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Abstract Background The global population’s aging has led to an increasing demand for long-term care (LTC), especially in developing countries like China. Comprehensive assessment of LTC service demands by including the time and cost analysis is crucial to inform the planning and financing of LTC resources, yet such research is lacking in China. Our research team has developed a quantitative index system of the medical and nursing services needs of older adults (QISMNSNE) based on the framework of Time-Driven Activity-Based Costing (TDABC), providing a valuable tool for measuring LTC service needs. This study aimed to assess the LTC service needs of older adults in China and the factors associated with such needs. Methods A cross-sectional study was conducted in Changsha City, Hunan Province, China, from June 2021 to December 2022. A stratified multistage cluster sampling method was used to recruit 1,270 older adults from five nursing homes and three communities/streets in three regions of Changsha City. The LTC service needs were assessed by calculating the service time required from caregivers, nurses, and doctors and the total service time (min/d) using the QISMNSNE. Participants’ disability, activities of daily living (ADLs), mental status and social involvement (MSSI), and sensory and communication (SC) were assessed using standard scales. Generalized linear regression models were used to analyze factors associated with LTC service needs. Results The participants had an average age of 76.41 ± 8.38 years, with 43.7% being female. The median service time required from caregivers, nurses, and doctors was 53.34 min/d, 3.66 min/d, and 0.33 min/d, respectively, and the total service time was 83.31 min/d. The generalized linear regression model identified the following factors that were associated with higher total service time: aged 75–84 years, living in nursing homes, income over 5000 per month, ADLs, MSSI (9 ~ 40), SC, and having 3 ~ 4 kinds of geriatric comorbidity (P

Abstract Background Alzheimer's disease is one common type of dementia. Numerous studies have suggested a correlation between Alzheimer's disease and inflammation. Microglia mainly participate in the inflammatory response in the brain. Currently, ample evidence has shown that microglia are closely related to the occurrence and development of Alzheimer's disease. Objective We opted for bibliometric analysis to comprehensively summarize the advancements in the study of microglia in Alzheimer's disease, aiming to provide researchers with current trends and future research directions. Methods All articles and reviews pertaining to microglia in Alzheimer's disease from 2000 to 2022 were downloaded through Web of Science Core Collection. The results were subjected to bibliometric analysis using VOSviewer 1.6.18 and CiteSpace 6.1 R2. Results Overall, 7449 publications were included. The number of publications was increasing yearly. The United States has published the most publications. Harvard Medical School has published the most papers of all institutions. Journal of Alzheimer’s Disease and Journal of Neuroscience were the journals with the most studies and the most commonly cited, respectively. Mt Heneka is the author with the highest productivity and co-citation. After analysis, the most common keywords are neuroinflammation, amyloid-beta, inflammation, neurodegeneration. Gut microbiota, extracellular vesicle, dysfunction and meta-analysis are the hotspots of research at the present stage and are likely to continue. Conclusion NLRP3 inflammasome, TREM2, gut microbiota, mitochondrial dysfunction, exosomes are research hotspots. The relationship between microglia-mediated neuroinflammation and Alzheimer's disease have been the focus of current research and the development trend of future research.

AbstractThe complete mitochondrial genomes of two spine-color individuals, red and white, of the tropical sea urchin species Tripneustes gratilla (Linnaeus, 1758) were sequenced on Illumina system platform. The red-spined species had a genome size of 15,774 bp, while the white-spined species had a genome size of 15,723 bp. Both genomes contained 13 protein-coding genes, 2 rRNA genes, and 22 tRNA genes. The GC composition in both species was above 40%. In order to investigate the phylogenetic relationships of two different spine-color individuals, a comprehensive analysis was conducted using eight complete mitochondrial genomic sequences of the genus Tripneustes on the software MEGA X. It was observed that the two spine color types of T. gratilla species showed a high similarity of 98.91%. However, different color-spined species of T. gratilla were found in separate branches of the phylogenetic tree of the same sea urchin species.

Abstract Objective The purpose of this study was to translate the Awareness of Rights Scale into Chinese and test its psychometric properties among nursing students in clinical practice. Methods The original English scale was translated, synthesized, and back-translated according to the Brislin translation model: the translated scale was cross-culturally adapted through expert correspondence and pretesting to form the Chinese version of the scale; a convenience sampling method was used to survey 486 nursing interns in Liaoning, Guangdong, and Anhui regions to assess the reliability and validity of the scale. Results The Chinese version of the scale consists of 14 items in three dimensions. The Cronbach’s alpha value of the scale was 0.916 and the range of Cronbach’s alpha coefficients of subscale was 0.768 to 0.894. The discounted half reliability was 0.867 and the retest reliability was 0.901. The scale content validity index (S-CVI) was 0.963. A total of three common factors were extracted for the exploratory factor analysis. The confirmatory factor analysis indices fit well (χ2/df = 1.092, RMSEA = 0.014, CFI = 0.998, IFI = 0.998. TLI = 0.997), and the model fit was good. Conclusion The Chinese version of the scale has good reliability and validity in the nursing intern population and can be used to assess nursing interns’ awareness of their rights in clinical practice in mainland China.

