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• Personally tailored exercises are effective for improving physical outcomes. • Personally tailored exercises are effective for reducing disease symptoms. • Personally tailored exercises have no advantage in improving exercise adherence. • Personally tailored exercises have no advantage in improving economic benefits. To identify the effects of personally tailored exercise programmes for improving physical outcomes amongst older people living in the community. Four databases (the Cochrane Library, PubMed, EMBASE, and Web of Science) were searched (from inception until Jan 25th, 2022) for original articles. All studies were randomized controlled trials (RCTs) and quasi-experimental trials reporting the effects of personally tailored exercise programmes on physical outcomes. Two independent reviewers extracted trial data and assessed the risk of bias using the risk of bias tool recommended by the Cochrane Back Review Group and the Methodological Index for Non-Randomized Studies (MINORS). Of the 7310 articles that were screened, 10 articles including 959 participants met the inclusion criteria. Nine of the included studies reported significant improvements in physical outcomes including balance, strength, mobility and physical activity, and disease symptoms. Meta-analysis was not conducted due to the heterogeneity of study designs and outcome measures. This study demonstrated that personally tailored exercises based on assessments of physical function may be a safe and effective approach to improve physical outcomes in older adults living in the community. However, personally tailored exercise has no advantage in improving exercise adherence or economic benefits, and thus, further high-quality RCTs with larger sample sizes and qualitative studies are needed to better understand the effectiveness of personally tailored exercise and the attitude of elderly individuals towards such exercise. Future research should consider not only physical functions but also psychological factors when developing personalized exercise programs. [ABSTRACT FROM AUTHOR]

The aim of this systematic review and meta-analysis was to investigate the pooled prevalence of cognitive frailty among community-dwelling older adults and provide evidence-based support for policy-makers planning health and social care policies. A systematic review and meta-analysis. PubMed, Web of Science, Embase and the Cochrane Library were systematically searched from their inception to December 10, 2020. Descriptive studies (cross-sectional studies or population-based longitudinal studies) and cohort studies were available. Participants were community-dwelling older adults aged 60 years and above. Two researchers independently screened the literature, extracted the data and evaluated the quality of the included studies. All statistical analyses were conducted using Stata 15.0. We screened 2815 records, among which 24 studies met the inclusion criteria and were included in the review. The pooled prevalence of cognitive frailty was 9% (95% CI: 8%-11%, I2 = 99.3%). The results of the subgroup analysis showed that the pooled prevalence of cognitive frailty was 11% (95% CI: 9%-14%) in men and 15% (95% CI: 11%-19%) in women. The pooled prevalence of cognitive frailty based on the descriptive studies and cohort studies was 7% (95% CI: 5%-9%) and 17% (95% CI: 11%-22%), respectively. The pooled estimates of cognitive frailty prevalence were 6% (95% CI: 4%-8%) from 2012 to 2017 and 11% (95% CI: 9%-14%) from 2018 to 2020. This systematic review analyzed the available literature and revealed that the pooled prevalence of cognitive frailty among community-dwelling older adults was 9%. The stratified analysis showed that the prevalence of cognitive frailty was higher in older women. In addition, the prevalence has increased in recent years, which has important implications for adapting health and social care systems. [ABSTRACT FROM AUTHOR]

CO2 air source heat pump (ASHP), as a kind of clean and efficient heating equipment, is a promising solution for domestic hot water and clean heating. However, the promotion of CO2 ASHP encounters a great resistance when it is used for space heating; namely, the return water temperature is too high that cased higher throttle loss, which decreases the COP of the CO2 ASHP unit. To solve this problem, a heating system of CO2 ASHP coupled with thermal energy storage (TES) is developed in this work. The simulation model of the studied system is established using TRNSYS software, and the model is verified by experimental data. Additionally, the performance of the studied system is optimized, and its economy is analyzed by life cycle cost (LCC). The results showed that, compared with the system before optimization, the cost of the optimized system increased, the annual operating cost of the system was reduced, and the COP of the system (COPsys) increased by 7.4%. This research is helpful in improving the application of the CO2 ASHP unit in cold server and cold areas. [ABSTRACT FROM AUTHOR]

[Display omitted] • Three porphyrins containing heavy atoms were synthesized (P1-P3), and their solubility were improved through the alkylation reaction of N-pyridyl substitution. • These porphyrin molecules as photosensitizers have excellent performance in PDT research, especially P3 molecules. • In vitro, the molecules could induce the high level of ROS production and cell apoptosis after photodynamic therapy for HepG2. However, it is not toxicity normal cell HUVECS. Porphyrin and its derivatives have become the second-generation photosensitizers for photodynamic therapy (PDT). Three water-soluble porphyrins containing halogen atoms (F, Cl, Br) were synthesized by N-pyridyl substituted alkylation reaction. We found that P3 has the highest singlet oxygen generation capacity and the results of density functional theory (DFT) further support this result. MTT assay was used to study cytotoxicity, which proved that P1-P3 have good phototoxicity and high selectivity. Fluorescence imaging and intracellular reactive oxygen species illustrate cell apoptosis and reactive oxygen species (ROS) production. High ROS production, excellent phototoxicity ensure that photosensitizers become potential candidates for PDT drugs. [ABSTRACT FROM AUTHOR]

An amendment to this paper has been published and can be accessed via the original article. [ABSTRACT FROM AUTHOR]

The high student-to-faculty ratio is an obstacle in the reform of teaching methods in master's programmes of nursing education in China. Though Kim's study showed that team-based learning (TBL) can be implemented in high student-to-faculty ratio classes, it is still a challenge for students accustomed to the traditional didactic lecture (TDL) teaching method, and the lack of an inclusive design model has restricted the effective application of TBL. To compare the effect of TBL on postgraduate nursing students with lecture-based teaching with small group discussion (LBTWSGD) and to clarify key factors to promote the effective application of TBL. A quasi-experimental study design. We selected 27 unbiased participants in the applied LBTWSGD group and 48 participants in the applied TBL group and conducted questionnaire surveys at the last day of the course which lasted for 10 weeks. Students' self-directed learning ability was assessed by the Self-Directed Learning Instrument (SDLI), classroom engagement was assessed by the Self-Report of Engagement Measure (SREM), and students' evaluation of the teaching experience was assessed by the Student Evaluation of Teaching and Units (SETU). A difference analysis between the two groups was performed by the SETU. The mean and standard deviation of each tool were calculated and compared between the two groups. The study determined that compared to LBTWSGD, TBL significantly improved students' self-directed learning (p < 0.01) and classroom engagement (p < 0.05). The scores for 6 of 9 items in the SETU were significantly higher in the TBL group than in the LBTWSGD group. The TBL teaching method can effectively improve nursing students' self-learning ability and classroom engagement through effective teacher feedback, discussion, and communication. The same clear and definite reading assignments in TBL can help students obtain effective teacher feedback and form effective discussions and communication. [ABSTRACT FROM AUTHOR]

