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Introduction: This study aimed to investigate the effects of educational intervention on nurses' knowledge, attitudes, and behavioral intentions regarding supplying artificial nutrition and hydration (ANH) to terminal cancer patients.Materials and Methods: A quasi-experimental design was adopted. A structured questionnaire evaluated the effects of educational intervention. From April to June 2005, 88 nurses were enrolled in the gastroenterology, general surgery, and intensive care unit of Taipei Veterans General Hospital in Taiwan. The nurses were randomly assigned into experimental and control groups in equal numbers (44 nurses in each group). After the experimental and control groups completed the pretest, the experimental group participated in a 50-min lecture. Both groups received a post-test 2 weeks after the lecture.Results: This study showed that prior to educational intervention, nurses have possessed experiences of ANH use in routine caring for terminal cancer patients. However, due to the lack of knowledge about supplying ANH to terminal cancer patients, the nurses trended toward the negative behavioral intention, although they realized the burdens of ANH in these patients. After educational intervention, mean scores of knowledge, attitudes and behavioral intentions of the experimental group increased significantly (z = -5.255, p < 0.001; t = -5.191, p < 0.001; z = -3.274, p <== 0.001). Mean score changes of knowledge and attitude between these two groups reached significant differences (t = -7.306, p < 0.001; t = -4.165, p < 0.001), but no significant difference was observed in the mean score change of behavioral intention (z = -1.943, p > 0.05).Conclusion: The educational intervention remarkably improved nurses' knowledge and attitudes regarding supplying terminal cancer patients with ANH. As for the changes in the behavioral intentions, it requires long-term moral and ethical training and communication. The results of this research emphasized the importance of educational interventions, which should be considered seriously in future reference nursing education program. [ABSTRACT FROM AUTHOR]

This study involved longitudinal evaluations of symptom severity and describes the symptom patterns of 77 terminal cancer patients (median age: 62 years; 61% female), selected from 537 consecutive patients admitted to the Palliative Care Unit of the National Taiwan University Hospital. The most common primary cancer sites in these patients were lung (23.4%), liver (15.6%), and stomach (13%). Nineteen physical and psychological symptoms were assessed using different scales. The median number of symptoms was 11 (range: 1-18) on admission, among which weakness, fatigue, anorexia, pain, and depression were the most common. A comparison of the initial symptom severity scores with those at one week after admission and two days before death suggested six symptom change patterns: A: continuous static (restless/heat, abdominal fullness, constipation, dizziness, and insomnia); B: static-increase (fatigue, weakness, nausea/vomiting, taste alteration, dysphagia, diarrhea, dry mouth, and night sweats); C: decrease-static (pain and depression); D: decrease-increase (anorexia and dyspnea); E: static-decrease (aggression); and F: gradually decrease (anxiety). These six symptom patterns can be divided into two categories on the basis of the relative severity of symptoms between one week after admission and two days before death. The first category included patterns A, C, E and F, and the symptoms improved with palliative care. However, the symptoms in the second category (patterns B and D), which were associated with the anorexia-cachexia syndrome and dyspnea, did not show improvement. As symptom management is an essential component of palliative care, holistic care, which encompasses physical, psychosocial and spiritual aspects, represents a rational approach for the relief of these incurable symptoms at the end stage of life for these patients. [ABSTRACT FROM AUTHOR]

Extracellular vesicles, including exosomes, are small extracellular vesicles that range in size from 30 nm to 10 μm in diameter and have specific membrane markers. They are naturally secreted and are present in various bodily fluids, including blood, urine, and saliva, and through the variety of their internal cargo, they contribute to both normal physiological and pathological processes. These processes include immune modulation, neuronal synapse formation, cell differentiation, cancer metastasis, angiogenesis, lymphangiogenesis, progression of infectious disease, and neurodegenerative disorders like Alzheimer's and Parkinson's disease. In recent years, interest has grown in the use of exosomes as a potential drug delivery system for various diseases and injuries. Importantly, exosomes originating from a patient's own cells exhibit minimal immunogenicity and possess remarkable stability along with inherent and adjustable targeting capabilities. This review explores the roles of exosomes in angiogenesis, lymphangiogenesis, and nerve repair with a specific emphasis on these processes within the cornea. Furthermore, it examines exosomes derived from specific cell types, discusses the advantages of exosome-based therapies in modulating these processes, and presents some of the most established methods for exosome isolation. Exosome-based treatments are emerging as potential minimally invasive and non-immunogenic therapies that modulate corneal angiogenesis and lymphangiogenesis, as well as enhance and accelerate endogenous corneal nerve repair., (Copyright © 2024. Published by Elsevier Inc.)

Endogenous retroviruses (ERVs) are involved in autoimmune diseases such as type 1 diabetes (T1D). ERV gene products homologous to murine leukemia retroviruses are expressed in the pancreatic islets of NOD mice, a model of T1D. One ERV gene, Gag, with partial or complete open reading frames (ORFs), is detected in the islets, and it contains many sequence variants. An amplicon deep sequencing analysis was established by targeting a conserved region within the Gag gene to compare NOD with T1D-resistant mice or different ages of prediabetic NOD mice. We observed that the numbers of different Gag variants and ORFs are linked to T1D susceptibility. More importantly, these numbers change during the course of diabetes development and can be quantified to calculate the levels of disease progression. Sequence alignment analysis led to identification of additional markers, including nucleotide mismatching and amino acid consensus at specific positions that can distinguish the early and late stages, before diabetes onset. Therefore, the expression of sequence variants and ORFs of ERV genes, particularly Gag, can be quantified as biomarkers to estimate T1D susceptibility and disease progression., (Copyright © 2024 by The American Association of Immunologists, Inc.)

The increasing elderly population is driving higher utilization rates of long-term care facilities, where residents often have multiple chronic diseases, making them potential candidates for palliative care. Timely palliative care interventions can improve their quality of life and medical autonomy. This study systematically reviews the effectiveness of palliative care programs in long-term care facilities. Databases such as PubMed, EMBASE, Cochrane Library, and Airiti Library were searched up to 31 December 2023, using PICO criteria and the following keywords: 'care home', 'nursing home', 'residential aged care facility', and 'long-term care facility' for patients; and 'Gold Standard Framework in Care Homes', 'integrated care pathway', 'care home project', and 'palliative care program' for interventions. Seven articles were included. The results indicate that the Program of All-Inclusive Care for the Elderly (PACE) intervention did not significantly influence overall quality of life but did improve the quality of death. There were no statistical differences in comfort or quality of death between the dementia and non-dementia groups. However, PACE significantly reduced healthcare costs. The implementation of the Liverpool Care Pathway (LCP) notably enhanced the control of terminal symptoms, while the Gold Standard Framework in Care Homes (GSFCH) effectively improved end-of-life care rates, do-not-resuscitate (DNR) signing rates, advance care planning (ACP) completion rates, and reduced inappropriate readmission rates. While palliative care interventions are shown to improve the quality of end-of-life care, their practical application should be adapted to fit the implementation conditions and capabilities of domestic long-term care facilities.

