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Abstract: Estrogen receptors (ERs) are steroid hormone receptors, which belong to a large nuclear receptor family. Endocrine diseases correlate strongly with dysregulated ER signaling. Traditional therapies continue to rely on small molecule inhibitors, including aromatase inhibitors (AIs) and selective estrogen receptor modulators (SERMs), all of which permit acquired resistance to endocrine therapy. Proteolytic targeting chimeras (PROTACs) offer unprecedented potential for solving acquired endocrine resistance. ARV-471, an ER-targeting PROTAC developed by Arvinas, was approved by the US FDA to entered clinical trials in 2019 to treat patients suffering from locally advanced or metastatic ER-positive/HER2-negative breast cancer, and has since been approved by the US FDA. In this review, we will focus on progress in developing ER-targeting PROTACs from publications and patents aimed at the treatment of endocrine diseases.

Overdrainage of cerebrospinal fluid is one of the most notorious complications after ventriculoperitoneal shunt implantation. Siphon effect plays a major role in the development of overdrainage. Various overdrainage-preventing devices have been invented to counteract the siphon effect. Though some of the devices are designed to reduce the flow instead of providing antisiphoning effect, they are generally called antisiphon devices (ASDs). The basics of siphoning, the mechanisms and physical properties of currently available devices are described in this article. The clinical efficacy, shunt survival, and considerations on patient factors are also discussed. There are three kinds of ASD design, diaphragm, gravitational, and flow reducing devices. Flow reducing ASD is always open and the flow it controls is relatively stable. On the other hand, it may not provide sufficient flow in nocturnal intracranial pressure elevations. Diaphragm and gravitational devices are sensitive to the position of the patients. Diaphragm device is sensitive to the external pressure and the relative position of the device to the mastoid process. The gravitational device is sensitive to the angle between the axis of the device and the head. Many studies showed encouraging results with gravitational devices. Studies regarding diaphragm devices either showed better or similar outcomes comparing to differential pressure valves. Clinical studies regarding flow-reducing devices and head-to-head comparison between different mechanisms are warranted. This review aims to provide a useful reference for clinical practice of hydrocephalus.

The occult pulmonary infection is the most common complications in elderly patients with type 2 diabetes mellitus (T2DM). Since its etiological characteristics has not been clarified, infection control remains a serious problem for public health. To investigate the prevalence and clinical significance of occult pulmonary infection in elderly T2DM patients, in this study, 573 elderly patients cochallenged with T2DM and community-acquired pulmonary infection from January 2018 to December 2020 were selected in the hospitals and divided into occult pneumonia group (OP, n = 249 ) and nonoccult pneumonia group (NOP, n = 324 ) according to the nature of infection. Clinical medical records were analyzed retrospectively to summarize the infection characteristics of elderly diabetics with occult pneumonia. The prevalence of the cases (278/324, 85.8%) in NOP group was not higher than that in OP group (206/249, 82.7%; P > 0.05 ). Also, there was not significant difference in the distribution of isolated pathogens among the positive patients. The length of hospitalization and mortality of OP patients were significantly higher than those NOP patients. Multivariate logistic regression showed that advanced age, comorbidities, hypothyroidism, senile dementia, and prolonged bed rest were independent risk factors for occult pneumonia in elderly diabetic patients. Therefore, the results demonstrated that the pulmonary infection in elderly patients with diabetes mellitus is often occult. Gram-negative bacteria are the predominant pathogens and cause poor prognosis. Advanced age, comorbidities (senile dementia, hypothyroidism), and prolonged bed rest are the independent risk factors for occult pneumonia.

A warm persistent luminescence (PersL) material SrBaZn2Ga2O7:Bi3+ was prepared using the conventional high-temperature solid-phase reaction method. We first investigated the PersL properties of SrBaZn2Ga2O7:Bi3+ in detail via PersL spectra, PersL excitation spectrum, PersL decay curves, and thermoluminescence (TL) spectra. The highlight of this study is that in addition to the 254 nm light source, the low-energy light source of 365 nm and sunlight can effectively excite electrons and charge traps, resulting in preferable orange PersL performance. The PersL decay time of the representative sample can last for 960 s after excitation by a 365 nm light source and 900 s after excitation by simulated sunlight. Meanwhile, the PersL color can be regulated by changing the excitation wavelength. In order to explain the infrequent PersL phenomena after different light source excitations, we recorded a series of TL spectra as a function of different light sources, different charging times, and different decay times to reveal the distribution of traps in the material and the influence of trap distribution on trapping and detrapping processes. This novel sunlight-activated orange PersL material is expected to promote the development of sunlight-activated PersL materials and expand potential applications in solar energy utilization and anticounterfeit marking.

BACKGROUND Colorectal cancer (CRC) is one of the most common malignant tumors of the digestive tract. Lymphatic metastases of this tumor are mostly confined to the regional lymph nodes, and distant supraclavicular lymph node metastases are very rare. CASE SUMMARY In this report, we describe a patient with sigmoid carcinoma and isolated synchronous supraclavicular lymph node metastases. A 56-year-old male presented with a left cervical mass that was confirmed as a lymph node metastasis from sigmoid cancer by several auxiliary examinations. After 6 cycles of chemotherapy with the 5-fluorouracil, leucovorin and oxaliplatin + cetuximab regimen, the sigmoid colon tumor and Virchow’s lymph node metastasis were significantly smaller than before treatment, and no new metastatic sites were observed. Considering the effects of chemotherapy on quality of life, resection of the primary tumor was performed followed by 4 cycles of chemotherapy with the original chemotherapy regimen. Virchow’s lymph node dissection was selected by mutual consultation between the patient and us. After the second surgery, the patient received capecitabine and cetuximab chemotherapy and did not experience recurrence or metastasis during follow-up. CONCLUSION In conclusion, supraclavicular lymph node metastasis without any other solid organ metastasis is a potential metastatic pathway for CRC. In addition, after resection of the primary lesion, postoperative chemotherapy combined with supraclavicular lymph node dissection is feasible for the treatment of patients with CRC and isolated synchronous Virchow’s lymph node metastases.

Ying-Tao Lin,1 Ying Chen,2 Tian-Xiu Liu,3 Fang Kuang,1 Ping Huang1 1Administration Office of Drug Clinical Trial, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, People’s Republic of China; 2Management Office of Science and Technology, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, 350014, People’s Republic of China; 3Department of Thoracic Radiotherapy, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, 350014, People’s Republic of ChinaCorrespondence: Ping HuangAdministration Office of Drug Clinical Trial, Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, Fuzhou, People’s Republic of ChinaTel +86 13960908650Fax +86 0591 62752517Email 1967217973@qq.comPurpose: The aim of this study was to assess the cost-effectiveness of camrelizumab immunotherapy versus docetaxel or irinotecan chemotherapy as second-line therapy for advanced esophageal squamous cell carcinoma (ESCC), which was evaluated in the ESCORT trial.Materials and Methods: A partitioned survival model was developed to reflect the costs and effectiveness of the ESCORT trial. The clinical efficacy data, safety data, and health-related costs and utilities were derived from published data from clinical trials or health administration departments in China. Adverse event-related costs, drug administration, and other expenses were derived from a single center of Fujian Medical University Cancer Hospital in 2021. All survival analyses were performed with SPSS software. Overall survival was estimated with the Kaplan–Meier method, and progression-free survival was estimated with the life table method. Sensitivity analyses were conducted to assess the uncertainty of the model. Incremental cost, quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER) were calculated.Results: Camrelizumab therapy had 0.232 QALYs at an incremental cost of USD$9959.44 compared with the chemotherapy group with 0.158 QALYs at an incremental cost of USD$8601.67. The ICER was USD$18393.12/QALY. Probabilistic sensitivity analyses showed that when the willingness-to-pay threshold reached USD$31200/QALY, which is nearly three times the Chinese gross domestic product per capita, camrelizumab had an 80% possibility of being cost-effective versus docetaxel or irinotecan chemotherapy.Conclusion: Camrelizumab is a cost-effective option compared with docetaxel or irinotecan chemotherapy in patients with advanced ESCC as second-line therapy in China.Keywords: camrelizumab, chemotherapy, cost-effectiveness, esophageal squamous cell carcinoma

