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The effectiveness and longevity of amendments will influence the reduction in cadmium (Cd) bioavailability by in situ remediation techniques. Different amendments, including red mud (RM), corn straw (CS), rape straw (RS), and their combinations with zinc (Zn) fertilizer, were evaluated based on a long-term field experiment. It was found that all amendments decreased the concentration of available-Cd (EDTA-Cd and Exch-Cd) in soil and also reduced the Cd content (%) in plants. The amendments were still effective after eight years, although the effect did decline over time. The reduction of plant Cd content was 83.5% for red mud plus rape straw (RMRS), 65.3% for red mud plus corn straw (RMCS), 50.9% for RS, 54.0% for RM, and 37.3% for CS in the first few years. The reduction in plant Cd content was still 17.2% for RMRS after eight years, and RMRS was found to be the most effective treatment for decreasing Cd bioavailability. This study also explained that why the reduction in plant Cd content declined over time is the change of available Cd content in soil over time, which is important for guiding agricultural practice. It was concluded that RM, CS, RS, and their combinations with Zn fertilizer as effective amendments can have a profound and lasting positive impact on Cd-contaminated soils.

Deubiquitinases (DUBs) and noncoding RNAs have been the subjects of recent extensive studies regarding their roles in lung cancer, but the mechanisms involved are largely unknown. In our study, we used The Cancer Genome Atlas data set and bioinformatics analyses and identified USP21, a DUB, as a potential contributor to oncogenesis in non-small-cell lung cancer (NSCLC). We further demonstrated that USP21 was highly expressed in NSCLCs. We then conducted a series of in vitro and in vivo assays to explore the effect of USP21 on NSCLC progression and the underlying mechanism involved. USP21 promoted NSCLC cell proliferation, migration, and invasion and in vivo tumor growth by stabilizing a well-known oncogene, Yin Yang-1 (YY1), via mediating its deubiquitination. Furthermore, YY1 transcriptionally regulates the expression of SNHG16. Moreover, StarBase bioinformatics analyses predicted that miR-4500 targets SNHG16 and USP21. A series of in vitro experiments indicated that SNHG16 increased the expression of USP21 through miR-4500. In summary, the USP21/YY1/SNHG16 axis plays a role in promoting the progression of NSCLC. Therefore, the USP21/YY1/SNHG16/miR-4500 axis may be a potential therapeutic target in NSCLC treatment., Lung cancer: Targeting a vicious circle Therapies targeting a molecular feedback loop involved in tumor growth may prove valuable for treating non-small-cell lung cancer. Fangbao Ding, Jianbing Huang, and co-workers at Shanghai Jiao Tong University in Shanghai, China, have shown how an enzyme called USP21 promotes cancer cell proliferation and tumor growth in non-small-cell lung cancer. The team took cancerous and non-cancerous lung tissue samples from 42 patients, and analyzed the expression and behavior of USP21. The enzyme was highly expressed in cancerous tissues, where it stabilized a known gene with the potential to cause cancer called YY1. This gene also regulated the expression of a particular RNA molecule, which in turn worked to increase levels of USP21. This cyclical process encouraged the proliferation, migration and invasion of non-small-cell lung cancer cells, and may provide a future therapeutic target.

In this paper, we prove new complete monotonicity properties of some functions related to generalized k-gamma and k-polygamma functions. Applications of the results yield various new inequalities. In the end, double inequalities are constructed involving the k-generalized digamma and polygamma functions.

Ratiometric thermometry with ultra-high sensitivity and tunable response range has been realized in a single molecular system by making full use of the excited-state configuration transformation of a dihydrophenazine derivative (dibenzo[a,c]phenazine-9,14-diylbis(4,1-phenylene))bis(methylene) bis(icosanoate), (DPC). By facilely manipulating the disaggregation and aggregation of DPC, the excited-state configuration transformation could be controlled, thus affording a ratiometric response to temperature change. By altering the composition of the ethanol/glycerol mixtures, the temperature response region could be finely tuned and the overall linear range is as broad as 49.1 °C (−11.4–37.7 °C). Surprisingly, apart from the relative sensitivity as high as around 2000% per °C, which is the highest among all reported luminescent thermometers, and the good repeatability (stability), the present thermometry scheme can even allow the temperature to be read out accurately from the fluorescence (FL) colour since the precise functional relationship between the CIE coordinates of the fluorescence colour and temperature was established. This is unprecedented for luminescent thermometers, meaning that there is no need for the luminescence-based thermometer to rely on a spectrometer. In this way, the application scope of luminescence-based thermometers could be significantly enlarged. The strategy proposed here solves the conflict between high sensitivity and wide temperature response range masterfully.

