Using a Zipper Device to Minimize Scarring After Excision of Facial Nevi in Pediatric Patients.

BACKGROUND: This study aims to investigate the safety and effectiveness of using a zipper device to minimize scarring after facial nevi excision in pediatric patients. METHODS: A total of 48 patients were included, with 23 in the control group and 25 in the zipper group. The zipper device was used immediately to equalize skin tension after facial nevi excision. The primary outcome was the scar width measured at 1, 3, 6, and 12 months postoperatively. The Vancouver Scar Scale (VSS) was used to assess patients' scars at postoperative 12 months as a secondary outcome. RESULTS: Two patients in the zipper group withdrew from the trial due to skin irritation. The symptom disappeared within a week after the zipper device was removed. The scar width in the zipper group was smaller than that in the control group at postoperative 1, 3, 6, and 12 months. In addition, the VSS scores for scarring also showed that patients in the zipper group had significantly better scar scores than those in the control group. At postoperative 6 months, scar morphology was essentially similar to that at post 12 months in both groups, and there was a significant positive correlation between scar morphology at the 2 time points. CONCLUSION: It is safe and effective to use this zipper device to minimize scarring after excision of facial nevi in pediatric patients, and we think it be a complementary therapeutic measure in pediatric patients after facial nevus excision. LEVEL OF EVIDENCE: II.

How to Stimulate Continuous Innovative Knowledge Contribution? Mediation by Self-Efficacy and Moderation by Knowledge Level.

Taking the perspective of innovative knowledge management, this study aimed to investigate the stimulation mechanism of continuous innovative knowledge contribution (CIKC). Through a quantitative study conducted in an open innovation community, we modeled a stimulus-organism-response framework to conduct a path analysis from the external environment to internal cognition, and then to knowledge contribution, and filled in the gaps in the mediating and moderating mechanisms. We focused on the stimuli of knowledge contribution, in view of both quantity and quality. Panel data from six periods in one year was collected for dynamic analysis, and we used the fixed effect model to test our hypotheses of mediation effect, moderation effect, and mediated-moderation effect. There were some interesting findings, showing that user's self-efficacy plays a partial mediating role in the quantity, rather than the quality, of CIKC; meanwhile, the users' knowledge level plays a moderating role, and there is a negative moderating mechanism of knowledge level in the process from participation value to the quality of CIKC.

Density functional theory guide for copolymerization mechanism between allyl radical with radicalophile: photo-driven radical mediated [3 + 2] cyclization.

CONTEXT: The challenge of activating inert allyl monomers for polymerization has persisted, prompting our proposal of the photo-driven radical mediated [3 + 2] cyclization reaction (PRMC). This innovative approach significantly expedites the homopolymerization of multi-allyl monomers, enabling the synthesis of embolic microspheres for hepatocellular carcinoma interventions. PRMC involves allyl monomers to form allylic radicals and then radicals participating in a cycloaddition reaction with unsaturated olefins as radicalophiles to form cyclopentane-based radical products. While extensively studied in the theoretical and experimental homopolymerization, PRMC's application in copolymerization remains unexplored. To address this knowledge gap, we explored the elementary reaction, selecting allyl methyl ether radicals (AMER) and α,ß-unsaturated ketones as radicalophiles for copolymerization investigations by density functional theory (DFT) analysis. We quantified energy differences between ground and excited states of reactants, elucidated frontier molecular orbitals, and assessed thermodynamic data for copolymerization feasibility. We also evaluated the electronic properties of reactants, predicting the reactivity of radicalophiles and the interactions of intermolecular reactions. Additionally, we applied transition state theory and interaction/deformation models and conducted a local orbital analysis to comprehensively study excess electron distribution and gyration radius of cyclic radical product. Our findings offer vital insights into PRMC's potential in copolymerization. This research provides a robust theoretical foundation for practical application, enhancing the polymerization field. METHODS: Based on density functional theory (DFT), the calculations were performed at the M06-2X/6-311 + + G(d,p) level in/by Gaussian 16 package. Subsequently, our analytical results apply time-dependent density-functional theory (TD-DFT) and solvent modeling (SMD). Single-point energy calculations determine the driving force behind the radicals' reaction with radicalophiles. Furthermore, we assessed the electrostatic potential (ESP) of the reactants. The results of the calculations were visualized by the Multiwfn 3.6 and VMD 1.9 programs.

circMTO1/miR-30c-5p/SOCS3 axis alleviates oral submucous fibrosis through inhibiting fibroblast-myofibroblast transition.