Siraitia grosvenorii (LHG) is widely used as a medicinal and edible material around the world. The objective of this study was to develop an effective method for the authentication of the geographical origin of LHG in its main producing area Guangxi, China, which is identified as Chinese Protected Designation of Origin product, against other producing regions in China. The content of 14 elements (K, Na, Ca, P, Mg, Al, B, Ba, Cu, Fe, Mn, Ni, Zn, and Sr) of 114 LHG samples was determined by inductively coupled plasma optical emission spectrometry. Multivariate analysis was then performed to classify the geographical origin of LHG samples. The contents of multielement display an obvious trend of clustering according to the geographical origin of LHG samples based on radar plot and principal component analysis. Finally, three supervised statistical techniques, including linear discriminant analysis (LDA), k-nearest neighbours (k-NN), and support vector machine (SVM), were applied to develop classification models. Finally, 40 unknown LHG samples were used to evaluate the predictive ability of model and discrimination rate of 100%, 97.5% and 100% were obtained for LDA, k-NN, and SVM, respectively. This study indicated that it is feasible to attribute unknown LHG samples to its geographical origin based on its multielement content coupled with chemometric techniques.

The article discusses a case of severe tsutsugamushi disease complicated with hemophagocytic syndrome in Guangdong Maternal and Child Health Hospital and concludes that blood purification technology has significant therapeutic effect among children with severe HLH complicated with multiple organ dysfunction.

Backgrounds:. Previous surveys have found that children with iron deficiency (ID) were likely to suffer from early childhood caries (ECC). We aimed to assess the scientific evidence about whether ID is intrinsically related to ECC. Methods:. The medical subject headings (MeSH) terms and free words were searched on PubMed, Web of Science, Cochrane, China National Knowledge Infrastructure, Wanfang, and the Database for Chinese Technical Periodicals from March 2020 to September 2020. Two researchers independently screened the articles. Data extraction and cross-checking were performed for the studies that met the inclusion criteria. Meta-analysis was performed using the Cochrane Collaboration's Review Manager 5.3 software. Results:. After excluding duplication and irrelevant literature, 12 case-control studies were included in the study. The meta-analysis demonstrated that children with ECC were more likely to have ID (odds ratio [OR] = 2.63, 95% confidence interval [CI]: [1.85, 3.73], P

The traditional method only pays attention to hardware construction and ignores the data processing steps, which leads to high redundant resource occupancy rate, untimely resource sharing, and low platform data safety factor. In order to solve this problem, this paper establishes an educational information platform based on cloud computing. The platform gives the overall structure of the education information platform, including the business layer and the support layer. Then the external interface is designed. Based on the MySQL database interface, users are allowed to use custom data formats and storage management modes to ensure flexibility in using data resources and improve the compatibility between smart terminals and virtual machines through the remote desktop terminal architecture. Through the educational data compression and educational resource sharing model, the generation of redundant messages is reduced, thereby realizing the design of the educational information platform. Experimental results show that this method can effectively reduce the occupancy rate of redundant resources, save network bandwidth, and improve the data safety factor of the platform. The resource sharing time is always less than 2.0 s, which verifies the effectiveness of the method

Autophagy plays a complicated role in the occurrence and development of cancer. Beclin 1 is a significant autophagy-related protein that plays an essential role in tumorigenesis, but its expression is controversial in melanoma. In this meta-analysis, we searched seven studies involving 638 melanoma patients. PubMed, Web of Science, Google Scholar, Elsevier, and Chinese National Knowledge Infrastructure were used for literature retrieval. The I2 index was used to assess heterogeneity. The expression of Beclin 1 in the primary melanoma group was significantly lower than the non-tumor group tissues (P0.01), while higher than the metastatic melanoma group (P0.01). Beclin 1 expression status could not distinguish between patients with melanoma by sex (male vs. female), lymph node metastasis (metastasis vs. non-metastasis), melanin deposition (present vs. absent), ulcer formation (present vs. absent), tumor necrosis status (present vs. absent), and Breslow thickness (1.5 mm vs. ≥1.5 mm) for the subgroups (all P values0.05). Different expression intensities of Beclin 1 did not affect the overall survival and disease-free survival of melanoma patients. This study showed a trend of low expression of Beclin 1 in melanoma; patients with low expression of Beclin 1 were prone to the possibility of distant metastasis. The inconsistent profile of Beclin 1 expression in the prognosis of melanoma patients warrants further clinical investigation.

Ankle injuries are common in forensic practice, which are mainly caused by falling and traffic accidents. Determining the mechanisms and manners of ankle injuries is a critical and challenging problem for forensic experts. The identification of the injury mechanism is still experience-based and strongly subjective. There also lacks systematic research in current practice. In our study, based on the widely used Total Human Model of Safety 4.0 (THUMS 4.0), we utilized the finite element (FE) method to simulate ankle injuries caused by falls from different heights (5 m, 10 m and 20 m) with different landing postures (natural posture, inversion, eversion, plantar-flexion and dorsi-flexion) and injuries caused by impacts from different directions (anterior-posterior, lateral-medial and posterior-anterior) with different speeds (10 m/s, 15 m/s and 20 m/s) at different sites (ankle and lower, middle and upper sections of leg). We compared the injury morphology and analyzed the mechanisms of ankle injuries. The results showed that falling causes a specific compression fracture of the distal tibia, while fractures of the tibia and fibula diaphysis and ligament injuries caused by falling from a lower height or inversion, planter flexion or dorsiflexion at a large angle are not distinguishable from the similar injury patterns caused by impact on the middle and upper segments of the leg. No obvious compression fracture of the tibia distal was caused by the impacts, whereas ligament injuries and avulsion fractures of the medial or lateral condyle and fractures of the diaphysis of the tibia and fibula were observed. Systematic studies will be helpful in reconstructing the ankle injury processes and analyzing the mechanisms in forensic practice, providing a deeper understanding of ankle injury mechanisms for forensic experts.