Natural silk fiber derived from the Bombyx mori (B. mori) silkworm has long been used as a luxury raw material in textile industry because of its shimmering appearance and durability, and as surgical suture for its high strength and flexibility. Regenerated silk fibroin, as the main protein extracted from the cocoons of the B. mori silkworm, recently has gained considerable attention due to its outstanding properties, including facile processability, superior biocompatibility, controllable biodegradation, and versatile functionalization. Tremendous effort has been made to fabricate silk fibroin into various promising materials with controlled structural and functional characteristics for advanced utilities in a multitude of biomedical applications, flexible optics, electronics devices, and filtration systems. Herein, reverse engineered silk fibroin extraction methods are reviewed, recent advances in extraction techniques are discussed. Fabrication methods of silk fibroin materials in various formats are also addressed in detail; in particular, progress in new fabrication technologies is presented. Attractive applications of silk fibroin-based materials are then summarized and highlighted. The challenges faced by current approaches in production of silk fibroin-based materials and future directions acquired for pushing these favorable materials further toward above mentioned applications are further elaborated.

Background Intracardiac septal defect is repaired using median sternotomy in most centers; however, there are several reports using minimally invasive surgery in both children and adults. This study summarized our strategy of minimally invasive therapy using various lateral mini-thoracotomies in patients with congenital septal defect. Methods In this study, 472 patients who underwent minimally invasive repair of intracardiac septal defects (atrial septal defect, (ASD), ventricular septal defect, (VSD), and atrioventricular septal defect, (AVSD)) from January 2012 to June 2020 were retrospectively reviewed. Those who underwent device closure were excluded. The minimally invasive strategy included three groups: the right sub-axillary vertical incision (RSAVI) group (N = 335, including192 ASDs, 135 VSDs and 8 AVSDs); the right anterolateral thoracotomy (RALT) group (N = 132, including 77 ASDs, 51 VSDs and 4 AVSDs); and the left anterolateral thoracotomy (LALT) group (N = 5, all subpulmonary VSDs). Results Concomitant surgeries included nine cases of right ventricular outflow tract obstruction relief, nine cases of mitral repairs and 37 cases of tricuspid repairs. There was one transition from thoracotomy to sternotomy. Three patients required second pump run for residual lesions (two residual VSD shunts and one mitral regurgitation). The age and body weight of the RSAVI group were significantly lower than those of the RALT and LALT groups (all P Conclusions Intracardiac septal defects can be safely and effectively repaired by minimally invasive surgery with good cosmetic results. RSAVI is suitable in infants and children, while RALT is more commonly used in adolescents and adults. LALT is an alternative incision to repair subpulmonary VSD.

As the third paper in the multiple-part series, we report the statistical properties of radio bursts detected from the repeating fast radio burst (FRB) source FRB 20201124A with the Five-hundred-meter Aperture Spherical radio telescope (FAST) during an extremely active episode between the 25th and the 28th of September 2021 (UT). We focus on the polarisation properties of 536 bright bursts with $\mathrm{S/N}>50$. We found that the Faraday rotation measures (RMs) monotonically dropped from $-579 \ {\rm rad \ m^{-2}}$ to $-605 \ {\rm rad \ m^{-2}}$ in the 4-day window. The RM values were compatible with the values ($-300$ to $-900\ {\rm rad \ m^{-2}}$ ) reported 4 month ago (Xu et al. 2022). However, the RM evolution rate in the current observation window was at least an order of magnitude smaller than the one ($\sim 500\ {\rm rad \ m^{-2}\, day^{-1}}$) previously reported during the rapid RM-variation phase, but is still higher than the one ($\le 1\ {\rm rad \ m^{-2} day^{-1}}$ ) during the later RM no-evolution phase. The bursts of FRB 20201124A were highly polarised with the total degree of polarisation (circular plus linear) greater than 90% for more than 90\% of all bursts. The distribution of linear polarisation position angles (PAs), degree of linear polarisation ($L/I$), and degree of circular polarisation ($V/I$) can be characterised with unimodal distribution functions. During the observation window, the distributions became wider with time, i.e. with larger scatter, but the centroids of the distribution functions remained nearly constant. For individual bursts, significant PA variations (confidence level 5-$\sigma$) were observed in 33% of all bursts. The polarisation of single pulses seems to follow certain complex trajectories on the Poincar\'e sphere, which may shed light on the radiation mechanism at the source or the plasma properties along the path of FRB propagation., Comment: 25 pages, 16 figures. Accepted by Research in Astronomy and Astrophysics (RAA)