Background: Previous observational studies have indicated a potential association between the gut microbiota and multiple myeloma (MM). However, the relationship between the gut microbiota and MM remains unclear. This study aimed to ascertain the existence of a causal link between the gut microbiota and MM., Methods: To investigate the potential causal relationship between gut microbiota and MM, a two-sample Mendelian randomization (MR) analysis was conducted. Exposure data was obtained from the MiBioGen consortium, which provided genetic variants associated with 211 bacterial traits. MM outcome data was obtained from the FinnGen consortium. The selection of Single nucleotide polymorphisms estimates was performed through meta-analysis using inverse-variance weighting, and sensitivity analyses were conducted using weighted median, MR Egger, Simple mode, and MR-PRESSO., Results: The results of the study demonstrated a significant positive correlation between the genus Eubacterium ruminantium group and the risk of MM (OR 1.71, 95% CI 1.21 to 2.39). Conversely, the genus: Dorea (OR 0.46, 95% CI 0.24 to 0.86), Coprococcus1 (OR 0.47, 95% CI 0.22 to 1.00), RuminococcaceaeUCG014 (OR 0.57, 95% CI 0.33 to 0.99), Eubacterium rectale group (OR 0.37, 95% CI 0.18 to 0.77), and order: Victivallales (OR 0.62, 95% CI 0.41-0.94), class: Lentisphaeria (OR 0.62, 95% CI 0.41 to 0.94), exhibited a negative association with MM. The inverse variance weighting analysis provided additional support for these findings., Conclusion: This study represents an inaugural exploration of MR to investigate the connections between gut microbiota and MM, thereby suggesting potential significance for the prevention and treatment of MM., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Zhang, Zhang, Sun, Tang, Tian, Hu, Hu, Gao, Li, Xiao, Gao and Gao.)

The COVID-19 pandemic led to significant burnout among nurses, resulting in a shortage of nursing staff. Issues related to nursing work have received significant attention recently, and only healthy nurses are capable of providing good quality patient care. The authors employed Bronfenbrenner's Ecological System Theory to analyze the impact of the COVID-19 pandemic on nurses and proposed specific strategies and recommendations to enhance the nursing workplace. Under the Ecological System Theory, several factors, including inadequate preparedness, dangerous working environment, work-family conflicts, discrimination due to public panic, and health damage, contribute to nurse burnout. Whether during or after the COVID-19 pandemic, it is necessary to provide education programs to enhance the professional abilities of nurses, foster policies that promote a positive practice work environment, implement a triage system based on the severity of patients, elevate the image of the nursing profession, monitor the health of nurses, and advocate for transformational leadership. The nursing workplace should help nurses gain greater confidence and improve their ability to handle various workplace challenges. In the future, medical institutions should provide a better work environment for nurses and expect the public to pay more attention to the development of the nursing profession.

(1) Background: Evidence suggested inconsistent results in anxiety and depression scores among female and male cancer patients. The present systematic review and meta-analysis aimed to assess how anxiety and depression conditions among cancer patients vary according to sex. (2) Methods: This systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). The protocol was registered in PROSPERO with id no. CRD42024512553. The search strategy involved combining keywords using Boolean operators, including "Anxiety", "Cancer", and "Depression", across several databases: Embase, PubMed, Scopus, and Web of Science. The outcomes were evaluated using the Hospital Anxiety and Depression Scale (HADS). (3) Results: Data were collected from five studies, enrolling a total of 6317 cancer patients, of whom 2961 were females and 3356 males. For each study, HADS-A and HADS-D scores were considered, also differentiating HADS scores according to cancer typology, and then three different meta-analyses were performed. Generally, females reported significantly higher levels of depression scores than males and, conversely, males reported significantly greater levels of anxiety than females. (4) Conclusions: Previous studies suggested higher rates of depression and anxiety conditions in females than in males, but the present data highlighted controversial findings, since males reported significantly higher levels of anxiety than females. In this scenario, the theoretical approach justified females being more open than males to expressing anxiety or depression conditions. It would be necessary for healthcare professionals to improve effective measures purposed at assessing and mitigating depressive symptoms in cases of advanced cancer, thereby improving their mental health, given the high rates of depression in advanced cancer patients, due to the difficulty level of performing their daily living activities, which deteriorate further over time.

