -31.27, 8.32; p = 0.26]. However, among those who did not have self-reported depressive symptoms at baseline, meditation ≥ twice a week was associated with improvement in cognitive outcomes such as total recall [β = 0.11; 95% CI: 0.03, 0.18; p = 0.01] and global cognitive function [β = 0.22; 95% CI: 0.05, 0.40; p = 0.01] over time. Conclusions: Frequent meditation practice might have a protective effect on cognitive outcomes over time, but this protection could be limited to those without self-reported baseline depressive symptoms. Future studies could incorporate more precise meditation practice assessment, investigate the effect of meditation on cognitive outcomes over time, and include more rigorous study designs with randomized group assignment. Pre-registration: This study is not preregistered. [ABSTRACT FROM AUTHOR]

Background: Attention-deficit hyperactivity disorder is a common disorder that affects both children and adults. However, for adults, little is known about ADHD-attributable medical expenditures. Objective: To estimate the medical expenditures associated with ADHD, stratified by age, in the US adult population. Design: Using a two-part model, we analyzed data from Medical Expenditure Panel Survey for 2015 to 2019. The first part of the model predicts the probability that individuals incurred any medical costs during the calendar year using a logit model. The second part of the model estimates the medical expenditures for individuals who incurred any medical expenses in the calendar year using a generalized linear model. Covariates included age, sex, race/ethnicity, geographic region, Charlson comorbidity index, insurance, asthma, anxiety, and mood disorders. Participants: Adults (18 +) who participated in the Medical Expenditure Panel Survey from 2015 to 2019 (N = 83,776). Main Measures: Overall and service specific direct ADHD-attributable medical expenditures. Key Results: A total of 1206 participants (1.44%) were classified as having ADHD. The estimated incremental costs of ADHD in adults were $2591.06 per person, amounting to $8.29 billion nationally. Significant adjusted incremental costs were prescription medication ($1347.06; 95% CI: $990.69–$1625.93), which accounted for the largest portion of total costs, and office-based visits ($724.86; 95% CI: $177.75–$1528.62). The adjusted incremental costs for outpatient visits, inpatient visits, emergency room visits, and home health visits were not significantly different. Among older adults (31 +), the incremental cost of ADHD was $2623.48, while in young adults (18–30), the incremental cost was $1856.66. Conclusions: The average medical expenditures for adults with ADHD in the US were substantially higher than those without ADHD and the incremental costs were higher in older adults (31 +) than younger adults (18–30). Future research is needed to understand the increasing trend in ADHD attributable cost. [ABSTRACT FROM AUTHOR]

Introduction: Tranexamic acid (TXA) is being increasingly utilized to reduce blood loss after knee joint arthroplasty. However, there is a lack of studies on the effect of topical TXA on the functional outcomes and quality of life after Unicompartmental Knee Arthroplasty (UKA). The aim of this study was to determine the effect of topical TXA on functional outcomes and quality of life scores in patients undergoing UKA. Materials and methods: We retrospectively analysed patients undergoing unilateral UKA at a single tertiary hospital from 2005 to 2017. Patients were divided into 2 groups: (1) The control group which did not receive TXA (n = 742); (2) The TXA group which received topical TXA (n = 331). Functional outcomes were assessed using the Knee Society Function Score (KSFS), Knee Society Knee Score (KSKS) and Oxford Knee Score (OKS), while quality of life was evaluated with the Physical Component Score (PCS) and Mental Component Score (MCS) of Short-Form 36 (SF-36) preoperatively and at 6 months and 2 years follow-up. Results: At 6 months and 2 years post-surgery, there were no significant differences in the functional scores between the groups. The number of patients who attained minimum clinically important difference (MCID) for each of the functional scores was also comparable between the groups. Conclusions: In patients undergoing UKA, functional outcomes and quality of life scores were comparable between those who received topical TXA and those who did not. There was no significant improvement or impairment in knee function associated with topical TXA administration in UKA up to 2 years follow-up. [ABSTRACT FROM AUTHOR]

Previous research has documented the association between racial discrimination and poor sleep quality. However, few studies have examined this association during the COVID-19 pandemic when racial discrimination is on the rise due to structural injustice and racism against people of color. Using data from the Health, Ethnicity, and Pandemic (HEAP) Study, a nationally representative survey of US adults, we assessed the association between racial discrimination and sleep quality among overall adults and by race and ethnicity. We found that racial discrimination during the pandemic was significantly associated with higher risks of poor sleep quality among non-Hispanic Black (OR = 2.19, 95% CI: 1.13–4.25) and Asian (OR = 2.75, 95% CI: 1.53–4.94) participants, but not among the other groups. The results suggested that sleep quality among Black and Asian populations may have been disproportionately affected by racial discrimination during the pandemic. Further study is needed to assess the causal relationship between racial discrimination and sleep quality. [ABSTRACT FROM AUTHOR]

