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Libin Liu,1,&ast; Chuyan Wang,2 Bin Mei,1 Jing Wang,1 Xiaoqun Xu,1 Hongjuan Zhou,1 Long Cai1,&ast; 1Centre of Laboratory Medicine, Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, People’s Republic of China; 2Department of Clinical Laboratory, The Third People’s Hospital of Lin’an District, Hangzhou, Zhejiang, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Long Cai, Centre of Laboratory Medicine, Hangzhou Red Cross Hospital, No. 208 East Huancheng Road, Hangzhou, 310003, People’s Republic of China, Email cailong317@hotmail.comPurpose: This study aimed to establish and validate a diagnostic nomogram for identifying false positives in the Xpert MTB/RIF (Xpert) for detection of rifampicin resistance (RIF-R).Patients and Methods: In this retrospective study, we collected basic patient characteristics and various clinical information from the electronic medical record database. Patients were randomly divided into training and validation groups in a 7:3 ratio. LASSO regression was used to screen variables and construct a diagnostic nomogram. The ROC curve, calibration curve, and decision curve analysis (DCA) were used to evaluate the performance of the nomogram.Results: A total of 384 patients were included in the study, with 268 and 116 patients in the training and validation cohorts, respectively. Finally, probe mutations and probe delay were identified as the independent influencing factors. Using the mutation of probe E as a reference, probes A or C (OR = 51.07, P< 0.001), probe D (OR = 7.48, P< 0.001), and multiple probes (OR = 4.42, P=0.029) were identified as factors influencing false positives in Xpert for detection of RIF-R. Taking probe delay ΔCT < 4 as a reference, ΔCT (4– 5.9) (OR = 17.06, P=0.005) and ΔCT (6– 7.9) (OR = 36.67, P< 0.001) were noted to be the factors influencing false positives in Xpert for detection of RIF-R. Based on these two variables, we constructed a diagnostic nomogram. The area under the curve of the nomogram model was 0.847 and 0.850 for the training and validation groups, respectively. The calibration curves were consistent. The DCA revealed that the model achieved the greatest net benefit when the threshold probability was set between 6% and 71% in the training cohort and 6% and 70% in the validation cohort.Conclusion: The nomogram constructed can identify false positives in Xpert for detection of RIF-R and provides basis for clinicians to formulate diagnosis and treatment plans.Keywords: nomogram, probe mutation, probe delay, calibration curve

Hongwei Huang,&ast; Wei Liao,&ast; Kaiyue Zhang, Hao Wang, Qi Cheng, Bin Mei Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Bin Mei; Qi Cheng, Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jie Fang Avenue, Qiaokou, Wuhan, 430030, People’s Republic of China, Email meibingluke@sina.com; chengqi@hust.edu.cnPurpose: The prognosis of patients with huge hepatocellular carcinoma (huge HCC, diameter ≥ 10 cm) is poor owing to the high early recurrence rate. This study aimed to explore the clinical value of postoperative adjuvant transarterial chemoembolization (PA-TACE) plus programmed cell death-1 (PD-1) inhibitors for huge HCC.Patients and Methods: Data from consecutive huge HCC patients treated with hepatectomy during June 2017 and July 2022 were retrospectively collected. Baseline differences were balanced between huge HCC patients who underwent PA-TACE with (AIT group) or without PD-1 inhibitors (AT group) by propensity-score matching (PSM). We compared recurrence-free survival (RFS), overall survival (OS) and recurrence patterns between the two groups. Independent risk factors for RFS and OS were confirmed by Cox regression analysis, and subgroup analysis was also conducted.Results: A total of 294 patients were enrolled, and 77 pairs of patients in the AIT and AT groups were matched by PSM. The 1-year and 2-year RFS were 49.9% and 35.7% in the AIT group compared to 24.7% and 15.5% in the AT group respectively (p< 0.001). The 1-year and 2-year OS were 83.6% and 66.9% in the AIT group compared to 50.6% and 36.8% in the AT group respectively (p< 0.001). There were no significant differences in recurrence patterns between the two groups. Multivariable analysis demonstrated that combined therapy of PA-TACE plus PD-1 inhibitors was a protective factor related to both RFS and OS.Conclusion: PA-TACE plus PD-1 inhibitors could improve survival outcomes for huge HCC patients.Keywords: hepatocellular carcinoma, postoperative adjuvant therapy, programmed cell death-1 inhibitors, transarterial chemoembolization, early recurrence