Background: Enhanced communication in end-of-life care (EOL) improves preparation and treatment decisions for patients with advanced cancer, affecting their quality of life at the end of life. Question prompt list (QPL) has been shown to enhance physician-patient communication in patients with cancer, but there is a lack of systematic review and meta-analysis for those with advanced cancer. Enhanced communication in end-of-life care improves preparation and treatment decisions for patients with advanced cancer, affecting their quality of life at the end of life., Objective: To review the effectiveness of QPL intervention on physician-patient communication and health outcomes during consultation in patients with advanced cancer., Methods: CINAHL, Embase, Scopus, and PsycINFO databases were undertaken using inclusion criteria for relevant articles up to August 2021. Pooled standardized mean difference (SMD) and 95% confidence intervals (CIs) were calculated using random-effects models. We used the Cochrane risk-of-bias assessment tool and modified Jadad scale to assess the quality of the studies., Results: Seven RCTs with 1059 participants were included, of which six studies were eligible for the meta-analysis. The pooled meta-analysis results indicated that QPL in patients with advanced cancer had a significant positive effect on the total number of questions asked (SMD, 0.73; 95% CI, 0.28 to 1.18; I 2  = 83%) and on the patients' expectations for the future (SMD, 0.67; 95% CI, 0.08 to 1.25; I 2  = 88%). There were no significant improvements in health-related outcomes such as end of life, anxiety, and quality of life., Conclusions: Using QPL in advanced cancer consultations boosts patient questions which helps communication but not health-related indicators. Optimal results depend on full reading, but timing varies. Future research should examine the relationship between communication and health outcomes, including patient/physician behavior and social context., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Liver fibrosis is a formidable global medical challenge, with no effective clinical treatment currently available. Yinhuang granule (YHG) is a proprietary Chinese medicine comprising Scutellariae Radix and Lonicerae Japonicae Flos. It is frequently used for upper respiratory tract infections, pharyngitis, as well as acute and chronic tonsillitis., Aim: To investigate the potential of YHG in alleviating carbon tetrachloride (CCl 4 )-induced liver fibrosis in mice., Methods: To induce a hepatic fibrosis model in mice, this study involved intraperitoneal injections of 2 mL/kg of CCl 4 twice a week for 4 wk. Meanwhile, liver fibrosis mice in the low dose of YHG (0.4 g/kg) and high dose of YHG (0.8 g/kg) groups were orally administered YHG once a day for 4 wk. Serum alanine/aspartate aminotransferase (ALT/AST) activity and liver hydroxyproline content were detected. Sirius red and Masson's trichrome staining assay were conducted. Real-time polymerase chain reaction, western-blot and enzyme-linked immunosorbent assay were conducted. Liver glutathione content, superoxide dismutase activity level, reactive oxygen species and protein carbonylation amount were detected., Results: The administration of YHG ameliorated hepatocellular injury in CCl 4 -treated mice, as reflected by decreased serum ALT/AST activity and improved liver histological evaluation. YHG also attenuated liver fibrosis, evident through reduced liver hydroxyproline content, improvements in Sirius red and Masson's trichrome staining, and lowered serum hyaluronic acid levels. Furthermore, YHG hindered the activation of hepatic stellate cells (HSCs) and ameliorated oxidative stress injury and inflammation in liver from CCl 4 -treated mice. YHG prompted the nuclear accumulation of nuclear factor erythroid 2-related factor 2 (Nrf2) and upregulated the expression of Nrf2-dependent downstream antioxidant genes. In addition, YHG promoted mitochondrial biogenesis in liver from CCl 4 -treated mice, as demonstrated by increased liver adenosine triphosphate content, mitochondrial DNA levels, and the expression of peroxisome proliferator-activated receptor gamma coactivator 1 alpha and nuclear respiratory factor 1., Conclusion: YHG effectively attenuates CCl 4 -induced liver fibrosis in mice by inhibiting the activation of HSCs, reducing inflammation, alleviating liver oxidative stress damage through Nrf2 activation, and promoting liver mitochondrial biogenesis., Competing Interests: Conflict-of-interest statement: The authors declared that they do not have anything to disclose regarding funding or conflict of interest with respect to this manuscript., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Background: In Taiwan, the Patients' Right to Autonomy Act was enacted in 2019. However, advance care planning (ACP) implementation rates remain low in long-term care facilities., Aim: This study explored the barriers to initiate a discussion about ACP among older Taiwanese residents of nursing homes and their families., Methods: A descriptive qualitative design was used. Face-to-face interviews were individually conducted with 38 participants (residents: 18; family members: 20), and data were analyzed through content analysis., Results: Five themes were identified: (1) having cultural or spiritual concerns (both groups), (2) prioritizing the bigger picture (family) (both groups), (3) waiting for the right time (both groups), (4) feeling unsure (residents), and (5) following the pace of the residents (family members)., Conclusion: The results indicate that discussing ACP with Chinese people and their families clashes with traditional Chinese culture. To implement ACP in long-term care facilities based in regions with ethnically Chinese populations, medical professionals must ensure that the residents and their family members understand advance directives and their role in ensuring a good death and must act as a bridge between residents and their family members to assist them in making consensual end-of-life-care decisions with residents., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

On the basis of variable-temperature single-crystal X-ray diffraction, variable-temperature/frequency dielectric analysis, variable-temperature solid-state nuclear magnetic resonance spectroscopy, and molecular dynamics simulations, here we present a new model of crystalline supramolecular rotor (i-PrNHMe 2 )[CdBr 3 ], where a conformationally flexible near-spherical (i-PrNHMe 2 ) + cation functions as a rotator and a rod-like anionic coordination polymer {[CdBr 3 ] - } ∞ acts as the stator, and the adhesion of them is realized by charge-assisted hydrogen bonds.

Mercury (Hg) is a highly toxic metal and can cause severe damage to many organisms under natural conditions. As an effective free radical scavenger and antioxidant, Melatonin (MT) has played important protective roles in alleviating oxidative damage caused by environmental cues including heavy metal stress in plants. However, the detailed mechanisms of melatonin in alleviating Hg toxicity still remain unclear in plants. Our results showed that the application of melatonin greatly reduced the concentrations of total and intracellular Hg in Taxiphyllum taxirameum. Meanwhile, melatonin significantly improved the antioxidant capacity and thus alleviated oxidative damage to the chloroplasts of T. taxirameum under Hg stress. Metabolic pathway analysis further revealed that melatonin-treated plants exhibited higher levels of 48 metabolites, including sugars, amino acids, and lipids, than non-melatonin-treated plants under Hg stress. Additionally, we further found that melatonin addition greatly improved the concentrations of four organic acids and three amino acids (Orn, Cit and Arg) related to the urea cycle, and thereby changed the levels of putrescine (Put) and spermidine (Spd) in T. taxirameum exposed to Hg stress. Further experiments showed that the high concentration of Put dramatically caused oxidative damage under Hg stress, while Spd effectively alleviated Hg toxicity in T. taxirameum. Taken together, this study provides new insight into the underlying mechanisms of melatonin in alleviating heavy metal toxicity in plants., 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 © 2023. Published by Elsevier B.V.)

Background: Neoadjuvant trastuzumab/pertuzumab (HP) plus chemotherapy for HER2-positive breast cancer (BC) achieved promising efficacy. The additional cardiotoxicity still existed. Brecan study evaluated the efficacy and safety of neoadjuvant pegylated liposomal doxorubicin (PLD)/cyclophosphamide and sequential nab-paclitaxel based on HP (PLD/C/HP-nabP/HP)., Patients and Methods: Brecan was a single-arm phase II study. Eligible patients with stages IIA-IIIC HER2-positive BC received 4 cycles of PLD, cyclophosphamide, and HP, followed by 4 cycles of nab-paclitaxel and HP. Definitive surgery was scheduled after 21 days for patients completing treatment or experiencing intolerable toxicity. The primary endpoint was the pathological complete response (pCR)., Results: Between January 2020 and December 2021, 96 patients were enrolled. Ninety-five (99.0%) patients received 8 cycles of neoadjuvant therapy and all underwent surgery with 45 (46.9%) breast-conserving surgery and 51 (53.1%) mastectomy. The pCR was 80.2% (95%CI, 71.2%-87.0%). Four (4.2%) experienced left ventricular insufficiency with an absolute decline in LVEF (43%-49%). No congestive heart failure and ≥grade 3 cardiac toxicity occurred. The objective response rate was 85.4% (95%CI, 77.0%-91.1%), including 57 (59.4%) complete responses and 25 (26.0%) partial responses. The disease control rate was 99.0% (95%CI, 94.3%-99.8%). For overall safety, ≥grade 3 AEs occurred in 30 (31.3%) and mainly included neutropenia (30.2%) and asthenia (8.3%). No treatment-related deaths occurred. Notably, age of >30 (P = .01; OR = 5.086; 95%CI, 1.44-17.965) and HER2 IHC 3+ (P = .02; OR = 4.398; 95%CI, 1.286-15.002) were independent predictors for superior pCR (ClinicalTrials.gov Identifier NCT05346107)., Conclusion: Brecan study demonstrated the encouraging safety and efficacy of neoadjuvant PLD/C/HP-nabP/HP, suggesting a potential therapeutic option in HER2-positive BC., (© The Author(s) 2023. Published by Oxford University Press.)