BACKGROUND: circRNAs have been shown to participate in diverse diseases; however, their role in oral submucous fibrosis (OSF), a potentially malignant disorder, remains obscure. Our preliminary experiments detected the expression of circRNA mitochondrial translation optimization 1 homologue (circMTO1) in OSF tissues (n = 20) and normal mucosa tissues (n = 20) collected from Hunan Xiangya Stomatological Hospital, and a significant decrease of circMTO1 expression was showed in OSF tissues. Therefore, we further explored circMTO1 expression in OSF. METHODS: Target molecule expression was detected using RT-qPCR and western blotting. The migration and invasion of buccal mucosal fibroblasts (BMFs) were assessed using wound healing and Transwell assays. The interaction between miR-30c-5p, circMTO1, and SOCS3 was evaluated using dual luciferase, RNA immunoprecipitation (RIP), and RNA pull-down assays. The colocalisation of circMTO1 and miR-30c-5p was observed using fluorescence in situ hybridisation (FISH). RESULTS: circMTO1 and SOCS3 expression decreased, whereas miR-30c-5p expression increased in patients with OSF and arecoline-stimulated BMFs. Overexpression of circMTO1 effectively restrained the fibroblast-myofibroblast transition (FMT), as evidenced by the increase in expression of Coll I, α-SMA, Vimentin, and the weakened migration and invasion functions in BMFs. Mechanistic studies have shown that circMTO1 suppresses FMT by enhancing SOCS3 expression by sponging miR-30c-5p and subsequently inactivating the FAK/PI3K/AKT pathway. FMT induced by SOCS3 silencing was reversed by the FAK inhibitor TAE226 or the PI3K inhibitor LY294002. CONCLUSION: circMTO1/miR-30c-5p/SOCS3 axis regulates FMT in arecoline-treated BMFs via the FAK/PI3K/AKT pathway. Expanding the sample size and in vivo validation could further elucidate their potential as therapeutic targets for OSF.

DP-GAN+B: A lightweight generative adversarial network based on depthwise separable convolutions for generating CT volumes.

X-rays, commonly used in clinical settings, offer advantages such as low radiation and cost-efficiency. However, their limitation lies in the inability to distinctly visualize overlapping organs. In contrast, Computed Tomography (CT) scans provide a three-dimensional view, overcoming this drawback but at the expense of higher radiation doses and increased costs. Hence, from both the patient's and hospital's standpoints, there is substantial medical and practical value in attempting the reconstruction from two-dimensional X-ray images to three-dimensional CT images. In this paper, we introduce DP-GAN+B as a pioneering approach for transforming two-dimensional frontal and lateral lung X-rays into three-dimensional lung CT volumes. Our method innovatively employs depthwise separable convolutions instead of traditional convolutions and introduces vector and fusion loss for superior performance. Compared to prior models, DP-GAN+B significantly reduces the generator network parameters by 21.104 M and the discriminator network parameters by 10.82 M, resulting in a total reduction of 31.924 M (44.17%). Experimental results demonstrate that our network can effectively generate clinically relevant, high-quality CT images from X-ray data, presenting a promising solution for enhancing diagnostic imaging while mitigating cost and radiation concerns.

Synthesis and characterization of 3-in-1 multifunctional lipiodol-doped Fe3O4@Poly (diallyl isophthalate) microspheres for arterial embolization, chemotherapy, and imaging.