Ping Luo,1 Ying Fan,2 Yusha Xiong,2 Chunlin Zhang,1 Zhiping Yang,1 Fenglan Sun,1 Bing Mei1 1Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, People’s Republic of China; 2Gongan County Maternal and Child Health Care Hospital, Jingzhou, People’s Republic of ChinaCorrespondence: Bing Mei, Department of Laboratory Medicine, Jingzhou Hospital Affiliated to Yangtze University, Jingzhou, People’s Republic of China, Email meibing008@163.comObjective: To describe the metabolic characteristics of gestational diabetes mellitus (GDM) and assess their effects on perinatal outcomes.Methods: A two-center nested case‒control study was designed, including 192 pregnant women with GDM and 191 pregnant women with normal glucose tolerance (NGT). Serum glucose and insulin concentrations based upon the 75 g oral glucose tolerance test (OGTT) were measured. Several indices were calculated to describe the metabolic characteristics of the subjects. The relationship between glucose metabolism parameters and pregnancy outcomes was evaluated using stepwise linear regression and binary logistic regression.Results: Compared with the NGT group, the GDM group showed significantly higher fasting and postprandial glucose parameters but significantly lower fasting and postprandial insulin responses. Meanwhile, the GDM group had significantly lower HOMA-β, DI and ISIMatsuda but comparable HOMA-IR. The IFG subgroup showed significantly lower FINS/FPG only, while the IGT and IFSG subgroups showed deficiency in both fasting and postprandial insulin response. The IFSG subgroup had the highest glucose parameters and the lowest insulin parameters, as well as significantly lower ISIMatsuda and HOMA-β than the NGT group. FPG had a significant effect on infants’ birth weight, and 1hPG and FINS/FPG had a significant effect on delivery gestational age. AUC-INS, IGI60 and DI were related to premature delivery risk after adjusting for confounders. The IFG subgroup of GDM was 2.319 times more likely to be subject to cesarean section than the NGT group. FPG, FINS/FPG, AUC-GLU, AUC-INS/AUC-GLU and HOMA-β were related to macrosomia risk.Conclusion: Beta cell dysfunction rather than insulin resistance determines the occurrence of GDM in the central Chinese population. Women with predominant insulin secretion defects had a similar risk of adverse perinatal outcomes to women with NGT. Our study provided a basis for the selection of glucose metabolism monitoring indicators useful for the prevention of adverse perinatal outcomes.Keywords: insulin resistance, insulin sensitivity, glucose metabolism, perinatal outcomes, type 2 diabetes mellitus

Rui Yang,&ast; Xiao-Xia Xu,&ast; Hu Liu, Wei Dai, Zheng-Qin Zhang, Ting-Ting Wang, Shi-Shou Chen, Er-Wei Gu, Xue-Sheng Liu, Bin Mei Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xue-Sheng Liu; Bin Mei, Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, Anhui, 230022, People’s Republic of China, Tel +86 551-62922344, Fax +86 551 62923704, Email liuxuesheng@ahmu.edu.cn; binmei@ahmu.edu.cnObjective: Postoperative sleep disturbance after surgery is not conducive to the recovery of patients. The purpose of this study was to determine the influence of the timing of surgery (morning vs afternoon) on the postoperative sleep quality of elderly patients and to analyze the relationship between the timing of surgery and the change in the melatonin level.Methods: Sixty patients who received hip surgery were randomly assigned to the Morning Group (Group M) or the Afternoon Group (Group A). The sleep quality was assessed by the Richards–Campbell Sleep Questionnaire. Before and after surgery, the nocturnal urine was collected over a 12-h period, and the 6-sulfatoxymelatonin concentration was measured. Also, the incidence of postoperative delirium (POD) was observed.Results: On the first and second nights after surgery, the sleep quality scores of the patients in Group A were greater than those in Group M, and there was no difference in the sleep quality scores between the two groups on the third night after surgery (P=0.000, P=0.002, P> 0.05, respectively). In addition, the urine 6-sulphatoxymelatonin concentration was found to be greater in Group A than in Group M on the first night of surgery (P=0.00). Both the postoperative sleep quality scores and urine 6-sulphatoxymelatonin concentration were significantly less than those before surgery (P=0.00, P=0.00).Conclusion: The postoperative sleep quality scores and melatonin levels of elderly patients who received hip surgery under general anesthesia were significantly less than those of the patients before surgery. Furthermore, the short-term sleep quality of the patients who received surgery in the afternoon was better than that of the patients who received surgery in the morning. This difference may be related to the short-term change of the melatonin level after surgery.Keywords: sleep quality, melatonin, timing of surgery