Objectives: We sought to identify the most common diagnostic categories linked to dispensed opioid prescriptions among children 1–36 months old and changes in patterns over the years 2000 to 2017. Methods: This study used South Carolina's Medicaid claims data of pediatric dispensed outpatient opioid prescriptions between 2000 and 2017. The major opioid-related diagnostic category (indication) for each prescription was identified using visit primary diagnoses and the Clinical Classification System (AHRQ-CCS) software. The variables of interest were the rate of opioid prescriptions per 1,000 visits for each diagnostic category and the relative percentage of opioid prescriptions assigned to each category compared to all categories. Results: Six major diagnostic categories were identified; Diseases of the respiratory system (RESP), Congenital anomalies (CONG), Injury (INJURY), Diseases of the nervous system and sense organs (NEURO), Diseases of the digestive system (GI), and Diseases of the genitourinary system (GU). The overall rate of dispensed opioid prescriptions per category declined significantly for four diagnostic categories throughout the study period, RESP by 15.13, INJURY by 8.49, NEURO by 7.33, and GI by 5.93. Two categories increased during the same time, CONG (by 9.47) and GU (by 6.98). RESP was the most prevalent category linked to a dispensed opioid prescription within 2010–2012 (almost 25%) but CONG was the most prevalent by 2014 (17.77%). Conclusions for practice: Among Medicaid children 1–36 months old, annual dispensed opioid prescription rates declined for most major diagnostic categories (RESP, INJURY, NEURO, and GI). Future studies should explore alternatives to current opioid dispensing practices for GU and CONG cases. Significance: Eventhough opioid is a high-risk medication for children, it is continued to be prescribed to pediatric population. A little is known about the diagnoses associated with opioid prescribing among children 1–36 months old and their trends. This study demonstrates that opioid prescriptions linked to respiratory diagnosis have become less prevalent, surpassed by opioids prescribed for surgical conditions. [ABSTRACT FROM AUTHOR]

Two new ratiometric hypoxia probes (Ir-C343 and Ir-GFP) are synthesized by covalently incorporating florescent internal standard molecules coumarin 343 (C343) and green fluorescent protein (GFP) into bis[1-(9,9-dimethyl-9H-fluoren-2-yl)-isoquinoline] (succinylacetone) Ir(III) (Ir-fliq), respectively. After connecting with internal standard molecules, the Ir-fliq moiety still exhibits high sensitivity to oxygen concentration, while the fluorescence intensity of the internal standard remains relatively constant under different oxygen concentrations. As a result, a ratiometric response is realized that is only related to oxygen concentration. In addition, Ir-GFP shows more promising applications in the ratiometric hypoxia imaging of cells due to its long excitation wavelength, good water solubility, high biocompatibility, and low relative fluorescence intensity compared with the phosphorescent emitter Ir-fliq. [ABSTRACT FROM AUTHOR]

Gas pressure biosensing is a promising portable analysis method. The gas-generation reaction is crucial to its sensitivity, speed, repeatability, and usability. However, very few gas-generation reactions are available for sensitive, safe, and diverse biosensing. Herein, acid-accelerated hydrolysis of sodium borohydride (NaBH4) was explored for the first time to achieve portable and diverse gas pressure biosensing. The slow hydrolysis and hydrogen generation of NaBH4 in alkaline medium is accelerated with increasing acidity, which increased the gas pressure in a small and sealed tube within 10 min. Thus, a label-free bioassay is easily and specifically achieved once analytes can in-situ generate acid to accelerate the hydrolysis rate of NaBH4, such as glucose, acetylcholine (ACh), adenosine triphosphate (ATP) and others. More importantly, analytes without acid generation could be quantitatively and selectively detected by combining target recognition with acid-generated biochemical reactions for enzyme-linked gas pressure biosensing. Inspired by this, aflatoxin B1 (AFB1)-aptamer interaction-triggered strand displacement reaction was combined with glucose oxidation by glucose oxidase (GOD) to detect AFB1 as low as 7.1 pM. Therefore, acid-accelerated hydrolysis of NaBH4 is powerful for developing portable, cheap, and diverse gas pressure biosensing. It opens up a new way for cheap, universal, and portable biosensing. [ABSTRACT FROM AUTHOR]

Background: Gene therapy is known to be unaffordable to those who need it the most; however, evidence on the financial impact is limited. Objective: This study aimed to estimate the budget impact and affordability of the gene therapy idecabtagene vicleucel for the treatment of adult patients with relapsed or refractory multiple myeloma (rrMM) in the US over a 3-year period from the payer healthcare perspective. Method: A budget impact model was developed to estimate the budget impact to the US healthcare plan compared with bortezomib-based maintenance therapy. The target population size was based on a hypothetical 1-million-member plan over a 3-year time horizon with and without idecabtagene vicleucel adoption. The cost of drug acquisition, drug administration, and grade 3–4 adverse events (AEs) were calculated for both scenarios. The budget impact of idecabtagene vicleucel was calculated as the difference in costs for these two scenarios. Costs were extracted from IBM-Micromedex Red Book, Centers for Medicare and Medicaid Services, and the literature. A one-way sensitivity analysis was performed to ensure robustness. Results: An estimated 22 patients with rrMM each year would be eligible for idecabtagene vicleucel. The model projected the annual cost per patient in the first year as $19,449 and $517,528.13 for bortezomib and idecabtagene vicleucel, respectively. Introducing idecabtagene vicleucel was predicted to increase the total budget by $13.4, $13.6, and $14 million in the first, second, and third years. There would be an additional $1.1128, $1.1252, and $1.1486 per member per month (PMPM) when using idecabtagene vicleucel over bortezomib. Conclusion: This study suggests that the high cost of the gene therapy idecabtagene vicleucel is justifiable due to the low number of rrMM patients. [ABSTRACT FROM AUTHOR]

Background: Two chimeric antigen receptor-engineered T (CAR T) cell therapy drugs were recently approved for the treatment of patients with relapsed or refractory multiple myeloma (rrMM). Their financial impact, however, is poorly described. Objective: The aim was to evaluate the economic burden of CAR T cell therapies ciltacabtagene autoleucel and idecabtagene vicleucel for the treatment of rrMM patients after at least four lines of therapy, and to compare the annual cost of these CAR T cell therapies over a hypothetical 1-million-member health plan from the US healthcare payer perspective. Patients and Methods: The annual economic burden of ciltacabtagene autoleucel and idecabtagene vicleucel was estimated using data from pivotal clinical trials. The costs of drug acquisition, administration, and adverse event (AE) management were extracted from the IBM-Micromedex Red Book online, the Centers for Medicare & Medicaid Services fee schedules, and a review of the literature. We used descriptive statistics for the analysis. Results: The annual costs (US dollars) of drug acquisition, administration, and AE management per patient were $465,000, $60,167, and $40,368 and $419,500, $61,250, and $47,270 for ciltacabtagene autoleucel and idecabtagene vicleucel, respectively. The total annual cost was higher for ciltacabtagene autoleucel ($565,534) than for idecabtagene vicleucel ($528,020). However, the total annual cost in a hypothetical 1-million-member plan was less with ciltacabtagene autoleucel, by $1.8 million. Conclusion: This study found that the CAR T cell gene therapies ciltacabtagene autoleucel and idecabtagene vicleucel for rrMM represent a significant economic burden for healthcare payers in the USA. [ABSTRACT FROM AUTHOR]