AbstractContext A Chinese herbal formula, Tiaopi Xiezhuo decoction (TXD), is developed from a classical Chinese prescription Sanhuang Xiexin decoction.Objective To investigate the regulatory effect of TXD on gut dysbiosis, as a treatment of constipation in patients with peritoneal dialysis (PD).Materials and methods The chemical content of TXD was assessed by high-performance liquid chromatography. A total of 29 PD patients were enrolled and treated with TXD orally (3 g crude drug/each/twice/day) for 3 months. Blood and faecal samples were collected at the beginning and end, to determine the changes in biochemical characteristics and gut microbial composition. The stool conditions were asked to be scored. Additional 30 healthy individuals were recruited as a control for the analysis of gut microbiota.Results Although having no significant effects on serum biochemical characteristics, 3-month TXD intervention improved constipation in PD patients: decreased 80% abdominal distention (p

Abstract Each step in angiogenesis is regulated by the extracellular matrix (ECM). Accumulating evidence indicates that ageing-related changes in the ECM driven by cellular senescence lead to a reduction in neovascularisation, reduced microvascular density, and an increased risk of tissue ischaemic injury. These changes can lead to health events that have major negative impacts on quality of life and place a significant financial burden on the healthcare system. Elucidating interactions between the ECM and cells during angiogenesis in the context of ageing is neceary to clarify the mechanisms underlying reduced angiogenesis in older adults. In this review, we summarize ageing-related changes in the composition, structure, and function of the ECM and their relevance for angiogenesis. Then, we explore in detail the mechanisms of interaction between the aged ECM and cells during impaired angiogenesis in the older population for the first time, discussing diseases caused by restricted angiogenesis. We also outline several novel pro-angiogenic therapeutic strategies targeting the ECM that can provide new insights into the choice of appropriate treatments for a variety of age-related diseases. Based on the knowledge gathered from recent reports and journal articles, we provide a better understanding of the mechanisms underlying impaired angiogenesis with age and contribute to the development of effective treatments that will enhance quality of life.

Background. Using a toxin-induced lethal acute liver failure (ALF) monkey model, we have recently shown that early peripheral infusion of human umbilical cord mesenchymal stem cells (hUC-MSCs) can alleviate liver damage and improve animal survival by suppressing the activation of circulating monocytes and the subsequent cytokine storm. Here, we explored whether the administration of hUC-MSCs could still improve ALF when the cytokine storm is fully developed. Method. We treated ALF monkeys with peripheral delivery of hUC-MSCs at 48 hr after toxin challenge. Liver indices, histology, imaging, and animal survival were recorded and analyzed. Results. In our cohort study, we conducted and demonstrated that the infusion of hUC-MSCs significantly improved liver histology, effectively controlled inflammatory cytokine storms, and increased survival rates. Additionally, the administration of a higher dose of hUC-MSCs (2 × 107/monkey) yielded superior outcomes compared to a lower dose (1 × 107/monkey). Conclusion. Treatment of hUC-MSCs can significantly improve the pathological and survival outcomes of ALF even when the cytokine storm has been fully developed, indicating a promising clinical solution for ALF.

Background: Single-cell sequencing (SCS) is a technique used to analyze the genome, transcriptome, epigenome, and other genetic data at the level of a single cell. The procedure is commonly utilized in multiple fields, including neurobiology, immunology, and microbiology, and has emerged as a key focus of life science research. However, a thorough and impartial analysis of the existing state and trends of SCS-related research is lacking. The current study aimed to map the development trends of studies on SCS during the years 2010–2022 through bibliometric software.Methods: Pertinent papers on SCS from 2010 to 2022 were obtained using the Web of Science Core Collection. Research categories, nations/institutions, authors/co-cited authors, journals/co-cited journals, co-cited references, and keywords were analyzed using VOSviewer, the R package “bibliometric”, and CiteSpace.Results: The bibliometric analysis included 9,929 papers published between 2010 and 2022, and showed a consistent increase in the quantity of papers each year. The United States was the source of the highest quantity of articles and citations in this field. The majority of articles were published in the periodical Nature Communications. Butler A was the most frequently quoted author on this topic, and his article “Integrating single-cell transcriptome data across diverse conditions, technologies, and species” has received numerous citations to date. The literature and keyword analysis showed that studies involving single-cell RNA sequencing (scRNA-seq) were prominent in this discipline during the study period.Conclusion: This study utilized bibliometric techniques to visualize research in SCS-related domains, which facilitated the identification of emerging patterns and future directions in the field. Current hot topics in SCS research include COVID-19, tumor microenvironment, scRNA-seq, and neuroscience. Our results are significant for scholars seeking to identify key issues and generate new research ideas.

