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Abstract Background Azathioprine is a purine synthesis inhibitor used as an immunosuppressive therapy for many immune-mediated diseases. Azathioprine hypersensitivity reaction is a rare, life-threatening adverse reaction characterized by a range of multisystem manifestations including fever, abdominal pain, arthralgias, erythematous cutaneous eruption, acute renal failure, neutrophilia, and more rarely, distributive shock. Although acute heart failure has been rarely described in association with azathioprine hypersensitivity syndrome, myocardial infarction has, to our knowledge, never been associated with this entity. Case Presentation We describe a case of a 59-year-old male with Crohn’s disease who developed severe azathioprine hypersensitivity syndrome that included distributive shock, neutrophilic dermatosis, and acute coronary syndrome with ST-elevation. Clinical improvement was seen after cessation of azathioprine and administration of glucocorticoid therapy. Conclusion Prompt recognition of azathioprine hypersensitivity syndrome, which can manifest as shock and neutrophilic dermatosis, is key to ensure rapid azathioprine cessation.

Objective To investigate the effect of bone window closure on moderate to severe traumatic brain injury (TBI) in mice by controlled cortical impact (CCI). Methods A total of 200 healthy male mice were divided into 2 groups for moderate and severe TBI. Fifty were randomly selected from each group for bone window closed, and the remaining 50 were not closed. The intracranial pressure (ICP) was monitored, the water content of brain tissue and the volume of cerebral edema were measured, the degree of neurological impairment was assessed by modified Neurological Severity Score (mNSS), and the spatial learning ability and memory were evaluated by Morris water maze test. Nissl staining assessed the degree of neuronal damage in the cerebral cortex and CA1 region of the hippocampus. Results For ICP, there were differences in ICP between the bone window closed group and the unclosed group in both the moderate and severe TBI (P = 0.007, 0.000). There were also significant differences in ICP at different observation time points after modeling (P = 0.000, 0.000). The ICP on 1 d of the moderate bone window closed group was higher than that in the moderate bone window unclosed group (P = 0.009), 1 d (P = 0.000) and 3 d (P = 0.038) of the severe bone window closed group was higher than that of the severe bone window unclosed group. On 7 d, the ICP in the moderate bone window closed group (P = 0.000, 0.000) and the severe bone window closed group (P = 0.000, 0.008) was lower than that on 1 and 3 d, and the ICP on 3 d was also lower than that on 1 d (P = 0.000, 0.000). The ICP in the moderate bone window unclosed group on 7 d was lower than that on 1 d (P = 0.031). The water content of brain tissue was lower on 1 d (P = 0.028), 3 d (P = 0.023) and 7 d (P = 0.023) in severe bone window closed group than that of severe bone window unclosed group. The volume of brain edema in the bone window closed group was smaller than that in the bone window unclosed group (P = 0.021, 0.037). In the evaluation of the degree of neurological impairment, there were differences in mNSS scores at different observation time points between the bone window closed group and the bone window unclosed group (P = 0.000, 0.001). On 7 d, the mNSS scores of the moderate bone window closed group (P = 0.002), the moderate bone window unclosed group (P = 0.013) and the severe bone window closed group (P = 0.009) were all lower than those on 1 d. The mNSS scores of the severe bone window closed group (P = 0.006) and the severe bone window unclosed group (P = 0.002) were all lower than those of 3 d. Morris water maze test showed that the platform latency of mice in the severe bone window closed group was longer than that in the severe bone window unclosed group (P = 0.045), and the target quadrant residence time was shorter than that in the severe bone window unclosed group (P = 0.025). Nissl staining showed compared with the moderate bone window unclosed group, the density of Nissl bodies in cerebral cortex neurons was decreased, the staining was lighter, and the density of Nissl bodies in cerebral cortex neurons of CA1 region of hippocampus was decreased, the Nissl staining was lighter and the shape was blurred in the moderate bone window closed group. In severe TBI model mice, compared with the bone window unclosed group, the density of Nissl bodies in cerebral cortex and hippocampal CA1 region of the bone window closed group was decreased, the staining was blurred, and more metachromic particles appeared, hippocampal CA1 region body edema, the Nissl staining blurred. Conclusions In moderate TBI model mice, bone window closure increases ICP in the acute stage, but has no significant effect on the degree of cerebral edema, neurological function and cognitive function. In severe TBI model mice, bone window closure can lead to increased ICP and decreased spatial learning ability and memory, but it can reduce the degree of brain edema and improve neurological function. It is suggested that bone window closure should be selected according to the purpose of the study.