Background: Epidemiological evidence on different classes of antihypertensives and risks of Alzheimer's disease and related dementias (ADRD) is inconclusive and limited. This study examined the association between antihypertensive use (including therapy type and antihypertensive class) and ADRD diagnoses among older adults with hypertension. Methods: A retrospective, cross-sectional study was conducted, involving 539 individuals aged ≥ 65 years who used antihypertensives and had ADRD diagnosis selected from 2013 to 2018 Medical Expenditure Panel Survey (MEPS) data. The predictors were therapy type (monotherapy or polytherapy) and class of antihypertensives defined using Multum Lexicon therapeutic classification (with calcium channel blockers [CCBs] as the reference group). Weighted logistic regression was used to assess the relationships of therapy type and class of antihypertensives use with ADRD diagnosis, adjusting for sociodemographic characteristics and health status. Results: We found no significant difference between monotherapy and polytherapy on the odds of ADRD diagnosis. As to monotherapy, those who used angiotensin-converting enzyme inhibitors (ACEIs) had significantly lower odds of developing AD compared to those who used CCBs (OR 0.36, 95 % CI 0.13–0.99). Conclusions: Findings of the study suggest the need for evidence-based drug therapy to manage hypertension in later adulthood and warrant further investigation into the mechanism underlying the protective effect of antihypertensives, particularly ACEIs, against the development of AD among older adults with hypertension. [ABSTRACT FROM AUTHOR]

The underlying cellular diversity and heterogeneity from cervix precancerous lesions to cervical squamous cell carcinoma (CSCC) is investigated. Four single-cell datasets including normal tissues, normal adjacent tissues, precancerous lesions, and cervical tumors were integrated to perform disease stage analysis. Single-cell compositional data analysis (scCODA) was utilized to reveal the compositional changes of each cell type. Differentially expressed genes (DEGs) among cell types were annotated using BioCarta. An assay for transposase-accessible chromatin sequencing (ATAC-seq) analysis was performed to correlate epigenetic alterations with gene expression profiles. Lastly, a logistic regression model was used to assess the similarity between the original and new cohort data (HRA001742). After global annotation, seven distinct cell types were categorized. Eight consensus-upregulated DEGs were identified in B cells among different disease statuses, which could be utilized to predict the overall survival of CSCC patients. Inferred copy number variation (CNV) analysis of epithelial cells guided disease progression classification. Trajectory and ATAC-seq integration analysis identified 95 key transcription factors (TF) and one immunohistochemistry (IHC) testified key-node TF (YY1) involved in epithelial cells from CSCC initiation to progression. The consistency of epithelial cell subpopulation markers was revealed with single-cell sequencing, bulk sequencing, and RT-qPCR detection. KRT8 and KRT15, markers of Epi6, showed progressively higher expression with disease progression as revealed by IHC detection. The logistic regression model testified the robustness of the resemblance of clusters among the various datasets utilized in this study. Valuable insights into CSCC cellular diversity and heterogeneity provide a foundation for future targeted therapy. [ABSTRACT FROM AUTHOR]

Background: Inflammation is involved in the healing process; however, when inflammation is overactivated, multiple diseases can occur. The continued discovery of new anti-inflammatory drugs is crucial in the treatment of inflammation-linked diseases. Objectives: Ferulic acid (FA), a precursor necessary for lignan synthesis, is widely distributed in plant-based whole foods and is a strong antioxidant. However, the effect of FA on the expression level of inflammatory factors in macrophages has not been fully clarified. The current study aimed to explore the anti-inflammatory effect and mechanism of ferulic acid. Results: The results showed that THP-1 cells were induced to differentiate into macrophages by Phorbol-12-myristate-13-acetate (PMA), and THP-1-derived macrophages were stimulated by LPS to establish an inflammatory cell model. Compared with the control group, low (5 μmol·mL−1), medium (10 μmol·mL−1), and high (20 μmol·mL−1) concentration ferulic acid groups have decreased cell viability and increased apoptosis rate in a dose-dependent manner. FA reduced the transcriptional levels of Interleukin-1β (IL-1β), Interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α). Importantly, FA-induced autophagy and inhibited NLRP3 inflammasome activation. 3-MA (a widely used autophagy inhibitor) enhanced the secretion of TNF-α, IL-6 and IL-1β. Moreover, autophagy inhibition by 3-MA resulted in increased proteins expression associated with NLRP3 inflammasome signaling pathway. Besides, the inhibition of inflammasome activation by MCC950 reduced the expression of TNF-α, IL-6 and IL-1β. Conclusion: It is concluded that FA enhanced autophagy, inhibited the activation of NLRP3 inflammasome and reduced the expression and release of inflammatory factors. [ABSTRACT FROM AUTHOR]