A scenario robust fall detection system based on few-shot learning (FDFL) in wireless environment was designed.The performance of existing fall detection methods based on Wi-Fi channel state information (CSI) degrades significantly across scenarios, which requires collecting and marking a large number of CSI samples in each application scenario, resulting in high cost for large-scale deployment.Therefore, the method of few-shot learning was introduced, which can maintain the performance of fall detection with high accuracy when the number of annotated samples in unfa-miliar scenes is insufficient.The proposed FDFL was mainly divided into two stages, source domain meta-training and target domain meta-learning.The meta training stage of the source domain consists of two parts: data preprocessing and classification training.In the data preprocessing stage, the collected original CSI amplitude and phase data were denoised and segmented.In the classification training stage, a large number of processed source domain data samples were used to train a CSI feature extractor based on convolutional neural network.In the meta-learning stage of the target domain, the limited labeled data sampled in the target domain was effectively extracted based on the feature extractor trained in the meta-training module, and then a lightweight machine learning classifier was trained to detect the fall behavior under the cross-scene.Through several experiments in different scenarios, FDFL can achieve an average accuracy of 95.52% for the four classification tasks of falling, sitting, walking and sit down with only a small number of samples in the target domain, and maintain robust detection accuracy for changes in test environment, personnel target and equipment location.

In order to study the characteristics of low frequency oscillation of summer precipitation over Qinghai-Xizang Plateau， based on the daily precipitation data of 62 meteorological stations over the Qinghai-Xizang Plateau from 1978 to 2017 and the high-resolution daily reanalysis data of ERA5.This paper adopted the collection of empirical mode decomposition （EEMD）， Lanczos filter and synthesis analysis method.Filter out the years of drought and flood， and analyzed the characteristics of low frequency oscillation， variation of meteorological elements and circulation of precipitation in dry and flood years in summer over the Qinghai-Xizang Plateau.Reveals the drought and flood years， the characteristics of low frequency oscillation period of precipitation in plateau area， the circulation characteristics and low frequency and other transmission characteristics of wind field and vorticity field.The results show that： （1） There is an oscillation period of 10~20 days in summer precipitation over the Qinghai-Xizang Plateau.The period frequency of drought and flood years is different， the oscillation frequency of flood years is obviously higher than that of drought years.In flood years， the significant oscillation is 10~20 days and 30-days oscillation， while in drought years， the oscillation is mainly 10~20 days.（2） In flood years， the low-frequency precipitation phase is strong， the high-altitude low-frequency cyclones control the plateau， the high-altitude divergence， the low-altitude convergence.The water vapor supply from the south of the Bay of Bengal， and the low-frequency disturbance is strong， which is conducive to the occurrence of precipitation， there is an abnormal circulation distribution of low-frequency anticyclone- low-frequency cyclone- low-frequency anticyclone from west to east.On the contrary， in the low frequency precipitation weak phase， the high frequency anticyclone controlled the main body of the plateau， high altitude convergence， low altitude divergence， the warm and wet southerly air is weak， the disturbance is weak， not conducive to the occurrence of precipitation.The distribution of low-frequency anticyclone， low-frequency cyclones and low-frequency anticyclone is not obvious in drought years， and the oscillation intensity is not as strong as that in flood years， and the intensity of low-frequency element field is weak.（3） The transmission of low-frequency fluctuation is different in drought and flood years.In flood years， the high and low plateau is the sink area of low-frequency oscillation， and the meridian is also the convergence area.The precipitation in the oscillation sink area is more frequent， so the precipitation in flood years is more.In the dry years， the low-frequency oscillation propagates upward from the plateau to the upper level， so the low-frequency precipitation occurs less in the dry years.

Abstract Developing cost‐efficient bifunctional water splitting catalysts is crucial for sustainable hydrogen energy applications. Herein, ruthenium (Ru)‐incorporated and phosphorus (P)‐doped nickel molybdate (Ru‐NiMoO(P)4) nanosheet array catalysts are synthesized. Due to the synergy of Ru clusters and NiMoO(P)4 by the modulated electronic structure and the rich active sites, impressively, Ru‐NiMoO(P)4 exhibits superior OER (194 mV @ 50 mA cm−2) and HER (24 mV @ 10 mA cm−2) activity in alkaline media, far exceeding that of commercial Pt/C and RuO2 catalysts. Meanwhile, as bifunctional catalyst, to drive the overall water splitting at the current density of 10 mA cm−2, Ru‐NiMoO(P)4 requires only 1.45 V and maintaining stable output for 100 h. Furthermore, Ru‐NiMoO(P)4 also possesses excellent capability for seawater electrolysis hydrogen production. Moreover, the successful demonstration of wind and solar hydrogen production systems provide the feasibility of the ultra‐low Ru loading catalyst for large‐scale hydrogen production in the future.