Background: Brain lactate concentrations are enhanced in response to cerebral ischemia and promote the formation of reactive astrocytes, which are major components of the neuroinflammatory response and functional recovery, following cerebral ischemia. NDRG2 is upregulated during reactive astrocyte formation. However, its regulation and function are unclear. We studied the relationship between lactate and NDRG2 in astrocytes under conditions of ischemia or oxygen–glucose deprivation (OGD). Methods: We examined astrocytic NDRG2 expression after middle cerebral artery occlusion (MCAO) using western blot and immunofluorescence staining. Under hypoxia conditions, we added exogenous L-lactate sodium (lactate) to cultured primary astrocytes to explore the effects of lactate on the ubiquitination modification of NDRG2. We profiled the transcriptomic features of NDRG2 silencing in astrocytes after 8 h of OGD conditions as well as exogenous lactate treatment by performing RNA-seq. Finally, we evaluated the molecular mechanisms of NDRG2 in regulating TNFα under OGD conditions using western blot and immunohistochemistry. Results: Reactive astrocytes strongly expressed NDRG2 in a rat model of MCAO. We also showed that lactate stabilizes astrocytic NDRG2 by inhibiting its ubiquitination. NDRG2 inhibition in astrocytes increased inflammation and upregulated immune-associated genes and signaling pathways. NDRG2 knockdown induced TNFα expression and secretion via c-Jun phosphorylation. Conclusions: We revealed that under OGD conditions, lactate plays an important anti-inflammatory role and inhibits TNFα expression by stabilizing NDRG2, which is beneficial for neurological functional recovery. NDRG2 may be a new therapeutic target for cerebral ischemia. [ABSTRACT FROM AUTHOR]

Background: Transient traumatic isolated neurogenic ptosis (TTINP) is a sporadically reported rare entity. However, to the best of our knowledge, nearly all the reported cases are either secondary to direct periorbital trauma or surgery. We would like to report on a case of TTINP with countre-coup injury of the periorbital region.Case Presentation: A 49-year-old female slipped and fell down while walking. She was hospitalized with a moderate headache and undisturbed mental state. The patient recalled that the force bearing point was her occipital region. Physical examination and computed tomography (CT) on admission showed right isolated ptosis and mild contusion and laceration in the bilateral frontal cortex. Further radiological investigation revealed nothing remarkable except for a fracture of the superior portion of the right medial orbital wall. She was managed conservatively and recovered completely in two months.Conclusion: TTINP might manifest as a unique entity with a relatively mild, reversible, and non-devastating injury to the terminal branch of the oculomotor nerve and for which perhaps no special treatment is needed. The proposed mechanism is injury of the terminal branch of the superior division of the oculomotor nerve. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Methods Results Conclusion Implications for the Profession and/or Patient Care Conduct a systematic review of existing studies on intrinsic capacity (IC) and a meta‐analysis of studies to assess the overall effectiveness of ICOPE in improving IC in older adults.Ten databases were systematically searched from inception to November 8, 2023, and the search was last updated on January 2, 2024. Randomised controlled trials (RCTs) were included. The main outcomes were IC (cognition, psychological, sensory, vitality and locomotion).The results showed ICOPE had a significant effect in improving cognitive function (SMD = 0.36; 95% CI, 0.17 to 0.56, p < 0.001, 12 RCTs, 7926 participants) and depressive symptoms (SMD = −0.70; 95% CI, −0.96 to −0.43, p < 0.001, 26 RCTs, 11,034 participants), but there was no statistically significant difference in improving locomotion (SMD = 0.16; 95% CI, −0.03 to 0.34, p = 0.098, 3 RCTs, 1580 participants). Meta‐regression analysis shows that intervention duration should be paid attention to when the source of heterogeneity is discussed on the cognition.The results suggest that ICOPE may be a potentially effective approach to help improve the IC in older adults, showing significant potential for improving cognitive function and reducing depressive symptoms in particular.ICOPE is expected to provide effective strategies to enhance issues such as IC and may be an innovative way to improve the overall health of older adults. This result provides strong support for geriatric nursing practice and encourages the adoption of ICOPE as a viable nursing approach to promote healthy ageing. [ABSTRACT FROM AUTHOR]

Background: Music interventions have several benefits for sleep quality. However, the effects of music interventions on sleep quality in older adults are controversial.Objective: To summarize and evaluate the efficacy of music interventions on sleep quality in older adults.Methods: The Cochrane Library, Embase, PubMed, Web of Science and Chinese National Knowledge Infrastructure (CNKI) were systematically retrieved until June 2020, updated on March 13, 2021. Both experimental and quasi-experimental studies were included if they evaluated the efficacy of music interventions on sleep outcomes in older adults. The methodological quality was assessed by the Cochrane RoB 2.0 and ROBINS-I Tool. The random effects models and effect measure (MD) were adopted, and sensitivity analysis by omitting each study was conducted to explore the source of heterogeneity.Results: A total of 489 participants from 9 studies met the inclusion criteria. 6 studies were included in meta-analysis and sensitivity analysis, and 3 studies were included in the qualitative analysis. Main concerns about risk of bias were lack of blinding participants and investigators, and confounding factors might exist in non-RCTs. The Post-hoc meta-analysis indicated that music interventions might have a positive effect on sleep quality [MD = -2.64, 95 % CI (-3.76, -1.53), p <  0.001; I2 = 75.0 %]. Only one study evaluated adverse events and reported zero discomfort.Conclusions: The results indicated that music interventions might be beneficial for improving sleep quality, especially in sleep latency, sleep duration, sleep efficiency and sleep of daytime dysfunction in elderly individuals. [ABSTRACT FROM AUTHOR]

The content of active components in traditional Chinese medicine is relatively small, and it is difficult to detect some trace components with modern analytical instruments, so good pretreatment and extraction are very important in the experiment. Graphene was introduced by a dispersive liquid–liquid microextraction method based on solidification of floating organic drop (DLLME-SFO) with graphene/1-dodecyl alcohol used as the extractant, and this method, combined with quantitative proton nuclear magnetic resonance spectroscopy (1H-qNMR), was used to simultaneously qualitative and quantitative osthole, columbianadin and isoimperatorin in Angelicae Pubescentis Radix. In this experiment, a magnetic stirrer was used for extraction, all NMR spectra were recorded on a Bruker Advance III 600 MHz spectrometer with dimethyl sulfoxide-d6 (DMSO-d6) as deuterated solvent and pyrazine as the internal standard. The influencing factors and NMR parameters in the extraction process were investigated and optimized. In addition, the methodology of the established method was also examined. The quantitative signals of osthole, columbianadin and isoimperatorin were at a chemical shift of δ6.25–δ6.26 ppm, δ6.83–δ6.85 ppm, and δ6.31–δ6.32 ppm. The linear ranges of osthole, columbianadin and isoimperatorin were all 0.0455–2.2727 mg/mL, and R2 were 0.9994, 0.9994 and 0.9995, respectively. The limits of detection of osthole, columbianadin and isoimperatorin were 0.0660, 0.0720, 0.0620 mg, and the limits of quantification of osthole, columbianadin and isoimperatorin were 0.2201, 0.2401, 0.2066 mg/mL. The solution had good stability and repeatability within 24 h. The recoveries of osthole, columbianadin and isoimperatorin were 102.26%, 99.89%, 103.28%, respectively. The established method is simple and easy to operate, which greatly reduces the cumbersome pretreatment of samples and has high extraction efficiency. [ABSTRACT FROM AUTHOR]

