Resilience among older adults with multimorbidity using the Connor-Davidson scale in the Canadian Longitudinal Study on Aging: health behaviour, socio-economic, and social support predictors.

OBJECTIVE: Multimorbidity is recognized as a serious health condition faced by a majority of older adults. Research investigating adaptive responses to multimorbidity, termed multimorbidity resilience, has been growing. This paper examines protective and risk factors, with a focus on health behaviours, socio-economic resources, and social support using an established measure of resilience (Connor-Davidson Resilience Scale) among older adults, focusing on older persons with two or more concurrent chronic conditions. METHODS: Using Baseline (2011-2015), Follow-up One (2015-2018), and Follow-up Two (2018-2021) data from the Comprehensive Cohort of the Canadian Longitudinal Study on Aging, we tested hypotheses using 13,064 participants aged 65 years and older, who completed all waves and reported two or more of 27 chronic conditions, for the full sample of multimorbid individuals and three multimorbidity clusters: Cardiovascular/Metabolic, Musculoskeletal, and Mental Health. Associations between protective and risk factors and resilience were examined using linear regression to model the Connor-Davidson resilience scale, adjusting for illness context and social determinants of health. RESULTS: Among all multimorbid individuals, the strongest associations with resilience were found for higher self-rated health, greater sleep satisfaction, better appetite, higher household income, more relatives and friends, being overweight (compared to normal weight), fewer housing problems, and fewer skipped meals. Weaker associations were found for non-smokers, less alcohol consumption, less pain, sedentary behaviour, being non-married (compared to married), and among Canadian born (compared to foreign). The analyses for the three multimorbidity clusters were largely replicated for the three multimorbidity clusters, but with some nuances depending on the cluster. DISCUSSION: This research provides confirmatory evidence for several protective and risk factors affecting the ability to cope and recover from multimorbidity adversity among older adults. There are consistent patterns for the multimorbidity disease clusters, but some distinct relationships arise that are worthy of attention. The implications of the findings for modifiable health behaviours and socio-economic factors are discussed for their public health and clinical relevance.

A nitrogen-responsive cytokinin oxidase/dehydrogenase regulates root response to high ammonium in rice.

Plant root system is significantly influenced by high soil levels of ammonium nitrogen, leading to reduced root elongation and enhanced lateral root branching. In Arabidopsis, these processes have been reported to be mediated by phytohormones and their downstream signaling pathways, while the controlling mechanisms remain elusive in crops. Through a transcriptome analysis of roots subjected to high/low ammonium treatments, we identified a cytokinin oxidase/dehydrogenase encoding gene, CKX3, whose expression is induced by high ammonium. Knocking out CKX3 and its homologue CKX8 results in shorter seminal roots, fewer lateral roots, and reduced sensitivity to high ammonium. Endogenous cytokinin levels are elevated by high ammonium or in ckx3 mutants. Cytokinin application results in shorter seminal roots and fewer lateral roots in wild-type, mimicking the root responses of ckx3 mutants to high ammonium. Furthermore, CKX3 is transcriptionally activated by type-B RR25 and RR26, and ckx3 mutants have reduced auxin content and signaling in roots under low ammonium. This study identified RR25/26-CKX3-cytokinin as a signal module that mediates root responses to external ammonium by modulating of auxin signaling in the root meristem and lateral root primordium. This highlights the critical role of cytokinin metabolism in regulating rice root development in response to ammonium.

Effects of outdoor activity time, screen time, and family socioeconomic status on physical health of preschool children.