Solar-powered electrochemical production of hydrogen through water electrolysis is an active and important research endeavor. However, technologies and roadmaps for implementation of this process do not exist. In this perspective paper, we describe potential pathways for solar-hydrogen technologies into the marketplace in the form of photoelectrochemical or photovoltaic-driven electrolysis devices and systems. We detail technical approaches for device and system architectures, economic drivers, societal perceptions, political impacts, technological challenges, and research opportunities. Implementation scenarios are broken down into short-term and long-term markets, and a specific technology roadmap is defined. In the short term, the only plausible economical option will be photovoltaic-driven electrolysis systems for niche applications. In the long term, electrochemical solar-hydrogen technologies could be deployed more broadly in energy markets but will require advances in the technology, significant cost reductions, and/or policy changes. Ultimately, a transition to a society that significantly relies on solar-hydrogen technologies will benefit from continued creativity and influence from the scientific community.

In this paper, an effective equivalent modeling technique has been proposed to describe small-signal characteristics of InP-based high electron mobility transistors (HEMTs) after proton radiation, which is composed of an artificial neural network and equivalent-circuit models. Small-signal intrinsic parameters of InP-based HEMTs are extracted from S-parameters before and after 2 MeV proton radiation as modeling objects. The deep learning model of a generative adversarial network has been explored to expand the measured finite data samples. Four feedforward neural networks are incorporated to equivalent-circuit topology to form the equivalent model, which are trained to accurately predict the radiation-induced variations of Cgs, Cgd, Rds, and gm, respectively. The prediction accuracy of the developed equivalent model has been well verified in terms of the broad-band S-parameters under radiation fluence of 1 × 1014 and 5 × 1013 H+/cm2. This equivalent modeling method with characterization of radiation damage effects could provide significant guidance for the aerospace monolithic millimeter-wave integrated circuit design. [ABSTRACT FROM AUTHOR]

Jia Liu,1,&ast; Jun-Fei Zhang,2,&ast; Han-Ning Ma,2 Ke Feng,2 Zhong-Wei Chen,2 Li-Shan Yang,2 Bin Mei,3 Jun-Jian Zhang4 1Medical Experimental Center, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750000, People’s Republic of China; 2Department of Emergency Medical, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750000, People’s Republic of China; 3Department of Social Medical Development, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, People’s Republic of China; 4Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zhong-Wei Chen; Li-Shan Yang Email 13995390007@163.com; nyfyyls@126.comObjective: Information regarding the epidemiology and clinical features of mild to moderate patients caused by COVID-19 in Fangcang Hospital is scarce. Through a retrospective cohort study, the clinical characteristics of COVID-19 patients in Dongxihu Fangcang shelter hospitals were analyzed, and the factors that affected the disease progression of COVID-19 patients were explored.Methods: The clinical characteristics of 714 patients with COVID-19 were retrospectively analyzed at Dongxihu Fangcang Hospital between February 7 and March 8, 2020. We described the clinical characteristics and distribution of discharge or transfer times for each patient. According to the disease progression of COVID-19 patients, we divided all patients into Non-Deteriorated group and Deteriorated group. Furthermore, binary logistic regression was used for a single outcome and multiple response variables.Results: We treated 789 patients with mild and moderate COVID-19, of which 714 were included in this study, which included 326 (45.66%) deteriorated patients and 388 (54.34%) non-deteriorated patients. The mean age of the study population was 48.16± 12.44 years. Of all patients, 319 (44.7%) were men and 395 (55.3%) were women. The average length of the patient’s stay was 16.08± 5.13 days. The most common clinical feature on admission was fever (593 of 714, 83.05%). It is worth noting that 80 (11.20%) of the 714 patients were asymptomatic from exposure to admission. Multivariate logistic regression analysis showed that gender, age, diabetes, respiratory system disease, fever, dyspnea, and nasal congestion were risk factors associated with deterioration in cases with COVID-19 patients, and asymptomatic (OR: 0.058; 95% CI: 0.022– 0.155; P< 0.001) was the protective factor for deterioration of COVID-19 patients.Conclusion: Accompanied by chronic diseases, old age, fever, nasal congestion, and dyspnea were factors that influenced the aggravation of COVID-19 patients, and more attention and treatment should be given to these patients.Keywords: clinical characteristics, mild to moderate, makeshift (fangcang) hospital, influence factors