An amendment to this paper has been published and can be accessed via the original article. [ABSTRACT FROM AUTHOR]

Cemented paste backfill (CPB) is widely used in underground mining, and attracts more attention these years as it can reduce mining waste and avoid environmental pollution. Normally, to evaluate the functionality of CPB, the compressive strength (UCS) is necessary work, which is also time and money consuming. To address this issue, seven machine learning models were applied and evaluated in this study, in order to predict the UCS of CPB. In the laboratory, a series of tests were performed, and the dataset was constructed considering five key influencing variables, such as the tailings to cement ratio, curing time, solids to cement ratio, fine sand percentage and cement types. The results show that different variables have various effects on the strength of CPB. The optimum models for predicting the UCS of CPB are a support vector machine (SVM), decision tree (DT), random forest (RF) and back-propagation neural network (BPNN), which means that these models can be directly applied for UCS prediction in future work. Furthermore, the intelligent model reveals that the tailings to cement ratio has the most important influence on the strength of CPB. This research can boost CPB application in the field, and guide the artificial intelligence application in future mining. [ABSTRACT FROM AUTHOR]

• The two-constituent model and multiscale structure model were established. • Fracture toughness of mineralogical compositions were investigated by using nanoindentation. • The mineral-mechanical statistical method and the upscaling method were proposed. The widespread occurrence of heterogeneous mudstone poses several challenges for the stability of engineering structures. To understand the failure mechanism of argillaceous projects, and reveal the heterogeneity of mudstone, the mechanical properties of mineralogical compositions in mudstone were investigated, by using the nanoindentation technique at the meso -scale. Through "X-ray diffraction (XRD), scanning electron microscope (SEM)- energy dispersive spectrometer (EDS), and mercury intrusion porosimeter (MIP)" observations, the mineralogical compositions in mudstone can be divided into two constituents: clay matrix and silt inclusions, further, the multiscale structure model of mudstone includes three scales: macro-, meso- and micro-scale. Nanoindentation technique was adopted to investigate the meso -scale mechanical properties of mudstone by setting four peak loads ranging from 1 mN to 30 mN on different positions to avoid measuring errors. A superposition of 2 Gaussian probability densities was used to represent the distributions of the mechanical parameters of the mudstone by applying a coupled mineral-mechanical approach proposed in this study. The results showed that the mean hardness and elastic modulus of clay matrix are 398.22 MPa and 11.89 GPa, which are much smaller than that of silt inclusions (1529.43 MPa and 22.08 GPa) in mudstone, inducing the soft properties of mudstone and argillaceous projects. Due to the influence of macro- and meso -scale pores and cracks in mudstone, the elastic modulus of both the clay matrix and silt inclusions in it, is larger than that of mudstone. [ABSTRACT FROM AUTHOR]

• A techno-economic analysis on the frost-free ASHP system was analyzed and compared. • The running cost reduced 23.2, 23.6 and 29.0 % compared with the reference system. • The payback period of the initial cost is about 3.3–4.2 years. • The studied system was a promising economical way for space heating. In order to improve the performance of air source heat pumps (AHSPs) when it is operated in winter, a novel frost-free ASHP system has been developed and the thermodynamic characteristics was performed in the previous work. Before it is large-scale promoted and applied, an economic analysis should be conducted. However, there is little research on the economic analysis of the system, which limits the development and application of innovation technologies. Therefore, a techno-economic analysis of the system was evaluated in typical climate zones in China and compared with a conventional ASHP unit in this paper. The results showed that the running cost of the frost-free ASHP system reduced 23.2, 23.6 and 29.0 % in comparison with the conversional ASHP system in Xi'an, Shenyang and Hefei cities respectively, also, corresponding to the payback period of the initial cost were 4.2 years, 3.3 years and 4.03 years respectively. It shows that the frost-free ASHP system is a promising economical way for space heating. Conclusion from this work will provide key information for the user in decision making and determining the economic viability of the frost-free ASHP system has been evaluated before it is large-scale promoted and applied. [ABSTRACT FROM AUTHOR]

• Dance intervention may reduce the presence and severity of frailty in older adults. • According to the frailty criteria, dance intervention reduced the prevalence of slowness, weakness, and low physical activity. • Dance is a popular recreational activity and can be promoted as preventive strategies for frailty. The aims of this study were to examine the effects of dance intervention on frailty in pre-frail and frail older persons. This is a quasi-experimental, two-group trial. Older adults living nursing home. Participants aged ≥ 60 years with low physical activity (mean age was 81.8 years; 71 % were female) (N = 66). Participants allocated to the dance group attended 40 min dance sessions in a nursing home, three times a week for 12-weeks. Participants allocated to the control group maintained their normal daily activities. Assessments were conducted at baseline, 6 weeks, and 12 weeks by researchers blinded to the allocation. Frailty was measured based on Fried criteria. Estimates of frailty between groups over time were calculated using the generalized estimating equations (GEE) and mixed effects models. The prevalence of frailty decreased over time in the dance group compared to the control group (P = 0.002). The mean frailty scores decreased 0.69 at 6 weeks and 1.06 at 12 weeks. Compared to the control group, the prevalence of slowness (p = 0.002), weakness (p = 0.005), and low physical activity (p < 0.001) significantly decreased in the dance group. Dance intervention may reduce the presence and severity of frailty in older adults. Slowness and low physical activity improve following 12 weeks of dance intervention. [ABSTRACT FROM AUTHOR]

• Cognitive frailty is a significant predictor of incident dementia. • It is much possible that the predictive validity on dementia is stronger than that of either frailty or cognitive impairment alone. • Health caregivers can identify and intervene cognitive frailty as soon as possible, which possesses a potential benefit of preventing or delaying dementia. The aim of this systematic review and meta-analysis was to synthesize the pooled risk effect and to determine whether cognitive frailty is a predictor of dementia among older adults. Systematic review and meta-analysis. PubMed, EMBASE, Web of Science, and the Cochrane Library were systematically searched until June 5, 2019. Only cohort studies and population-based longitudinal studies published in English were eligible. Study selection, data extraction and quality assessment of including studies were independently completed by two researchers. A fixed-effects model was used to synthesize the risk of baseline cognitive frailty on dementia in the older adults compared with older adults without cognitive frailty. The risk of cognitive frailty on incident dementia. Of the 1566 identified records, 7 studies met the inclusion criteria and were included in the review. And 4 studies reporting hazard ratio (HR) of incident dementia for cognitive frailty were included in the meta-analysis. Synthesized results showed that baseline cognitive frailty in the elderly was significantly associated with an increased risk of developing dementia as compared with those without cognitive frailty (prefrailty + CI model: pooled HR = 3.99, 95 %CI = 2.94–5.43, p < 0.00001, I2 = 31 %; frailty + CI model: pooled HR = 5.58, 95 %CI = 3.17–9.85, p < 0.00001, I2 = 0 %). Heterogeneity across the studies was low. Cognitive frailty is a significant predictor of dementia. Cognitive frailty status may be a novel modifiable target in identification of early signs before dementia. [ABSTRACT FROM AUTHOR]