Transcatheter arterial embolization plays a pivotal role in treating various diseases. However, the efficacy of embolization therapy in cancer treatment can be limited by several factors, such as inevitable incomplete or non-target embolization, and the tumor recurrence and metastasis caused by the hypoxic microenvironment. Moreover, it is essential to explore simpler, more economical, and efficient methods for microsphere synthesis. Herein, we achieved one-step photocatalytic synthesis of lipiodol-doped Fe3O4@Poly (diallyliso-phthalate) multifunctional microspheres (IFeD MS) for arterial embolization, chemotherapy, and imaging. The prepared microspheres are in the shape of dried plums, with a particle size of 100-300 µm. Lipiodol demonstrates a certain degree of chemotherapeutic activity, and the incorporation of Fe3O4enables the microspheres to exhibit magnetothermal response and magnetic resonance imaging capabilities. Furthermore, the radiopaque characteristics of both agents provide the microspheres with promising potential for computed tomography and digital radiography imaging. The renal embolization experiment in rabbits demonstrated that IFeD MS achieved significant embolization and chemotherapeutic effects. Biocompatibility experiments revealed that this embolic agent did not induce tissue damage or inflammation beyond the treatment area. Additionally, IFeD MS exhibited promising imaging potential. The results of this study imply that the developed multifunctional embolic agent IFeD MS may have significant potential in transforming tumors previously only suitable for palliative cares into resectable radical treatments.

Valuation and comparison of the actual and optimal control strategy in an emerging infectious disease: Implication from a COVID-19 transmission model.

To effectively combat emerging infectious diseases like COVID-19, it is crucial to adopt strict prevention and control measures promptly to effectively contain the spread of the epidemic. In this paper, we propose a transmission model to investigate the influence of two control strategies: reducing contact numbers and improving medical resources. We examine these strategies in terms of constant control and time-varying control. Through sensitivity analysis on two reproduction numbers of the model with constant control, we demonstrate that reducing contact numbers is more effective than improving medical resources. Furthermore, these two constant controls significantly influence the peak values and timing of infections. Specifically, intensifying control measures can reduce peak values, albeit at the expense of delaying the peak time. In the model with time-varying control, we initially explore the corresponding optimal control problem and derive the characteristic expression of optimal control. Subsequently, we utilize real data from January 10th to April 12th, 2020, in Wuhan city as a case study to perform parameter estimation by using our proposed improved algorithm. Our findings illustrate that implementing optimal control measures can effectively reduce infections and deaths, and shorten the duration of the epidemic. Then, we numerically explore that implementing control measures promptly and increasing intensity to reduce contact numbers can make actual control be more closer to optimized control. Finally, we utilize the real data from October 31st to November 18th, 2021, in Hebei province as a second case study to validate the feasibility of our proposed suggestions.

SUnet: A multi-organ segmentation network based on multiple attention.

Organ segmentation in abdominal or thoracic computed tomography (CT) images plays a crucial role in medical diagnosis as it enables doctors to locate and evaluate organ abnormalities quickly, thereby guiding surgical planning, and aiding treatment decision-making. This paper proposes a novel and efficient medical image segmentation method called SUnet for multi-organ segmentation in the abdomen and thorax. SUnet is a fully attention-based neural network. Firstly, an efficient spatial reduction attention (ESRA) module is introduced not only to extract image features better, but also to reduce overall model parameters, and to alleviate overfitting. Secondly, SUnet's multiple attention-based feature fusion module enables effective cross-scale feature integration. Additionally, an enhanced attention gate (EAG) module is considered by using grouped convolution and residual connections, providing richer semantic features. We evaluate the performance of the proposed model on synapse multiple organ segmentation dataset and automated cardiac diagnostic challenge dataset. SUnet achieves an average Dice of 84.29% and 92.25% on these two datasets, respectively, outperforming other models of similar complexity and size, and achieving state-of-the-art results.

Factors related to microimplant-assisted rapid palatal expansion in teenagers and young adults: A cone-beam computed tomography study.