This study investigated the effects of quercetagetin (QG) on growth performance, nutrient digestibility, meat quality, and antioxidant capacity of broilers. Four hundred 1-day-old Cobb broilers were randomly divided into five diets, each with eight replicates and 10 birds per replicate. The diets included a basal diet, and four diets with 25, 50, 100, and 200 mg/kg QG supplemented in basal diet. Body weight on d 21, average daily gain, and average daily feed intake on days 1-21 were quadratically (p < 0.05) increased with increasing QG supplementation. The apparent digestibility of crude protein, ether extract, and total phosphorus increased linearly (p < 0.05) from day 1 to 21, and increased quadratically (p < 0.05) from day 22 to 42. The L* values of leg muscles were lower (p < 0.05) in QG groups than control group. QG supplementation quadratically (p < 0.05) elevated glutathione peroxidase (GSH-Px) activity and reduced malondialdehyde (MDA) levels in serum. The L* value was negatively correlated with GSH-Px. These results suggested that QG supplementation (50-100 mg/kg) enhanced early growth, nutrient digestibility, and antioxidant status in broilers, highlighting its functional properties and potential as an additive to improve broiler productivity., (© 2024 Japanese Society of Animal Science.)

Primary head and neck hematolymphoid neoplasms (PHNHLN) are defined as a series of hematolymphoid system-derived neoplasms which primarily emanate in head and neck region. Due to the rarity and absence of symptomatic specificity, PHNHLN is easily neglected. The objective of this study is to investigate demographics, pathological subtype distribution, anatomical location, survival outcomes and prognostic factors of PHNHLN among older patients aged ≥ 60. The individual patient information in our study was derived from Surveillance, Epidemiology and End Results database. Descriptive epidemiological methods were used to analyze the distribution of histologic subtypes and primary anatomical sites. Kaplan-Meier survival curves and log-rank test were conducted to evaluate the effect of variables on the prognosis. Cox hazard regression was conducted to identify the independent prognostic factors. The male-to-female ratio in most pathological subtypes was close to 1:1. The most common pathological subtype was diffuse large B-cell lymphoma. The most commonly involved sites outside the lymph nodes were salivary glands, especially parotid gland, followed by tonsil, thyroid gland and tongue. The prognosis of mature T- and NK-cell non-Hodgkin lymphoma (NHL) was bleaker than Hodgkin lymphoma, mature B-cell NHL and plasma cell neoplasm. Age at diagnosis, presence of second primary malignancy (SPM), pathological subtype, Ann-Arbor stage, chemotherapy and radiation were independent prognostic factors of overall survival. Our study comprehensively reported the subtype distribution, anatomical sites and survival outcomes of PHNHLN among older patients, improving understanding of this rare group of cancer entities., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

An abundance of early warning graphene-based nano-materials and sensors have been developed to avoid and prevent the critical fire risk of combustible materials. However, there are still some limitations that should be addressed, such as the black color, high-cost and single fire warning response of graphene-based fire warning materials. Herein, we report an unexpected montmorillonite (MMT)-based intelligent fire warning materials that have excellent fire cyclic warning performance and reliable flame retardancy. Combining phenyltriethoxysilane (PTES) molecules, poly(p-phenylene benzobisoxazole) nanofiber (PBONF), and layers of MMT to form a silane crosslinked 3D nanonetwork system, the homologous PTES decorated MMT-PBONF nanocomposites are designed and fabricated via a sol-gel process and low temperature self-assembly method. The optimized nanocomposite paper shows good mechanical flexibility (good recovery after kneading or bending process), high tensile strength of ∼81 MPa and good water resistance. Furthermore, the nanocomposite paper exhibits high-temperature flame resistance (almost unchanged structure and size after 120 s combustion), sensitive flame alarm response (∼0.3 s response once exposure onto a flame), cyclic fire warning performance (>40 cycles), and adaptability to complex fire situations (several fire attack and evacuation scenarios), showing promising applications for monitoring the critical fire risk of combustible materials. Therefore, this work paves a rational way for design and fabrication of MMT-based smart fire warning materials that combine excellent flame shielding and sensitive fire alarm functions., 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 © 2023 Elsevier Inc. All rights reserved.)

Although public opinion in Taiwan has shifted to favoring self-determination regarding end-of-life care, many nursing home residents still entrust their end-of-life care decision making to family members. This study examined Chinese cultural impediments to nursing home residents signing advance directives. A descriptive qualitative study was conducted using content analysis. In total, 18 nursing home residents participated in face-to-face interviews. Five main themes were identified: (1) bad omens, (2) inability, (3) traditional culture, (4) uncertainty, and (5) unmet needs. The death taboo that is a prominent feature of Chinese culture and the delivery of generic information are primary impediments. Therefore, health care providers should provide tailored information about advance directives, communicate directly with residents, ensure that residents understand the relationship between signing an advance directive and having a good death, and respect the final decisions of residents., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The Hospice and Palliative Nurses Association.)

Objective: The participation of patients with advanced cancer(s) in clinical trials is vital for new drug development. We aimed to investigate patients' decision-making processes and satisfaction with their decision (SWD) to participate; the study's purpose was to provide results that can help support high-quality research in clinical trials. In addition, we explored how shared decision-making (SDM) mediates the relationship between understanding informed consent forms and SWD to participate in a clinical trial., Methods: A cross-sectional study was conducted. A purposive sample of 111 cancer patients was recruited, and they completed a questionnaire on demographic characteristics, SDM, and decision-making satisfaction to participate in a clinical trial. Correlation and mediation analyses were used., Results: Participants aged under 65 years and with higher education reported high SWDs, and SDM significantly mediated the relationship between self-assessed understanding of informed consent forms and SWDs related to clinical trials., Conclusions: SDM in patients with lung or liver cancer was a significant mediator between understanding the informed consent form and the patient's SWD. The higher the SWD level of participating in clinical trials, the better study team members' SDM involvement and the better the comprehension of informed consent forms. In addition, patients' age and education level should also be considered as influencing factors in SWD. This survey is the first in Taiwan to examine SDM in drug-related clinical trials. The study results provide evidence to support SDM in a clinical trial model and develop informed consent process policies in research facilities., (© 2023 The Authors.)