Abstract Background This study aimed to evaluate the effect of virtual cement space and restorative materials on the fit of computer-aided design and computer-aided manufacturing (CAD-CAM) endocrowns. Methods A mandibular first molar tooth model received a butt joint margin endocrown preparation with a 2-mm occlusal thickness. Then, using a 3D-printing system, 120 copies of this prepared die were printed and assigned equally to three groups with different cement space settings (30, 60, and 120 μm) during the chairside CAD design. In the milling process, CAD-based models with a particular space setting were subdivided into four groups (n = 10) and fabricated from different CAD-CAM materials: Vita Suprinity (VS), Celtra Duo (CD), Lava Ultimate (LU), and Grandio blocs (GR). Finally, the endocrowns were stabilized over their corresponding models with siloxane and subjected to micro-computed tomography to measure the fit. Results The cement space that was predesigned at 30 μm generated the largest marginal discrepancy (from 144.68 ± 22.43 μm to 174.36 ± 22.78 μm), which was significantly different from those at 60 μm and 120 μm (p

ObjectiveTo explore the effects of inspiratory muscle training (IMT) on hypertension and provide guidance for its clinical application as an auxiliary approach.MethodsArticles published prior to July 2022 were searched in Cochrane Library, Web of Science, PubMed, Embase, CNKI, and Wanfang databases. Included were randomized controlled studies that used IMT to treat individuals with hypertension. The mean difference (MD) was computed using the Revman 5.4 software. In individuals with hypertension, the effects of IMT on systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and pulse pressure (PP) were compared and studied.ResultsThere were found to be eight randomized controlled trials totaling 215 patients. According to a meta-analysis, the IMT reduced the SBP (MD: −12.55 mmHg, 95% CI: −15.78, −9.33), DBP (MD: −4.77 mmHg, 95% CI: −6.00, −3.54), HR (MD: −5.92 bpm, 95% CI: −8.72, −3.12), and PP (MD: −8.92 mmHg, 95% CI: −12.08, −5.76) in patients with hypertension. In subgroup analyses, low-intensity IMT showed a better reduction in SBP (MD: −14.47 mmHg, 95% CI: −17.60, −11.34), DBP (MD: −7.70 mmHg, 95% CI: −10.21, −5.18).ConclusionIMT may become an auxiliary means to improve the four hemodynamic indexes (SBP, DBP, HR and PP) in patients with hypertension. In subgroup analyses, low-intensity IMT was more effective in regulating blood pressure than medium-high-intensity IMT.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42022300908.

As the "water tower of Asia"， it’s of great significance to study the precipitation sources of the Qinghai-Xizang Plateau for China's water security and water resources utilization.Using the methods of diagnostic analysis and Lagrangian model simulation， a heavy rainfall in Naqu caused by the plateau vortex was analyzed and studied， the source of water vapor in the Naqu area was determined and the contribution of the water vapor source area to the summer precipitation in the study area was further quantified.The results show that there is a strong upward movement over Naqu and has good water vapor conditions.Many strong convective cloud clusters have been formed successively， forming short-term heavy precipitation.The majority of target air blocks that affect precipitation come from the relatively low atmosphere south of the target area and can be traced back to the Bay of Bengal， Arabian Sea and Indian Ocean.In addition， a small part of the target gas block in the western path of the Qinghai-Xizang Plateau comes from the middle and lower atmospheres.High-level water vapor is mainly transported by high-pressure anticyclones in South Asia.A few blocks of gas come from eastern China and the South China Sea.The transportation of water vapor along the western and southern borders is the main source of heavy precipitation in Naqu.The main sources of water vapor are the Indian Ocean， Arabian Sea， India， the Bay of Bengal， Xinjiang， and Central Asia.The water vapor from the Indian Ocean and the Arabian Sea plays a key water vapor contribution to the precipitation area， and the local water vapor contribution is negligible.

Artificial Intelligence has been widely applied in intelligent transportation systems. In this work, Swin-APT, a deep learning-based approach for semantic segmentation and object detection in intelligent transportation systems is presented. Swin-APT includes a lightweight network and a multiscale adapter network designed for image semantic segmentation and object detection tasks. An inter-frame consistency module is proposed to extract more accurate road information from images. Experimental results on four datasets: BDD100K, CamVid, SYNTHIA, and CeyMo, demonstrate that Swin-APT outperforms the baseline by 13.1%. Furthermore, experiments on the road marking detection benchmark show an improvement of 1.85% of mAcc.