Objectives: This study includes a systematic review of cost-effectiveness analyses (CEAs) and cost–benefit analyses (CBAs) of mindfulness-based interventions (MBIs). Methods: A literature search was conducted using PubMed, Web of Science, JSTOR, and CINAHL for studies published between January 1985 and September 2021, including an original cost-related evaluation of an MBI. A qualitative assessment of bias was performed using the Drummond checklist. Results: Twenty-eight mindfulness-based intervention studies (18 CEAs and 10 CBAs) were included in this review. Mindfulness-based stress reduction (MBSR) was less costly and more effective when compared with the usual care of cognitive behavioral therapy among patients with chronic lower back pain, fibromyalgia, and breast cancer. MBSR among patients with various physical/mental conditions was associated with reductions in healthcare costs. Mindfulness-based cognitive therapy (MBCT) was also less costly and more effective than the comparison group among patients with depression, medically unexplained symptoms, and multiple sclerosis. MBCT's cost-effectiveness advantage was also identified among breast cancer patients with persistent pain, non-depressed adults with a history of major depressive disorder episodes, adults diagnosed with ADHD, and all cancer patients. From a societal perspective, the cost-saving property of mindfulness training was evident when used as the treatment of aggressive behaviors among persons with intellectual/developmental disabilities in mental health facilities. Conclusions: Based on this review, more standardized MBI protocols such as MBSR and MBCT compare favorably with usual care in terms of health outcomes and cost-effectiveness. Other MBIs may result in cost savings from both healthcare and societal perspectives among high-risk patient populations. [ABSTRACT FROM AUTHOR]

Background: While hate crimes rose during the COVID-19 pandemic, few studies examined whether this pandemic-time racial discrimination has led to negative health consequences at the population level. Objective: We examined whether experienced and perceived racial discrimination were associated with mental or behavioral health outcomes during the pandemic. Design: In October 2020, we conducted a national survey with minorities oversampled that covered respondents' sociodemographic background and health-related information. Participants: A total of 2709 participants responded to the survey (response rate: 4.2%). Main Measures: The exposure variables included (1) experienced and encountered racial discrimination, (2) experienced racial and ethnic cyberbullying, and (3) perceived racial bias. Mental health outcomes were measured by psychological distress and self-rated happiness. Measures for behavioral health included sleep quality, change in cigarette smoking, and change in alcohol consumption. Weighted logistic regressions were performed to estimate the associations between the exposure variables and the outcomes, controlling for age, gender, race and ethnicity, educational attainment, household income, eligibility to vote, political party, COVID-19 infection, and geographic region. Separate regressions were performed in the six racial and ethnic subgroups: non-Hispanic White, non-Hispanic Black, Hispanic, East Asian, South Asian, and Southeast Asian respondents. Key Results: Experienced racial discrimination was associated with higher likelihood of psychological distress (adjusted odds ratio [AOR] = 2.18, 95% confidence interval [95% CI]: 1.34–3.55). Experienced racial discrimination (AOR = 2.31, 95% CI: 1.34–3.99) and perceived racial bias (AOR = 1.05, 95% CI: 1.00–1.09) were both associated with increased cigarette smoking. The associations between racial discrimination and mental distress and substance use were most salient among Black, East Asian, South Asian, and Hispanic respondents. Conclusions: Racial discrimination may be associated with higher likelihood of distress, and cigarette smoking among racial and ethnic minorities. Addressing racial discrimination is important for mitigating negative mental and behavioral health ramifications of the pandemic. [ABSTRACT FROM AUTHOR]

To investigate associations between parent–child relationships, children's externalizing and internalizing symptoms, and lifestyle responses to the COVID-19 epidemic, we conducted an online survey of a random, representative sample of residents with children aged 3–17 years during mid-March 2020 in Wuhan and Shanghai, China. A total of 1655 parents and children were surveyed with a response rate of 80.1% in the survey. During the epidemic, the frequency of children enquiring about the epidemic (AOR = 1.46, 95% CI: 1.04, 2.06), parents explaining the epidemic to them (AOR = 2.87, 95% CI: 1.80, 4.58), parents expressing negative emotions in front of them (AOR = 2.62; 95% CI = 2.08–3.30), and parents with more irritable attitudes (AOR = 1.93; 95% CI = 1.33–2.81) were significantly associated with children's externalizing symptoms. For internalizing symptoms, significant associations were found with worse parent–child closeness (AOR = 2.93; 95% CI = 1.80–4.79), the frequency of parents expressing negative emotions in front of them (AOR = 2.64; 95% CI = 1.68, 4.12), and more irritable attitudes (AOR = 2.24; 95% CI = 1.42–3.55). We also found that each indicator of parent–child relationships had the significantly similar associations with children's lifestyle behaviors. These findings suggest that improving parents' attitudes towards their children and parent–child closeness during the epidemic, especially among parents with lower educational levels, are important to ensure the wellbeing of children. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the pharmacodynamic effects of indobufen and low-dose aspirin in patients with coronary atherosclerosis. Methods: In the first phase, 218 patients with coronary atherosclerosis were randomly assigned to receive aspirin 100 mg once daily (standard dose); 100 mg once every 2 days; 100 mg once every 3 days; 50 mg twice daily; 75 mg once daily; 50 mg once daily; or indobufen 100 mg twice daily for 1 month. In the second phase, 20 healthy subjects were treated with indobufen 100 mg twice daily for 1 week followed after a 2-week washout by aspirin 100 mg once daily for 1 week. The primary outcome was arachidonic acid-induced platelet aggregation (PLAA), and the secondary outcomes included plasma thromboxane B2 (TXB2) and urinary 11-dehydro-TXB2 (11-dh-TXB2) levels at the end of each treatment. Results: In the first phase, compared with aspirin 100 mg once daily: all aspirin groups had similar suppression of PLAA whereas indobufen group had significantly less suppressed PLAA. Aspirin given every second or third day, and indobufen produced less suppression of plasma TXB2. All treatment regimens produced similar inhibition of 11-dh-TXB2. In the second phase, compared with aspirin, indobufen produced less suppression of plasma TXB2 at 8 h and 12 h after the last dose. Conclusions: Aspirin 50 mg twice daily, 75 mg once daily, and aspirin 50 mg once daily produce antiplatelet effects that are similar to aspirin 100 mg once daily. Aspirin given less often than once daily and indobufen 100 mg twice daily do not suppress platelets as effectively as aspirin 100 mg once daily. [ABSTRACT FROM AUTHOR]