In the context of the “dual carbon” goals， photovoltaic energy storage charging stations （PSCSs） are gradually emerging as the mainstream form of electric vehicle （EV） charging stations. To address the uncertainty associated with photovoltaic （PV） generation and user charging behavior， while ensuring the profitability of PSCSs， the paper proposes a method for optimal allocation of energy storage capacity for PSCSs that takes account of EV user behavior and PV uncertainty. Firstly， an improved K-means algorithm is employed to cluster PV output data， establishing typical PV output scenarios and their rules of probability distribution. Secondly， the charging behavior characteristics of EVs are analyzed， incorporating the impact of environmental temperature variations on EV power consumption to develop an EV charging load model. Lastly， considering demand response， an economic operational model is formulated with the objective functions including purchasing cost， carbon emission cost， and electricity sales revenue. Case study results demonstrate that incorporating PV output uncertainty and demand response during energy storage capacity configuration of PSCSs can reduce carbon emissions and ensure the economic viability of PSCSs.

With the development of the smart grid, power quality issues have been widespread in the power grid and it threaten the safety and stability of the power grid. The monitoring data of power quality disturbances (PQDs) increase rapidly, and it is of great significance to achieve deep feature extraction and intelligent classification of PQDs in large-scale systems for power system pollution detection and management. To this end, stacked sparse auto encoder (SSAE) and feedforward neural network (FFNN) based method for composite PQDs classification is proposed in this paper. Firstly, a PQDs simulation model is constructed based on IEEE standard. Then, a PQDs classification model based on SSAE-FFNN is established, and the scaled conjugate gradient (SCG) algorithm is used to optimize the model, in order to accelerate gradient descent and improve training efficiency. Next, to reduce the reconstruction loss of the stacked network and extract deep low-dimensional features, the layer-wise training and fine-tuning strategy of SSAE are constructed. Finally, the examples are used to verify the classification effect, robustness, generalization and applicable scenario scale of the proposed method. The results show that the method can effectively identify composite PQDs and it has a high accuracy even for both error-containing disturbances and 21 sets of measured disturbance data of a local municipal grid.

Abstract Background With the aging of human society, more and more elderly patients have to undergo surgery and anesthesia. Clinical observations have indicated from time to time that spinal anesthesia in the elderly appears to last longer than in young people, although there is limited research in this area and the mechanism is unclear at present time. This research work is expected to help understand the decline of local anesthetic metabolism in cerebrospinal fluid of elderly patients so as to help them with precise anesthesia and rapid rehabilitation. Methods Twenty patients with spinal anesthesia in orthopedic lower limb surgery were selected to study the rate of drug metabolism in cerebrospinal fluid in two age groups, i.e.,18–30 years old and 75–90 years old. Ropivacaine in peripheral blood is used as a probe to reflect the speed of drug metabolism in cerebrospinal fluid. The contents of total Aβ protein and hyaluronic acid in the cerebrospinal fluid were investigated as well. Results The equivalent dose of ropivacaine anesthetizes the elderly group for a longer time. The metabolism rate of ropivacaine in an elderly patient was slower than that of a young patient. No significant difference in total Aβ protein between the two groups was observed while hyaluronic acid in the elderly group was significantly higher than that in the young group. Conclusions This study shows that the dose of ropivacaine should be reduced when used for anesthesia in elderly patients. The cumulation of ropivacaine and HA appears to imitate the degeneration of central lymphatic circulation metabolism in elderly people.