Fast radio bursts (FRBs) are brief, intense flashes of radio waves from unidentified extragalactic sources. Polarized FRBs originate in highly magnetized environments. We report observations of the repeating FRB 20190520B spanning seventeen months , which show its amount of Faraday rotation is highly variable and twice changes its sign. The FRB also depolarizes below radio frequencies around 1 to 3 GHz. We interpret these properties as due to change in the parallel component of the integrated magnetic field along the line-of-sight, including reversals. This could result from propagation through a turbulent, magnetized screen of plasma located between $10^{-5}$ to 100 parsecs of the FRB source. This is consistent with the bursts passing through the stellar wind of a binary companion of the FRB source., Comment: arXiv:2203.08151 has been merged into this

Diffuse pulmonary vein stenosis (PVS) is an intractable congenital heart disease for which the underlying mechanism remains unclear. In this study, we investigated the effect of losartan and the role of the Hippo pathway in PVS.A total of 19 neonatal piglets were divided into 3 groups: a sham group (n=7), a banded group (n=6) with the left upper pulmonary vein and common trunk of both lower pulmonary veins banded, and a losartan group (n=6) with losartan treatment (1 mg/kg/d) after the banding operation. After 8 weeks, the piglets underwent hemodynamic measurement and harvesting. The upstream pulmonary veins were collected for histological staining and molecular biological analysis. Losartan and/or angiotensin II (stepwise concentrations from 0.1 to 100 µmol/L) were added to a human umbilical vein endothelial cell culture to investigate the potential mechanismThe modified model demonstrated the main characteristics of patients with PVS, including pulmonary hypertension and intimal hyperplasia in the upstream veins. Upregulation of yes-associated protein (YAP) and angiotensin II type 1 receptor was observed in the neointima (P0.01). Losartan treatment improved the pathological changes in piglets and decreased YAP expression in the neointima (P0.01). In vitro, losartan suppressed angiotensin II-induced cell proliferation by inhibiting dephosphorylation and nuclear translocation of YAP in human umbilical vein endothelial cells (P0.05).Losartan treatment ameliorates intimal hyperplasia and inhibits YAP activation. The activation of the Hippo-YAP pathway is involved in the vasculopathy of progressive PVS. These findings may contribute to the development of new approaches for treating PVS.

Using the principles and methods of dendrochronology, we measured tree-ring width of four dominant coniferous species,运用树木年代学的原理和方法,对普达措国家公园大果红杉、长苞冷杉、高山松和麦吊云杉4个优势针叶树种的年轮宽度进行测量,建立年轮宽度差值年表。分析年表与香格里拉气象站的日、月气候数据的相关性,研究4个优势针叶树种的径向生长对气候因子的响应。结果表明: 大果红杉的年生长速率最高,长苞冷杉的年生长速率最低;4种针叶树径向生长对气候因子的响应存在物种特异性,大果红杉与气候因子的相关性最强,麦吊云杉的径向生长对气候因子的响应不敏感;长苞冷杉树轮宽度年表与上年冬季(11、12月)和当年夏季(7月)的平均温度呈显著正相关;大果红杉树轮宽度年表与生长季早期(6月)温度呈显著正相关,与同期降水量和相对湿度呈显著负相关;而高山松树轮宽度年表与生长季早期(5月)的降水量和相对湿度呈显著正相关,与同期最高温度呈显著负相关,表明高山松的径向生长主要受生长季早期水分可利用性的影响。.