Purpose: The Attune® Knee System provides new instrumentation to achieve symmetric flexion/extension gaps in total knee arthroplasty (TKA). However, there is limited information on the optimal TKA technique using this system. The aim of this randomised controlled trial was to determine which surgical technique results in better postoperative clinical outcomes after TKA using the contemporary Attune® Knee System: the measured resection or gap balancing technique. Methods: A prospective randomized controlled trial was conducted with 100 patients undergoing TKA using measured resection (n = 50) or gap balancing (n = 50) technique. The measured femoral sizer was used in the measured resection group, while the balanced femoral sizer was used in the gap balancing group. Functional outcomes and quality of life were assessed preoperatively and at 6 months and 2 years post-surgery, using the Knee Society Function Score (KSFS), Knee Society Knee Score (KSKS), Oxford Knee Score (OKS), the Physical Component Score (PCS) and Mental Component Score (MCS) of Short-Form 36 (SF-36). Using weight-bearing coronal radiographs, the hip-knee-ankle angle (HKA), coronal femoral component angle (CFA), coronal tibial component angle (CTA) and joint line height were also evaluated for each patient. Results: There were no significant differences in the functional scores or the proportion of patients from each group who were satisfied or had their expectations fulfilled at 6 months or 2 years post-surgery. There was also no significant difference in the number of patients who attained minimum clinically important difference (MCID) postoperatively between the groups. Postoperatively, there was no significant difference in the number of HKA outliers between the groups (p = 0.202). The postoperative CFA (p = 0.265) and CTA (p = 0.479) were similar between the groups. There was also no significant difference in the absolute change (p = 0.447) or proportion of outliers (p = 0.611) for joint line height between the groups. Conclusion: Both measured resection and gap balancing techniques resulted in comparable functional and quality of life outcomes up to 2 years post-surgery. Both techniques appear to be equally effective in achieving excellent outcomes with the Attune® Knee System. Level of evidence: I. [ABSTRACT FROM AUTHOR]

The accurate detection and tracking of pupil is important to many applications such as human–computer interaction, driver's fatigue detection and diagnosis of brain diseases. Existing approaches however face challenges in handing low quality of pupil images. In this paper, we propose an integrated pupil tracking framework, namely LVCF, based on deep learning. LVCF consists of the pupil detection model VCF which is an end-to-end network, and the LSTM pupil motion prediction model which applies LSTM to track pupil's position. The proposed network was trained and evaluated on 10600 images and 75 videos taken from 3 realistic datasets. Within an error threshold of 5 pixels, VCF achieves an accuracy of more than 81%, and LVCF outperforms the state of arts by 9% in terms of percentage of pupils tracked. The project of LCVF is available at https://github.com/UnderTheMangoTree/LVCF. [ABSTRACT FROM AUTHOR]

Background: Asthma has been a global problem, especially in children. We aim to evaluate the contemporary prevalence and influencing factors of asthma among children aged 3–7 years in Shanghai, China. Methods: A random sample of preschool children was included in this study. The International Study of Asthma and Allergies in Childhood questionnaire was adopted to assess the childhood asthma. Multivariable logistic regression models were used to evaluate the associations between independent variables and childhood asthma. Results: Of 6389 preschool children who were invited to take part in this study, 6163 (response rate: 96.5%) completed the questionnaire and were included in the analysis. The overall prevalence of asthma was 14.6% which increased more than six folds from 2.1% in 1990. Being male, younger age, preterm delivery, being born in spring or autumn, being delivered by elective cesarean section without indication, miscarriage, high socioeconomic status, having allergy history, and exposure to passive smoking, latex paint, and dust were potential risk factors for childhood asthma. Spending more time outdoors (> 30 min/day), having indoor plants, and cleaning rooms more frequently were potential protective factors. Conclusions: The prevalence of childhood asthma in Shanghai has increased dramatically during the past three decades. The findings about risk and protective factors of childhood asthma could be used to develop appropriate strategies to prevent and control childhood asthma in Shanghai and in other similar metropolitan cities. [ABSTRACT FROM AUTHOR]

Introducing heating function to oil sorbents opens up a new pathway to the fast cleanup of viscous crude oil spills in situ. The oil sorption speed increases with the rise of the temperature, thus oil sorbents with high heating temperature are desirable. Besides, the oil sorbents also need to be produced environment-friendly. Here we present carbonized melamine-formaldehyde sponges (CMSs) that exhibited superior heating performance and the CMSs could be massively fabricated through a non-polluting pyrolysis process. The conductive CMSs could be heated over 300 °C with a low applied voltage of 6.9 V and keep above 250 °C for 30 min in the air without obvious damage. Such high heating performance enabled heating up the oil spills with a high rate of 2.65 °C·s−1 and 14% improvement of oil sorption coefficient compared with the state-of-the-art value. We demonstrated that one joule-heated CMS could continuously and selectively collect viscous oil spills (9,010 mPa·s) 690 times its own weight in one hour. The CMSs will be a highly competitive sorbent material for the fast remediation of future crude oil spills. [ABSTRACT FROM AUTHOR]