IntroductionIn the context of the deep coupling and synergistic development of digital villages and healthy villages, the development of China’s rural society harbors a huge potential for medical and healthcare consumption.MethodsOn the basis of theoretical research, a framework was constructed to analyze the influence mechanism of farmers’ medical and healthcare consumption in the context of Internet medical information overflow, and empirically examines the research and analysis framework by using the 2020 China Household Tracking Survey data with the OLS model, mediation effect model, and instrumental variable method.ResultsIt is found that Internet medical information spillover has a “crowding-in effect” on farmers’ healthcare consumption; Medical attendance behavior, economic capital utilize the intermediary effect between Internet medical information spillover and farmers’ healthcare consumption. And there is age group heterogeneity in the effect of Internet medical information spillover on farmers’ healthcare consumption, The ability of rural middle-aged and old-aged groups to recognize new things such as Internet medical information needs to be improved, so the overflow of Internet medical information will induce rural middle-aged and old-aged groups to generate a certain amount of medical and health care consumption. However, the impact on healthcare consumption is not sensitive to the youth cohort group.DiscussionThe sinking of Internet medical resources should be accelerated in the future to promote the high-quality development of rural medical and health services, at the same time the “Internet + healthcare services” should be optimized to promote scientific and rational stratification of farmers’ access to healthcare, and economic capital for farmers’ access to health care should be improved in order to alleviate the burden of health care, etc.

Abstract To evaluate the comparative efficacy and safety of different intubation devices on intubation outcomes in pediatric intubation. We identified relevant studies from previous meta-analyses and literature retrieval in PubMed, EMBASE, and Cochrane Library. The primary outcome was the first-pass success (FPS), and the secondary outcome included the time to intubation (TTI) and the risk of local complications (LC). Network meta-analysis was performed using STATA 14.0. Twenty-three randomized comparative trials (RCTs) including 12 devices were included. Compared with Macintosh, Airtraq (odds ratio [OR] = 13.05, 95% confidence interval [CI] = 4.68 to 36.38), Miller (OR = 4.77, 95%CI = 1.32 to 17.22), Glidescope (OR = 2.76, 95%CrI = 1.60 to 4.75) and McGrath (OR = 4.61, 95%CI = 1.18 to 17.99) obtained higher PFS. Meanwhile, Airtraq was superior to Glidescope (OR = 0.21, 95%CI = 0.07 to 0.65) for PFS. For TTI, Canada was superior to other intubation devices, as well as CMAC was superior to TruViewEVO2, Glidescope, and StorzDCI. Airtraq lowered the risk of LC compared with Macintosh and Pentax but there was no statistical difference between Airtraq and KingVision. Airtraq may be the optimal option for FPS, Canada for TTI, and KingVision for LC in pediatric intubation.

To construct an index system for evaluating the supply of Internet+ public health services, and to provide a practical tool for assessing the supply of Internet+ public health services in an objective and scientific manner. The research team drafted the index system framework by combing the literature. The Delphi method was used to determine the content and weight of the index through two rounds of expert consultations. At the same time, the Cronbach coefficient and factor analysis were adopted to test the reliability and validity. What's more, the analytic hierarchy process and the TOPSIS method were applied to analyze the empirical data of 15 counties and cities in the eastern, central, and western regions of China. The constructed indicator system includes 3 first-level indicators, 6 second-level indicators and 29 third-level indicators. Through reliability and validity tests, the stability and practicability of the index system are demonstrated in empirical research. The evaluation index system constructed in this article can be applied to the performance evaluation of Internet + public health service.

Objective: This study aimed to explore the feasibility of low-frequency electric field assisted controlled freezing-point storage (CFPS) technology improving the quality of shrimp. Methods: Low-frequency electric field was applied on the basis of controlled freezing-point storage (LFEF+CFPS) to preserve prawns, and the contents of malondialdehyde and salt soluble protein, as well as the changes of Ca2+-ATPase activity, pH value, shear force, color difference and protein molecular weight of prawns were monitored. Results: Compared with the conventional CFPS, the LFEF+CFPS had no significant effect on the content of malondialdehyde, salt-soluble protein, pH, shear force and color of prawn meat. However, after 3 days of storage, LFEF + CFPS treatment significantly inhibit the decrease of Ca2+-ATPase activity, and the Ca2+-ATPase activity of LFEF+CFPS treatment group stored for 15 days was 2.20 times that of the CFPS treatment group. In addition, LFEF + CFPS treatment significantly inhibited the decrease in the density of myosin heavy chain, actin and tropomyosin bands. Conclusion: Compared with conventional CFPS treatment, LFEF + CFPS treatment significantly inhibited the decrease of Ca2+-ATPase activity and protein degradation, maintained the stability of protein structure and properties, and slowed down the deterioration of prawn meat quality.