Background: Stroke is one of the leading causes of mortality and permanent disability worldwide. However, the current stroke treatment has a limited effect. Therefore, a new treatment is urgently needed. Stem cell therapy is a cutting-edge treatment for stroke patients. This study aimed to gain better understanding of global stem cell trends in stroke via a bibliometric analysis.Methods: We used the Web of Science Core Collection to search pertinent articles about stem cells in stroke published between 2004 and 2022. Analysis was conducted using CiteSpace, VOSviewer, and the R package “bibliometrix” to identify publication outputs, countries/regions, institutions, authors/co-cited authors, journals/co-cited journals, co-cited references, and keywords.Results: A total of 6,703 publications were included in the bibliometric analysis. The total number of citations significantly and rapidly increased between 2004 and 2022, with the most pronounced growth pattern observed in the period of 2008–2009. In terms of authoritarian countries, the USA had the most publications among the countries. As for institutions and authors, the most prolific institution was the University of South Florida, followed by Oakland University and then Shanghai Jiao Tong University, and Chopp, M. and Borlongan, Cesario V, had the most output among the authors. Regarding the journals, Cell Transplantation had the highest publication, followed by Brain Research. As for references, “Mesenchymal stem cells as trophic mediators” was the most frequently cited (2,082), and the article entitled Neuronal replacement from endogenous precursors in the adult brain after stroke had the strongest burstiness (strength = 81.35). Emerging hot words in the past decade included “adhesion molecule,” “mesenchymal stromal cell,” “extracellular vesicle,” “pluripotent stem cells,” “signaling pathway,” “plasticity,” and “exosomes.”Conclusion: Between 2004 and 2022, the terms “neurogenesis,” “angiogenesis,” “mesenchymal stem cells,” “extracellular vesicle,” “exosomes,” “inflammation,” and “oxidative stress” have emerged as the hot research areas for research on stem cells in stroke. Although stem cells exert a number of positive effects, the main mechanisms for mitigating the damage caused by stroke are still unknown. Clinical challenges may include complicating factors that can affect the efficacy of stem cell therapy, which are worth a deep exploration.

BackgroundOne of the main objectives of stroke rehabilitation is to alleviate post-stroke spasticity. Over the recent years, many studies have explored the potential benefits of whole-body vibration (WBV) treatment for post-stroke spasticity, but it is still controversial.ObjectiveThe current study aims to assess the efficacy and safety of WBV for post-stroke spasticity and determine the appropriate application situation.MethodsFrom their establishment until August 2022, the following databases were searched: PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Medline, China National Knowledge Infrastructure (CNKI), and Wanfang. Only randomized controlled trials (RCTs) that were published in either English or Chinese were taken into consideration. We independently filtered the research, gathered the data from the studies, and evaluated the research quality (Cochrane RoB tool) and the overall evidence quality (GRADE). Rev Man 5.4 software was utilized to conduct statistical analysis.ResultsIn this analysis, 11 RCTs with 475 patients that reported on the effectiveness of WBV therapy for post-stroke spasticity were taken into account. Compared to the control groups, the results revealed that WBV combined with conventional rehabilitation at a vibration frequency lower than 20 Hz (SMD = −0.58, 95% CI: −0.98 to −0.19, P = 0.004) was more effective in relieving upper (SMD = −0.53, 95% CI: −1.04 to 0.03, P = 0.03) and lower limb spasticity (SMD = −0.21, 95% CI: −0.40 to −0.01, P = 0.04); similarly, it was superior for patients aged under 60 years (SMD = −0.41, 95% CI: −0.66 to −0.17, P = 0.0008) with acute and subacute stroke (SMD = −0.39, 95% CI: −0.68 to −0.09, P = 0.01). The valid vibration for reducing spasticity was found to last for 10 min (SMD = −0.41, 95% CI: −0.75 to −0.07, P = 0.02). None of the included studies revealed any serious adverse impact.ConclusionModerate-quality evidence demonstrated when WBV was used as an adjuvant, vibration