Background: Investigations into drivers and barriers to the uptake of learner-centered instructional practices in STEM courses have identified the climate within a department as a potential influential factor. However, few studies have explored the relationship between adoption of learner-centered instructional practices and departmental climate around teaching. Moreover, surveys that have been designed to measure climate around teaching have been focused on measuring individual faculty member's description of their colleagues' perceptions of the climate within their department (psychological collective climate) and ignored whether there was a consensus among respondents within the same department on these descriptions. This latter measure (departmental collective climate) is best aligned with the definition of organizational climate. There is thus a need to explore whether departmental climate measured at the individual or collective level relate to the use of learner-centered instructional practices. Results: This study demonstrates that the Departmental Climate around Teaching (DCaT) survey provides valid and reliable data that can be used to measure psychological collective climate within a STEM department. Analysis of the 166 faculty members who responded to the survey indicated that (1) four different types of psychological collective climate existed among our population and (2) multiple types could be present within the same STEM department. Moreover, it showed that measuring departmental collective climate is challenging as few constructs measured by the DCaT survey reached high level of consensus within faculty members from the same department. Finally, the analysis found no relationship between psychological collective climate and the level of use of learner-centered instructional practices. Conclusions: Results from the validation studies conducted on the DCaT survey that most elements that define a climate (e.g., policies, practices, expectations) are lacking when it comes to teaching. These findings could explain the challenges experienced in this study in measuring departmental collective climate. Without these climate elements, faculty members are left to work autonomously with little expectations for growth in their instructional practices. Establishing policies, practices, and expectations with respect to teaching is thus an essential step toward instructional change at a departmental level. [ABSTRACT FROM AUTHOR]

Photoelectrochemical catalysis is an attractive way to provide direct hydrogen production from solar energy. However, solar conversion efficiencies are hindered by the fact that light harvesting has so far been of limited efficiency in the near-infrared region as compared to that in the visible and ultraviolet regions. Here we introduce near-infrared-active photoanodes that feature lattice-matched morphological hetero-nanostructures, a strategy that improves energy conversion efficiency by increasing light-harvesting spectral range and charge separation efficiency simultaneously. Specifically, we demonstrate a near-infrared-active morphological heterojunction comprised of BiSeTe ternary alloy nanotubes and ultrathin nanosheets. The heterojunction's hierarchical nanostructure separates charges at the lattice-matched interface of the two morphological components, preventing further carrier recombination. As a result, the photoanodes achieve an incident photon-to-current conversion efficiency of 36% at 800 nm in an electrolyte solution containing hole scavengers without a co-catalyst. The solar conversion efficiencies of photoelectrochemical catalysis are hindered by the light harvesting range. Here, the authors use near-infrared-active photoanodes that feature lattice-matched morphological hetero-nanostructures to realize efficient photoelectrochemical hydrogen production. [ABSTRACT FROM AUTHOR]

Semiconductor metal oxides have attracted wide attention in the area of gas sensor due to that they have unique advantages in the rapid and accurate detection of harmful gases. A simple strategy is to synthesize porous NiO hollow microspheres via a simple hydrothermal method with trisodium citrate as structure guide agent is presented in this paper, and the shell of the microsphere is composed of porous and lamellar assembly units. The cavity proportion can be adjusted by changing the amount of trisodium citrate. A reasonable mechanism was proposed to explain the formation of porous NiO hollow microspheres. As a gas-sensing material, porous NiO hollow microspheres show excellent gas selectivity and rapid response recovery time for n-butyl alcohol gas. When the content of trisodium citrate was 0.10 g, the synthesized hollow sphere NiO had the highest response value (25.6) to 100 × 10–6 of n-butyl alcohol at 300 °C and the response and recovery times were only 68 and 10 s. [ABSTRACT FROM AUTHOR]

National-based prospective surveillance of all-age patients with acute diarrhea was conducted in China between 2009‒2018. Here we report the etiological, epidemiological, and clinical features of the 152,792 eligible patients enrolled in this analysis. Rotavirus A and norovirus are the two leading viral pathogens detected in the patients, followed by adenovirus and astrovirus. Diarrheagenic Escherichia coli and nontyphoidal Salmonella are the two leading bacterial pathogens, followed by Shigella and Vibrio parahaemolyticus. Patients aged <5 years had higher overall positive rate of viral pathogens, while bacterial pathogens were more common in patients aged 18‒45 years. A joinpoint analysis revealed the age-specific positivity rate and how this varied for individual pathogens. Our findings fill crucial gaps of how the distributions of enteropathogens change across China in patients with diarrhea. This allows enhanced identification of the predominant diarrheal pathogen candidates for diagnosis in clinical practice and more targeted application of prevention and control measures. Diarrhoea is a major cause of morbidity and mortality in China. Here, the authors present results from a large sentinel surveillance scheme from 217 hospitals in all 31 provinces in mainland China, including ~150,000 patients with acute diarrhoea and covering years 2009-2018. [ABSTRACT FROM AUTHOR]

Introduction: Patient-specific instrumentation (PSI) utilizes three-dimensional imaging to produce total knee arthroplasty cutting jigs which matches patient's native anatomy. However, there are limited mid- to long-term studies examining its clinical efficacy. The aim of this study was to compare functional outcomes of PSI surgery versus conventional TKA surgery at 5-year follow-up. Materials and methods: Sixty patients were prospectively recruited into either the MRI-based PSI or conventional TKA group. Functional outcomes were assessed using the Knee Society Function Score (KSFS), Knee Society Knee Score (KSKS) and Oxford Knee Score (OKS), while quality of life was evaluated with the Physical Component Score (PCS) and Mental Component Score (MCS) of Short-Form 36 and compared between the two groups at 5-year follow-up. Results: Although the PCS was 7 ± 3 points better in the PSI group preoperatively (p = 0.017), it became 5 ± 2 points worse than the conventional group at 5-year follow-up (p = 0.025). As compared to the PSI group, the conventional group showed a significantly greater improvement in PCS at 5 years as compared to before surgery (p = 0.003). There were no significant differences in KSFS, KSKS, OKS or MCS between the two groups. Conclusions: PSI TKA did not result in improved functional outcomes or better quality of life when compared to conventional TKA. The additional costs and waiting time associated with PSI are not justifiable and therefore not recommended as an alternative to conventional TKA. Level of evidence: II. [ABSTRACT FROM AUTHOR]