Studies of environmental chemistry and its related life science are essential to understand the exposure of environmental pollution to living species and the resulted health problems. During this process, mass spectrometry is an indispensably powerful tool thanks to its qualitative and quantitative abilities and remarkable mass resolution. In this review, the state-of-the art mass spectrometric methods were introduced, including inductively coupled plasma mass spectrometry (ICP-MS), electron capture negative ionization mass spectrometry (ECNI-MS), electrospray ionization mass spectrometry (ESI-MS), matrix-assisted laser desorption/ionization mass spectrometry (MALDI-MS), high-resolution tandem mass spectrometry (HR-MS) and native mass spectrometry (nMS) as well as mass spectrometry imaging (MSI), which have been applied in environmental chemistry and the related life science research, with an emphasis on their role in the determination, characterization, discovery and biological impacts research of environmental pollutants in the environmental media, and the related metabolites during life process. Furthermore, the trend of MS methods from fundamental to applied perspectives was outlooked, in order to solve the emerging issues, such as the ambiguous interaction mechanisms of the environmental pollutants and/or their metabolites with biomolecules. It is very much expected that novel MS-based strategy like reactive proteomics approach together with the design of new molecular ruler will help to solve the “mystery” of the environmental pollutants and/or their biological metabolites impacted on a normal physiological process, deepening our understanding on the influence of environmental pollution on health.

The specific surface area and surface hydrophilicity of metal-organic frameworks can be tailored by changing their central metal ions and organic ligands. In this study, the surface of the metal-organic framework MIL-101(Cr) was modified in an aqueous solution of tetrahydropyran via the radiolytic method. A large number of hydroxyl groups were introduced to the surface of MIL-101(Cr), thereby effectively improving its surface hydrophilicity and substantially increasing its specific surface area without changing its central metal ion and organic ligand. Fourier transform infrared spectroscopy and X-ray photoelectron spectroscopy demonstrated that the irradiation products of tetrahydropyran were bound to the surface of MIL-101(Cr) through covalent bonding. X-ray diffractometry demonstrated that the crystal structure of the material was retained after irradiation. The specific surface area of MIL-101(Cr) significantly increased, and water contact angle tests indicated that the surface changed from hydrophobic to hydrophilic after modification. These results show that the irradiation reaction of MIL-101(Cr) with tetrahydropyran significantly improves its specific surface area and hydrophilicity. This study provides guidance on the application of the irradiation method to prepare metal-organic frameworks with various properties by simple and rapid modification.

There are more than 13,000 new cases of cervical cancer each year in the United States and approximately 245,000 survivors. External beam radiation and brachytherapy are the front-line treatment modalities, and 60% of patients develop vaginal damage and constriction, i.e., stenosis of the vaginal vault, greatly impeding sexual function. The incidence of vaginal stenosis (VS) following radiotherapy (RT) for anorectal cancer is 80%. VS causes serious quality of life (QoL) and psychological issues, and while standard treatment using self-administered plastic dilators is effective, acceptance and compliance are often insufficient. Based on published patient preferences, we have pursued the design of a soft inflatable dilator for treating radiotherapy-induced vaginal stenosis (VS). The critical component of the novel device is the dilator balloon wall material, which must be compliant yet able to exert therapeutic lateral force levels. We selected a commercially available silicone elastomer and characterized its stress–strain characteristics and hyperelastic properties. These parameters were quantified using uniaxial tensile testing and digital image correlation (DIC). Dilator inflation versus internal pressure was modeled and experimentally validated in order to characterize design parameters, particularly the dilator wall thickness. Our data suggest that an inflatable silicone elastomer-based vaginal dilator warrants further development in the context of a commercially available, well-tolerated, and effective device for the graded, controlled clinical management of radiotherapy-induced VS.