Objective: Experienced 3 years of pandemic-induced home life, in the post-epidemic period, preschoolers in China are falling short of the World Health Organization's standards for screen time and outdoor activities. This notably impacts their physical well-being. The study aims to probe the associations between screen time, outdoor activities, and the physical health of preschoolers, offering insights to shape interventions targeting myopia and obesity prevention in children. Methods: A cross-sectional study was conducted in Guangdong Province, involving a representative sample of 23,992 preschoolers and their caregivers recruited through proportional stratified cluster sampling. Data collection utilized the Chinese Early Human Capability Index (CHeHCI, eHCi), a questionnaire on children's media use in daily family life, and Body Mass Index (BMI). Linear regression and binary logistic regression models were employed to analyze the impact of screen time and outdoor activity duration on the physical health of preschoolers. Results: In the high family socioeconomic status (SES) group, children had significantly less screen time compared to those in the medium and low SES groups. Outdoor activity time varied significantly based on SES, with higher SES linked to extended outdoor engagement. Additionally, children's eHCi health dimension score exhibited significant SES-related differences, showcasing higher scores for children in higher SES groups. In terms of gender differences, boys dedicated significantly more time to outdoor activities than girls, yet boys had a notably higher overweight rate. Furthermore, girls demonstrated better health outcomes based on eHCi health scores. A significant association emerged between overweight and screen time in children with high SES, indicating that prolonged screen time was linked to a higher likelihood of overweight based on BMI. Additionally, a substantial negative correlation was observed between children's eHCi health dimension score and screen time. Furthermore, children's outdoor activity time exhibited a significant positive correlation with eHCi health dimension score. Regression analysis revealed that screen time could significantly negatively predict children's physical health score, while outdoor activity time could significantly positively predict children's eHCi physical health score. Conclusion: The current study highlights that family SES, age, and gender play pivotal roles in influencing preschoolers' screen time and outdoor activity duration, with family SES being particularly influential. Higher family SES correlates with reduced screen time, increased outdoor activity, and elevated health levels among children. Importantly, children's screen time negatively predicts their health status, while outdoor time positively predicts their health status.

Comparing long-term prognosis following different surgical methods in patients with early stage breast cancer and obesity: a retrospective cohort study in China.

OBJECTIVE: Breast-conserving therapy (BCT) includes breast-conserving surgery (BCS) combined with radiation therapy (RT). RT plays a crucial role in improving the prognosis of patients who undergo BCS. However, obesity is a potential risk factor for resistance to radiation. The aim of this study was to evaluate any difference in the long-term prognosis of patients with early stage breast cancer and obesity treated with BCT or total mastectomy (TM). DESIGN, SETTING AND PARTICIPANTS: This was a retrospective cohort study involving 1125 patients diagnosed with early stage breast cancer and obesity at the Shanghai Cancer Center of Fudan University from 2013 to 2016. OUTCOME MEASURES: Obesity in the Chinese population was defined as a body mass index ≥28 kg/m2. Surgical options included BCT and TM. The primary survival outcomes were overall survival (OS), disease-free survival (DFS) and recurrence-free survival (RFS). Inverse probability of treatment weighting (IPTW) was used to control for the impact of confounding factors on prognosis. RESULTS: The median follow-up times in the BCT group and TM group without postoperative RT were 51.1 months (IQR of 40.6-68.1 months) and 61.8 months (IQR of 46.5-76.7 months), respectively. After IPTW, the baseline data were balanced. Compared with those in the TM cohort, patients in the whole IPTW cohort in the BCT cohort had worse DFS (HR 4.280, 95% CI 2.180 to 8.400; p<0.001), RFS (HR 4.380, 95% CI 2.370 to 8.120; p<0.001) and OS (HR 3.590, 95% CI 1.620 to 7.950; p=0.002). CONCLUSION: In patients with early stage breast cancer and obesity, TM is associated with better survival outcomes than BCT.

Energy efficient cluster-based routing protocol for WSN using multi-strategy fusion snake optimizer and minimum spanning tree.