The materials used in variable temperature conditions are required to have excellent thermal fatigue performance. The effects of laser shock processing (LSP), solid solution and aging treatment (T6), and cryogenic treatment (CT) on both microstructure and thermal fatigue performance of ZCuAl10Fe3Mn2 alloys were studied. Microstructure and crack morphology were then examined by scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS). The result showed that, after being subjected to the combination treatment of T6+CT+LSP, the optimal mechanical properties and thermal fatigue performance were obtained for the ZCuAl10Fe3Mn2 alloy with the tensile strength, hardness, and elongation of 720 MPa, 300.16 HB, and 16%, respectively, and the thermal fatigue life could reach 7,100 cycles when the crack length was 0.1 mm. Moreover, the ZCuAl10Fe3Mn2 after combination treatment shows high resistance to oxidation, good adhesion between the matrix and grain boundaries, and dramatically reduced growth rate of crack. During thermal fatigue testing, under the combined action of thermal and alternating stresses, the microstructure around the sample notch oxidized and became loose and porous, which then converted to micro-cracks. Fatigue crack expanded along the grain boundary in the early stage. In the later stage, under the cyclic stress accumulation, the oxidized microstructure separated from the matrix, and the fatigue crack expanded in both intergranular and transgranular ways. The main crack was thick, and the path was meandering. [ABSTRACT FROM AUTHOR]

The dynamic permeability evolution of a fracture is a key scientific problem for fluid flows in rock masses within engineering systems. Understanding the dynamic permeability evolution and its mechanism is conducive to design and operation engineering. The dynamic permeability evolution of a rough granite fracture was revealed by laboratory experiments and numerical models. The permeability evolution of six fractured samples with rough fractures were monitored under 1.9–20 MPa effective normal stresses. The results show that the shearing process significantly affects the permeability and that the variation trend of the permeability depends on the magnitude of the effective normal stress. Under effective normal stresses of 1.9–5 MPa, the permeability is first significantly enhanced and then decreased by shearing. When effective normal stresses of more than 5 MPa are applied, the permeability only shows a decreasing trend. A high effective normal stress not only limits the dilatancy of a fracture but also enhances the formation of fault gouges. The mechanism of the dynamic permeability evolution was revealed by numerical simulations based on the discrete element method. The shearing mechanism includes the sliding mechanism and shearing mechanism. Under a low normal stress, first, the sliding mechanism is dominant and decreases the contact area, which is conducive to establishing a flow channel and increases the permeability. Then, the shearing mechanism becomes increasingly impactful, causing the contact area to increase and the permeability to decrease. Under a high normal stress, the sliding and shearing mechanisms are always engaged, which generates many wear products and reduces the permeability. [ABSTRACT FROM AUTHOR]

Disturbance observer (DOB) based controller performs well in estimating and compensating for perturbation when the external or internal unknown disturbance is slowly time varying. However, to some extent, robot manipulators usually work in complex environment with high-frequency disturbance. Thereby, to enhance tracking performance in a teleoperation system, only traditional DOB technique is insufficient. In this paper, for the purpose of constructing a feasible teleoperation scheme, we develop a novel controller that contains a variable gain scheme to deal with fast-time varying perturbation, whose gain is adjusted linearly according to human surface electromyographic signals collected from Myo wearable armband. In addition, for tracking the motion of operator's arm, we derive five-joint-angle data of a moving human arm through two groups of quaternions generated from the armbands. Besides, the radial basis function neural networks and the disturbance observer-based control (DOBC) approaches are fused together into the proposed controller to compensate the unknown dynamics uncertainties of the slave robot as well as environmental perturbation. Experiments and simulations are conducted to demonstrated the effectiveness of the proposed strategy. [ABSTRACT FROM AUTHOR]

Introduction: With increasing life expectancies worldwide, more elderly patients with isolated medial compartment osteoarthritis may become suitable UKA candidates. However, there is a paucity of literature comparing outcomes between older patients (≥ 75 years) and younger patients undergoing UKA. The aim of this study was to determine if there were differences in functional and HRQoL measures between older patients (≥ 75 years) and younger controls (< 75 years) undergoing primary UKA.Materials and Methods: Prospectively collected registry data of 1041 patients who underwent primary, cemented, fixed-bearing medial UKA at a single institution from 2002-2013 were reviewed. Propensity scores generated using logistic regression was used to match older patients (≥ 75 years, n = 94) to controls (< 75 years, n = 188) in a 1:2 ratio. Knee Society Scores, Oxford Knee Score, Short Form-36, satisfaction/expectation scores, proportion of patients attaining OKS/SF-36 PCS MCID and survivorship were analysed.Results: Patients ≥ 75 years had significantly lower KSFS (67.1 ± 17.9 vs 79.4 ± 18.2, p < 0.001) and SF-36 PCS (47.3 ± 10.1 vs 50.4 ± 9.1, p = 0.01) as compared to the control group. In addition, a significantly lower proportion of patients ≥ 75 years attained MCID for SF-36 PCS when compared to the controls (50.0% vs 63.8%, p = 0.04). Survival rates at mean 8.3 ± 3.0 years were 98.9% (95% CI, 96.7-100) in the older group versus 92.8% (95% CI, 86.8-98.8) in the younger group (p = 0.31).Conclusions: Our findings highlight the need to counsel older patients regarding potentially reduced improvements in functional outcomes, despite advantages of lower revision. However, UKA in older patients continues to be a viable option for isolated medial compartment osteoarthritis LEVEL OF EVIDENCE: Level III Propensity score matched study. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate whether there are any differences in patient-reported outcome measures between semi-constrained condylar constrained knee (CCK) and fully constrained rotating hinge knee (RHK) prostheses in midterm follow-up. We reviewed prospectively collected data of our hospital arthroplasty registry between 2007 and 2014. Thirty-nine patients were identified to have RHK prosthesis TKA and matched for a number of primary/revision TKA, gender, age, body mass index and pre-operative clinical scores to a control group of 78 patients with CCK TKA. Patient demographics, range of movement, varus/valgus deformity, Short Form 36 (SF-36) scores, Oxford Knee Score (OKS), Knee Society Score (KSS) and patient satisfaction were evaluated. Pre-operatively, the RHK and the control group of CCK had similar demographics, proportion of primary/revision TKA and baseline clinical scores (p > 0.05). At 2-year follow-up, patients with CCK prostheses had significantly better clinical outcomes as compared to patients with RHK prosthesis in terms of KSS functional scores, OKS, SF-36 sub-domains of physical functioning, physical role functioning and physical component score. We conclude that at midterm follow-up of 2 years, the CCK patients as compared to RHK patients reported better clinical and functional outcomes in terms of OKS, KSS functional score and SF-36 with a greater proportion of patients who were satisfied and had their expectations met by surgery. Further biomechanical studies are needed to investigate the association between component constraint and clinical outcomes for these prostheses. [ABSTRACT FROM AUTHOR]