ObjectiveIn this study, we aimed to investigate the effects of non-invasive brain stimulation (NIBS) on cognitive and motor functions in patients with multiple sclerosis (pwMS).MethodsA literature search was performed in the Cochrane Library, Embase, PubMed, Web of Science, Medline, CNKI, and Wan fang. The time interval used for database construction was up to December 2022, and the language was not limited. The collected trials were subsequently screened, the data were extracted, the quality was evaluated, and the effect sizes were computed using STATA/MP Version 13 for outcome analysis. Standard mean difference (SMD) and 95% confidence interval (CI) were calculated for domain of interest.ResultsIn total, 17 articles that examined 364 patients with multiple sclerosis were included in this analysis. Non-invasive brain stimulation did not improve the overall cognitive function [SMD = 0.18, 95% CI (−0.32, 0.69), P = 0.475] but helped improve motor function in patients [SMD = 0.52, 95% CI (0.19, 0.85), P = 0.002]. Moreover, this study specifically indicated that non-invasive brain stimulation improved alerting [SMD = 0.68, 95% CI (0.09, 1.26), P = 0.02], whereas non-invasive brain stimulation intervention improved motor function in patients aged

AimsTo assess emergency department (ED) nurses' ability to communicate with angry patients and to explore the factors that influence nurses' communication skills.DesignA cross-sectional survey design.MethodsThis study was conducted in November and December 2020. Stratified sampling was adopted to recruit ED nurses from 18 tertiary hospitals in western, eastern, and central China to complete an online questionnaire. The Nurses' Communication Ability with Angry Patients Scale (NCAAPS) and the General Self-Efficacy Scale were used to assess ED nurses' communication ability and self-efficacy, respectively. Descriptive statistics, the Mann–Whitney U-test, the Kruskal–Wallis H test, Spearman's correlation analysis, and the generalized linear model were used for data analysis.ResultsA total of 679 valid questionnaires were collected. The mean total score for the NCAAPS was (3.79 ± 0.47), while the scores for its four dimensions were (3.87 ± 0.59) for communication skills, (3.82 ± 0.59) for anger perception, (3.79 ± 0.53) for self-preparation, (3.73 ± 0.54) for exploring the cause of anger. The generalized linear regression analysis result showed that a longer employment duration, previous communication ability training, and higher self-efficacy were significantly and independently associated with higher NCAAPS scores (p < 0.05).ConclusionsThe mean total score and the four dimensions score for the NCAAPS were moderate. But there is still room for improvement in ED nurses' ability to communicate with angry patients. “Exploring the cause of anger” was the lowest score among the four dimensions. To improve ED nurses' ability to communicate with angry patients, future studies should focus on constructing specific communication training, improving nurses' ability to explore the cause of anger and self-efficacy.ImpactThe findings of this study provide important insights into ED nurses' ability to communicate with angry patients and can thus guide the future development of intervention programmes to improve this ability among ED nurses.

Abstract Purpose This study aimed to evaluate the influence of different types of restorative materials and resin cements on the stress distribution in the regions of the restoration, cement layer and dental remnant in endodontically treated posterior endocrowns. Methods A 3D finite element analysis (FEA) model of the first mandibular molar that was restored with an endocrown designed by computer-aided design (CAD) software was generated. Three kinds of restorative materials (Vita Enamic (VE), IPS e.max CAD (EMX) and Grandio blocs (GR)) and two types of cementing materials (NX3 and Maxcem Elite Chroma (MX)) were analysed with such a model. The food layer was also designed before vertical (600 N) forces were applied to simulate physiological masticatory conditions. Thermal expansion was used to simulate the polymerization shrinkage effects of cement layers. The results were obtained by colorimetric graphs of the maximum principal stress in the restoration and tooth remnant. The failure risk of the cement layer was also calculated based on the normal stress. Results The elastic modulus was positively correlated with the tensile stress peak values in the restoration, mainly at the intaglio surface. However, in the cervical enamel and cement layer, restorative material with a higher elastic modulus generated lower peak stress values. The cement with a higher elastic modulus resulted in higher stress peak values inside the cement layer. The combination of EMX (restorative material) and NX3 (cement material) in the cement layer resulted in the lowest failure risk. Significance The ceramic material EMX with a higher elastic modulus appeared to be more effective at protecting the cement layer and residual enamel tissue. Based on the analysis of the failure risk of the cement layer, the combination of EMX and NX3 was recommended as an optional material for endocrowns for endodontically treated posterior teeth.

Summary: Our recent study has found that gut bacteria Enterococcus faecalis contributes to hypertension and upregulates lysophospholipase A1 (LYPLA1) in the renal medulla of rats. This work aimed to investigate the role of LYPLA1 in the development of E. faecalis-induced hypertension. Compared to control, E. faecalis treatment increased blood pressure (BP), serum angiotensin II, sodium reabsorption, and expression of αENaC and LYPLA1 in the renal medulla of mice, and these effects were attenuated by knockdown of LYPLA1. Moreover, the intrarenal lypla1 overexpression increased sodium reabsorption and BP. Further studies showed that LYPLA1 promoted the accumulation of renal glycerophosphocholine (GPC), which directly elevated the expression of αENaC and sodium reabsorption. In addition, enriched abundance of LYPLA1 in the renal medulla and urine was also observed in other hypertensive animals. Overall, our results demonstrate that LYPLA1 contributes to E. faecalis-induced hypertension by accumulating GPC and activating ENaC in the renal medulla.