In recent years, the widespread adoption of wireless sensor networks (WSN) has resulted in the growing integration of the internet of things (IoT). However, WSN encounters limitations related to energy and sensor node lifespan, making the development of an efficient routing protocol a critical concern. Cluster technology offers a promising solution to this challenge. This study introduces a novel cluster routing protocol for WSN. The system selects cluster heads and relay nodes utilizing the multi-strategy fusion snake optimizer (MSSO) and employs the minimum spanning tree algorithm for inter-cluster routing planning, thereby extending the system's lifecycle and conserving network energy. In pursuit of an optimal clustering scheme, the paper also introduces tactics involving dynamic parameter updating, adaptive alpha mutation, and bi-directional search optimization within MSSO. These techniques significantly increase the algorithm convergence speed and expand the available search space. Furthermore, a novel efficient clustering routing model for WSN is presented. The model generates different objective functions for selecting cluster heads and relay nodes, considering factors such as location, energy, base station distance, intra-cluster compactness, inter-cluster separation, and other relevant criteria. When selecting cluster heads, the fuzzy c-means (FCM) algorithm is integrated into MSSO to improve the optimization performance of the algorithm. When planning inter-cluster routing, the next hop node is selected for the relay node based on distance, residual energy, and direction.The experimental results demonstrate that the proposed protocol reduces energy consumption by at least 26.64% compared to other cluster routing protocols including LEACH, ESO, EEWC, GWO, and EECHS-ISSADE. Additionally, it increases the network lifetime of WSN by at least 25.84%, extends the stable period by at least 52.43%, and boosts the network throughput by at least 40.99%.

Dispersion of Single-Walled Carbon Nanotubes by Aromatic Cyclic Schiff Bases via Non-Covalent Interactions.

One of the challenging issues that hinders the application of single-walled carbon nanotubes (SWCNTs) is the poor solubility and the inevitable formation of bundles. Efforts still need to be made towards solving the problem. Herein, we report a non-covalent strategy to disperse aggregated SWCNTs by aromatic cyclic Schiff bases assisted by ultrasonic techniques. The aromatic cyclic Schiff base (OMM) was synthesized via Schiff base reactions, and the molecular structure was determined by ATR-FT-IR, solid-state 13C-NMR, and HRMS. Although the yielded product showed poor solubility in aqueous solution and organic solvents, it could interact with and disperse the aggregated SWCNTs in dimethyl formamide (DMF) under the condition of ultrasound. UV-vis-NIR, FL, Raman spectra, AFM, and TEM, along with computer simulations, provide evidence for the interactions between OMM molecules and SWCNTs and the dispersion thereof. The semiconductive (7,5), (8,6), (12,1), and (9,7)-SWCNTs expressed a preference for dissolution. The capability of dispersion is contributed by π-π, C-H·π, and lone pair (lp)·π interactions between OMM and SWCNTs based on the simulated results. The present non-covalent strategy could provide inspiration for preparing organic cyclic compounds as dispersants for SWCNTs and then facilitate their further utilization.

Survey on hospice care attitude of family members of advanced cancer patients at different ages.

BACKGROUND: Hospice care plays an important role in improving the quality of life of advanced cancer patients, but controversy remains over whether age affects the attitudes of family members toward hospice care. AIM: To investigate the attitudes of family members of advanced cancer patients of different ages toward hospice care. METHODS: The study participants were 175 family members of patients with advanced cancer from January 2020 and October 2022. The participants were divided into youth (< 40 years, n = 65), middle-aged (40-60 years, n = 59), and elderly (> 60 years, n = 51) groups. Researchers investigated and compared the degree of awareness regarding hospice care, attitudes, and whether the family members of patients would choose hospice care. RESULTS: Among the family members of 175 patients, approximately 28% (49/175) were aware of hospice care. Awareness of hospice care, the proportion of hospice care acceptance and adaptation attitudes, and the proportion of those who chose hospice care in the youth group were higher in the middle-aged and elderly groups (P < 0.05). No statistically significant difference was found in these three indicators between the middle-aged and elderly groups (P > 0.05). Hospice care was chosen mainly to relieve pain and reduce unnecessary treatment, whereas the reasons for not choosing hospice care were mainly distrust and ethical concerns. CONCLUSION: The family members of patients with advanced cancer had relatively low awareness of hospice care, while youth had a higher awareness of hospice care, acceptance, and adaptation attitudes, and were more willing to choose hospice care.