Rui Yang,1 Rui-hong Liu,1 Jia-nan Xu,1 Guang-hong Xu,1,2 Xiao-bin Jin,1 Rui Xiao,1 Bin Mei1 1Department of Anesthesiology, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, 230022, People’s Republic of China; 2Department of Neurology, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, 230022, People’s Republic of ChinaCorrespondence: Guang-hong XuDepartment of Anesthesiology, First Affiliated Hospital, Anhui Medical University, 218 Jixi Road, Hefei, Anhui, 230022, People’s Republic of ChinaTel +86-551-62922344Fax +86 551 62923704Email xuguanghong2004@163.comBackground: Both lumbosacral plexus block (LSPB) and local infiltration analgesia (LIA) can provide postoperative analgesia for patients undergoing total hip arthroplasty (THA). The current study aimed to compare the differences between LSPB and LIA on postoperative pain and quality of life (QoL) in THA patients.Methods: A total of 117 patients aged 40– 80 years, ASA I-III, were prospectively randomized into two groups: a general anesthesia plus LSPB (Group LSPB) and a general anesthesia plus LIA (Group LIA). Pain intensity and opioid consumption were recorded Within 72 hours after surgery. QoL was measured by EQ-5D and EQ-VAS questionnaires, and the incidence of postoperative pain was measured as part of the EQ-5D on day 1, day 3, day 7, and month 1, month 3, and month 6 after surgery.Results: EQ-5D scores: Mobility, Self-Care, Usual Activities, Pain/Discomfort, and Anxiety/Depression were higher in Group LSPB versus Group LIA throughout six-month follow-ups (p = 0.039). The pain intensity was lower in Group LSPB than in Group LIA 0– 12 h after surgery (2.41 vs 2.79, p = 0.01), but was higher in Group LSPB than in Group LIA 12– 24 h (2.59 vs 2.05, p = 0.02) and 24– 48 h (2.18 vs 1.73, p = 0.02) after surgery. There were no differences in opioid consumption between the groups during the first 72 postoperative hours. In the first month after surgery, more patients in Group LSPB than in Group LIA had no pain (52 vs 40, p = 0.04).Conclusion: Both LSPB and LIA can provide satisfactory postoperative analgesia. The LSPB is better than LIA for long-term QoL in THA patients undergoing general anesthesia.Clinical Trial Registration Number: The Chinese Clinical Trial Registry (ChiCTR-INR-17012545).Keywords: total hip arthroplasty, lumbosacral plexus block, local infiltration analgesia, postoperative pain, quality of life

Jun-Fei Zhang,1,* Jia Liu,2,* Han-Ning Ma,1 Ke Feng,1 Zhong-Wei Chen,1 Li-Shan Yang,1 Bin Mei,3 Jun-Jian Zhang4 1Department of Emergency Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia 750000, People’s Republic of China; 2Medical Experiment Center, General Hospital of Ningxia Medical University, Yinchuan, Ningxia 750000, People’s Republic of China; 3Department of Social Medical Development, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, People’s Republic of China; 4Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhong-Wei Chen; Li-Shan Yang Email 13995390007@163.com; nyfyyls@126.comRationale: Currently, the “gold standard” is real-time reverse transcriptase–polymerase chain reaction (RT-PCR) amplification of the viral DNA for diagnosis of COVID-19 infection. However, early reports of test performance in the Wuhan outbreak showed variable sensitivities. Therefore, the simple use of RT-PCR as a discharge standard for COVID-19 patients may be risky. Early discussions suggested that CT should be the preferred modality for the diagnosis of COVID-19. However, the use of CT for COVID-19 discharge is controversial. In the Fangcang hospital, we performed multiple nucleic acid tests and chest CT examinations in all patients. For discharged patients, we performed multiple nucleic acid tests and chest CT scans on the basis of discharge standards to minimize the incidence of false negatives in nucleic acid tests.Patient Concerns: Two 42-year-old male patients with mild to moderate COVID-19 were treated in the Fangcang Hospital According to the treatment, one patient was cured and discharged, while the other patient was sent to a higher-level hospital for further treatment.Diagnoses: Real-time reverse transcriptase–polymerase chain reaction amplification of the viral DNA for diagnosis of COVID-19 infection.Interventions: The patients received Chinese medicine and antiviral treatment in the Fangcang Hospital.Outcomes: At follow-up, both patients were cured after treatment and returned to normal life after 2 weeks of home isolation and a negative nucleic acid test.Lessons: The use of nucleic acid testing combined with chest CT examination can quickly diagnose patients with COVID-19 infection and evaluate their treatment in the Fangcang Hospital.Keywords: case report, COVID-19, CT, Fangcang Hospital