Metal powder bed fusion (PBF) is an advanced metal additive manufacturing (AM) technology. Compared with traditional manufacturing techniques, PBF has a higher degree of design freedom. Currently, although PBF has received extensive attention in fields with high–quality standards such as aerospace and automotive, there are some disadvantages, namely poor process quality and insufficient stability, which make it difficult to apply the technology to the manufacture of critical components. In order to surmount these limitations, it is necessary to monitor the process. Online monitoring technology can detect defects in time and provide certain feedback control, so it can greatly enhance the stability of the process, thereby ensuring its quality of the process. This paper presents the current status of online monitoring technology of the metal PBF process from the aspects of powder recoating monitoring, powder bed inspection, building process monitoring, and melt layer detection. Some of the current limitations and future trends are then highlighted. The combination of these four–part monitoring methods can make the quality of PBF parts highly assured. We unanimously believe that this article can be helpful for future research on PBF process monitoring.

Precise and early detection of Aβ fibrils/plaques is pivotal to the diagnosis and treatment of Alzheimer's disease (AD), a serious disease threatening human health. Optical imaging stands out to be a promising technique for such task. However, restricted by poor blood-brain barrier penetrability, short-wavelength excitation and emission, and aggregation-caused quenching effect, the clinically used gold-standard probes are usually powerless in early in-vivo diagnosis of AD. To address these issues, we put forward an “all-in-one” design principle and develop a simple rod-like amphiphilic NIR AIE probe to demonstrate its feasibility. In-vitro, ex-vivo, and in-vivo experiments with different strains of mice indicates that AIE-CNPy-AD holds the universality to Aβ fibrils/plaques identification. Noteworthily, AIE-CNPy-AD is even able to precisely trace the small and sparsely-distributed Aβ fibrils/plaques in AD model mice as young as 4-month-old APP/PS1 mice, the youngest having Aβ deposits, suggesting the probe might be an ideal alternative for early AD diagnosis.

Polyurethanes (PUs) are a very attractive type of segmented polymer with unique mechanical properties derived from thermodynamic incompatibility between flexible soft segments and hard segments. The performance of PUs is closely related to their microphase separation structures, in which the hard domains serve as physical cross-linking points in the soft matrix. Studying the microphase separation of PUs in a facile manner is thus of great significance but challenging due to the complexity of the internal structures of PUs.

Developing red fluorescence emitters with simple structures via convenient synthetic routes is highly desirable yet challenging. A novel simple AIE-active red emitter featured with intramolecular charge transfer (ICT) effect was designed by simply integrating common electron donor (D) and acceptors (A) through π bridges, and facilely synthesized via stepwise asymmetric Knoevenagel condensations. Its AIE property comes out from the non-planar 3D configuration and multiple rotors, and the ICT effect is originated from its D–A electronic structure. This aldehyde group-functionalized AIEgen holds the capability to specifically detect thiol-containing amino acids in a light-up fashion with notable blue-shift in fluorescence in 2 min. Dramatic difference in the kinetics enabled this probe to differentiate cysteine (Cys) and homocysteine (Hcy) from glutathione (GSH). More interestingly, it generally shows a higher sensitivity to Hcy over Cys. Moreover, the remarkable fluorescence enhancement when the Cys concentration is above 250 μM and the obvious blue-shift in the UV-Vis absorption spectrum at 15 μM for Hcy reveal the potential of this AIEgen to be applied as an indicator of Cys/Hcy-related diseases.

Cerebral small vessel disease (cSVD) is the leading cause of chronic cerebral hypoperfusion. Gait, balance disorders and falls associated with white matter lesions can increase the risk of sickness and death in patients with cSVD. Therefore, understanding the correlations between gait, balance disorders and falls and white matter lesions, pathophysiological mechanisms, evaluation methods, etc., can help to predict the occurrence of falls and can be taken against their potential risks. Corresponding interventions can improve the quality of life of patients with cSVD. DOI: 10.3969/j.issn.1672-6731.2019.04.012

Epicardial surgical repair has been proven to be effective for patients with coronary- pulmonary artery fistula (CPAF). However, most of the surgery has been performed through a median sternotomy under cardiopulmonary bypass. In this report, we describe a novel technique of performing minimally invasive surgery for CPAF patients without extracorporeal circulation via a parasternal minithoracotomy. This technique has proved to be safe and effective and may be worthy of use for patients with CPAF.