METTL1-modulated LSM14A facilitates proliferation and migration in glioblastoma via the stabilization of DDX5.

Glioblastoma (GBM) is characterized by aggressive growth, invasiveness, and poor prognosis. Elucidating the molecular mechanisms underlying GBM is crucial. This study explores the role of Sm-like protein 14 homolog A (LSM14A) in GBM. Bioinformatics and clinical tissue samples analysis demonstrated that overexpression of LSM14A in GBM correlates with poorer prognosis. CCK8, EdU, colony formation, and transwell assays revealed that LSM14A promotes proliferation, migration, and invasion in GBM in vitro. In vivo mouse xenograft models confirmed the results of the in vitro experiments. The mechanism of LSM14A modulating GBM cell proliferation was investigated using mass spectrometry, co-immunoprecipitation (coIP), protein half-life, and methylated RNA immunoprecipitation (MeRIP) analyses. The findings indicate that during the G1/S phase, LSM14A stabilizes DDX5 in the cytoplasm, regulating CDK4 and P21 levels. Furthermore, METTL1 modulates LSM14A expression via mRNA m7G methylation. Altogether, our work highlights the METTL1-LSM14A-DDX5 pathway as a potential therapeutic target in GBM.

Flame synthesis of nanoparticles based on high flux electrostatic atomization burner.

This study presents an innovative electrostatic spray flame synthesis (ESFS) reactor that combines the advantages of electrostatic spray and flame synthesis for precise spray control and efficient single-step continuous synthesis. To overcome the limitations of conventional ESFS systems, which often suffer from low atomized precursor flux, we successfully demonstrated a high-flux disk electrostatic atomizer coupled low-swirl flame reactor, achieving a precursor flux of up to 30 ml/h about 30 times higher than that of typical ESFS devices. The atomized precursor being rapidly carried away from the burner is undergoing high-temperature pyrolysis and particle formation through lifted premixed turbulent flames. The ESFS system provides extensive control over parameters such as flame temperature, equivalence ratio, residence time, initial droplet sizes, and precursor concentrations. For illustrative purposes, the ESFS system was utilized to synthesize silica nanoparticles, demonstrating the capability of synthesizing nanoparticles with various properties. By manipulating the collection position and height, the particle size has made a substantial leap from the nanoscale to the micrometer level. This remarkable achievement underscores the system's enormous potential for precise particle size regulation and one-step synthesis of complex structured thin films.

Exploring the association between type 2 diabetes and fecal incontinence in american adults: insights from a large cross-sectional study.

BACKGROUND: The relationship between fecal incontinence (FI) and type 2 diabetes (T2D) has been well recognized, but a comprehensive understanding of this relationship is lacking, taking into account demographic factors and lifestyle variables. METHODS: Using a cross-sectional approach, 13,510 adults aged 20 years and older were identified from the 2005-2010 National Health and Nutrition Examination Survey. Multivariate logistic regression models were used to calculate the adjusted odds ratios (ORs), and further subgroup analyses and propensity score analysis were performed to ensure stable results. RESULTS: Among 13,510 adults, 11.2% had T2D, and 8.8% had FI. We found a strong T2D-FI link (OR: 1.30; 95% CI: 1.09-1.54, P < 0.001), even after adjusting for covariates. Age > 45 was a critical factor, with a stronger T2D-FI association. Sedentary behavior (OR: 1.41; 95% CI: 1.15-1.73) in T2D patients were associated with FI. CONCLUSIONS: Our study highlights the significant T2D-FI link in US adults, especially in older T2D patients. Lifestyle changes may reduce FI risk. More research is needed for causality and mechanisms.

[Effects and Mechanisms of Polystyrene Microplastics on Extracellular Antibiotic Resistance Genes in Wastewater].