In this study, quantum dot light-emitting diodes with a side-pumping structure were designed for efficient heat management. The COMSOL Multiphysics software suite was used to conduct numerical evaluations. The electrical and optical field distributions and the heat distribution capability of the aforementioned structure were investigated. The side-pumping package was found to be capable of effectively dissipating heat and significantly reducing the areal temperature from 32.1 °C (in-chip) to 28.9 °C with an operating current of 35 mA. The integrated intensities of the perovskite quantum dot photons of the in-chip and side-pumping devices were approximately identical (1.23:1). However, the side-pumping device required 58.3% less filling material than the in-chip device. Optical and thermal modeling and measurements indicated that the side-pumping architecture can not only enhance thermal dissipation but also reduce the usage of quantum dot material. The findings of this study provide useful information for the incorporation of quantum dots in photonic devices.

Probiotics effectively prevent and improve metabolic diseases such as diabetes by regulating the intestinal microenvironment and gut microbiota. However, the effects of probiotics in gestational diabetes mellitus are not clear. Here, we showed that probiotic supplements significantly improved fasting blood glucose in a gestational diabetes mellitus rat model. To further understand the mechanisms of probiotics in gestational diabetes mellitus, the gut microbiota were analyzed via 16S rRNA sequencing. We found that compared with the normal pregnant group, the gestational diabetes mellitus rats had decreased diversity of gut microbiota. Moreover, probiotic supplementation restored the diversity of the gut microbiota in gestational diabetes mellitus rats, and the gut microbiota structure tended to be similar to that of normal pregnant rats. In particular, compared with gestational diabetes mellitus rats, the abundance of Firmicutes and Actinobacteria was higher after probiotic supplementation. Furthermore, activating carbohydrate metabolism and membrane transport pathways may be involved in the potential mechanisms by which probiotic supplements alleviate gestational diabetes mellitus. Overall, our results suggested that probiotic supplementation might be a novel approach to restore the gut microbiota of gestational diabetes mellitus rats and provided an experimental evidence for the use of probiotic supplements to treat gestational diabetes mellitus.

Irreversible loss of retinal ganglion cells (RGCs) is a common pathological feature of various optic nerve degenerative diseases such as glaucoma and ischemic optic neuropathy. Effective protection of RGCs is the key to successful treatment of these diseases. Total Panax notoginseng saponins (TPNS) are the main active component of Panax notoginseng, which has an inhibitory effect on the apoptosis pathway. This study is aimed at assessing the protective effect of TPNS on RGCs of the optic nerve crush (ONC) model of rats and exploring the underlying mechanisms. The intraperitoneal or intravitreal injection of TPNS was used based on the establishment of the rat ONC model. Fifteen days after the injury, the cell membrane fluorescent probe (Fluoro-Gold) was applied to retrograde RGCs through the superior colliculus and obtain the number of surviving RGCs. TUNEL assay was also used to detect the number and density of RGC apoptosis after the ONC model. The expression and distribution of Bcl-2/Bax, c-Jun/P-c-Jun, and P-JNK in the retina were demonstrated by Western blot analysis. After the intervention of TPNS, the rate of cell survival increased in different retinal regions ( p < 0.05 ) and the number of apoptosis cells decreased. Regarding the expression of Bcl-2/Bax, c-Jun/P-c-Jun, and P-JNK-related apoptotic proteins, TPNS can reduce the level of apoptosis and play a role in protecting RGCs ( p < 0.05 ). These findings indicate that topical administration of TPNS can inhibit cell apoptosis and promote RGC survival in the crushed optic nerve.

Objective: To observe the clinical effect of modified Yu Rong San gel eye mask in the treatment of dark circles. Methods: 96 cases of patients with dark circles were randomly divided into treatment group and control group. In the control group and the treatment group, the common eye mask and the modified Yu Rong San gel eye mask were applied to the black circle area respectively. After 15min, water was used to wash the face, the application of the mask for one time a day, four weeks, one course, and three courses were observed. Results: After three courses of treatment, the total effective rate of the treatment group was higher than that of the control group (P

BACKGROUND: Cytokines play critical roles in the inflammatory processes underlying liver failure. The relevance of interleukin-35 (IL-35), an anti-inflammatory cytokine, in liver failure remains uncharacterized. This study was conducted to investigate whether the IL-35 level in patients with prophase of liver failure (PLF) is associated with prognosis and the possible mechanism of immune regulation for IL-35. METHODS: This retrospective study enrolled 42 patients with PLF at the Department of Infection, First Affiliated Hospital of Soochow University between January 2016 and December 2018. Thirty patients with hepatitis and 30 healthy controls were also enrolled. We divide patients with prophase of liver failure into improvement group who recovered quickly (n=33) and deteriorate group who deteriorated to overt liver failure (n=9). Serum IL-35 level was measured by enzyme-linked immunosorbent assay (ELISA). The ratio of regulatory T cells to T-helper type-17 cells (Treg/Th17) in peripheral blood was determined by flow cytometry. RESULTS: Serum IL-35 level was higher in patients with PLF who showed subsequent improvement than in patients with PLF who showed deterioration to overt liver failure. The Treg/Th17 ratio was higher in patients with PLF who showed improvement than in patients with PLF who developed overt liver failure. The serum IL-35 level and Treg/Th17 ratio were positively correlated in patients with PLF. CONCLUSIONS: High serum IL-35 level is associated with better prognosis in patients with PLF.

A Sn-ball was integrated with a colloidal quantum dot light-emitting diode package to achieve effective heat and reliability management. The electric, optical intensity, and heat distributions of the package were evaluated under various radiant fluxes; data were collected at the 90th hour of aging. Under 1 W/cm2, the areal temperature decreased from 38.5 °C (without Sn-ball) to 32.3 °C (with Sn-ball), which helped extend the lifetime of the colloidal quantum dots in the package. Specifically, the introduction of the metal ball structure engendered a two- to three-fold increase in lifetime. The study findings could contribute toward integrating quantum dots into photonic devices.

Exploring highly efficient near-infrared (NIR) emitting materials is desirable for the advancement of next-generation smart NIR light sources. Different from most reported Cr3+-doped emitters with far-red emissions, Yb3+-activated phosphors are expected to yield pure NIR (∼1000 nm) light. Herein, a new hot-injection route using all metal-oleate salts to fabricate Yb3+-doped CsPbCl3 perovskite nanocrystals (PeNCs) is reported for the first time, which produce PeNC-sensitized Yb3+ NIR emission with photoluminescence quantum yields (PLQYs) higher than 100%. With the help of temperature-dependent PL spectra, femtosecond transient absorption spectra, and time-resolved PL spectra, it is evidenced that the in situ produced intrinsic shallow trap states in a CsPbCl3 host play a key role in facilitating the picosecond nonradiative cooperative energy transfer from PeNCs to two Yb3+ dopants simultaneously. Using the optimized Yb3+:CsPbCl3 quantum cutters, a phosphor-converted NIR light-emitting diode (pc-NIR-LED) is fabricated, exhibiting an external quantum efficiency of 2%@28 mA, a high NIR output irradiance of 112 mW/cm2@400 mA, and excellent long-term stability. Finally, the designed pc-NIR-LED is demonstrated to have great potential as an invisible night-vision light source.