The variable anatomy of Ebstein’s anomaly leads to its various surgical procedures. The long-term outcomes of different operations were not well established. Thirty-five patients with Ebstein’s anomaly who underwent operations from 2006 to 2018 in our department were retrospectively reviewed. Individualized surgical plans were performed according to the preoperative echocardiography and surgeons’ preference. Tricuspid repair, either Danielson’s or Carpentier’s technique, was the primary choice in patients who had sufficient tricuspid leaflets and adequate right ventricle, while tricuspid replacement was used when a reliable repair is not achievable. Additional bidirectional cavopulmonary shunt was performed in those who had unstable hemodynamics despite of high central venous pressure after separation from cardiopulmonary bypass. The perioperative and follow-up data were collected. The age was 26.9 (0.6–54) years [16 children (age

The objective of the study is to investigate the concentration of heavy metals(Cr, Ni, Cd, Pb, As) and enlighten the accumulation status in soils and vegetables in greenhouses of Hebei Province. Four vegetable bases(Yongnian of Handan City, Dingzhou of Baoding City, Qingxian of Cangzhou City, Gaocheng of Shijiazhuang City) from Hebei Province were selected. The method of the geo-accumulation index was used to evaluate the environment quality condition of heavy metals in soil and the target hazard quotient was used to assess the health risk caused by intaking vegetables. The results indicated that the mean concentrations of Cr, Ni, Cd, Pb and As in the greenhouses soil of four vegetable bases did not exceed the critical value of grade Ⅱ of the Soil Quality Standard(GB 15618-1995). However, the accumulation of Cd and Cr in greenhouses were 100% and 40.6% respectively, which were the ratios of exceeding the background values. The contents of Cd and Cr in greenhouse soil were 1.99, 1.10 times of the background values respectively. The accumulation of Pb and As was only in some investigation spots. Besides, the contents of Ni were all lower than the background value. In the evaluation of index of geoaccumulation, the accumulation pollution level of Cd was slight to medium while Cr、Ni、Pb、As were all clean in greenhouses soil of Hebei Province. Approximately 15.63% Cr in vegetables exceeded the Criteria Level of Contaminants in the Foods(GB 2762-2017), the contents of other heavy metals didn't exceed the criteria. The BCFs(Bioconcentration factors) of five heavy metals in spinach, scallion and green garlic were relatively higher than other vegetables. The average BCFs in different categories of vegetables were ranked in the order of leaf vegetable > root vegetables > bulbous vegetables > fruit vegetables, and in different heavy metals were ranked in the order of Cd > Ni > Cr > As > Pb. The health risk assessment using target hazard quotient illustrated that there was no significant human health risk caused by heavy metal in greenhouse vegetables of Hebei Province, while the content of Cr in Gaocheng vegetable presented a significant risk to human health, which should be given more attention.

The repeating FRB 20190520B is localized to a galaxy at $z=0.241$, much closer than expected given its dispersion measure $\rm DM=1205\pm4\ pc\ cm^{-3}$. Here we assess implications of the large DM and scattering observed from FRB 20190520B for the host galaxy's plasma properties. A sample of 75 bursts detected with the Five-hundred-meter Aperture Spherical radio Telescope shows scattering on two scales: a mean temporal delay $\tau(1.41\ {\rm GHz})=10.9\pm1.5$ ms, which is attributed to the host galaxy, and a mean scintillation bandwidth $\nu_{\rm d}(1.41\ {\rm GHz})=0.21\pm0.01$ MHz, which is attributed to the Milky Way. Balmer line measurements for the host imply an H$\alpha$ emission measure (galaxy frame) $\rm EM_s=620$ pc cm$^{-6} \times (T/10^4 {\rm K})^{0.9}$, implying $\rm DM_{\rm H\alpha}$ of order the value inferred from the FRB DM budget, $\rm DM_h=1121^{+89}_{-138}$ pc cm$^{-3}$ for plasma temperatures greater than the typical value $10^4$ K. Combining $\tau$ and $\rm DM_h$ yields a nominal constraint on the scattering amplification from the host galaxy $\tilde{F} G=1.5^{+0.8}_{-0.3}$ (pc$^2$ km)$^{-1/3}$, where $\tilde{F}$ describes turbulent density fluctuations and $G$ represents the geometric leverage to scattering that depends on the location of the scattering material. For a two-screen scattering geometry where $\tau$ arises from the host galaxy and $\Delta \nu_{\rm d}$ from the Milky Way, the implied distance between the FRB source and dominant scattering material is $\lesssim100$ pc. The host galaxy scattering and DM contributions support a novel technique for estimating FRB redshifts using the $\tau-\rm DM$ relation, and are consistent with previous findings that scattering of localized FRBs is largely dominated by plasma within host galaxies and the Milky Way., Comment: 14 pages, 9 figures, accepted to ApJ