Aim: To pool existing studies to assess the overall effectiveness of integrated care for older adults (ICOPE)‐based interventions in improving depressive symptoms in older adults. Design: A systematic review and meta‐analysis. Data Sources: Ten databases were systematically searched from inception to 15 July 2023 and the search was last updated on 2 September 2023. Methods: Standardized mean difference (SMD) was calculated using random effects models. RoB 2 and GRADEpro GDT were used to assess the methodological quality and confidence in the cumulative evidence. Funnel plots, egger's test and begg's test were used to analyse publication bias. Sensitivity, subgroup and meta‐regression analyses were performed to explore potential sources of heterogeneity. Results: The results of 18 studies showed ICOPE‐based interventions had a significant effect on improving depressive symptoms (SMD = −.84; 95% CI, −1.20 to −.3647; p <.001; 18 RCTs, 5010 participants; very low‐quality evidence). Subgroup analysis showed the intervention group was characterized by mean age (70–80 years old), intervention duration between 6 to 12 months, gender (female <50%), non‐frail older adults, depressed older adults and mixed integration appeared to be more effective. Sensitivity analysis found the results to be robust. Conclusion: ICOPE‐based interventions may be a potentially effective alternative approach to reduce depressive symptoms in the older adults. Implications for the Profession and/or Patient Care: Healthcare professionals are expected to use ICOPE as one of the interventions for depressive symptoms in older adults, and this ICOPE could provide more comprehensive care services for older adults to reduce depressive symptoms. Impact: ICOPE‐based interventions may be a potentially effective alternative approach to reduce depressive symptoms in the older adults.ICOPE‐based interventions had a significant effect on reducing depressive symptoms in the older adults.The intervention group characterized by mean age of older adults, intervention duration, gender ratio, health condition and integration types may influence the effect size. Reporting Method: According to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Patient or Public Contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Background: Dural arteriovenous fistula (DAVF) is an uncommon subtype among the intracranial arteriovenous malformations, which is characterized by pathological anastomoses between meningeal arteries and dural venous sinuses, meningeal veins, or cortical veins. While intracerebral hemorrhage accounts for most of the hemorrhagic cases in patients with DAVF, isolated subdural hematoma (SDH) is rarely reported.Case Presentation: A 45-year-old man was admitted for a progressively worsening headache over 2 weeks. Head computed tomography on admission revealed an isodense chronic SDH (CSDH) on the left hemisphere with mild midline shift. Further angiography of the external carotid artery revealed a DAVF at the transverse sinus. The DAVF was embolized via the middle meningeal artery. His CSDH gradually resolved without surgical intervention. In order to further elucidate this rare entity, a review of relevant literature was also conducted.Conclusions: Isolated SDH is a rare complication of DAVF. In this report, we presented a rare case of CSDH secondary to an intracranial DAVF. According to this case report and our literature review, the so-called benign type of DAVF without cortical venous drainage does not always warrant a benign process and might be complicated with SDH. Careful preoperative investigation is needed for relative young patients presenting with idiopathic or atypical SDH. [ABSTRACT FROM AUTHOR]

Abstract The coalcrete, a new supporting material produced by jet grouting (JG) technique was firstly studied for improving soft coal mass to support roadways in Guobei coal mine, China. Young's modulus is an essential indicator to evaluate the deformation-resisting ability of coalcretes. In this study, for determining Young's modulus of coalcretes efficiently, an intelligent technique was proposed using the support vector machine (SVM) and beetle antennae search (BAS). The hyper-parameters of SVM were firstly tuned by BAS, and then the SVM-BAS model with optimum hyper-parameters was employed to model the non-linear relationship between the inputs (coal content, water content, cement content, and curing time) and output (Young's modulus). By combining these variables, 360 coalcrete samples in total were prepared and tested for establishing the dataset. The results show that BAS is more reliable and efficient than the trial–and–error tuning method. Moreover, by comparison with other baseline models such as back-propagation neural network (BPNN), logistic regression (LR) and multiple linear regression (MLR), the optimized SVM-BAS model is more reliable, accurate and less time consuming for predicting Young's modulus of coalcretes. Besides, by conducting sensitivity analysis (SA), the importance of different input variables was determined. This pioneering work provides guidelines for predicting Young's modulus of coalcretes and designing proper JG parameters in engineering applications. Highlights • The jet grouting technique was firstly utilized in underground coal mine for generating coalcrete to reinforce the roadway stability • A total of 360 specimens were tested to determine the deformation-resisting ability of coalcrete. • A support vector machine model was proposed for predicting Young's modulus of coalcrete. • The hyperparameters of support vector machine were tuned by beetle antennae search algorithm. [ABSTRACT FROM AUTHOR]

Pancreatic cancer is characterized by its high malignancy, insidious onset and poor prognosis. Most patients with pancreatic cancer are usually diagnosed at advanced stage or with the distant metastasis due to the lack of an effective early screening method. Liquid biopsy technology is promising in studying the occurrence, progression, and early metastasis of pancreatic cancer. In particular, exosomes are pivotal biomarkers in lipid metabolism and liquid biopsy of blood exosomes is valuable for the evaluation of pancreatic cancer. Lipid metabolism is crucial for the formation and activity of exosomes in the extracellular environment. Exosomes and lipids have a complex relationship of mutual influence. Furthermore, spatial metabolomics can quantify the levels and spatial locations of individual metabolites in cancer tissue, cancer stroma, and para-cancerous tissue in pancreatic cancer. However, the relationship among exosomes, lipid metabolism, and pancreatic cancer is also worth considering. This study mainly updates the research progress of metabolomics in pancreatic cancer, their relationship with exosomes, an important part of liquid biopsy, and their lipometabolic roles in pancreatic cancer. We also discuss the mechanisms by which possible metabolites, especially lipid metabolites through exosome transport and other processes, contribute to the recurrence and metastasis of pancreatic cancer. [Display omitted] Liquid biopsy of lipometabolic exosomes in pancreatic cancer patients. • Widely known for its high malignancy, insidious onset, and poor prognosis, early detection of pancreatic cancer is a worldwide problem. • Exosomes are pivotal in liquid biopsy and have been found to play significant roles in pancreatic cancer lipid metabolism. • Lipid metabolism is involved in the formation of exosomes structure, and contribute to exosomes' activity in tumor extracellular environment. • Lipometabolic liquid biopsy is a powerful technology for early detection and prognosis of pancreatic cancer. [ABSTRACT FROM AUTHOR]

The ultrasonic cell disruption method was used to efficiently extract isothiocyanates and other volatile compounds from radish microgreens. A total of 51 volatiles were identified and quantified by headspace solid-phase micro-extraction and gas chromatography–mass spectrometry (HS-SPME/GC–MS) in four radish microgreen cultivars, mainly including alcohols, aldehydes, isothiocyanates, sulfides, ketones, esters, terpenes, and hydrocarbons. The correlation between cultivars and volatile compounds was determined by chemometrics analysis, including principal component analysis (PCA) and hierarchical clustering heat maps. The aroma profiles were distinguished based on the odor activity value (OAV), odor contribution rate (OCR), and radar fingerprint chart (RFC) of volatile compounds. This study not only revealed the different flavor characteristics in four cultivars but also established a theoretical basis for the genetic improvement of radish microgreen flavors. [ABSTRACT FROM AUTHOR]