In this paper, we theoretically propose and demonstrate a non-unitary beam-splitter (BS) by introducing coupling losses at the interface of the plasmonic waveguide and multimode dielectric waveguide (DW). The coupling losses enable us to modify the reflection and transmission factors, which can result in arbitrary shift of interference curves of two outputs. Specially, the lossy non-unitary BS can tune the amplitudes and phases of two outputs, even making them change synchronously, regardless of input phase differences. After a $$\pi /2$$ phase delay in one arm, these two outputs are fed into another multimode DW. This DW is a normal unitary BS, working like the Michelson interferometer, where anti-synchronous interference can take place. At last, the whole device outputs an invariant zero energy state in one port, exhibiting a phase-insensitive performance. Our study provides a versatile design platform to realize non-unitary/unitary BS and construct more multi-functional devices.

Background Non-vitamin K antagonist oral anticoagulants (NOACs) are as effective and safe as warfarin for thromboembolic prevention and treatment. The efficacy of NOACs lacks evidence from large and randomized studies in patients with inherited severe thrombophilia, including protein S deficiency. Further, some concerns still exist regarding the relative efficacy of edoxaban in preventing arterial thromboembolism in patients with normal to high creatinine clearance (CrCl). We present a case of a rare complication of lead thrombus under standard-dose edoxaban in a patient with protein S deficiency and supernormal renal function. Case presentation A 65-year-old man experienced persistent chest tightness and a high level of D-dimer. Chest computed tomography (CT) showed a lead thrombus at the superior vena cava. He had a medical history including, paroxysmal atrial fibrillation (PAf), sick sinus syndrome after permanent pacemaker implantation, and transient ischemic attack. He received standard-dose edoxaban (60 mg daily) after PAf was diagnosed. His estimated CrCl was 98.6–102.1 mL/min. However, protein S deficiency (22.8%; normal range: 55–130%) was diagnosed. After switching to dabigatran (150 mg twice daily) for 3 months, the chest CT showed lead thrombus resolution and no symptoms were seen during the follow-up period. Conclusions This case was a rare complication of lead thrombus in a protein S deficient patient with normal renal function receiving standard-dose edoxaban. Edoxaban efficacy is uncertain in patients with protein S deficiency, and intracardiac devices also increase the risk of thromboembolic events.

Numerous studies have demonstrated the benefits and safety of ultrasound guidance in comparison with conventional palpation for radial artery cannulation in adult patients. However, the current evidence for paediatric patients is not fully understood.The objective of this study was to compare the efficiency and safety of ultrasound guidance with those of traditional palpation for radial artery cannulation in paediatric patients and provide convincing evidence for clinical practice.PubMed, Cochrane Library, ClinicalTrials.gov (Min et al-2019, NCT02795468, Anantasit et al-2017, NCT02668471), China National Knowledge Infrastructure, and Wanfang Data were systematically searched from their inception until December 31, 2019, to identify relevant randomised controlled trials. Data were extracted from the included studies independently by two investigators. The primary outcome of interest was the first-attempt success rate. Review Manager Version 5.3 and trial sequential analysis (beta = 0.9) were applied to analyse the collected data.A total of eight randomised controlled trials involving 680 paediatric patients were included in this study. The pooled findings showed that ultrasound-guided radial artery cannulation, in comparison with traditional palpation, can significantly improve the first-attempt success rate (relative risk [RR] = 1.65, 95% confidence interval [CI] = 1.36-2.01, P 0.00001). Trial sequential analysis indicated that this available evidence was conclusive. Moreover, ultrasound guidance was associated with an increased total success rate (RR = 1.38, 95% CI = 1.15-1.66, P = 0.0004), a decreased mean procedural time (standardised mean difference = -0.89, 95% CI = -1.52 to -0.25, P = 0.006), and incidence of haematoma (RR = 0.19, 95% CI = 0.10-0.35, P 0.00001).Ultrasound-guided radial arterial cannulation in paediatric patients is associated with improved first-attempt success rates, total success rates, and mean procedural time and decreased incidence of haematoma. The current evidence suggests that ultrasound guidance should be the standard of care for radial artery cannulation in clinical practice.

Background. Cardiac hypertrophy is one of the initial disorders of the cardiovascular system and can induce heart failure. Oxidative stress is an important pathophysiological mechanism of cardiac hypertrophy. Wogonin (Wog), an important flavonoid derived from the root of Scutellaria baicalensis Georgi, is known to possess antioxidant properties. Methods. An in vitro model of cardiac hypertrophy was established by stimulating H9C2 cells and neonatal rat cardiomyocytes (NRCMs) with angiotensin II (AngII). The indices related to myocardial hypertrophy and oxidative stress were detected. An in vivo model of cardiac hypertrophy was induced by transverse aortic constriction (TAC) in C57BL/6 mice. Cardiac function was monitored by chest echocardiography, and the hypertrophy index was measured. The mice were then sacrificed for histological assays, with mRNA and protein detection. To further explore the role of nuclear factor- (erythroid-derived 2-) like 2 (Nrf-2) in regulating the antioxidant effects of Wog in cardiac hypertrophy, siRNA analysis was conducted. Results. Our results showed that Wog significantly ameliorated AngII-induced cardiomyocyte hypertrophy by inhibiting oxidative stress in H9C2 cells and NRCMs. In addition, Wog treatment prevented oxidative stress and improved cardiac hypertrophy in mice that underwent TAC. Using gene-specific siRNA for Nrf-2, we discovered that these antioxidative effects of Wog are mediated through Nrf-2 induction. Conclusions. Our results provide further evidence for the potential use of Wog as an antioxidative agent for treatment of cardiac hypertrophy, and Nrf-2 might serve as a therapeutic target in the treatment of cardiac hypertrophy.

Inorganic luminescent nanocrystals (NCs) doped with main-group ns2-metal ions have evoked tremendous interest in many technological fields owing to their superior optical properties. Herein, we report a new class of luminescent nanoprobes based on 5s2-metal Sb3+-doped CaS NCs that are excitable by using a near ultraviolet light-emitting diode. The optical properties and excited-state dynamics of Sb3+ in CaS NCs are comprehensively surveyed through temperature-dependent steady-state and transient photoluminescence (PL) spectroscopies. Owing to the strong electron-phonon coupling of Sb3+ in CaS NCs, Sb3+ ions experience a dynamic Jahn-Taller distortion on the excited state, which results in bright green PL of Sb3+ with a broad emission band, a large Stokes shift, and a high PL quantum yield up to 17.3%. By taking advantage of the intense PL of Sb3+, we show in proof-of-concept experiments the application of biotinylated CaS:Sb3+ NCs as sensitive luminescent nanoprobes for biotin receptor-targeted cancer cell imaging and zebrafish imaging with a high imaging contrast. These findings provide fundamental insights into the excited-state dynamics of Sb3+ in CaS NCs, thus laying a foundation for future design of novel and versatile luminescent nanoprobes via main-group ns2-metal doping.

Colorectal cancers common tumors that develop in the large intestines. The incidence of colorectal cancer is second only to gastric and esophageal cancers. Both S-1 and capecitabine are the third-generation fluorouracil-based chemotherapeutic drugs. We hope to summarize the therapeutic effects of tecotae and capecitabine in patients with colorectal cancer through this Meta-analysis. We performed a meta-analysis of the findings in the current literature. We performed a systematic review of outcomes associated with S-1 and capecitabine used to treat advanced colorectal cancer based on findings from both English and Chinese publications listed in PubMed, Embase, CNKI, Wanfang, EBSCO, Web of Science and the Cochrane Library. End-points included ORR, DCR, OS, and PFS; adverse events (grades 1–2 and 3–4) were also evaluated. Statistical analysis was performed using RevMan 5.3. A total of 12 studies were eventually included, involving a total of 3,375 patients. Of this group, 1,683 and 1,692 patients underwent treatment with S-1 or capecitabine, respectively. There were no greatly differences with respect to ORR, DCR, or OS; however, PFS was bettered in the group of S-1 compared to those treated with capecitabine. The incidence of leukopenia, diarrhea and anorexia were all higher among those in S-1 group compared to the capecitabine group, but a higher incidence of hand-foot syndrome was linked with use of capecitabine. Use of S-1 for the treatment of colorectal cancer may result in superior outcomes when compared to use of capecitabine.