In this study, four typical metal-organic frameworks (MOFs), (MIL-101 (Cr), ZIF-8, UiO-66, and UiO-66-NH2) were irradiated using electron beam radiation under different atmospheres (air, nitrogen), and dispersion liquids (water, methanol, and ethanol). The chemical composition, crystal structure, and surface morphology of MOFs before and after irradiation were characterized by Fourier transform infrared spectroscopy, X-ray diffraction spectroscopy, and scanning electron microscopy. The results showed that the corresponding infrared characteristic peaks, diffraction peaks, and surface morphology characteristics of all four MOFs did not change significantly after irradiation at the dose of 5 000 kGy, showing good radiation stability. This provides the basis for further application of MOFs in a radiation environment.

There are some shortcomings for Xinjiang Naan prepared by traditional process. In this paper, Naan was prepared by oven. The amino acid composition, flavor substances and infrared spectra of self- made electric oven Naan were investigated, and compared to the commercial Naan. The experimental results showed that there were 17 kinds of amino acids in all samples, and the total amino acid content of self-made Naan was higher than that of commercial naan (P

Traditional textile dyeing processes produce a large amount of wastewater due to the weak interaction and low reaction efficiency between dyes and textiles. In this work, polydimethylaminoethyl methacrylate (PDMA) was successfully grafted onto the surface of cotton fabrics by radiation grafting, as proven by infrared spectral analysis. “Green” dyeing was realized via enhanced interactions between the cotton fabrics and dyes, increased dyeing rates, and reduced organic matter in the wastewater. The effects of the concentration of the monomer and absorbed dose on the grafting rate were systematically studied. A modified cotton fabric was dyed with three primary-color acid dyes (acid red 18, acid blue EA, and acid yellow 23), and the influence of the concentration of the dye on the dyeing rate was studied. The washing wastewater was analyzed. The results showed that the dye utilization was high and the chemical oxygen demand (COD) of the wastewater was lower than the direct emission limit of the national standard using this new method of dyeing. This method is expected to play a significant role in reducing pollution in the dyeing industry.

Objective: To precision survey a fetal congenital primary aphakia molecular etiology. Case report: A case of 42 years old pregnancy woman prenatal diagnostic examination by amniocentesis conducted at 17 weeks' gestation and demonstrated a normal female karyotype. Trio studies based on chromosome microarray analysis (CMA) and Sanger's genetic analysis did not detect a pathologic variant of the FOXE3 gene. Fetal congenital primary aphakia accompanied with microphthalmia detected by sonography in the second trimester (22 weeks). MRI indicated bilateral absence of the lenses, consistent with primary congenital aphakia. Due to the poor prognosis of congenital aphakia, the parents decided to terminate the fetus and provided consent for an autopsy. Pathological analysis revealed dysplasia of the anterior segment of both eyes. However, post fetal mortem extended trio whole exon sequencing (WES) and Sanger's genetic analysis identified compound heterozygous variants in the chromosomal location 2p25.3 in the PXDN gene. Conclusion: Extended whole exon sequencing is an important tool to study primary congenital aphakia.

Objective: To study the etiology of congenital hydrocephalus in genetic aqueduct stenosis. Case report: We report the case of a 31-year-old pregnant female, G2P0A1, with a history of hyperthyroidism under medical control. The patient received regular prenatal care, with no specific findings in the Level II ultrasound at 21 weeks of gestation. However, hydrocephalus was noted at GA 31 weeks. High-resolution sonography and fetal magnetic resonance imaging (MRI) reported fetal aqueduct stenosis. Maternal HSV, CMV, and toxoplasma infection were not detected. Fetal karyotype and chromosomal microarray analysis (CMA) indicated a normal. After intensive counseling, the parents decided to terminate the pregnancy due to the poor fetal prognosis. Post-mortem, a whole-exome sequencing (WES) and Sanger sequencing analysis trio study identified two compound heterozygous variants in the POMT2 gene inherited from both recessive parents. In the subsequent pregnancy, a WES survey revealed inheritance of only the maternal POMT2 gene variant; a live, healthy male baby was born. Conclusion: Extended WES represents a precision maternal medicine tool for novel prenatal diagnosis of congenital aqueduct stenosis.