It is acknowledged that most surrounding rocks of underground engineering are subjected to biaxial static stresses and various dynamic fatigue loads. In most cases, the dynamic loads have a point or local acting area, which affect the failure properties of rocks greatly. To reveal the failure mechanism of rocks under the combined effects of biaxial static stress and dynamic fatigue loads, a series of biaxial compression tests and point/local fatigue-induced failure tests on cubic granite specimens with a side length of 50 mm were conducted out. In the biaxial compression tests (the maximum principal stress σ1 > the intermediate principal stress σ2 > the minimum principal stress σ3 = 0), the biaxial compressive strength of granite presents a monotonous increasing trend with the σ2 increasing from 0 to 40 MPa, while the increasing rate of biaxial compressive strength increases firstly and then decreases with the increase in σ2. The rock failure induced by point/local fatigue loads with 5 kHz frequency was analyzed in this study. It shows that the fatigue life of granite is much shorter than that in the traditional full-section fatigue tests, which increases with the increase in σ2 and decreases as the upper level of the fatigue stress or predefined stress of σ1 increase. From the acoustic emission properties, the failure of rocks under biaxial confinements induced by point/local static or fatigue loads are mainly because of tensile cracks. Meanwhile, the application of a disturbance bar with a smaller cross-sectional area induces rock broken more quickly. It seems that the following measures can be used to improve rock breakage efficiency: increasing the predefined stress in the breaking direction, reducing the lateral confinement, using the breaking bar with a small cross-sectional area, and changing the static loading into the dynamic loading of the breaking force. [ABSTRACT FROM AUTHOR]

Background interventions targeting older adults with cognitive frailty have grown rapidly in recent years with inconsistent findings. However, there is no meta-analysis that has synthesised pooled estimates. Objective to synthesise the pooled effect of current targeted interventions in older people with cognitive frailty. Methods we conducted a systematic search in PubMed, Embase, Web of Science, the Cochrane Library, the JBI database and three Chinese databases (CNKI, Wan-Fang and VIP) for literature from the inception of the database until 8 March 2022. The mean difference or standardised mean difference with 95% CIs was calculated. The methodological quality was assessed by the Cochrane RoB 2.0. The certainty of evidence was assessed using the GRADE criteria. Results thirteen randomised controlled trials with a total of 1,089 participants were included. The results of the meta-analysis showed that older adults with cognitive frailty in the intervention groups had significant improvement in frailty score [MD = −1.67, 95% CI (−2.39, −0.95), P  < 0.00001, I 2 = 97%], global cognitive function [MD = 3.38, 95% CI (1.90, 4.85), P  < 0.00001, I 2 = 93%], mobility [MD = −0.96, 95% CI (−1.27, −1.66), P  < 0.00001, I 2 = 0%], muscle strength [SMD = 0.75, 95% CI (0.09, 1.41), P  = 0.03, I 2 = 85%] and nutritional status [MNA:MD = 5.64, 95% CI (3.99, 7.29), P  < 0.00001, I 2 = 89%; ALB: MD = 3.23, 95% CI (0.76, 5.71), P  = 0.01, I 2 = 93%; PALB: MD = 54.52, 95% CI (25.26, 83.77), P  = 0.0003, I 2 = 96%; TRF: MD = 0.64, 95% CI (0.22, 1.06), P  = 0.003, I 2 = 97%]. The overall certainty of the evidence ranged from low to moderate. Conclusions interventions targeting older adults with cognitive frailty are effective in improving physical frailty, global cognitive function, physical function and nutritional status with low to moderate certainty. More research is still needed in the future to further enrich the evidence in these fields. PROSPERO number CRD42022318758. [ABSTRACT FROM AUTHOR]

Comprehensive geriatric assessment (CGA) is performed by a multidisciplinary team and includes systematic comprehensive team assessment and treatment. Comprehensive geriatric assessment has become a fundamental component of geriatric nursing, as a multidimensional approach is necessary to achieve the best diagnosis and therapy for older adults with frailty. The aim of our review was to analyze the effects of comprehensive geriatric assessment interventions on older adults with frailty in hospital settings. The PubMed, Web of Science, Embase, CINAHL and Cochrane Library databases were systematically searched from inception to February 28, 2024. Only randomized controlled trials were included in the analysis. The risk ratios (RRs) or standardized mean differences (SMDs) were calculated to determine the pooled intervention effects. Sensitivity analyses and publication bias analyses were also conducted. Methodological quality and evidence were assessed using the RoB2 tool and GRADE pro online tool. A total of 18 randomized controlled trials were included in this review. The results showed that participants in the intervention group had a lower risk of having decreased activities of daily living than did those in the control group (RR = 0.55, 95 % CI: 0.33 to 0.92, P = 0.021, low certainty evidence). Comprehensive geriatric assessment was associated with a reduced mortality risk (RR = 0.85, 95 % CI: 0.73 to 0.99, P = 0.038, high certainty evidence). In conclusion, this systematic review analyzed the available literature, and the results showed that comprehensive geriatric assessment had significant benefits in terms of increased independence and was associated with a reduced mortality risk for older adults with frailty in hospital settings. However, the evidence was limited. Thus, more research is needed in the future to further enrich the evidence in the field of comprehensive geriatric assessment interventions for older adults with frailty. [ABSTRACT FROM AUTHOR]

Globally, there is an increase in the number of older people living with frailty, thus effective strategies to prevent and manage frailty are of paramount importance. The effects of nurse-led interventions on the physical and mental health of (pre) frail people have not yet been systematically reviewed. We searched the PubMed, Web of Science, EMBASE, CINAHL, and the Cochrane Library from inception to 8 May 2024. Eligible studies included randomized controlled trials and quasi-experimental trials reporting the effects of nurse-led interventions on physical and mental health outcomes among (pre) frail people. Two researchers independently extracted trial data and assessed the risk of bias by using the risk of bias tool recommended by the Cochrane Back Review Group and the Methodological Index for Non-Randomized Studies. 14 randomized controlled trials and 6 quasi-experimental studies, encompassing 3943 participants, were included in the review. Nurse-led interventions included function-based care (cognitive behavioral therapy, exercise, and multi-domain intervention), personalized integrated care, and advance care planning. The reported outcomes were multiple with most results showing inconsistencies. Overall, function-based care showed more positive effects on physical outcomes (31/37, 84 %) and mental health (11/12, 92 %). However, the effectiveness of existing personalized integrated care and advance care planning might be limited. Nurse-led interventions may effectively improve both physical and mental health among (pre) frail older adults, although effectiveness varies by intervention type. Nurses have the potential to play a leading role, both individually and within multidisciplinary teams, in alleviating the rising global burden of frailty. We need more well-designed randomized controlled trials to confirm the effectiveness of nurse-led interventions and identify the most effective type of interventions. • Nurses, both individually and within multidisciplinary teams, are potentially well-positioned to alleviate the global burden of frailty. • Nurse-led interventions may be effective in improving physical and mental health among (pre)frail older adults. • This study highlights the benefits of function-based care on physical and mental outcomes. • The most effective type and cost-effectiveness of nurse-led interventions need further exploration. [ABSTRACT FROM AUTHOR]