Background: Mindfulness-based cognitive therapy (MBCT) may have positive physiological and psychological benefits for breast cancer survivors. However, few studies involved a combination of the relevant literatures to confirm the effects., Methods: Our study included randomized controlled trials (RCTs) and non-RCTs comparing interventions of MBCT and control protocols for alleviation of symptoms among breast cancer survivors. We calculated pooled mean differences (MDs), standardized mean differences (SMDs), and 95% confidence intervals (CIs) by using random effects models to estimate summary effect sizes., Results: Thirteen trials with 20-245 participants were considered in our studies; for the meta-analysis, 11 of these studies were eligible for assessment. The pooled meta-analysis results revealed that at the end of the MBCT intervention, participants' anxiety (SMD, - 0.70; 95% CI, - 1.26 to - 0.13; I 2  = 69%), pain (SMD, - 0.64; 95% CI, - 0.92 to - 0.37; I 2  = 0%), and depression (SMD, - 0.65; 95% CI, - 1.14 to - 0.17; I 2  = 75%) levels significantly decreased, and their mindfulness (MD, 8.83; 95% CI, 3.88 to 13.78; I 2  = 68%) levels significantly increased., Conclusion: The MBCT may be associated with improved pain, anxiety, depression, and mindfulness. However, the quantitative analysis pointed to an inconclusive result due to moderate to high levels of heterogeneity among indicator of anxiety, depression, and mindfulness. Future work requires more studies to better elucidate the clinical significance of this possible association. The results suggest that MBCT is highly beneficial as an intervention for patients who have received treatment for breast cancer., (© 2023. The Author(s).)

Guided respiration mindfulness therapy (GRMT) is a clinical model of breathwork that has shown promise as a treatment for depression, anxiety, and stress. This study examined the effectiveness of GRMT as a holistically oriented intervention for reducing psychological distress in nurses. Sixty-two nurses were assigned to either five sessions of GRMT or 5 sessions of a mindfulness-based intervention (MBI) comparison condition which were conducted over 5 weeks. A no-treatment control was also included. Session-by-session change in depression, anxiety, and stress, along with change in mindfulness and self-compassion were assessed. Multilevel analysis showed GRMT resulted in statistically significant reductions in overall psychological distress, anxiety, and stress levels, as well as significant increases in mindfulness and self-compassion with large to very large effect sizes. On all measures, GRMT performed better than the comparison MBI intervention which showed no significant effect on stress levels. Results suggest that GRMT can provide nurses with an effective group intervention for reducing stress, and increasing mindfulness and self-compassion which are foundational elements of self-care for the holistic nurse.

Food security is the top priority of a country. As an important granary in China, the northeast black land is a "ballast" to ensure national food security. However, the long-term and high-intensity application of herbicides in black land farmland has led to the accumulation and migration of herbicides in the soil, which affects soil quality, crop yield, and quality and hinders sustainable agricultural development in the black soil. To solve the problem of herbicide residues in black land farmland, it is necessary to control the application of herbicides from the source, as well as to elucidate the current situation, spatial and temporal evolution, and driving factors of herbicide residues, in order to achieve scientific prevention and control and precise policy implementation. The main contents of this study were as follows:1systematically summarize the application status and problems of herbicides in the farmland of black soil in China, suggesting that there are currently problems such as irregular application and insufficient product innovation of herbicides in the farmland of black soil; 2 comprehensively analyze the current status of herbicide residues, identify the deficiencies in recent studies on herbicide residue characteristics, spatial distribution, and pollution diagnosis in the farmland of black soil, and clarify the gaps in the research on the residue characteristics of herbicides in the farmland of black soil; and 3 propose the research prospect and key orientation for the herbicide residue diagnosis and risk management in the farmland of the black soil region of China. The results of this study can provide science and technology support for guaranteeing soil health, food security, and ecosystem security of black land farmland in China.

Introduction: Major depression disorder (MDD) is a common and potentially life-threatening mental illness; however, data on its pathogenesis and effective therapeutic measures are lacking. Pathological changes in astrocytes play a pivotal role in MDD. While hypidone hydrochloride (YL-0919), an independently developed antidepressant, has shown rapid action with low side effects, its underlying astrocyte-specific mechanisms remain unclear. Methods: In our study, mice were exposed to chronic restraint stress (CRS) for 14 days or concomitantly administered YL-0919/fluoxetine. Behavioral tests were applied to evaluate the depression model; immunofluorescence and immunohistochemistry staining were used to explore morphological changes in astrocytes; astrocyte-specific RNA sequencing (RNA-Seq) analysis was performed to capture transcriptome wide alterations; and ATP and oxygen consumption rate (OCR) levels of primary astrocytes were measured, followed by YL-0919 incubation to appraise the alteration of energy metabolism and mitochondrial oxidative phosphorylation (OXPHOS). Results: YL-0919 alleviated CRS-induced depressive-like behaviors faster than fluoxetine and attenuated the number and morphologic deficits in the astrocytes of depressed mice. The changes of gene expression profile in astrocytes after CRS were partially reversed by YL-0919. Moreover, YL-0919 improved astrocyte energy metabolism and mitochondrial OXPHOS in astrocytes. Conclusion: Our results provide evidence that YL-0919 exerted a faster-onset antidepressant effect on CRS-mice possibly via astrocyte structural remodeling and mitochondria functional restoration., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Li, Hu, Chang, Bao, Kong, Ma and Li.)

Background: The relationship between hepatitis B surface antigen (HBsAg)-positive carrier status and liver cancer has been extensively studied. However, the epigenetic changes that occur during progression from HBsAg-positive carrier status or cirrhosis to liver cancer are unknown. The epigenetic modification of DNA hydroxymethylation is critical in tumor development. Further, 5-hydroxymethylcytosine (5hmC) is an important base for DNA demethylation and epigenetic regulation. It is also involved in the assembly of chromosomes and the regulation of gene expression. However, the mechanism of action of 5hmC in HBsAg-positive carriers or patients with cirrhosis who develop liver cancer has not been fully elucidated., Aim: To investigate the possible epigenetic mechanism of HBsAg-positive carriers and hepatocellular carcinoma (HCC) progression from cirrhosis., Methods: Forty HBsAg-positive carriers, forty patients with liver cirrhosis, and forty patients with liver cancer admitted to the First People's Hospital of Yongkang between March 2020 and November 2021 were selected as participants. Free DNA was extracted using a cf-DNA kit. cfDNA was extracted by 5hmC DNA sequencing for principal component analysis, the expression profiles of the three groups of samples were detected, and the differentially expressed genes (DEGs) modified by hydroxymethylation were screened. Bioinformatic analysis was used to enrich DEGs, such as in biological pathways., Results: A total of 16455 hydroxymethylated genes were identified. Sequencing results showed that 32 genes had significant 5hmC modification differences between HBsAg carriers and liver cancer patients, of which 30 were upregulated and 2 downregulated in patients with HCC compared with HBsAg-positive carriers. Significant 5hmC modification differences between liver cirrhosis and liver cancer patients were identified in 20 genes, of which 17 were upregulated and 3 were downregulated in patients with HCC compared with those with cirrhosis. These genes may have potential loci that are undiscovered or unelucidated, which contribute to the development and progression of liver cancer. Analysis of gene ontology enrichment and Kyoto Encyclopedia of Genes and Genomes showed that the major signaling pathways involved in the differential genes were biliary secretion and insulin secretion. The analysis of protein interactions showed that the important genes in the protein-protein interaction network were phosphoenolpyruvate carboxykinase and solute carrier family 2., Conclusion: The occurrence and development of liver cancer involves multiple genes and pathways, which may be potential targets for preventing hepatitis B carriers from developing liver cancer., Competing Interests: Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this study., (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)