Aims CHD4 gene, encoding chromodomain helicase DNA‐binding protein 4, is a vital gene for fetal development. In this study, we aimed to explore the association between CHD4 variants and idiopathic epilepsy. Methods Trios‐based whole‐exome sequencing was performed in a cohort of 482 patients with childhood idiopathic epilepsy. The Clinical Validity Framework of ClinGen and an evaluating method from five clinical‐genetic aspects were used to determine the association between CHD4 variants and epilepsy. Results Four novel heterozygous missense mutations in CHD4, including two de novo mutations (c.1597A>G/p.K533E and c.4936G>A/p.E1646K) and two inherited mutations with co‐segregation (c.856C>G/p.P286A and c.4977C>G/p.D1659E), were identified in four unrelated families with eight individuals affected. Seven affected individuals had sinus arrhythmia. From the molecular sub‐regional point of view, the missense mutations located in the central regions from SNF2‐like region to DUF1087 domain were associated with multisystem developmental disorders, while idiopathic epilepsy‐related mutations were outside this region. Strong evidence from ClinGen Clinical Validity Framework and evidences from four of the five clinical‐genetic aspects suggested an association between CHD4 variants and epilepsy. Conclusions CHD4 was potentially a candidate pathogenic gene of childhood idiopathic epilepsy with arrhythmia. The molecular sub‐regional effect of CHD4 mutations helped explaining the mechanisms underlying phenotypic variations., CHD4 missense mutations associated with multisystem developmental abnormalities were clustered in the central region from SNF2‐like region to DUF 1087 domain, while the variants associated with other mild phenotypes were located outside this region. The potentially molecular sub‐regional effects of missense mutations may explain for the phenotypic severity of CHD4 mutations and would help understand the underlying mechanisms of phenotypic variation.

Background Falls among older adults are a serious public health problem. Many studies indicate that positive functional fitness performance decreases the risk of falls. A limited amount of previous study has investigated the association between broad functional fitness and the fall risk. This study examines the associations between functional fitness and the risk of falling among community-dwelling older adults. Methods Three waves of cross-sectional data were collected from 2017 to 2019 in Taipei City, Taiwan. Six hundred sixty-five participants aged ≥65 years were randomly recruited from 12 districts of Taipei. Eight functional fitness tests (i.e., back scratch, chair-sit and-reach, 8-ft up-and-go, 30-s sit-to-stand, 30-s arm curl, 30-s single-leg stance, 2-min step, and hand grip strength tests) were performed to record the physical performance of older subjects. A Chinese version of the fall-risk questionnaire (FRQ) was used to calculate the fall risk scores. Linear regression and logistic regression were utilized to estimate the relationships of each functional fitness and fall risk. Result The results showed that 37.45% of older adults had a high risk of falling. It was found for each functional fitness that performance was linearly associated with the risk of falling. Moreover, older adults with low-performance levels in all functional fitness except back-scratching were more likely to have a higher risk of falling. Conclusions Our study indicated that functional fitness performance appears to provide valid predictive guidance for reducing the risk of falling among the older population.

Abstract: Metals occur naturally in soil and many kinds of rocks, particularly in minerals and ores, which also play a vital role in living systems such as plants and animals. Over the large time scale, metal evolution from toxins to drugs has achieved a milestone mean in medicine. Currently, a few metal-based drugs (i.e., metallodrugs) have been used in the clinic to treat patients with different medical conditions, making exciting new developments in anticancer therapeutics (e.g., arsenic trioxide and cisplatin) that quickly move into focus. Moreover, a thorough understanding of the properties and effects of metals on the human body could improve the development and innovation of metal-based drugs. In this review, we have comprehensively described the discovery and development of metal-based anticancer drugs, as well as their side effects in clinical treatment. Although metallodrugs have shown promising outcomes in the treatment of cancers, further investigation is needed to optimize their side effect for broader applications.

It is of great clinical importance to explore more efficacious treatments for OCD. Recently, cognitive-coping therapy (CCT), mainly focusing on recognizing and coping with a fear of negative events, has been reported as an efficacious psychotherapy. However, the underlying neurophysiological mechanism remains unknown. This study of 79 OCD patients collected Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and resting-state functional magnetic resonance imaging (rs-fMRI) scans before and after four weeks of CCT, pharmacotherapy plus CCT (pCCT), or pharmacotherapy. Amygdala seed-based functional connectivity (FC) analysis was performed. Compared post- to pretreatment, pCCT-treated patients showed decreased left amygdala (LA) FC with the right anterior cingulate gyrus (cluster 1) and with the left paracentral lobule/the parietal lobe (cluster 2), while CCT-treated patients showed decreased LA-FC with the left middle occipital gyrus/the left superior parietal/left inferior parietal (cluster 3). The z-values of LA-FC with the three clusters were significantly lower after pCCT or CCT than pretreatment in comparisons of covert vs. overt and of non-remission vs. remission patients, except the z-value of cluster 2 in covert OCD. CCT and pCCT significantly reduced the Y-BOCS score. The reduction in the Y-BOCS score was positively correlated with the z-value of cluster 1. Our findings demonstrate that both pCCT and CCT with large effect sizes lowered LA-FC, indicating that FCs were involved in OCD. Additionally, decreased LA-FC with the anterior cingulate cortex (ACC) or paracentral/parietal cortex may be a marker for pCCT response or a marker for distinguishing OCD subtypes. Decreased LA-FC with the parietal region may be a common pathway of pCCT and CCT. Trial registration: ChiCTR-IPC-15005969.

Background Hepatitis C virus (HCV) is one of the major causes of chronic liver disease, cirrhosis, and liver cancer. Most of the infected people have no clinical symptoms. The current strategy for HCV elimination includes test and treatment. In this study, we aimed to evaluate the campaign for retrieving patients who were lost to follow-up, for subsequent re-evaluation. Methods From January 2020 to October 2020, patients who had prior tests for positive anti-HCV antibody in 2010–2018 in our hospital were enrolled for our patient callback campaign. Patients who had unknown HCV RNA status or no documented successful antiviral therapy history were selected for anti-HCV therapy re-evaluation. To facilitate patient referral in the hospital, we developed an electronic reminding system and called the candidate patients via telephone during the study period. Results Through the hospital electronic system, 3783 patients with positive anti-HCV antibody documentation were identified. Among them, 1446 (38.22%) had tested negative for HCV RNA or had anti-HCV therapy, thereby excluded. Of the 2337 eligible patients, 1472 (62.99%) were successfully contacted and called back during the study period for subsequent HCV RNA testing and therapy. We found that 42.19% of the patients had positive HCV RNA and 88% received subsequent anti-HCV therapy. Conclusions A significant number of patients with positive HCV serology were lost for HCV confirmatory test or therapy in the hospital. Therefore, this targeted HCV callback approach in the hospital is feasible and effective in achieving microelimination.