[Display omitted] • The catechol-functionalized hydrogel was prepared with 4-arm-PEG-SH as cross-linkers. • The hydrogel with fast-forming property exhibited wet adhesion. • The hydrogel exhibited outstanding mechanical strength. • The hydrogel had self-healing property and good biocompatibility. • The hydrogel was an effective rapid hemostatic adhesive. The application of traditional commercial and clinical tissue adhesive materials such as fibrin and albumin-glutaraldehyde are limited because these materials do not possess all the requirements for biomaterials, including high mechanical strength, strong wet adhesion, and good biocompatibility. We have developed a novel bio-inspired hydrogel (HA-catechol/4-arm-PEG-SH) based on a catechol-modified polymer with 4-arm-PEG-SH as a cross-linker that exhibits excellent wet adhesion in aqueous environments. Because the Michael addition reaction between 4-arm-PEG-SH, which contains a large amount of thiol groups, and catechol groups is highly efficient, the HA-CA/4-arm-PEG-SH hydrogel exhibits excellent wet adhesion and outstanding mechanical strength. Thus, the hydrogel shows promise as a hemostatic material. At the same time, the self-healing property of the hydrogel allows it to withstand high strain and repeated deformation. The hydrogel automatically recovers its mechanical properties and structure after deformation, making it effective for hemostasis. Moreover, the hydrogel can quickly gel within 30 s and shows good cell compatibility with slight promotion of cell proliferation. The HA-CA/4-arm-PEG-SH hydrogel is a promising bioadhesive for biomedical applications. [ABSTRACT FROM AUTHOR]

Background: Efficacy of pancreatic enzyme inhibitors in acute pancreatitis (AP) is unclear in China.Aims: We aimed to present the current status of AP and evaluate the efficacy of pancreatic enzyme inhibitors in a larger population in China.Method: A retrospective, cross-sectional, real-world, multicenter analysis of a large dataset of patients presenting with AP from four hospitals of China over a two-year period was performed. Data were collected from the existing clinical records and the patients were grouped into medication group (somatostatin or octreotide or somatostatin and octreotide) and no medication group. Pair wise propensity score matching was performed for comparing somatostatin, octreotide and somatostatin/octreotide. The end points were incidence of disease complications, organ failure, hospitalization duration, and recovery time taken (hours) for serum amylase/serum lipase to normalcy.Results: A total of 3900 patients were recruited and 2775 patients were included for analysis. A total of 1100, 661, 676 and 338 patients received either somatostatin or octreotide or somatostatin and octreotide or no medication, respectively. The incidence of complications (7.6% vs 13.6%), organ failure (4.5% vs 7.4%), and the instances of entering ICU (9.3% vs 13.3%) were higher in unmedicated group. Complications at discharge (2.91 times), organ failure (2.53 times), and hospitalization stay were higher in octreotide-treated patients compared with somatostatin-treated patients. In comparison to the octreotide group, the serum amylase/lipase recovery time was shorter in the somatostatin group.Conclusion: This real-world study suggested that the use of pancreatic enzyme inhibitors was positively associated with greater clinical efficacy in AP patients and somatostatin might be more effective than octreotide in real-world settings in China. [ABSTRACT FROM AUTHOR]

The CO2 air source heat pump (ASHP) has been widely used for space heating and domestic hot water because of its energy saving, high efficiency and environmental protection. However, when used for space heating, the high return water temperature causes higher throttle loss, which results in the energy efficiency of the system obviously decreasing. To solve this problem, a CO2 ASHP integrated with thermal energy storage (TES) is proposed in this paper. A simulation model of the system was established by TRNSYS software, and the operating characters of the studied system were investigated under the typical daily operating conditions. Additionally, its performance was compared with the benchmark system. This research shows that the average unit COP of the studied system was increased by 14.1 % compared with the benchmark system. It indicates that TES is beneficial for promoting CO2 heat pump application in cold areas. [ABSTRACT FROM AUTHOR]

Highlights • Using meta-analysis to examine the efficacy of pet robot intervention (PRI) for people with dementia. • PRI significantly ameliorated behavioral and psychological symptoms of dementia. • No positive effect of PRI was observed on cognitive state or quality of life. • PRI may be suitable as a nonpharmacological treatment option for BPSD in people with dementia. Abstract This study aims to systematically evaluate the efficacy of Pet robot intervention (PRI) for people with dementia. Two waves of electronic searches of the PubMed, EMBASE, Web of Science, Cochrane library, IEEE Digital Library and PsycINFO databases were conducted. In total, eight articles from six randomized controlled trials (RCTs) met the eligibility criteria and were included in this systematic review. The results of the meta-analysis showed a statistically significant decrease in behavioral and psychological symptoms of dementia (BPSD), especially agitation and depression, in people with dementia who were treated with PRI. Both individual and group format PRI significantly ameliorated BPSD. However, there were no significant improvements in cognitive function or quality of life. The results of the meta-analysis suggest that PRI may be suitable as a treatment option for BPSD in people with dementia and should be considered as a useful tool in clinical practice. [ABSTRACT FROM AUTHOR]

Cancer cells subvert multiple properties of normal cells, including escaping strict cell cycle regulation, gaining resistance to cell death, and remodeling the tumor microenvironment. The hallmarks of cancer have recently been updated and summarized. Nuclear factor erythroid 2-related factor 1 (NFE2L1, also named NRF1) belongs to the cap'n'collar (CNC) basic-region leucine zipper (bZIP) family. It acts as a transcription factor and is indispensable for maintaining both cellular homoeostasis and organ integrity during development and growth, as well as adaptive responses to pathophysiological stressors. In addition, NFE2L1 mediates the proteasome bounce-back effect in the clinical proteasome inhibitor therapy of neuroblastoma, multiple myeloma, and triple-negative breast cancer, which quickly induces proteasome inhibitor resistance. Recent studies have shown that NFE2L1 mediates cell proliferation and metabolic reprogramming in various cancer cell lines. We combined the framework provided by "hallmarks of cancer" with recent research on NFE2L1 to summarize the role and mechanism of NFE2L1 in cancer. These ongoing efforts aim to contribute to the development of potential novel cancer therapies that target the NFE2L1 pathway and its activity.