INTRODUCTION: For patients with maxillary transverse deficiency, selecting an appropriate therapeutic method is important for the treatment effect and prognosis. Our study aimed to explore factors related to microimplant-assisted rapid palatal expansion (MARPE) in teenagers and young adults using cone-beam computed tomography. METHODS: Twenty-five patients who underwent MARPE were included in this retrospective study from February 2014 to June 2019. Midpalatal suture density (MPSD) ratio, midpalatal suture maturation (MPSM), bone effect, dentoalveolar effect, and dental effect in maxillary first molar were evaluated using cone-beam computed tomography. Spearman correlation analysis was used to analyze the correlation between the MPSD ratio, MPSM, age, and the expansion amount generated by MARPE. RESULTS: Twenty-five patients (mean age, 19.84 ± 3.96 years; range, 15-29 years) with maxillary transverse deficiency were analyzed. Age was negatively correlated with bone expansion, alveolar expansion, and alveolar change (all P <0.05). There was a negative correlation between MPSM and nasal cavity variation, bone expansion, and alveolar change (all P <0.05). The bone expansion was negatively correlated with MPSD ratio 3 (r = -0.417; P <0.05) and MPSD ratio 4 (all P <0.05). CONCLUSIONS: Age, MPSM, and MPSD ratio were significantly related to the MARPE effect. Age, MPSM, and MPSD ratio should be considered when choosing MARPE.

Measuring depression severity based on facial expression and body movement using deep convolutional neural network.

Introduction: Real-time evaluations of the severity of depressive symptoms are of great significance for the diagnosis and treatment of patients with major depressive disorder (MDD). In clinical practice, the evaluation approaches are mainly based on psychological scales and doctor-patient interviews, which are time-consuming and labor-intensive. Also, the accuracy of results mainly depends on the subjective judgment of the clinician. With the development of artificial intelligence (AI) technology, more and more machine learning methods are used to diagnose depression by appearance characteristics. Most of the previous research focused on the study of single-modal data; however, in recent years, many studies have shown that multi-modal data has better prediction performance than single-modal data. This study aimed to develop a measurement of depression severity from expression and action features and to assess its validity among the patients with MDD. Methods: We proposed a multi-modal deep convolutional neural network (CNN) to evaluate the severity of depressive symptoms in real-time, which was based on the detection of patients' facial expression and body movement from videos captured by ordinary cameras. We established behavioral depression degree (BDD) metrics, which combines expression entropy and action entropy to measure the depression severity of MDD patients. Results: We found that the information extracted from different modes, when integrated in appropriate proportions, can significantly improve the accuracy of the evaluation, which has not been reported in previous studies. This method presented an over 74% Pearson similarity between BDD and self-rating depression scale (SDS), self-rating anxiety scale (SAS), and Hamilton depression scale (HAMD). In addition, we tracked and evaluated the changes of BDD in patients at different stages of a course of treatment and the results obtained were in agreement with the evaluation from the scales. Discussion: The BDD can effectively measure the current state of patients' depression and its changing trend according to the patient's expression and action features. Our model may provide an automatic auxiliary tool for the diagnosis and treatment of MDD.

Skill levels and gains in university STEM education in China, India, Russia and the United States.

Universities contribute to economic growth and national competitiveness by equipping students with higher-order thinking and academic skills. Despite large investments in university science, technology, engineering and mathematics (STEM) education, little is known about how the skills of STEM undergraduates compare across countries and by institutional selectivity. Here, we provide direct evidence on these issues by collecting and analysing longitudinal data on tens of thousands of computer science and electrical engineering students in China, India, Russia and the United States. We find stark differences in skill levels and gains among countries and by institutional selectivity. Compared with the United States, students in China, India and Russia do not gain critical thinking skills over four years. Furthermore, while students in India and Russia gain academic skills during the first two years, students in China do not. These gaps in skill levels and gains provide insights into the global competitiveness of STEM university students across nations and institutional types.

Cardiac valvular involvement of Takayasu arteritis.