BACKGROUND AND AIMS Nonalcoholic fatty liver disease (NAFLD) has been widely recognized as a precursor to metabolic complications. Elevated inflammation levels are predictive of NAFLD-associated metabolic disorder. Inactive rhomboid-like protein 2 (iRhom2) is regarded as a key regulator in inflammation. However, the precise mechanisms by which iRhom2-regulated inflammation promotes NAFLD progression remain to be elucidated. APPROACH AND RESULTS Here, we report that insulin resistance, hepatic steatosis, and specific macrophage inflammatory activation are significantly alleviated in iRhom2-deficient (knockout [KO]) mice, but aggravated in iRhom2 overexpressing mice. We further show that, mechanistically, in response to a high-fat diet (HFD), iRhom2 KO mice and mice with iRhom2 deficiency in myeloid cells only showed less severe hepatic steatosis and insulin resistance than controls. Inversely, transplantation of bone marrow cells from healthy mice to iRhom2 KO mice expedited the severity of insulin resistance and hepatic dyslipidemia. Of note, in response to HFD, hepatic iRhom2 binds to mitogen-activated protein kinase kinase kinase 7 (MAP3K7) to facilitate MAP3K7 phosphorylation and nuclear factor kappa B cascade activation, thereby promoting the activation of c-Jun N-terminal kinase/insulin receptor substrate 1 signaling, but disturbing AKT/glycogen synthase kinase 3β-associated insulin signaling. The iRhom2/MAP3K7 axis is essential for iRhom2-regulated liver steatosis. CONCLUSIONS iRhom2 may represent a therapeutic target for the treatment of HFD-induced hepatic steatosis and insulin resistance.

To build energy-efficient datacenters, one widely used way is to dynamically manipulate the quantity of available hardware resources on demand. However, when bursty workloads appear, additional time overhead is required for resource gearing, thus incurring a performance degradation. To explore this problem, we present an intelligible analysis on the request handing in a VM. From the analysis, we find that, when workloads are overloaded (i.e., peak loads appear), the number of QoS guaranteed requests can be greatly increased by deferring the scheduling of a few requests. Inspired by this finding, we propose a Peak Load Scheduling Control (PLSC) method to promote the Quality of Service (QoS) of peak loads for modern energy-efficient datacenters. However, peak loads are usually difficult to identify. To overcome this difficulty, PLSC tracks the number of requests residing in a VM by leveraging a two-tier request queue maintained by it. When the number exceeds the capability of the VM, it means that peak loads appear. In this case, PLSC adds some delay-tolerant requests to the secondary queue. The scheduling of requests in the secondary queue is controlled with a lower priority than that of requests in the primary queue. Sequentially, with critical requests maintained in the primary queue, PLSC shortens the response time of critical requests. In addition, PLSC expands the number of QoS-guaranteed requests. Comprehensive experiments are conducted to attest the effectiveness of PLSC, by simulating a typical energy-efficient datacenter. The experimental results show that PLSC significantly promotes the QoS of workloads with a negligible impact on energy saving.

The early diagnosis of Parkinson’s disease (PD) is important to reduce deaths due to this disease. Images of patients with PD obtained through magnetic resonance imaging (MRI) show gray matter, white matter, and cerebrospinal fluids; images of these components provide physicians with important information to determine the severity of the disease. Therefore, methods for segmenting these regions in images have been employed. However, difficulties have been encountered in the segmentation of the PD MRI images owing to the unclear boundaries between the gray matter and white matter and the regions being contained in homogeneous and unclear structures. Therefore, we propose a hybrid wavelet k-means clustering (KMC) and fuzzy median filter (FMF) method. First, detailed information from the MRI images was extracted using discrete wavelet transform; these images were enhanced by increasing the pixel values. The enhanced images were then fed into the KMC model for segmentation. Finally, the segmented images were input into the FMF for removing uncertainty and noise. This method can also be used for segmenting the MRI images of other diseases such as tuberous sclerosis (TBS) and atrial fibrillation (AF). The results of a qualitative and quantitative evaluation conducted using an open-source benchmark dataset and a clinical dataset were presented. The peak signal-to-noise ratio, structural similarity, and mean-squared error were used to compare the efficiency of the proposed method with that of other segmentation methods. The results proved that the proposed method can assist in the early detection of PD, TBS, and AF from MRI.

BACKGROUND China has a high prevalence of hepatitis B virus (HBV), but most chronic hepatitis B (CHB) patients do not receive standardized antiviral therapy. There are few relevant reports addressing the outcomes of the large number of CHB patients who do not receive antiviral therapy. AIM To observe the outcomes of long-term follow-up of patients with CHB without antiviral treatment. METHODS This study included 362 patients with CHB and 96 with hepatitis B cirrhosis without antiviral treatment and with only liver protection and anti-inflammatory treatment from 1993 to 1998. The median follow-up times were 10 and 7 years, respectively. A total of 203 CHB and 129 hepatitis B cirrhosis patients receiving antiviral therapy were selected as the control groups. The median follow-up times were 8 and 7 years, respectively. Kaplan-Meier curves were used to analyze the cumulative incidence of hepatocellular carcinoma (HCC), and the Cox regression model was used to analyze the risk factors for HCC. RESULTS Among the patients in the non-antiviral group, 16.9% had spontaneous decreases in HBV DNA to undetectable levels, and 32.8% showed hepatitis B e antigen (HBeAg) seroconversion. In the antiviral group, 87.2% of patients had undetectable HBV DNA, and 52% showed HBeAg seroconversion. Among CHB and hepatitis B cirrhosis patients, the cumulative incidence rates of HCC were 14.9% and 53.1%, respectively, in the non-antiviral group and were 10.7% and 31.9%, respectively, in the antiviral group. There was no difference between the two groups regarding the CHB patients (P = 0.842), but there was a difference between the groups regarding the hepatitis B cirrhosis patients (P = 0.026). The cumulative incidence rates of HCC were 1.6% and 22.3% (P = 0.022) in the groups with and without spontaneous HBeAg seroconversion, respectively. The incidence rates of HCC among patients with and without spontaneous declines in HBV DNA to undetectable levels were 1.6% and 19.1%, respectively (P = 0.051). There was no difference in the cumulative incidence of HCC between the two groups regarding the patients with drug-resistant CHB (P = 0.119), but there was a significant difference between the two groups regarding the patients with cirrhosis (P = 0.004). The Cox regression model was used for regression of the corrected REACH-B score, which showed that alanine aminotransferase > 400 U/L, history of diabetes, and family history of liver cancer were risk factors for HCC among men aged > 40 years (P < 0.05). Multifactorial analysis showed that a family history of HCC among men was a risk factor for HCC. CONCLUSION Antiviral therapy and non-antiviral therapy with liver protection and anti-inflammatory therapy can reduce the risk of HCC. Antiviral therapy may mask the spontaneous serological response of some patients during CHB. Therefore, the effect of early antiviral therapy on reducing the incidence of HCC cannot be overestimated.