Microplastics (MPs) and antibiotic resistance genes (ARGs) are typical co-existing emerging pollutants in wastewater treatment plants. MPs have been shown to alter the distribution pattern of ARGs in sludge, but their effects on free extracellular ARGs (feARGs) in wastewater remain unclear. In this study, we used fluorescence quantitative PCR to investigate the dynamics of feARGs (including tetC, tetO, sul1, and sul2) in wastewater and their transition mechanisms after 60 d of exposure to typical MPs (polystyrene, PS). The results showed that the absolute abundance of tetracycline feARGs decreased by 28.4 %-76.0 % and 35.2 %-96.2 %, respectively, under nm-level and mm-level PS exposure and changed by -55.4 %-122.4 % under µm-level PS exposure. The abundance of sul1 showed a trend of nm-level > µm-level > mm-level upon PS exposure, and the changes in sul1 abundance was greater with ρ(PS)=50 mg·L-1 exposure. The relative abundance of sul2 was reduced by 25.4 %-42.6 % and 46.1 %-90.3 % after µm-level and mm-level PS exposure, respectively, and increased by 1.9-3.9 times after nm-level PS exposure, and the sul2 showed a higher reduction at ρ (PS)=50 mg·L-1 exposure than that at ρ (PS)=0.5 mg·L-1. The Pearson correlation analysis showed that the relative abundance of feARGs during PS exposure was positively correlated with cell membrane permeability and typical mobile genetic elements (intI1) abundance and negatively correlated with reactive oxygen species level. Our findings elucidated the effects and corresponding mechanisms of PS on the growth and mobility of feARGs in wastewater, providing a scientific basis for the control of the combined MPs and ARGs pollution in wastewater.

GSOOA-1DDRSN: Network traffic anomaly detection based on deep residual shrinkage networks.

One of the critical technologies to ensure cyberspace security is network traffic anomaly detection, which detects malicious attacks by analyzing and identifying network traffic behavior. The rapid development of the network has led to explosive growth in network traffic, which seriously impacts the user's information security. Researchers have delved into intrusion detection as an active defense technology to address this challenge. However, traditional machine learning methods struggle to capture complex threats and attack patterns when dealing with large-scale network data. In contrast, deep learning methods have the advantages of automatically extracting features from network traffic data and strong generalization capabilities. Aiming to enhance the ability of network anomaly traffic detection, this paper proposes a network traffic anomaly detection based on Deep Residual Shrinkage Network (DRSN), namely "GSOOA-1DDRSN". This method uses an improved Osprey optimization algorithm to select the most relevant and essential features in network traffic, reducing the features' dimensionality. For better detection performance of network traffic anomalies, a one-dimensional deep residual shrinkage network (1DDRSN) is designed as a classifier. Validation is performed using the NSL-KDD and UNSW-NB15 datasets and compared with other methods. The experimental results show that GSOOA-1DDRSN has improved multi-classification accuracy, precision, recall, and F1 Score by approximately 2 % and 3 %, respectively, compared to the 1DDRSN model on two datasets. Additionally, it reduces the time computation costs by 20 % and 30 % on these datasets. Furthermore, compared to other models, GSOOA-1DDRSN offers superior classification accuracy and effectively reduces the number of features.

Identification and characterization of two Bacillus anthracis bacteriophages.

Anthrax is an acute infectious zoonotic disease caused by Bacillus anthracis, a bacterium that is considered a potential biological warfare agent. Bacillus bacteriophages shape the composition and evolution of bacterial communities in nature and therefore have important roles in the ecosystem community. B. anthracis phages are not only used in etiological diagnostics but also have promising prospects in clinical therapeutics or for disinfection in anthrax outbreaks. In this study, two temperate B. anthracis phages, vB_BanS_A16R1 (A16R1) and vB_BanS_A16R4 (A16R4), were isolated and showed siphovirus-like morphological characteristics. Genome sequencing showed that the genomes of phages A16R1 and A16R4 are 36,569 bp and 40,059 bp in length, respectively. A16R1 belongs to the genus Wbetavirus, while A16R4 belongs to the genus Hubeivirus and is the first phage of that genus found to lyse B. anthracis. Because these two phages can comparatively specifically lyse B. anthracis, they could be used as alternative diagnostic tools for identification of B. anthracis infections.