Interactions between fibroblasts and immune cells play an important role in tissue inflammation. Previous studies have found that eosinophils activated with interleukin-3 (IL-3) degranulate on aggregated immunoglobulin G (IgG) and release mediators that activate fibroblasts in the lung. However, these studies were done with eosinophil-conditioned media that have the capacity to investigate only one-way signaling from eosinophils to fibroblasts. Here, we demonstrate a coculture model of primary normal human lung fibroblasts (HLFs) and human blood eosinophils from patients with allergy and asthma using an open microfluidic coculture device. In our device, the two types of cells can communicate via two-way soluble factor signaling in the shared media while being physically separated by a half wall. Initially, we assessed the level of eosinophil degranulation by their release of eosinophil-derived neurotoxin (EDN). Next, we analyzed the inflammation-associated genes and soluble factors using reverse transcription quantitative polymerase chain reaction (RT-qPCR) and multiplex immunoassays, respectively. Our results suggest an induction of a proinflammatory fibroblast phenotype of HLFs following the coculture with degranulating eosinophils, validating our previous findings. Additionally, we present a new result that indicate potential impacts of activated HLFs back on eosinophils. This open microfluidic coculture platform provides unique opportunities to investigate the intercellular signaling between the two cell types and their roles in airway inflammation and remodeling.

With an aging population, kidney health becomes an important medical and socioeconomic factor. Kidney aging mechanisms are not well understood. We previously showed that podocytes isolated from aged mice exhibit increased expression of programmed cell death protein 1 (PD-1) surface receptor and its 2 ligands (PD-L1 and PD-L2). PDCD1 transcript increased with age in microdissected human glomeruli, which correlated with lower estimated glomerular filtration rate and higher segmental glomerulosclerosis and vascular arterial intima-to-lumen ratio. In vitro studies in podocytes demonstrated a critical role for PD-1 signaling in cell survival and in the induction of a senescence-associated secretory phenotype. To prove PD-1 signaling was critical to podocyte aging, aged mice were injected with anti–PD-1 antibody. Treatment significantly improved the aging phenotype in both kidney and liver. In the glomerulus, it increased the life span of podocytes, but not that of parietal epithelial, mesangial, or endothelial cells. Transcriptomic and immunohistochemistry studies demonstrated that anti–PD-1 antibody treatment improved the health span of podocytes. Administering the same anti–PD-1 antibody to young mice with experimental focal segmental glomerulosclerosis (FSGS) lowered proteinuria and improved podocyte number. These results suggest a critical contribution of increased PD-1 signaling toward both kidney and liver aging and in FSGS.

Abstract Background Endocrown restoration is widely used to restore endodontically treated teeth. However, the clinical effects of different computer-aided design/computer-aided manufacturing (CAD/CAM) materials for endocrown restoration are not clear. The primary objective of this trial is to compare the clinical efficacy of resin-based bloc and ceramic endocrowns for restoring endodontically treated teeth. Methods The proposed resin-based bloc and ceramic endocrown assessment trial is a parallel group-designed randomized controlled trial. We will recruit 156 adults between 18 and 75 years old with a minimum of one such molar. The inclusion criteria were good oral hygiene habits, root apex of molar without evident damage, receipt of standard endodontic treatment, need for endocrown restoration, and only one endocrown restoration performed per patient. Patients participating in another study or those with systemic diseases, disabilities, or known allergies to used materials will be excluded. All patients will be randomized and restored with resin-based bloc and ceramic endocrown according to a random number table. Clinical evaluations will be performed at baseline and after treatment at 6, 12, and 24 months, in accordance with the modified Federation Dentaire Internationale (FDI) criteria, by two independent evaluators. The primary outcome is marginal adaptation; secondary outcomes include wear, tooth integrity, fracture of material and retention, marginal staining, and patient view. All data will be analyzed by an independent statistician. Signed rank-sum tests will be used for intragroup comparisons. Wilcoxon rank-sum tests will be used for intergroup comparisons. Hierarchical logistic regression will be used to adjust the baseline and other important indicators. Discussion This study will investigate endocrowns of two CAD/CAM materials for endodontically treated molars. The results may help clinicians choose the better CAD/CAM material option and explain to patients the advantages and disadvantages of these two materials with evidence-based support. For patients, the results may lead to improvement in long-term restoration. Trial registration ClinicalTrials.gov NCT04033380 . Registered on 24 July 2019