Objectives: Meningitis in neonates and young infants leads to significant morbidity and mortality worldwide. This study aimed to investigate pathogens, antibiotic resistance and secular change of incidence in Hong Kong. Methods: A retrospective search was performed on meningitis in neonates and infants aged

Introduction PCSK9 inhibitors demonstrated their effectiveness in reducing low-density lipoprotein cholesterol (LDL-C) and cardiovascular events in landmark trials. It remains unclear whether the results can be translated to Asian populations. This study was designed to assess the real-world safety, adherence and efficacy of PCSK9 inhibitors. Methods A retrospective review for patients newly initiated on PCSK9 inhibitors between 1st June 2017 and 31st July 2021 was conducted in a tertiary cardiology centre. Patients aged ≥ 21 years with a minimum one-month follow-up were included. Adverse drug reactions (ADRs), drug discontinuation, adherence patterns and efficacy between evolocumab and alirocumab groups were compared. Multivariable and propensity score adjusted Cox regression analyses were applied to analyse the outcomes. Results Of 87 patients screened, 80 (51 evolocumab; 29 alirocumab) were included. There were no significant differences between evolocumab and alirocumab groups in ADRs (11.8% vs 3.4%, adjusted HR, 2.97; 95% CI, 0.34 – 25.89 in multivariable analysis; adjusted HR, 3.24; 95% CI, 0.38–27.69 after propensity score adjustment) and discontinuation rates (27.5% vs 34.5%, adjusted HR, 0.89; 95% CI, 0.40–2.02 in multivariable analysis; adjusted HR, 0.88; 95% CI, 0.39–1.99 after propensity score adjustment). High medication cost was the main reason for discontinuation. One-third of patients had inadequate adherence to PCSK9 inhibitors. Both groups showed significant reductions of LDL-C compared to baseline. Conclusions PCSK9 inhibitors are efficacious, safe and well tolerated. Further studies are warranted to examine the cost-effectiveness of PCSK9 inhibitors to rationalise their sustainable use for cardiovascular prevention.

Objective: To report a prenatal diagnosis of int22h1/int22h2-mediated Xq28 duplication syndrome. Case report: Herein, we present the case of a 28-year-old female who had a previous ambiguous genitalia pregnancy without genetic abnormality that was terminated at 23+2 weeks of gestation. The fetus of the current pregnancy harbored a de novo copy number variation at the Xq recurrent region (int22h1/int22h2-flanked; including the RAB39B gene) with a 0.397 Mb microduplication. The literature suggests the clinical manifestation of int22h1/int22h2-mediated Xq28 duplication syndrome tends to show a milder clinical phenotype in females than males. Although the fetus in this case was female, taking into consideration the parents' age and culture, the family decided to terminate this pregnancy due to the genetic abnormality. Conclusion: Prenatally diagnosed de novo int22h-1/int22h-2-mediated Xq28 duplication syndrome exhibits variable phenotypic traits in female fetuses.

Objective: To study prenatal diagnosis of congenital Treacher Collins syndrome, an etiology of craniofacial abnormalities. Case report: We present a case of fetal craniofacial abnormalities identified by antepartum sonography screening in the third trimester (28 weeks); features of micrognathia, hypoplastic zygomatic arches and bilateral low-set microtia were detected. Due to the unknown severity of the craniofacial abnormalities and poor prognosis, the parents decided to terminate the fetus after through counselling. A normal female karyotype was detected. The parents consented to chromosome microarray analysis (CMA), which identified a de novo mutation of the TCS1 gene locus on chromosome 5. Conclusion: Molecular CMA is an effective tool for prenatal diagnosis of congenital craniofacial abnormalities associated with Treacher Collins syndrome.