Intrinsically Stretchable Organic Thermoelectric Polymers Enabled by Incorporating Fused-Ring Conjugated Breakers.

While research on organic thermoelectric polymers is making significant progress in recent years, realization of a single polymer material possessing both thermoelectric properties and stretchability for the next generation of self-powered wearable electronics is a challenging task and remains an area yet to be explored. A new molecular engineering concept of "conjugated breaker" is employed to impart stretchability to a highly crystalline diketopyrrolepyrrole (DPP)-based polymer. A hexacyclic diindenothieno[2,3-b]thiophene (DITT) unit, with two 4-octyloxyphenyl groups substituted at the tetrahedral sp3-carbon bridges, is selected to function as the conjugated breaker that can sterically hinder intermolecular packing to reduce polymers' crystallinity. A series of donor-acceptor random copolymers is thus developed via polymerizing the crystalline DPP units with the DITT conjugated breakers. By controlling the monomeric DPP/DITT ratios, DITT30 reaches the optimal balance of crystalline/amorphous regions, exhibiting an exceptional power factor (PF) value up to 12.5 µW m-1 K-2 after FeCl3-doping; while, simultaneously displaying the capability to withstand strains exceeding 100%. More significantly, the doped DITT30 film possesses excellent mechanical endurance, retaining 80% of its initial PF value after 200 cycles of stretching/releasing at a strain of 50%. This research marks a pioneering achievement in creating intrinsically stretchable polymers with exceptional thermoelectric properties.

Impact of obesity on sentinel lymph node biopsy outcomes and survival in breast cancer patients: A single-center retrospective study.

BACKGROUND: Sentinel lymph node biopsy (SLNB) is a common choice for axillary surgery in patients with early-stage breast cancer (BC) who have clinically negative lymph nodes. Most research indicates that obesity is a prognostic factor for BC patients, but studies assessing its association with the rate of positive sentinel lymph nodes (SLN) and the prognosis of patients with early BC undergoing SLNB are limited. METHODS: Between 2013 and 2016, 7062 early-stage BC patients from the Shanghai Cancer Center of Fudan University were included. Based on the Chinese Body Mass Index (BMI) classification standards, the patients were divided into three groups as follows: normal weight, overweight, and obese. Propensity score matching analysis was used to balance the baseline characteristics of the participants. Logistic regression analysis was used to determine the association between obesity and positive SLN rate. Cox regression analysis was used to investigate whether obesity was an independent prognostic factor for early-stage BC patients who had undergone SLNB. RESULTS: No significant association was observed between obesity and positive SLN rate in early-stage BC patients who had undergone SLNB. However, multivariate analysis revealed that compared to patients with normal BMI, the overall survival (hazard ratio (HR) 2.240, 95% confidence interval (CI) 1.27-3.95, p = 0.005) and disease-free survival (HR 1.750, 95% CI 1.16-2.62, p = 0.007) were poorer in patients with high BMI. CONCLUSION: Obesity is an independent prognostic factor for early-stage BC patients who undergo SLNB; however, it does not affect the positive SLN rate.

Volunteering among Older Adults and Effects of Ethnic Minority Status before and during the COVID-19 Pandemic: Longitudinal Analyses of the CLSA.