Introduction. Catheter-based renal denervation (RDN) could reduce cardiac sympathetic nerve activity (SNA) and inhibit atrial fibrillation (AF). However, the reliability is uncertain, because the renal sympathetic nerves are mainly distributed in the adventitial surface of the renal artery. Objective. The aims of this study were to test the hypothesis that renal artery adventitial ablation (RAAA) definitely had the effects of RDN and to study the effects of RDN via renal artery adventitial cryoablation (RAAC) on AF and cardiac neural remodeling. Methods. Twenty beagle canines were randomly assigned to two groups: the left RDN group (LRDN, n=10), which underwent left RDN via RAAC; the Sham group (n=10). After 2 months of postoperative recovery, AF vulnerability, AF duration, and histological examination were performed in both groups. Results. Compared with the Sham group, left stellate ganglion (LSG) tissue fibrosis was increased in the LRDN group. LRDN significantly increased the percentage of TH-negative ganglionic cells and decreased the density of TH-positive nerves in the LSG (P<0.001). Also, the densities of TH-positive nerves and GAP43 immunoreactivity within the left atrium (LA) were significantly decreased in the LRDN group (P<0.05). After LA burst pacing, all 10 canines (100%) could be induced AF in the Sham group, but only 4 of 10 canines (40%) could be induced AF in the LRDN group (P=0.011). The percentage of LA burst stimulation with induced AF was 26.7% (8/30) in the LRDN group, which was significantly decreased compared with that of the Sham group (53.3%, 16/30) (P=0.035). In addition, AF duration was also significantly decreased in the LRDN group (13.3 ± 5.1 s) compared with that of the Sham group (20.3 ± 7.3 s, P=0.024). Conclusions. RDN via RAAC could cause cardiac neural remodeling and effectively inhibit AF inducibility and shorten AF duration. It may be useful in selecting therapeutic approaches for AF patients.

Background The aim of this study is to identify whether the balance between T helper 17 (Th17) cells and CD4+CD25+Foxp3+ regulatory T (Treg) cells could predict the postoperative atrial fibrillation (POAF) after coronary artery bypass graft surgery (CABG). Methods We enrolled 88 patients from Xinhua Hospital who received off-pump CABG (OPCABG) surgery. The baseline characteristics of patients were recorded. The preoperative variables C-reactive protein (CRP) level, left atrial (LA) volume, EuroSCORE I score, CHADS2 score, and CHA2DS2-VASc score were calculated at enrolment. Circulating Th17 and Treg cell frequencies were determined by flow cytometry, and expressions of Th17- and Treg-related cytokines were measured by enzyme-linked immunosorbent assay (ELISA). Results Compared to patients without POAF, the CRP level and peripheral circulating Th17 cell were significantly increased in POAF patients. Th17/Treg ratio was positively correlated with CRP level, LA volume, CHADS2 score, and CHA2DS2-VASc score. The areas under the receiver-operating characteristic (AUC) curves of Th17/Treg ratio for predicting POAF occurrence was higher than that of CRP level, LA volume, CHADS2 score and CHA2DS2-VASc score. Th17/Treg ratio combined with CRP level has the highest AUC and a greater balance between sensitivity and specificity for predicting POAF. Conclusions Our data suggest that a Th17/Treg imbalance due to a Th17 shift, representing a pro-inflammatory tendency, participates in the development of POAF. Combining the Th17/Treg ratio with CRP level may provide a more accurate, sensitive, and specific indicator for prediction of POAF.