Castleman disease (CD) is a rare chronic lymphoproliferative disease with unknown etiology and pathogenesis disease. When the lesion is located in the mediastinum, the diagnosis of CD is easy. However, if the lesion presents as a perigastric mass mimicking other subserosal gastric mesenchymal tumors, the diagnosis can be challenging. As few sonographic manifestations of hyaline-vascular variant CD, especially contrast-enhanced ultrasound (CEUS) imaging, as well as computed tomography (CT) and histopathological imaging, have been reported in literature, this case may provide a vivid example of a comprehensive CEUS and CT usage in the diagnosis and surgery with regard to CD. This report presents a case of a 50-year-old female diagnosed with hyaline-vascular variant CD in a random physical examination, the ultrasound examination first revealed a 24.3 mm × 15.4 mm hypoechogenic lesion abutting the stomach, esophagus, and liver, which was under the suspicion of gastrointestinal stromal tumor. Following a series of medical examinations, including CEUS, CT, postoperative histopathological examination, and immunohistochemical analysis, the patient was diagnosed with hyaline-vascular variant unicentric CD. After the mass was completely excised through laparoscopic surgery, the woman recovered very well without recurrence during a follow-up period of 15 months. Thus, mastering ultrasound and CT-imaging characteristics of CD and applying ultrasound and CT examination together would do help to preoperative diagnosis.

Abstract Background A number of studies have explored the association between depression and ghrelin, leptin, and cortisol; further, postprandial C-peptide levels have a therapeutic effect on type 2 diabetes mellitus (T2DM). However, the relationship between C-peptide and depression in patients with diabetes, remains unclear. The aim of this study was to explore the association between depression and ghrelin, leptin, cortisol, and C-peptide in patients with diabetes. Methods We enrolled 50 adults without T2DM, 77 non-depressed adults with T2DM (free of Axis-I psychiatric disorders as assessed using the Mental Illness Needs Index (MINI), Patient Health Questionnaire (PHQ-9 score ≤ 4)) and 59 patients with T2DM and depression (PHQ-9 ≥ 7 and positive by the Structured Clinical Interview for DSM-5). The age range of the participants was 45–59 years of age. We compared the above three groups and explored the association between ghrelin, leptin, cortisol, C-peptide, and depression in patients with diabetes. A post-hoc power-analysis was finished. Results Compared with the non-depression T2DM group, the depression T2DM group had significantly higher blood glucose fluctuations. Further, compared with the non-depression T2DM and non-diabetic groups, the depression T2DM group had significantly lower levels of post-meal 2-h C-peptide and elevated evening cortisol (p

INTRODUCTION: Early neoplastic progression of Barretts esophagus (BE) is often treated with endoscopic therapy. Although effective, some patients are refractory to therapy or recur after apparent eradication of the BE. The goal of this study was to determine whether genomic alterations within the treated BE may be associated with persistent or recurrent disease. METHODS: We performed DNA sequencing on pre-treatment esophageal samples from 45 patients who were successfully treated by endoscopic therapy and did not recur as well as pre-treatment and post-treatment samples from 40 patients who had persistent neoplasia and 21 patients who had recurrent neoplasia. The genomic alterations were compared between groups. RESULTS: The genomic landscape was similar between all groups. Patients with persistent disease were more likely to have pre-treatment alterations involving the receptor tyrosine kinase pathway ( P = 0.01), amplifications of oncogenes ( P = 0.01), and deletions of tumor suppressor genes ( P = 0.02). These associations were no longer significant after adjusting for patient age and BE length. More than half of patients with persistent (52.5%) or recurrent (57.2%) disease showed pre-treatment and post-treatment samples that shared at least 50% of their driver mutations. DISCUSSION: Pre-treatment samples were genomically similar between those who responded to endoscopic therapy and those who had persistent or recurrent disease, suggesting there is not a strong genomic component to treatment response. Although it was expected to find shared driver mutations in pre-treatment and post-treatment samples in patients with persistent disease, the finding that an equal number of patients with recurrent disease also showed this relation suggests that many recurrences represent undetected minimal residual disease.

In this study, we will derive the conception of modified (p, h)-convex functions which will unify p-convexity with modified h-convexity. We will investigate the fundamental properties of modified (p, h)-convexity. Furthermore, we will derive the Hermite-Hadamard, Fejér and Jensen’s type inequalities for this generalization.