Objective: The aims of this systematic review were to explore the pooled prevalence of multidimensional frailty assessed by the Tilburg Frailty Indicator among community-dwelling older adults., Design: A systematic review and meta-analysis., Methods: A comprehensive literature search was conducted across multiple databases, including PubMed, Web of Science, Embase, the Cochrane Library, CINAHL and three Chinese databases. Two independent researchers selected the literatures, extracted the data and evaluated the quality. All statistical analyses were performed using STATA version 16.0., Results: There were 66 studies with a total of 40,597 individuals that were eligible for the meta-analysis. Data from the meta-analysis revealed the pooled prevalence of 42 % for multidimensional frailty (95 % CI: 38 %-45 %, I 2  = 98.9 %, T 2  = 0.024, p < 0.001). Among the six studies that provided data for different age groups, the results demonstrated an increasing trend in the prevalence of multidimensional frailty with advancing age. The results of gender-stratified analysis proved that the pooled prevalence of multidimensional frailty in women (45 %, 95 % CI: 39 %-51 %, p < 0.001) was higher than that in men (33 %, 95 % CI: 28 %-39 %, p < 0.001). Based on different education levels, the prevalence of multidimensional frailty is highest in the primary elementary or illiterate group (41 %, 95 % CI: 30 %-52 %, p < 0.001). According to different marital status types, the pooled prevalence of multidimensional frailty in the married group was significantly lower (36 %, 95 % CI: 28 %-43 %) than that in the unmarried, divorced or widowed group (51 %, 95 % CI: 37 %-65 %)., Conclusions: Through a comprehensive review, we identified that 42 % of elderly individuals living in communities exhibit multidimensional frailty, indicating that multidimensional frailty is relatively common in this population. Stratified analysis revealed that advanced age, female gender, lower education level and unmarried status were associated with higher rates of multidimensional frailty., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Mineral transformations often induce microstructural deteriorations during temperature variations. Hence, it is crucial to understand why and how this microstructure weakens due to mineral alteration with temperature and the correlated physical and mechanical responses. Therefore, in this study, physical, chemical, thermal, petrographic, and mechanical analyses were carried out to comprehend better the thermal behaviors of Egyptian granodiorite exposed to temperatures as high as 800 °C. The experimental results indicate that the examined attributes change in three distinct temperature phases. Strength zone (up to 200 °C): During this phase, the temperature only slightly impacts the granodiorite mass loss and porosity, and the P-wave velocity and E slightly decrease. However, the rock structure was densified, which resulted in a minor increase in strength. After that, the transition zone (200-400 °C) was distinguished by the stability of most studied parameters. For instance, mass and porosity did not significantly alter, and the uniaxial compressive strength steadily increased with an axial failure mode. When the temperature rises, transgranular cracks cause the P-wave velocity and elastic modulus to decrease moderately. The decay zone started after 400 °C and continued to 800 °C. This zone is characterized by complicated factors that worsen the granodiorite properties, lead to color shift, and produce a shear failure mode. The properties of granodiorite became worse because of chemical reactions, structural and crystal water evaporation, rising thermal expansion coefficient variation, and quartz inversion at 575 °C (α to β, according to the differential thermal analysis). Thermal damage greatly affected granodiorite's physical and mechanical properties and microstructure at 800 °C. As a result, UCS measurements were extremely small with a complex failure pattern, making Vp and E unattainable.

Background: With the aging of the population, frailty has attracted much attention, and the social dimension of frailty, namely social frailty, has also attracted attention. Studies have shown that social frailty can bring some adverse effects to the elderly, such as physical and cognitive function., Aims: To explore the risk of adverse health outcomes in older adults with social frailty compared with older adults with non-social frailty., Methods: Five databases were systematically searched from inception to February 28, 2023. Screening, data extraction and quality assessment were conducted independently by two researchers. The included studies were longitudinal studies of adverse outcomes in community-dwelling socially frail older adults, and the quality of each study was assessed using the Newcastle‒Ottawa Scale., Results: A total of 15 studies were included based on the inclusion criteria, of which 4 were subjected to meta-analysis. The mean age of the included population ranged from 66.3 to 86.5 years. According to existing research, social frailty was predictive of some adverse outcomes, such as incident disability, depressive symptoms, and reduced neuropsychological function. The meta-analysis showed that social frailty had a significant predictive effect on mortality among older adults [HR = 2.27, (95% CI = 1.03-5.00)]., Conclusion: In community-dwelling older adults, social frailty was a predictor of mortality, incident disability, depressive symptoms and other adverse outcomes. Social frailty had a negative impact on older adults, so it was necessary to strengthen the screening of social frailty to reduce the incidence of adverse outcomes., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Aims: To systematically search for clinical practice guidelines focusing on the prevention and management of frailty, to evaluate their methodological quality and to synthesize the consensus recommendations., Design: A systematic review., Data Sources: Guideline websites, related professional association websites and electronic databases were systematically searched through 4 November 2020., Review Methods: We evaluated the methodological quality of the eligible guidelines using the Appraisal of Guidelines Research and Evaluation II (AGREE II). Two reviewers synthesized the consensus recommendations proposed by at least two guidelines., Results: Eight guidelines met the eligibility criteria and were included in the review. The mean scores of the six domains were as follows: the 'scope and purpose' domain scored 88.0%, the 'clarity of presentation' domain scored 81.9%, the 'stakeholder involvement' domain scored 63.4%, the 'editorial independence' domain scored 62.2%, the 'rigour of development' domain scored 61.1% and the 'applicability' domain scored 57.8%. In total, we synthesized 23 recommendations for the prevention and management of frailty that are consistent among the included guidelines., Conclusions: The number of clinical practice guidelines for the prevention and management of frailty is limited. The methodological quality of existing guidelines needs to be improved. Our synthesized findings provide an intuitive, convenient and summative reference resource for frailty prevention and management. It' is worth noting that recommendations described in the included guidelines require additional detail., Impact: Although the prevention and management of frailty is urgent, there is currently a lack of evidences guiding these processes, especially in the prevention. The methodological quality of existing guidelines is insufficient, and the recommendations described in the guidelines require additional detail. Therefore, users of these guidelines, especially nurses, should make a careful decision according to the specific situation when using. Nurses also have a key role in providing more clinical evidences for the improvement of the quality of the guidelines., (© 2021 John Wiley & Sons Ltd.)

Background: The state of mild cognitive impairment (MCI) provides an optimal window for preventing progression to dementia. Combined cognitive intervention and physical exercise may yield additive and synergistic effects on cognition in older adults with MCI., Objectives: The purpose of this study was to assess the efficacy of a combined intervention to improve cognition in older adults with MCI by comparing a control group that underwent only cognitive intervention, a control group that underwent only physical exercise, and a control group that did not undergo cognitive intervention or physical exercise., Design: Meta-analysis of randomized controlled trials (RCTs)., Data Sources: The online databases of PubMed, Web of Science, Embase, the Cochrane Library, PsycINFO, and CINAHL were systematically searched., Review Methods: The outcomes were global cognition, memory, and executive function/attention. A sensitivity analysis was conducted when the I 2 statistic was > 50%., Results: A total of 16 studies were included. The results showed that the combined intervention had positive effects on global cognition compared to the effects of the other control group [SMD = 0.27, 95% CI (0.09, 0.44), p = 0.003]. Regarding memory, the combined intervention had positive effects compared to the effects observed in the single physical exercise group [SMD = 0.25, 95% CI (0.07, 0.44), p = 0.006] and the other control group [SMD = 0.29, 95% CI (0.12, 0.47), p = 0.001]. For executive function/attention, the combined intervention had also positive effects compared to the effects of the single cognitive intervention group [SMD = 0.28, 95% CI (0.09, 0.47), p = 0.004], the single physical exercise group [SMD = 0.32, 95% CI (0.16, 0.49), p = 0.0002], and the other control group [SMD = 0.23, 95% CI (0.05, 0.41), p = 0.01]., Conclusions: The combined intervention resulted in cognitive benefits in older adults with MCI and exhibited limited superiority over the single cognitive intervention and the single physical exercise on cognitive subdomains., (© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Growing evidence indicates that circular RNAs (circRNAs) are closely involved in tumorigenesis, but the association between circRNAs and pancreatic ductal adenocarcinoma (PDAC) is far from clear. Here, we focused on the functional investigation of circ-0005105, a newly identified circRNA, in PDAC progression. In the present study, we assessed circ-0005105 expression in PDAC tissues and cell lines with quantitative reverse transcription-polymerase chain reaction (qRT-PCR). The biological functions of circ-0005105 in cellular proliferation and invasion were identified through gain- and loss-of-function experiments in vitro and in vivo. The interaction between circ-0005105 and the microRNA (miR)-20a-3p-COL11A1 (collagen type XI alpha 1) axis was examined using luciferase reporter and RNA immunoprecipitation assays. We found that circ-0005105 expression was upregulated in both PDAC tissues and cell lines. Higher circ-0005105 expression correlated positively with the malignant clinical phenotype and poor prognosis of patients with PDAC. Gain- and loss-of-function analysis showed that circ-0005105 facilitated both in vitro and in vivo cellular proliferation and invasion. Mechanistically, circ-000510 served as a competing endogenous RNA (ceRNA) of miR-20a-3p and indirectly modulated COL11A1 expression, leading to activation of epithelial-mesenchymal transition (EMT). Rescue experiments suggested that the oncogenic activity of circ-0005105 was dependent on the modulation of the miR-20a-3p-COL11A1 axis. More importantly, COL11A1 overexpression was significantly associated with poor prognosis in PDAC, and silencing COL11A1 reduced PDAC cell tumorigenicity and metastasis. Taken together, our findings confirm for the first time that circ-0005105 has critical functions by regulating the miR-20a-3p-COL11A1 axis. In the clinic, circ-0005105 can act as a potential prognostic marker and therapeutic target in PDAC.