The COVID-19 pandemic has presented numerous challenges to older adults in Canada, including the ability to volunteer. The purpose of this study is to improve the understanding of the social context surrounding volunteering in Canada, by (a) determining changes in associations between human, social, and cultural capital and volunteering among older adults; and (b) examining the relationship between ethnic minority status and volunteering, using data from the Canadian Longitudinal Study on Aging (CLSA), collected prior to and during the pandemic. This study utilized data from 24,306 CLSA Baseline, Follow-up 1 (FUP1), and COVID-19 Baseline Survey participants (aged 55+). Results confirm a decrease in volunteering during the early stages of the pandemic. Compared to pre-pandemic associations, volunteers during the early stages of the pandemic were more likely to be young-old, male, employed, and not involved in religious activities. Findings provide evidence of pandemic effects on volunteering among older adults in Canada.

Consulting doctors online after offline treatment: investigating the effects of online information on patients' effective use of online follow-up services.

Introduction: The use of online follow-up services (OFUS) is becoming an increasingly important supplement to hospital care. Through OFUS, patients can find their doctors in online health communities (OHCs) and receive remote medical follow-ups after hospital treatment. However, the rate of effective use of OFUS by current patients is still low, and there is an urgent need for research to investigate the online information factors that affect patients' effective use of OFUS. Methods: Based on the elaboration likelihood model (ELM) of persuasion and an analysis of a panel dataset including 3,672 doctors in a leading OHC in China, this study explores how online information from doctors' knowledge contributions and patient feedback influences patients' effective use of OFUS. Results: The results show that both doctors' knowledge contributions and patient feedback positively influence patients' effective use of OFUS. Doctors' paid knowledge contributions and patients' paid feedback have stronger persuasive effects than doctors' free knowledge contributions and patients' free feedback, respectively. Moreover, there is a substitutional relationship between doctors' paid and free knowledge contributions and between patients' paid and free feedback in influencing patients' effective use of OFUS. Discussion: The findings of this study suggest that OHC platforms and healthcare providers should account not only for the persuasive effects of doctors' knowledge contributions and patient feedback but also for influential differences and relationships between the types of doctors' knowledge contributions and patient feedback to better persuade patients to effectively use OFUS.

Treatment of malignant airway obstruction with Y-shape sigma stent loaded with I125 seeds installed via rigid bronchoscopy.

PURPOSE: To summarize and analyze the safety and efficacy of a Y-shape Sigma stent loaded with I125 in patients with inoperable malignant main airway obstruction. METHODS: This study was approved by the Institutional Ethics Committee, and a written informed consent was obtained from each participant. A Y-shape Sigma stent loaded with I125 was placed under vision from rigid bronchoscopy. The primary endpoint was alleviation of symptoms and improvement of Karnofsky Performance Status (KPS) score, and the secondary endpoint was complications and technical success. RESULTS: From November 2018 through June 2023, total 33 patients with malignant airway obstruction were palliatively treated by installing Y-shape Sigma stents loaded with I125. The airway lumen was immediately restored and the average airway opening significantly increased to 70 ± 9.4% after the procedure from baseline 30.2 ± 10.5% (p < 0.05). Average KPS score was improved from baseline 30.0 ± 10.0 to 70.0 ± 10.0 (p < 0.05) as well as PaO2 from baseline 50.1 ± 15.4 mmHg to 89.3 ± 8.6 mmHg (p < 0.05). The technical success rate of placing the stent in this study was 73%, and adverse events or complications including bleeding, I125 loss, and airway infection occurred during or after the procedure. CONCLUSION: Placement of Y-shape Sigma stents under vision from rigid bronchoscopy in the patients with malignant airway obstruction is feasible and it immediately alleviates dyspnea and significantly improves quality of life.

Catalytic asymmetric construction of helicenes via transformation of biaryls.

This review showcases a systematic overview of the available tools for the catalytic asymmetric transformation of biaryl substrates toward the construction of challenging enantioenriched helicenes and the conceptual aspects associated with each type of transformation. Depending on the properties of the biaryl and the nature of the process, several methodologies have been developed, including olefin metathesis, hydroarylation of alkynes, C-X (X = C, O, N) coupling, and C-H functionalization. Pioneering studies and an array of representative reactions are discussed to underscore the potential of these synthetic protocols.