Background: HLA-DR+ T cell, accounting for 1.2%-5.8% of peripheral lymphocyte, is a type of activated T lymphocyte. This retrospective study aimed to evaluate the prognostic value of HLA-DR+ T cell for progression-free survival (PFS) and overall survival (OS) in hepatocellular carcinoma (HCC) patients after curative surgery. Patients and Methods . Clinicopathological data of 192 patients who underwent curative resection for hepatocellular carcinoma in the affiliated hospital of Qingdao University between January 2013 and December 2021 were collected and analyzed. Statistical tests used in this study were the chi-square test and Fisher's exact test. The prognostic value of the HLA-DR+ T cell ratio was analyzed using univariate and multivariate Cox regression analyses. The Kaplan-Meier curves were drawn by the R programming language., Results: HCC patients were divided into high (≥5.8%) and low (<5.8%) HLADR+ T cell ratio groups. Cox regression analysis indicated that a high HLA-DR+ T cell ratio was positively related to the PFS in HCC patients ( P =0.003) and AFP-positive (≥20 ng/ml) HCC patients ( P =0.020). HCC patients and AFP-positive HCC patients in the high HLA-DR+ T cell ratio group were prone to have a higher T cell ratio, a higher CD8+T cell ratio, and a lower B cell ratio than the low HLA-DR+ T cell ratio group. However, the HLA-DR+ T cell ratio was not a statistically significant predictor for OS in HCC patients ( P =0.57) as well as PFS ( P =0.088) and OS ( P =0.63) in AFP-negative HCC patients., Conclusions: This study confirmed that the HLA-DR+ T cell ratio was a significant predictor of PFS in HCC patients and AFP-positive HCC patients after curative surgery. This association may have guiding significance for the follow-up work of HCC patients after surgery., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2023 Rui-Qian Gao et al.)

Corneal lymphangiogenesis is one component of the neovascularization observed in several inflammatory pathologies of the cornea including dry eye disease and corneal graft rejection. Following injury, corneal (lymph)angiogenic privilege is impaired, allowing ingrowth of blood and lymphatic vessels into the previously avascular cornea. While the mechanisms underlying pathological corneal hemangiogenesis have been well described, knowledge of the lymphangiogenesis guidance mechanisms in the cornea is relatively scarce. Various signaling pathways are involved in lymphangiogenesis guidance in general, each influencing one or multiple stages of lymphatic vessel development. Most endogenous factors that guide corneal lymphatic vessel growth or regression act via the vascular endothelial growth factor C signaling pathway, a central regulator of lymphangiogenesis. Several exogenous factors have recently been repurposed and shown to regulate corneal lymphangiogenesis, uncovering unique signaling pathways not previously known to influence lymphatic vessel guidance. A strong understanding of the relevant lymphangiogenesis guidance mechanisms can facilitate the development of targeted anti-lymphangiogenic therapeutics for corneal pathologies. In this review, we examine the current knowledge of lymphatic guidance cues, their regulation of inflammatory states in the cornea, and recently discovered anti-lymphangiogenic therapeutic modalities.

Cancer stem cells (CSCs) are resistant to conventional cancer therapies, permitting the repopulation of new tumor growth and driving disease progression. Models for testing prostate CSC-propagated tumor growth are presently limited yet necessary for therapeutic advancement. Utilizing the congenic nontumorigenic NRP152 and tumorigenic NRP154 rat prostate epithelial cell lines, the present study investigated the self-renewal, differentiation, and regenerative abilities of prostate stem/progenitor cells and developed a CSC-based PCa model. NRP154 cells expressed reduced levels of tumor suppressor caveolin-1 and increased p-Src as compared to NRP152 cells. Gene knockdown of caveolin-1 in NRP152 cells upregulated p-Src, implicating their role as potential oncogenic mediators in NRP154 cells. A FACS-based Hoechst exclusion assay revealed a side population of stem-like cells (0.1%) in both NRP152 and NRP154 cell lines. Using a 3D Matrigel culture system, stem cells from both cell lines established prostaspheres at a 0.1% efficiency through asymmetric self-renewal and rapid proliferation of daughter progenitor cells. Spheres derived from both cell lines contained CD117 + and CD133 + stem cell subpopulations and basal progenitor cell subpopulations (p63 + and CK5 + ) but were negative for luminal cell CK8 markers at day 7. While some NRP152 sphere cells were androgen receptor (AR) positive at this timepoint, NRP154 cells were AR - up to 30 days of 3D culture. The regenerative capacity of the stem/progenitor cells was demonstrated by in vivo tissue recombination with urogenital sinus mesenchyme (UGM) and renal grafting in nude mice. While stem/progenitor cells from NRP152 spheroids generated normal prostate structures, CSCs and progeny cells from NRP154 tumoroids generated tumor tissues that were characterized by immunohistochemistry. Atypical hyperplasia and prostatic intraepithelial neoplasia (PIN) lesions progressed to adenocarcinoma with kidney invasion over 4 months. This provides clear evidence that prostate CSCs can repopulate new tumor growth outside the prostate gland that rapidly progresses to poorly differentiated adenocarcinoma with invasive capabilities. The dual in vitro / in vivo CSC model system presented herein provides a novel platform for screening therapeutic agents that target prostate CSCs for effective combined treatment protocols for local and advanced disease stages., Competing Interests: None., (AJCEU Copyright © 2022.)