In face of the advance of technology, increase in competitors, and shortening product life cycle, enterprises could face market change and competition with other enterprises through constant innovation, e.g. creation of new knowledge, to maintain corporate competitive advantage. With better relationship between team members and other members, members present more social interaction to acquire more knowledge. In order to maintain more relational capital, individuals would invest in more resources, including interaction with others or providing message, resources, or knowledge required for others. In this case, individuals with more social interaction would be willing to share knowledge with others. Employees in medical technology industry in Fujian, as the research samples, are distributed 450 copies of questionnaire in this study. After deducting invalid and incomplete ones, 316 valid copies are retrieved, with the retrieval rate 70%. According to the results, suggestions are proposed, expecting to help employees in medical technology industry possess high-level professional knowledge and skills to deal with complicated work and develop the effectiveness of organizational resource application, regardless of medical technology industry product knowledge or customer needs, to achieve organizational performance.

Laparoscopic surgery for rectal cancer is technically challenging. Robotic and transanal TME (TaTME) are both novel approaches developed to provide better visualization and dissection. We aim to combine both approaches in a hybrid procedure and evaluate the feasibility as well as patient and oncological outcomes in this study. A review of a prospectively maintained database of patients who underwent a hybrid abdominal robotic approach with TaTME for rectal cancer between January 2016 and October 2018 was undertaken. Patient demographics, tumor characteristics and surgical outcomes were recorded and analyzed. A total of 69 patients (43 males, 26 females) received this hybrid approach. Their median age was 58 years (range 35–87) with a mean BMI of 24.3 kg/m2 (range 16.4–44.2). Median distance from anal verge was 5 cm (range 2–9). The patients had a median hospital length of stay of 7 days (range 5–28). Complication rate was 17.4% (12 patients) with 3 patients (4.3%) requiring a reoperation. TME quality was optimal with all of them either complete (81.2%) or almost complete (18.8%). 65 patients (94.2%) had an R0 resection with 4 patients (5.8%) with involved circumferential resection margins (≤ 1 mm). The median number of lymph nodes harvested was 20 (range 6–37). After a median follow-up of 27.7 months (range 7–42), local recurrence was identified in 2 patients (4%). Three patients (5.2%) had distant recurrence at the 3-year mark. Hybrid robotic abdominal dissection with transanal TME for rectal cancer appears to be feasible with comparable surgical outcomes to other traditional approaches.

We investigated the effects of botulinum toxin on gait in Parkinson’s disease (PD) patients with foot dystonia. Six patients underwent onabotulinum toxin A injection and were assessed by Burke–Fahn–Marsden Dystonia Rating Scale (BFMDRS), visual analog scale (VAS) of pain, Timed Up and Go (TUG), Berg Balance Test (BBT), and 3D gait analysis at baseline, 1 month, and 3 months. BFMDRS (p = 0.002), VAS (p = 0.024), TUG (p = 0.028), and BBT (p = 0.034) were improved. Foot pressures at Toe 1 (p = 0.028) and Midfoot (p = 0.018) were reduced, indicating botulinum toxin’s effects in alleviating the dystonia severity and pain and improving foot pressures during walking in PD.

It has been a vital issue to ensure both the accuracy and efficiency of computational models for analyzing the ballistic impact response of fiber-reinforced composite plates (FRCP). In this paper, a machine learning (ML) model is established in an effort to bridge the ballistic impact protective performance and the characteristics of microstructure for unidirectional FRCP (UD-FRCP), where the microstructure of the UD-FRCP is characterized by the two-point correlation function. The results showed that the ML model, after trained by 175 cases, could reasonably predict the ballistic impact energy absorption of the UD-FRCP with a maximum error of 13%, indicating that the model can ensure both computational accuracy and efficiency. Besides, the model’s critical parameter sensitivities are investigated, and three typical ML algorithms are analyzed, showing that the gradient boosting regression algorithm has the highest accuracy among these algorithms for the ballistic impact problem of UD-FRCP. The study proposes an effective solution for the traditional difficulty of the ballistic impact simulation of composites with both high efficiency and accuracy.

Background. Kawasaki disease (KD) is a systemic vasculitis of unknown etiology in children. Coronary artery abnormalities are the most common complications of KD. Recent evidence showed that genetic polymorphisms may lead to susceptibility to KD. Genetic variants in platelet glycoprotein have been reported to be associated with coronary artery disease. The aim of the present study is to investigate the correlation between the role of platelet glycoprotein and coronary artery aneurysms in KD patients. Methods. We did a case-control study that enrolled 818 KD patients and 1401 healthy children with the same age and sex from January 2013 to December 2016. Analysis of single-nucleotide polymorphism (rs1126643) of the platelet glycoprotein Ia/IIa C807T was performed by multiplex polymerase chain reactions in this study. Results. A significant difference in the genotype distribution between KD cases and controls was observed for the glycoprotein Ia/IIa C807T (rs1126643) polymorphism ( p = 0.026 ). Compared with the healthy children, the rs1126643T allele carriers had odds ratio (OR) of 0.63 for developing KD (TT vs. CC: adjusted OR = 0.62, 95% confidence interval (CI) = 0.43–0.88, p = 0.0078 ; TT vs. CT/CC: adjusted OR = 0.63, 95% CI = 0.44–0.889, p = 0.0093 ). Furthermore, we also found that children less than 60 months of age and female patients with rs1126643 T allele carriers had an adjusted OR of 0.66 (95% CI = 0.46–0.95) for noncoronary artery aneurysm patients ( p = 0.0242 ). Single-nucleotide polymorphism rs1126643 TT seems to represent a protective factor against KD in coronary artery aneurysm formation in multivariate analysis. Conclusions. The platelet glycoprotein Ia/IIa T allele carriers may have a protective effect on the risk of coronary artery aneurysms of KD patients, especially in females and children aged less than 60 months. These results may provide evidence for platelet glycoprotein Ia/IIa gene polymorphisms in the pathogenesis of KD patients.

OBJECTIVE This study explored the multiple mediating effects of cancer threat appraisal, functional status, and symptom distress on the association between mindfulness and depression in colorectal cancer (CRC) patients at the transition stage after completing cancer treatments. METHODS A total of 90 CRC survivors who received cancer treatments within 3 months participated in this cross-sectional study. The functional status and symptom distress (EORTC-C30 and EORTC CR29), dispositional mindfulness (Five Facet Mindfulness Questionnaire), cancer threat appraisal ( Constructed Meaning Scale), and depressive symptoms (Beck Depression Inventory-II scale) were collected. The mediation and moderation analyses were conducted using the PROCESS macros for SPSS. RESULTS Survivors' dispositional mindfulness (γ = -0.49, p

Fluorescent TiO2/carbon quantum dots (CQDs) nanocomposites are prepared through incorporating CQDs into TiO2 nanofilms, which are regarded as pressure sensitives to fabricate fluorescent pressure sensors for the first time. The TiO2/CQDs sensors emit bright white fluorescence, and the fluorescence intensity of the TiO2/N-doped CQDs (NCQD) sensor is much higher than the TiO2/undoped CQDs (UCQD). The current response of the TiO2/CQDs sensors have a good linear relationship with the applied pressure (R2 > 0.96), while that of the pure TiO2 sensor does not. Furthermore, the sensitivity of the TiO2/NCQD sensor is 2.27 times larger than that of the TiO2/UCQD sensor. In addition, the thickness of the nanocomposite film has a great influence on pressure sensing. The fluorescence and sensing performance of the fluorescent pressure sensors based on TiO2/CQDs nanocomposite films are expected to be further simultaneously optimized by modulating CQDs for dynamically monitoring indoor security, such as recognizing the hit from the outdoor and simultaneously generating a self-warning signal of abnormal ultraviolet illumination from the surroundings.