The COVID-19 pandemic, which has ravaged the world, has led to a rethinking of the relationship between humans and nature and the clichés of the economic-centered model. Thus, the ecological economy has been reviewed, especially from an ethical worldview. This paper uses statistical methods to retrieve and categorize 3,646 wildlife crime cases for analysis and quantitative research. It adopts legal and ethical perspectives to analyze the subject and the subjective, incidence, and sentencing factors of wildlife crimes and uses the ecological economic ethical model to measure wildlife crimes. We argue that the existing judicial system fails to answer the difficulties of the economic ethics of wildlife crimes. It is recommended that ecological and economic ethical awareness be internalized. We suggest calling for comprehensive legislation on wildlife crimes from the perspective of ecological economic ethics to effectively prevent and reduce wildlife crime and eventually promote public health.

Background: Osteogenesis imperfecta (OI) is a clinical and genetic disorder that results in bone fragility, blue sclerae and dentineogenesis imperfecta (DGI), which is mainly caused by a mutation in the COL1A1 or COL1A2 genes, which encode type I procollagen.Case Report: A missense mutation (c.1463G > C) in exon 22 of the COL1A1 gene was found using whole-exome sequencing. However, the cases reported herein only exhibited a clinical DGI-I phenotype. There were no cases of bone disease or any other common abnormal symptom caused by a COL1A1 mutation. In addition, the ultrastructural analysis of the tooth affected with non-syndromic DGI-I showed that the abnormal dentine was accompanied by the disruption of odontoblast polarization, a reduced number of odontoblasts, a reduction in hardness and elasticity, and the loss of dentinal tubules, suggesting a severe developmental disorder. We also investigated the odontoblast differentiation ability using dental pulp stem cells (DPSCs) that were isolated from a patient with DGI-I and cultured. Stem cells isolated from patients with DGI-I are important to elucidate their pathogenesis and underlying mechanisms to develop regenerative therapies.Conclusion: This study can provide new insights into the phenotype-genotype association in collagen-associated diseases and improve the clinical diagnosis of OI/DGI-I.

We report a radio-over-fiber (ROF) access network with multiple high-repetive frequency mm-wave signals generation utilizing a dual-parallel Mach-Zehnder modulator (DP-MZM) and an semiconductor optical amplifier (SOA) for multiple base stations (BSs). In the scheme, at the central station (CS), signal and pump with frequency interval of 8fRF are generated by properly adjusting the parameters of the DP-MZM. After FWM in a SOA, new converted optical signals are obtained. Two tones of the optical signals are selected by using tunable optical filter (TOF), which are then sent into a photodiode (PD) to generate multiple mm-wave signals with different frequencies (8fRF, 16fRF, and 24fRF) for different BSs. Based on the proposed scheme, the mm-wave signals with frequencies of 20, 40, and 60 GHz carrying 2.5 Gb/s signal by a 2.5GHz RF signal have been generated by numerical simulation. Simulation results show that the proposed ROF system architecture with multiple-frequency millimeter-wave signals generation serving multiple BSs can work well. This scheme can raise the capacity of ROF system, reduce the requirement of the repetitive frequency of the driven RF signal, and support multiple mm-wave wireless access for BSs.

As life expectancy continues to rise, age-related diseases are becoming more prevalent. For example, proteinuric glomerular diseases typified by podocyte injury have worse outcomes in the elderly compared with young patients. However, the reasons are not well understood. We hypothesized that injury to nonaged podocytes induces senescence, which in turn augments their aging processes. In primary cultured human podocytes, injury induced by a cytopathic antipodocyte antibody, adriamycin, or puromycin aminonucleoside increased the senescence-related genes CDKN2A (p16INK4a/p14ARF), CDKN2D (p19INK4d), and CDKN1A (p21). Podocyte injury in human kidney organoids was accompanied by increased expression of CDKN2A, CDKN2D, and CDKN1A. In young mice, experimental focal segmental glomerulosclerosis (FSGS) induced by adriamycin and antipodocyte antibody increased the glomerular expression of p16, p21, and senescence-associated β-galactosidase (SA-β-gal). To assess the long-term effects of early podocyte injury-induced senescence, we temporally followed young mice with experimental FSGS through adulthood (12 m of age) and middle age (18 m of age). p16 and Sudan blackstaining were higher at middle age in mice with earlier FSGS compared with age-matched mice that did not get FSGS when young. This was accompanied by lower podocyte density, reduced canonical podocyte protein expression, and increased glomerular scarring. These results are consistent with injury-induced senescence in young podocytes, leading to increased senescence of podocytes by middle age accompanied by lower podocyte lifespan and health span. [ABSTRACT FROM AUTHOR]