Objective: The objective of this study was to develop a team-based institutional infrastructure for navigating management of a novel disease, to determine a safe and effective approach for performing tracheostomies in patients with COVID-19 respiratory failure, and to review outcomes of patients and healthcare personnel following implementation of this approach. Methods: An interdisciplinary Task Force was constructed to develop innovative strategies for management of a novel disease. A single-institution prospective non-randomized cohort study was then conducted on patients with COVID-19 respiratory failure who underwent tracheostomy using an induced bedside apneic technique at a tertiary care academic institution between April 27th, 2020, and June 30th, 2020. Results: 28 patients underwent tracheostomy with induced apnea. The median lowest procedural oxygen saturation was 95%. The median number of ventilated days following tracheostomy was 11. There were 3 mortalities (11%) due to sepsis and multiorgan failure; of 25 surviving patients, 100% were successfully discharged from the hospital and 76% are decannulated, with a median time of 26 days from tracheostomy to decannulation (range 12 - 57). There was no symptomatic disease transmission to healthcare personnel on the COVID-19 Tracheostomy Team. Conclusions: Patients with respiratory failure from COVID-19 disease may benefit from tracheostomy. This can be completed effectively and safely, without viral transmission to healthcare personnel. Performing tracheostomies earlier in the course of disease may expedite patient recovery and improve ICU resource utilization. Creation of a collaborative Task Force is an effective strategic approach for management of novel disease.

OBJECTIVES Pectus excavatum (PE) can be secondary in patients who underwent sternotomy for cardiac surgery. Retrosternal adhesions increase the complexity and risk of traditional Nuss repair. Thus, we summarized the outcomes of our modified Nuss procedure using a newly designed bar. METHODS A retrospective analysis was performed on 35 patients who underwent modified PE repair after open heart surgery from January 2011 to July 2019. The surgery was performed using a novel bar with no need for intraoperative reshaping and rotation, assisted by thoracoscopy and subxiphoid incision when necessary. RESULTS There were 19 males and 16 females with a median age of 5.3 years (interquartile range, 4.1–10.9) at PE repair. All patients underwent the modified procedure uneventfully with no death. The median operating time was 70 min. Twenty-nine (82.9%) patients required subxiphoid incision assistance. There was 1 case (2.8%) with unexpected sternotomy due to intraoperative bleeding. The median length of postoperative hospital stay was 4 days. During the median 3.5 years of follow-up, no bar dislocation was found and 30 (85.7%) patients had their bars removed with no recurrence recorded. After PE repair, the Haller index improved significantly (2.6 ± 0.4 vs 4.9 ± 1.3, P CONCLUSIONS The novel bar can be placed and removed easily with a low rate of adverse events. This modified Nuss procedure seems to be a safe, effective and convenient approach for the management of PE after cardiac surgery.

With increase of social aging, Alzheimer's disease (AD) has been one of the serious diseases threatening human health. The occurrence of Aβ fibrils or plaques is recognized as the hallmark of AD. Currently, optical imaging has stood out to be a promising technique for the imaging of Aβ fibrils/plaques and the diagnosis of AD. However, restricted by their poor blood-brain barrier (BBB) penetrability, short-wavelength excitation and emission, and aggregation-caused quenching (ACQ) effect, the clinically used gold-standard optical probes such as thioflavin T (ThT) and thioflavin S (ThS), are not effective enough in the early diagnosis of AD in vivo. Herein, we put forward an “all-in-one” design principle and demonstrate its feasibility in developing high-performance fluorescent probes which are specific to Aβ fibrils/plaques and promising for super-early in-vivo diagnosis of AD. As a proof of concept, a simple rod-like amphiphilic NIR fluorescent AIEgen, i.e., AIE-CNPy-AD, is developed by taking the specificity, BBB penetration ability, deep-tissue penetration capacity, high signal-to-noise ratio (SNR) into consideration. AIE-CNPy-AD is constituted by connecting the electron-donating and accepting moieties through single bonds and tagging with a propanesulfonate tail, giving rise to the NIR fluorescence, aggregation-induced emission (AIE) effect, amphiphilicity, and rod-like structure, which in turn result in high binding-affinity and excellent specificity to Aβ fibrils/plaques, satisfactory ability to penetrate BBB and deep tissues, ultrahigh SNR and sensitivity, and high-fidelity imaging capability. In-vitro, ex-vivo, and in-vivo identifying of Aβ fibrils/plaques in different strains of mice indicate that AIE-CNPy-AD holds the universality to the detection of Aβ fibrils/plaques. It is noteworthy that AIE-CNPy-AD is even able to trace the small and sparsely distributed Aβ fibrils/plaques in very young AD model mice such as 4-month-old APP/PS1 mice which are reported to be the youngest mice to have Aβ deposits in brains, suggesting its great potential in diagnosis and intervention of AD at a super-early stage.