OBJECTIVE: This study aimed to investigate the imaging and serological features in Takayasu arteritis (TA) patients with valvular involvement and determine the relationship between them. METHOD: This is a retrospective single-center study enrolled 103 TA patients fulfilling the American College of Rheumatology criteria. An independent medical chart review was performed by two senior rheumatologists from Beijing Anzhen Hospital, Capital Medical University. The logistic analysis was used to investigate the relationship between valvular involvement in TA patients and the imaging and serological features of them. RESULTS: Sixty-six TA patients (64.08%) had cardiac valvular involvement in our study. Aortic insufficiency (62.12%) was the most common valvular involvement. Twelve (22.22%) patients developed heart failure. In patients with valvular involvement, the most common angiographic type was Numano type V, which was significantly higher than that in patients without valvular involvement (53.30% vs 32.43%, p = 0.044), followed by coronary involvement (28.79% vs 10.81%, p = 0.036) and Numano type IIb (21.21% vs 5.41%, p = 0.034). Serum levels of immunoglobulin A (2.84 ± 1.42 g/L vs 2.26 ± 0.97 g/L, p = 0.032) and immunoglobulin G (13.5 ± 4.71 g/L vs 11.42 ± 3.01 g/L, p = 0.015) were significantly higher in patients with valvular involvement. Numano type IIb is significantly related to moderate-severe aortic valvular regurgitation in TA patients (4.10 [1.03-16.33], p = 0.04). Elevated C-reactive protein (CRP) level is associated with moderate-severe mitral valve involvement in TA patients (p = 0.05, OR = 17.75, 95% CI 1.07-295.41). CONCLUSIONS: CRP elevation and Numano type IIb are significantly related to different types of valvular involvement in TA patients. Key Points • The Numano types IIb and V were common in TA patients with valvular involvement. • CRP elevation and Numano type IIb are close related to valvular involvement in TA patient. • Echocardiogram screening and CRP level examination are reasonable to TA patients which might have valvular involvement.

[Effect of sandblasting combined with femtosecond laser-etching on surface physicochemical properties of pure titanium].

PURPOSE: The aim of this study was to generate periodic microstructures on pure titanium surface by femtosecond laser-etching after sandblasting, and to assess the physicochemical properties of its surface. METHODS: Twelve pure titanium discs with diameter of 10 mm and thickness of 4 mm were used and divided into 3 groups according to different surface treatment methods: group S (sandblasting surface), group SA (sandblasting surface with acid-etching), and group SL (sandblasting surface with femtosecond laser-etching). Scanning electron microscopy (SEM) was used to observe the surface morphology. X-ray energy spectrum(EDS) was used to observe the surface chemical compositions. Three dimensional surface topography and surface roughness were evaluated by laser scanning confocal microscope (CLSM). The static contact angle was detected by high temperature wetting angle measuring instrument. SPSS19.0 software package was used for statistical analysis. RESULTS: SEM and CLSM showed well-distributed periodic and cyclic microstructure which formed second-order roughness composite structure in group SL. EDS analysis showed that the Al element on SL surface decreased (group SL 4.37%group SA 0.32>group S 0). Surface roughness analysis showed that surface roughness significantly increased in group SL [group SL (7.33±0.38)µm>group SA (1.08±0.12)µm>group S (1.05±0.14)µm](P<0.001). Static contact angle analysis showed that the static contact angle of surface was significantly reduced in group SL [group SL (34.4±2.5)°

Computer science skills across China, India, Russia, and the United States.

We assess and compare computer science skills among final-year computer science undergraduates (seniors) in four major economic and political powers that produce approximately half of the science, technology, engineering, and mathematics graduates in the world. We find that seniors in the United States substantially outperform seniors in China, India, and Russia by 0.76-0.88 SDs and score comparably with seniors in elite institutions in these countries. Seniors in elite institutions in the United States further outperform seniors in elite institutions in China, India, and Russia by ∼0.85 SDs. The skills advantage of the United States is not because it has a large proportion of high-scoring international students. Finally, males score consistently but only moderately higher (0.16-0.41 SDs) than females within all four countries.