Yu Mao,1,2,* Youmei Zuo,2,* Bin Mei,2 Lijian Chen,2 Xuesheng Liu,2 Zhi Zhang,1 Erwei Gu2 1Key Laboratory of Brain Function and Disease of Chinese Academy of Science, Department of Biophysics and Neurobiology, University of Science and Technology of China, Hefei City, Anhui 230027, People’s Republic of China; 2Department of Anaesthesiology, First Affiliated Hospital of Anhui Medical University, Hefei City, Anhui 230031, People’s Republic of China *These authors equally contributed to this work Purpose: The purpose of this study was to assess the efficacy of perineural dexamethasone with ropivacaine in multimodal analgesia for thoracic paravertebral block (TPVB) in patients undergoing elective thoracotomy. Patients and methods: Ninety-six patients undergoing thoracotomy were enrolled in this trial and randomized to adjuvant therapy for TPVB: group S (saline), group R (0.5% ropivacaine), or group RD (5 mg dexamethasone and 0.5% ropivacaine). Postoperative analgesia, recovery duration, and chronic pain were recorded. Results: Groups R and RD spent less time in the postanaesthesia care unit, had earlier out-of-bed activity, and had shorter postoperative hospital stays compared with group S. The RD group regained consciousness faster and had lower acute pain scores and used less patient-controlled analgesia during the first 72 h after surgery compared with group S. Postthoracotomy pain was decreased in group RD (19.0%) compared with group S (47.6%) 3 months postoperatively, p = 0.050. Conclusion: Perineural dexamethasone with ropivacaine for TPVB improves postoperative analgesia quality, reduces recovery time, and may decrease the incidence of chronic pain after thoracotomy with an opioid-based anesthetic regimen. Keywords: chronic pain, dexamethasone, nerve block, thoracotomy

This study utilized a Quasi-Experimental Research Pre-test - Post-test Non-Control Group Design explored the effectiveness of the two interventions namely, audio books and traditional books, as motivation in the listening comprehension of grade 3 learners. The results showed that using both audio books and traditional books, the students' post-test scores were greater than their pre-test levels. However, as compared to students who were exposed to traditional books, those who were exposed to audio books had somewhat higher mean scores. The outcomes showed that the students' listening comprehension levels improved after they were exposed to both audio books and traditional books. Statistically speaking, there was no significant difference between listening comprehension of learners using audio books and traditional books. Furthermore, this study revealed that whatever methods used between audio books and traditional books in teaching students to improve their listening comprehension would be considered effective tool in enhancing listening comprehension skills and being prompted in listening stories. [ABSTRACT FROM AUTHOR]

Introduction. Communication has a crucial role in public health, because it becomes an essential component of prevention; it is also a proactive tool in health promotion. From a planning perspective, it is appropriate to use communication means that can help the bidirectional communication process, such as face-to-face communication and telephone communication. Materials and methods. In relation to this, the Italian National Institute of Health has developed the "Modello Operativo Comunicativo-Relazionale" (the "Communicative-Relational Operating Model"). It is based on the fundamental skills of the counselling, this gives a protocol to the health professionals that is replicable and organized and it allows health professionals to carry out a telephone communication that is efficient with the user through technical-scientific and communication-relational skills. The goal is to answer in a customized way to the various users' health needs. The Operating Model was created by experts of the National AIDS and Sexually Transmitted Infections Helpline of the Operational Unit of Psycho-Socio-Behavioural Research, Communication, Training, of the Infectious Diseases Department. Later, the Operating Model was proposed to the experts of the Helplines in the National Centre on Addictions and Doping and the National Helpline of the National Centre for Rare Diseases in the National Institute of Health that integrated this method into their telephone approach. Results. The Operating Model illustrated above was applied to several helplines of the National Institute of Health as an example of correct scientific information, updated and customized on sexual transmitted infections, addictions and rare diseases. Conclusions. This article aims to illustrate the Operating Model, the theoretical prerequisites that subtend it and its possible application in the different public health structures that use the telephone for a professional relationship with their users. [ABSTRACT FROM AUTHOR]