Convex functions play an important role in many areas of mathematics. They are especially important in the study of optimization problems where they are distinguished by a number of convenient properties. Many generalizations of convex functions exists in literature. The main aim of the article is to develop fractional integral inequalities for generalized strongly modified h-convex functions. Based on obtained fractional type integral inequalities we give some applications to the means. Our results are extension and generalization of many existing results.

Let $G=(V(G),E(G))$ be a graph. An ordered set of vertices $\Re=\{v_1,v_2,\ldots,v_l\}$ is a $2-$resolving set for $G$ if for any distinct vertices $s,w \in V(G)$, the representation of vertices $r(s|\Re)=(d_G(s,v_1),\ldots,d_G(s,v_l))$ and $r(w|\Re)=(d_G(w,v_1),\ldots, d_G(w,v_l))$ differs in at least $2$ positions. A $2-$resolving set of minimum cardinality is called a $2-$metric basis of $G$ and its cardinality is called the $2-$metric dimension (fault-tolerant metric dimension). In this article, the exact value of the $2-$metric dimension of the family circulant graph $C_n(1,2)$ is computed and thereby disproving the conjecture given by H. Raza et al., [Mathematics. 2019, 7(1), 78]. The $2-$metric dimension of the family generalized prism graph $P_m\times C_n$ and the Möbius ladder graph $M_n$ is computed. Furthermore, we improved the result given by M. Ali et al., [Ars Combinatoria 2012, 105, 403-410].

In the article, we establish a Simpson-type generalized identity containing multi-parameters and derive some new estimates for the generalized Simpson’s quadrature rule via the Raina fractional integrals. As applications, we provide several inequalities for the f -divergence measures and probability density functions.

Introduction Spinal cord injury (SCI) alters the integrity of the spinal cord, which leads to loss of multiple organs’ function including locomotor function. The present study evaluates the protective effect of tabersonine against SCI. Material and methods SCI was induced by traumatic injury and animals were treated with tabersonine 20 and 40 mg/kg, intraperitoneally for the period of 10 days. Tabersonine’s effect was determined by estimating locomotor and neurological function in spinal cord injured rats. Moreover, mediators of inflammation were estimated using enzyme-linked immunosorbent assay (ELISA) and the effect of tabersonine on Notch/inflammasome signaling was estimated by reverse transcription polymerase chain reaction (RT-PCR), western blot assay and immunohistochemistry. Apoptosis of neuronal cells was estimated by staining with Nissl stain on spinal cord tissue in SCI rats. Results Data of the study suggest that neurological and motor functions were improved in the tabersonine treated group compared to the spinal cord injured (SI) group. There was a decrease in the mediators of inflammation in the spinal cord tissue of the tabersonine treated group compared to the SI group. Treatment with tabersonine ameliorates the altered expression of NICD, Nestin and Hes-1 protein and mRNA expression of Notch-1 and Hes-1 in the SCI rats. It was also observed that the tabersonine treated group showed activation of CREB and inhibition of the NLRP-3 pathway in SCI rats. Moreover, apoptosis of neuronal cells was reduced in the tabersonine treated group compared to the SI group. Conclusions Data of the investigation suggest that tabersonine protects against spinal cord injury by activating CREB and reducing NLRP3/Notch signaling.

An optimization design and application of high temperature–resistant shielding material was carried out according to the nuclear power plant source characteristics and special protection requirements such as loss-of-coolant accident (LOCA). The composition of lead–boron polyethylene shielding composite was optimized based on the genetic algorithm and Monte Carlo methods and then realized by blending modification and graft copolymerization to improve its high temperature–resistant, shielding, and mechanical properties. Then comprehensive properties such as mechanical, neutron shielding, damp heat aging, irradiation resistance, and high temperature resistance were tested. These experiments proved that the high temperature–resistant lead–boron polyethylene shielding composite has excellent performance; especially, as it is able to keep a complete structure in a high-temperature environment of up to 190°C for 48 h. Finally, the shielding composite was applied to the shielding door design of a reactor pit chamber. When the shield thickness is 60 mm, the level of the neutron dose rate was reduced by 10 times, and that of the γ dose rate was reduced by 5 times, which meets all the requirements of radiation protection safety for nuclear power plants.