Changes in coagulation factor XII and its function during aortic arch surgery for acute aortic dissection-a prospective observational study.

BACKGROUND: Changes in the intrinsic coagulation pathway during aortic arch surgery in patients with acute aortic dissection (AAD) have not yet been reported. The aim of this study is to describe the changes in intrinsic coagulation factor XII, explore its function and find a new target for the treatment of coagulopathy during surgery. METHODS: Eighty-eight patients undergoing emergent surgery for AAD were enrolled. Changes in the intrinsic and extrinsic coagulation pathways were evaluated at 5 different timepoints during the perioperative period by measuring intrinsic coagulation factor XII, extrinsic coagulation factor VII and some intrinsic upstream stimulating factors. The 88 patients were also divided into two groups according to whether reoperation for coagulopathy was required after surgery. RESULTS: Both coagulation factors XII and VII demonstrated a significant and similar change during the perioperative period. These factors decreased significantly during hypothermia circulation arrest (P<0.001) and recovered to normal levels by 24 hours after surgery. Among the intrinsic upstream stimulating factors, bradykinin (BK) demonstrated a similar changing trend with coagulation factors XII and VII, while other stimulating factors did not. However, compared with factor VII, factor XII demonstrated a greater decline during surgery. The proportion of decline of factor XII from anesthesia induction to hypothermia circulation arrest was 42%, whereas the proportion of decline of factor VII during the same period was 20% (P<0.001). Moreover, factor VII recovered to preoperative levels 4 hours after surgery with a relatively faster speed (P<0.001) while factor XII had not recovered (P=0.010). The independent t-test and Wilcoxon test showed that coagulation factor XII levels during hypothermia circulation arrest (P=0.002), total dosage of fibrinogen (P=0.027), total dosage of packed red blood cells (PRBCs) (P=0.006) and total dosage of fresh frozen plasma (FFP) (P=0.022) during the perioperative period were significantly different between the patients who did or did not require reoperation for coagulopathy. Multivariable logistic regression analysis suggested that the factor XII level during hypothermia circulation arrest was an independent risk factor for reoperation for coagulopathy [odds ratio (OR): 1.342, 95% confidence interval (CI): 1.058-1.570; P=0.012]. CONCLUSIONS: Factor XII levels are more influenced by surgery and require a longer period of time to recover to preoperative levels compared with factor VII, and the level of factor XII during hypothermia circulation arrest might be an independent risk factor for reoperation for coagulopathy. Therefore, supplementation of coagulation factor XII and its upstream stimulating factors might be a promising therapeutic modality in the future.

CD40L promotes development of acute aortic dissection via induction of inflammation and impairment of endothelial cell function.

Acute aortic dissection is one of the most lethal cardiovascular disease. The major histopathological feature of AAD is medial degradation, especially breakdown of elastin and collagen. However, the underlying mechanism remains a mystery. Platelets expressed CD40 Ligand (CD40L) is recently recognised as a key effector of cardiovascular disease development through its pro-inflammatory effect. To clarify the role of CD40L in AAD, we examined level of CD40L in human blood serum samples and found that it is significantly higher in AAD patients compared with healthy subjects (26.8±5.52 ng/mL versus 13.4±4.00 ng/mL). To further investigate if CD40L is involve in the development of AAD, we applied ß-aminopropionitrile (BAPN) induced mouse model of AAD. Consistent with the human data, circulating CD40L in AAD mice much higher than normal mice (148.40±75.96 pg/mL versus 44.09±19.65 pg/mL). Meanwhile, multiple pro-inflammatory chemokines significantly increased in AAD mice. Importantly, the CD40L-/- mice treated with BAPN did not develop these phenotypes. Lastly, we confirmed that endothelial cells migration was significantly inhibited by CD40L, suggesting impaired recovery from intimal injury. In summary, we found that CD40L promoted AAD development through its pro-inflammatory effects and inhibition of endothelial cell function.