Background: Increased lipoprotein (a) [lp (a)] has proinflammatory effects, which increase the risk of coronary artery disease. However, the association between lp (a) variability and follow-up C-reactive protein (CRP) level in patients undergoing percutaneous coronary intervention (PCI) has not been investigated., Aim: To explore the association between lp (a) variability and mean CRP levels within the 1 st year post-PCI., Methods: Results of lp (a) and CRP measurements from at least three follow-up visits of patients who had received PCI were retrospectively analyzed. Standard deviation (SD), coefficient of variation (CV), and variability independent of the mean (VIM) are presented for the variability for lp (a) and linear regression analysis was conducted to correlate lp (a) variability and mean follow-up CRP level. The relationship of lp (a) variability and inflammation status was analyzed by restricted cubic spline analysis. Finally, exploratory analysis was performed to test the consistency of results in different populations., Results: A total of 2712 patients were enrolled. Patients with higher variability of lp (a) had a higher level of mean follow-up CRP ( P < 0.001). lp (a) variability was positively correlated with the mean follow-up CRP (SD: β = 0.023, P < 0.001; CV: β = 0.929, P < 0.001; VIM: β = 1.648, P < 0.001) by multivariable linear regression analysis. Exploratory analysis showed that the positive association remained consistent in most subpopulations., Conclusion: Lp (a) variability correlated with mean follow-up CRP level and high variability could be considered an independent risk factor for increased post-PCI CRP level., Competing Interests: Conflict-of-interest statement: All authors have no conflicts of interest to declare., (©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.)

A mild and efficient transition-metal-free radical difluorobenzylation/cyclization of unactivated alkenes toward the synthesis of difluorobenzylated polycyclic quinazolinone derivatives with easily accessible α,α-difluoroarylacetic acids has been developed. This transformation has the advantages of wide functional group compatibility, a broad substrate scope, and operational simplicity. This methodology provided a highly attractive access to pharmaceutically valuable ArCF 2 -containing polycyclic quinazolinones.

Background: When older nursing home residents and their families are faced with end-of-life care decisions in Taiwan, they make them in the context of traditional cultural norms and socioeconomic changes. Both parties (residents and their family members) are often unwilling to broach the topic, leading to a decisional impasse. The aim of this study was to understand difficult-to-raise issues related to end-of-life care by investigating the perspectives of older nursing home residents and their family members., Methods: This qualitative descriptive study was conducted using content analysis based on the Consolidated Criteria for Reporting Qualitative Research. Purposive sampling was used to select the participants, and sampling continued until data saturation. Data were collected using semi structured interviews, and related analyses were conducted using an inductive approach., Results: Ten residents and twelve family members were interviewed individually. Six main themes were identified: (1) the inevitability of a goodbye; (2) a good death; (3) going with or against traditional culture; (4) better a good death than a bad life; (5) abiding by the residents' decisions; and (6) being willing but unable to take care of residents., Conclusion: Nursing home residents and their family members' thoughts on end-of-life care shifted toward the concept of a good death, and they even regarded death as a form of liberation. Health care providers may serve as mediators to counsel a resident and their family members separately, enabling them to speak up and understand each other's thoughts on end-of-life care before a decision is made so that neither party has regrets., (© 2022. The Author(s).)

Objective: To explore the expression of autophagy related factors microtubule associated protein 1 light chain 3B (LC3B), p62, autophagy key factor Beclin1 in oral lichen planus (OLP) tissues and their relationships with the clinicopathological characteristics of OLP, investigating the function and significance of autophagy in pathogenesis of OLP. Methods: Forty-one lesion tissues (OLP group, twenty-one cases of erosive OLP and twenty cases of non-erosive OLP) were selected from OLP patients visiting the Department of Periodontal and Oral Medicine, School and Hospital of Stomatology, Guizhou Medical University from October 2017 to December 2019. Fifteen cases of normal oral mucosal tissues (control group) were collected from oral and maxillofacial surgery at The Affiliated Stomatology Hospital of Guizhou Medical University during the same period. Protein and mRNA expression levels of LC3B, p62 and Beclin1 were detected by immunohistochemistry (IHC) and real-time quantitative PCR (RT-qPCR) in OLP lesions respectively. The protein expression levels of LC3B, p62, Beclin1 and ratio of LC3B-Ⅱ/LC3B-Ⅰ in sixteen cases (eight cases of erosive OLP and eight cases of non-erosive OLP) from the OLP group were detected by Western blotting (WB). The potential relationship between LC3B, p62, Beclin1, LC3B-Ⅱ/LC3B-Ⅰ ratio and clinical features of OLP were analyzed. Results: IHC results showed that the positive expression rates of LC3B and p62 proteins in OLP lesion tissues [LC3B: 68% (28/41); p62: 59% (24/41)] were higher than those in the control group [LC3B: 5/15; p62: 3/15] (LC3B: χ 2 =5.55, P= 0.019; p62: χ 2 =5.55, P= 0.015). The positive expression rates of LC3B and p62 proteins in the erosive OLP group [LC3B: 86% (18/21); p62: 76% (16/21)] were higher than those in the non-erosive OLP group [LC3B: 50% (10/20); p62: 40% (8/20)] (LC3B: χ 2 =4.50, P= 0.034; p62:χ 2 =5.53, P= 0.019). The positive expression rate of Beclin1 protein in the OLP lesions[20% (8/41)] was lower than that in the control group (7/15) (χ 2 =4.13, P= 0.042), but was not statistically different between the two types of OLP ( P> 0.05). The RT-qPCR results showed that the mRNA expression levels of LC3B and p62 in OLP lesions [LC3B: 2.78 (1.59, 6.15); p62: 4.30 (2.34, 6.29)] were higher than those in the control group [LC3B: 1.05 (0.88, 1.21); p62: 1.12 (0.89, 1.36)] (LC3B: Z= -4.56, P< 0.001; p62: Z= -4.78, P< 0.001), and the mRNA expression levels of LC3B and p62 in the erosive OLP group were higher than those in the non-erosive OLP group (LC3B: Z= -2.87, P= 0.004; p62: Z= -2.95, P= 0.003). The mRNA expression level of Beclin1 in OLP tissues was lower than that in the control group ( Z= -2.43, P= 0.015), but the difference was not statistically significant between the two types of OLP ( P> 0.05). WB results showed that the LC3B-Ⅱ/LC3B-Ⅰ ratio was higher in the OLP lesions than that in the control group ( t= -2.45, P= 0.021), and the LC3B-Ⅱ/LC3B-Ⅰ ratio was higher in the non-erosive OLP group than in the erosive OLP group ( t= -2.38, P= 0.032). Spearman's correlation analysis showed that the ratio was negatively correlated with the clinical staging and the degree of basal cell liquefaction in OLP (clinical staging: r= -0.57, P= 0.021; basal cell liquefaction: r= -0.54, P= 0.032), but not with the disease duration and the degree of lymphocytic infiltration ( P> 0.05). Conclusions: Autophagy related factors LC3B, p62 and Beclin1 may play a role in the formation and progression of OLP lesions. The autophagy level was relatively lack in erosive OLP compared to non-erosive OLP, contributing to the increased local lesion destruction in erosive OLP. Abnormal cellular autophagy may play an important role in the formation of OLP lesions.