Background Survival rates among gynaecological cancer patients have increased over time; however, patients must now cope with long-term treatment-related issues affecting their quality of life (QOL). Little is known about the factors influencing QOL in patients with gynaecological cancers in the Chinese population. Aim To identify QOL predictors among patients with gynaecological cancers, and examine the relationship between QOL and demographics, stress, coping strategies, and social support. Methods: A cross-sectional survey was conducted with 111 patients who were recruited from the gynaecological oncology outpatient department of a hospital in Taiwan. Findings Patients’ QOL was positively correlated with marriage, emotion-focused coping, problem-focused coping, and social support. QOL was negatively correlated with malfunctioning coping strategies and stress. Regression models accounted for 19%–30% of the variance across the four domains of QOL. Stress was a significant predictor of all QOL domains. Social support was the main predictor of the social relationships and environment QOL domains. The lowest QOL score was for sexual life. Discussion Patients with gynaecological cancers reported lower levels of satisfaction with the social relationships and psychological health domain of QOL. Diagnosis and treatment for a gynaecological cancer may impact how women perceive their femininity and relationship with their husband. Conclusions This study provides a comprehensive picture for nurses to understand the factors associated with QOL among patients with gynaecological cancers in the Chinese cultural context. Screening for stress is important since stress was the main predictor for all domains of QOL among patients. Providing support, especially familial and emotional support, to patients with Chinese cultural backgrounds is critical because of their family values. Offering a private space to discuss the patients’ concern and carefully observing their non-verbal language are essential because these patients often do not talk about their cancer and sexual life openly and publicly.

BACKGROUND: In March 2020, the World Health Organization (WHO) declared COVID-19 a public health emergency of international concern. A small proportion of patients infected with COVID-19 go on to develop pneumonia. We speculated that COVID-19 may be likely to result in psychological disorders such as anxiety and depression. In this study, we conducted an investigation of anxiety and depression in patients with COVID-19. METHODS: Sixty-five COVID-19 patients were randomly enrolled into this study. Anxiety and depression among participants were measured through the completion of anonymous Chinese-language Zung self-rating anxiety scale and self-rating depression scale questionnaires. Data were analyzed using independent samples t-tests, Mann-Whitney U-tests, and χ2 tests. RESULTS: The questionnaire results showed that 26.15% and 41.54% of participants suffered from anxiety and depression, respectively, although there was no significantly statistical difference between the proportions of COVID-19 patients with anxiety and depression. Statistically significant differences in employment status, partial pressure of oxygen, and corticosteroid application existed between moderate- and severe COVID-19 patients (P

This study describes a patient with an autograft-derived spinal cord mass following transplantation of olfactory mucosa for treatment of cervical spine injury. The authors report the case of a 35-year-old man who suffered a complete spinal cord injury (SCI) at C5–6 in 2001. The patient underwent an olfactory mucosal cell implantation at the location of injury 4 years following initial trauma. Twelve years later, the patient presented with rapidly progressive decline in upper-extremity function as well as neuropathic pain. Imaging revealed a heterogeneously enhancing intramedullary mass from C3 to C7. At surgery, the patient was found to have a posttransplant mucinous mass. Each mucinous cyst was drained and a portion of the cyst wall was removed. Histological examination demonstrated ciliated epithelium-lined fibrous tissue, submucosal glands, and mucoid material, consistent with a transplant-derived tumor. This case report both documents a rare long-term complication of olfactory mucosal cell transplantation and serves as a cautionary tale encouraging prudent use of novel treatments in a vulnerable population of patients with severe SCI.

BackgroundKawasaki disease (KD) is a systemic vasculitis, and the formation of coronary artery lesions(CAL) is its most common sequela. Both genetic and environmental factors are considered to be important factors of in KD. Integrin α2 (ITGA2) is a transmembrane receptor that is associated with susceptibility to several diseases, but its relevance to KD with CAL is unclear.MethodsWe genotyped ITGA2 rs1126643 in 785 KD patients with the CAL and no-CAL(NCAL) (300 patients with CAL, and 485 age- and sex-matched patients with NCAL). OR (95% CI) and adjusted OR (95% CI) were used to evaluate the intensity of the association.ResultsWe found a significantly increased risk of KD with CAL associated with ITGA2 rs1126643 genotypes (CT vs CC: adjusted OR = 1.57, 95% CI = 1.16–2.12,P = 0.0032; CT/TT vs CC: adjusted OR = 1.49, 95% CI = 1.12–2.00,P = 0.0068; T vs C: adjusted OR = 1.66, 95% CI = 1.16–2.51,P = 0.0165). Moreover, we found that carriers of the CT/TT genotype had a significant risk of KD with coronary artery lesion susceptibility for children ≤60 months of age, and the CT/TT genotype was significantly associated with an increased risk of SCAL formation and MCAL formation when compared with the CC genotype.ConclusionITGA2 rs1126643 was associated with increased susceptibility and severity of CAL in KD.

Automatic detection of crop yield ripeness is a tedious task because of the presence of various intensities of color in crops. One of the solutions to this problem is the monitoring of those crops by performing segmentation operations. This operation can help to distinguish the ripe and non-ripe regions among the crop images. For this purpose, this study presents a new hybrid crop image segmentation method utilizing type-2 fuzzy set (T2FS), K-means clustering algorithm, and modified quantum optimization algorithm (MQOA). The proposed method fully utilizes the indispensable qualities of these three techniques by (a) using T2FS to represent each color component of crop images in terms of secondary memberships, (b) applying K-means clustering algorithm to extract the similar features from the set of type-2 entropy values obtained from the secondary memberships, and (c) exploiting MQOA to optimize the distance function used in K-means clustering algorithm to obtain the optimal clusters. The performance of the proposed method is assessed based on the experiments carried out on color images of cherry tomatoes. Evidence of experimental results suggests that the proposed method produces extremely effective segmented images relative to those well-known color image segmentation methods available in the literature of pattern recognition and computer vision domains.

Seasonal or monthly databases of the diatom populations in specific bodies of water are needed to infer the drowning site of a drowned body. However, existing diatom testing methods are laborious, time-consuming, and costly and usually require specific expertise. In this study, we developed an artificial intelligence (AI)-based system as a substitute for manual morphological examination capable of identifying and classifying diatoms at the species level. Within two days, the system collected information on diatom profiles in the Huangpu and Suzhou Rivers of Shanghai, China. In an animal experiment, the similarities of diatom profiles between lung tissues and water samples were evaluated through a modified Jensen-Shannon (JS) divergence measure for drowning site inference, reaching a prediction accuracy of 92.31%. Considering its high efficiency and simplicity, our proposed method is believed to be more applicable than existing methods for seasonal or monthly water monitoring of diatom populations from sections of interconnected rivers, which would help police narrow the investigation scope to confirm the identity of an immersed body.