Moyamoya disease (MMD) is characterized by progressive stenosis or occlusion of the distal internal carotid artery and simultaneous formation of collateral vasculature. The fragile alteration and increased hemodynamic stress in the intra- and extracranial vasculature would conjointly result in the formation of intracranial aneurysms in MMD patients. According to our classification, the MMD-associated aneurysms are divided into the major artery aneurysms (MAAs) and non-MAAs. The non-MAAs are further subdivided into the distal choroidal artery aneurysms, moyamoya vessel aneurysms, transdural collateral aneurysms, and anastomosis aneurysms. Currently, endovascular treatment (EVT) has become the main stream for the MMD-associated aneurysms. There is no difference to EVT for the MMD-associated MAAs of the non-stenosed major arteries with that in the non-MMD patients. While it is a big challenge to perform EVT for MMD-associated aneurysms in the stenosed arteries. Generally speaking, the parent arteries of the non-MAAs are slim, and super-selective catheterization is technically difficult. Most of the times, parent artery occlusion with liquid embolic agents or coils can only be performed. The vasculature in MMD patients is fragile; perioperative management and meticulous intraoperative manipulation are also very important to avoid complications during EVT. In spites of the complications, the EVT can bring good outcome in selected cases of MMD-associated aneurysms.

Background: Having a senior surgeon present for high-risk patients is an important safety measure in emergency surgery, but 24-h consultant cover is not efficient. We aimed to develop a user-friendly toolbox (risk identification, outcome prediction and patient stratification) to support when to involve a senior surgeon., Materials and Methods: We included 11,901 general surgery patients (10.0% emergencies) in a multicenter prospective cohort in China (2015-2016). Patient information and surgeons' seniority were compared between emergency and elective surgery with the same procedure codes. Risk indicators common in these two surgical timings and specific to emergency surgery were identified, and their clinical importance was evaluated by a working group of 48 experienced surgeons. Predictive models for mortality and morbidity were built using logistic regression models. Stratification rules were created to balance patients' risk and surgeons' caseload with an Acute Call Team (ACT) model., Results: Emergency patients had significantly higher risks of mortality (3.6% vs 0.6%) and morbidity (7.8% vs 4.3%) than elective patients, but disproportionally fewer senior surgeons (59.9% vs 91.4%) were present. Using three risk indicators (American Society of Anesthesiologists score, age, blood urea nitrogen), C-statistic (95% CI) for prediction of emergency mortality was high [0.90 (0.84-0.96)]. It was less complex but equally accurate as two existing and validated models (0.86 [0.79-0.93] and 0.86 [0.77-0.95]). Using five indicators, C-statistic (95% CI) was moderate for prediction of overall morbidity [0.77 (0.72-0.83)], but high for severe morbidity [0.92 (0.88-0.97)]. Based on stratification rules of the ACT model, patient mortality and morbidity were 0.5% and 5.3% in the low-risk stratum (composing 64.6% of emergency caseload), and 15.9% and 29.0% in the very high-risk stratum (6.9% of caseload)., Conclusion: These findings show the practical feasibility of using a risk assessment tool to direct senior surgeons' involvement in emergency general surgery., (Copyright © 2020 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.)

Introduction: Acute hydrocephalus is a common complication of spontaneous or traumatic intracranial bleeding with extensive subarachnoid hemorrhage (SAH) or ventricular extension. However, it has never been reported to be secondary to pneumocephalus., Patient Concerns: A 32-year-old man was admitted following a motorcycle accident. Head computed tomography (CT) performed right after the accident revealed a skull base fracture and mild perimesencephalic SAH. Three days later, repeated CT revealed delayed perimesencephalic pneumocephalus and an evident enlargement of the ventricular system., Diagnosis: The patient was diagnosed with acute obstructive hydrocephalus, which was secondary to pneumocephalus and traumatic SAH., Interventions: The patient was treated with temporary external ventricular drainage (EVD)., Outcomes: The patient experienced an unremarkable recovery process. At follow-up 3 months later, he showed no recurrence of the hydrocephalus and the score of Glasgow Outcome Scale was 5., Conclusion: Transient mechanical obstruction of CSF circulation and disturbance of CSF physiology might conjointly lead to the acute obstructive hydrocephalus.

Rationale: Brain arteriovenous malformation (BAVM)-associated varix is always asymptomatic, and no special treatment is needed. However, there is no consensus regarding how to address a varix that has led to clinical manifestation., Patient Concerns: An 11-year-old girl was admitted complaining of left hemiparesis for 4 days. She was previously healthy and denied any history of similar ictus. She was alert, and a physical examination performed upon admission was unremarkable except for the left hemiparesis., Diagnoses: Head magnetic resonance imaging (MRI) showed a linear and round flow void and perilesional edema in the region of the right basal ganglia, indicating a BAVM. Gadolinium-enhanced MRI showed peripheral enhancement of the round lesion. Computed tomography angiography (CTA) showed that the BAVM was fed by the ipsilateral posterior cerebral artery and anterior choroidal artery and drained into the vein of Galen. A large varix was also noted at the top of the BAVM and was consistent with the round flow void observed at the right basal ganglia on MRI. The Spetzler-Martin grading scale was grade IV INTERVENTIONS:: The patient experienced a TAE of the BAVM nidus with liquid embolic agent., Outcomes: A follow-up investigation showed regression of the varix, although there was still some residual BAVM. The patient experienced a favorable recovery., Lessons: In the case of a BAVM-associated symptomatic varix, if surgical resection cannot readily be performed, initial TAE of the BAVM nidus can be attempted.