Background The clinical pharmacist has been an important partner in clinical treatment team. In China, there is no systematic review to evaluate the effectiveness of clinical pharmacy services on patients' outcomes such as hospitalization days, readmission rate and mortality. Aim of the review To investigate the impact of clinical pharmacist services on patients' length of hospitalization, readmission and mortality in China. Methods A literature search was performed in PubMed, EMBASE, Cochrane Library, clinicaltrials.gov, and a Chinese database (up to January 2019). Randomized control trials or pre- to post-intervention comparison studies were included to investigate the impact of clinical pharmacist-led interventions on the length of stay, readmission rate and mortality of inpatients. Basic information, intervention and therapeutic area were extracted. Results After screening all articles from the mentioned databases, 14 studies were included for meta- analysis and subgroup analysis. Most studies focused on cardiology and respiratory diseases. Results show that clinical pharmacist services can reduce the length of stay of inpatients (MD: - 3.00, 95% CI - 4.72 to - 1.29, P < 0.01) and the readmission rate (RR 0.44, 95% CI 0.35-0.56, P < 0.01) as well as the mortality of patients during hospitalization (RR 0.57, 95% CI 0.35-0.92, P = 0.02). Conclusions Clinical pharmacist-led interventions could significantly reduce Chinese patients' length of hospitalization and readmission rate. More studies are needed to confirm the relationship between the clinical pharmacist-led interventions and patients' mortality. [ABSTRACT FROM AUTHOR]

Based on the unique advantages of terahertz (THz) spectrum on the detection of energetic cocrystals, the low-temperature dependent THz spectra of CL-20/TNT cocrystal were investigated by using molecular dynamics (MD) simulations from 5 to 296 K, as well as three different crystal faces, (001), (120), and (010). When the temperature decreases below 95 K, we have observed two new peaks for CL-20/TNT cocrystal, at 4.58 and 5.99 THz, respectively. Also, the THz peaks below 1.5 THz gradually disappear under cooling from 296 to 5 K, and they should originate from the lattice thermal vibrations. THz absorption peaks of CL-20/TNT cocrystal reveal frequency shifting, linearly dependent on temperature. Four of them are red shift and other two are blue shift of THz vibrational peaks of CL-20/TNT cocrystal with the temperature increase. The frequency shifts can be attributed to the effects of lattice thermal expansion on inter-/intramolecular vibrational modes as well as their coupling. From the temperature-dependent THz spectra of different crystal faces, we further confirm the response of different kinds of intermolecular interactions on the THz spectrum of CL-20/TNT cocrystal. [ABSTRACT FROM AUTHOR]

A new species Ufadendron elongatum sp. nov., attributed to the family Tomiodendraceae Naugolnykh, is represented by two well-preserved stems in the collection under study. This new species was recently discovered from the Upper Permian Linxi Formation in the Jalaid locality, the Inner Mongolia Autonomous region, China. The genus Ufadendron is characterized as having the long fusiform leaf cushions, with small and rounded leaf scar containing a central point-like scar which is situated at the upper part of leaf cushion; the infrafoliar bladder of fusiform shape positioned in the middle part of leaf cushion; the wings and heel well-developed in the lateral parts and the lower part of leaf cushion, respectively. The new species is different from the type species U. ufaense (Naugolnykh 2014) collected from the Lower Permian of the Cis- Urals, western limits of Angaraland, in the elongated leaf cushion and in the well-pronounced heel. It should be noted, that a vascular bundle (conductive strand) occupied the middle part of the central point-like scar. So far, only 5 genera of Angaran elements among lycopsids have been discovered in the region geographically belonging to Angaran Realm (Phytogeoprovince) in China. The new species U. elongatum not only enlarges our knowledge on the taxonomy of Tomiodendraceae lycopsids, and also provides an opportunity to understand the difference between Angaran and Cathaysian floras in paleoclimatic context. [ABSTRACT FROM AUTHOR]

To conduct the shear-flow test under high pore pressure at elevated temperatures and the permeability test of a joint/fracture during shearing, a new direct-shear apparatus was developed. Thus, the shear module of type L was adopted in this new direct-shear test apparatus coupling with high pore pressure and elevated temperature. For the shear-flow test, the pore fluid is injected into the sample, and the designed pore pressure is maintained until the end of the test. For the shear-flow test, the curves of the shear stress and normal displacement versus shear displacement, the shear strength, and the pore volume change of the joint under special fluid/pore pressure/temperature conditions can be gained. [Extracted from the article]