Rieske-type non-heme iron oxygenases/oxidases catalyze a wide range of transformations. Their applications in bioremediation or biocatalysis face two key barriers: the need of expensive NAD(P)H as a reductant and a proper reductase to mediate the electron transfer from NAD(P)H to the oxygenases. To bypass the need of both the reductase and NAD(P)H, using Rieske-type oxygenase (Stc2) catalyzed oxidative demethylation as the model system, we report Stc2 photocatalysis using eosin Y/sulfite as the photosensitizer/sacrificial reagent pair. In a flow-chemistry setting to separate the photo-reduction half-reaction and oxidation half-reaction, Stc2 photo-biocatalysis outperforms the Stc2-NAD(P)H-reductase (GbcB) system. In addition, in a few other selected Rieske enzymes (NdmA, CntA, and GbcA), and a flavin-dependent enzyme (iodotyrosine deiodinase, IYD), the eosin Y/sodium sulfite photo-reduction pair could also serve as the NAD(P)H-reductase surrogate to support catalysis, which implies the potential applicability of this photo-reduction system to other redox enzymes., Competing Interests: The authors declare no competing financial interest.

Brucellosis is a common zoonotic infectious disease worldwide that can affect almost all organs in the human body. Osteonecrosis of the femoral head has numerous possible causes. Patients usually experience movement disorders, severe pain, and an extremely high disability rate. We herein describe a 32-year-old male farmer living in Shanxi, China who accidentally injured his right hip while working. After 1 month of rest, the pain in the right hip was relieved, and the patient began to walk again. However, after 2 months of walking, he developed aggravated pain and claudication in the right lower limb. Examination revealed shortening of the right lower limb. We carried out a comprehensive and systematic examination and performed total hip arthroplasty. Hip trauma with Brucella infection may progress to osteonecrosis of the femoral head in a short period of time without typical symptoms of Brucella infection. Systematic examination and treatment should be performed at an early stage to prevent the eventual deterioration of the disease and serious complications that are difficult to treat.

The Yangtze River Economic Belt is one of the major strategic development regions in China. It is of great significance to clarify the characteristics and sources of heavy metal pollution in farmland soil of the Yangtze River Economic Belt for the prevention and control of heavy metal pollution and to ensure safe agricultural production. After collecting extensive literature data, we analyzed the pollution characteristics, environmental risk, and potential sources of heavy metals (Cd, Cr, Hg, As, Pb, Cu, Zn, and Ni) in farmland soil of the Yangtze River Economic Belt through the integrated use of spatial and geo-accumulation index analyses. The results showed that:① the proportion of soil samples exceeding the risk screening values for soil contamination of agricultural land of Cd, Cu, Pb, Hg, Zn, and As were 39.8%, 18.5%, 8.3%, 6.9%, 6.9%, and 6.4%, respectively. Compared with the risk standard, soil Cd had the highest rate of exceeding the standard. ② The contents of Cr, Cu, Zn, and Ni in the upper reaches were higher than those in the middle and lower reaches, and the contents of Cd, As, and Pb in the middle reaches were higher than those in the upper and lower reaches. ③ The results of the geo-accumulation index analysis showed that the contamination degree of the eight heavy metals decreased in the order of Cd(0.42)>Hg(-0.28)>Pb(-0.32)>Zn(-0.39)>Cu(-0.42)>Cr(-0.7)>As(-0.81)>Ni(-0.73), where the accumulation risk of soil Cd and Hg was relatively higher. ④ Higher environmental background and mining activities were the main factors affecting the accumulation of heavy metals in soils in the upper and middle reaches. By contrast, rapid urbanization, industrial production, and intensive agricultural activities were the main factors affecting the heavy metal accumulation in soils in the middle and lower reaches. In view of the current status and control needs of heavy metal pollution in the Yangtze River Economic Belt, it is recommended to strengthen source prevention and control and to also carry out hierarchical control and regional classification management of heavy metal pollution in farmland soils according to the degree of heavy metal pollution, geological background, and quality of agricultural products. The ultimate objective of this research was to archive the farmland soil environmental quality safety and agricultural green sustainable production in the Yangtze River Economic Belt.

Objective: To investigate the relationship between KCNE family gene polymorphisms of potassium channel gene and the susceptibility of atrial fibrillation (AF). Methods: In the case-control study, a total of 648 subjects were studied, of which 338 patients with atrial fibrillation were selected from the Department of Cardiovascular Medicine, Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2019 to December 2019, and 310 healthy people were selected from the physical examination population during the same period. DNA sequencing technology and polymerase chain reaction (PCR) were used to detect the genotype and allele frequency of rs1805127 of KCNE1, rs9984281 of KCNE2, rs9516, rs626930 of KCNE3 and rs12621643 of KCNE4. Results: The ages of subjects in atrial fibrillation group and control group were (69±13) and (73±8) years, respectively ( P =0.077). Men subjects accounted for 57.70% (195 men) and 40.00% (124 men) in the two groups, respectively ( P =0.092). The distribution frequencies of the allele C at rs1805127 of gene KCNE1, the allele A at rs9984281 of gene KCNE2 and the allele G at rs12621643 of gene KCNE4 were significantly different between groups ( P <0.05). After adjustment for sex, smoking, hypertension, cardiac insufficiency and other factors, it was found that the increase in the frequency of the above three loci would increase the risk of atrial fibrillation (rs1805127 OR =7.064, 95% CI :1.559-31.997; rs9984281 OR =4.210, 95% CI :1.118-15.850; rs12621643 OR =2.679, 95% CI :1.025-6.998). Conclusion: The rs1805127 of KCNE1, the rs9984281 of KCNE2,the rs12621643 of KCNE4 were significantly associated with the susceptibility to atrial fibrillation.

Limbal stem cells constitute an important cell population required for regeneration of the corneal epithelium. If insults to limbal stem cells or their niche are sufficiently severe, a disease known as limbal stem cell deficiency occurs. In the absence of functioning limbal stem cells, vision-compromising conjunctivalization of the corneal epithelium occurs, leading to opacification, inflammation, neovascularization, and chronic scarring. Limbal stem cell transplantation is the standard treatment for unilateral cases of limbal stem cell deficiency, but bilateral cases require allogeneic transplantation. Herein we review the current therapeutic utilization of limbal stem cells. We also describe several limbal stem cell markers that impact their phenotype and function and discuss the possibility of modulating limbal stem cells and other sources of stem cells to facilitate the development of novel therapeutic interventions. We finally consider several hurdles for widespread adoption of these proposed methodologies and discuss how they can be overcome to realize vision-restoring interventions.