Association of sleep duration, sleep apnea, and shift work with risk of colorectal neoplasms: a systematic review and meta-analysis.

Background: Although studies have reported that certain sleep characteristics, such as sleep duration and sleep apnea, are linked to the risk of colorectal cancer (CRC), this link remains contentious because of the limited evidence from individual studies. Furthermore, evidence indicated that shift work involving circadian disruption as a probable human carcinogen. This systematic review and meta-analysis aimed to examine the associations between sleep duration, sleep apnea, and shift work with the risk of colorectal neoplasms, including CRC and colorectal adenoma (CRA). Methods: We conducted a comprehensive literature search in PubMed, Embase, and Web of Science databases. The inclusion criteria were determined using PICOS principles. Observational studies reporting associations of sleep duration, sleep apnea, or shift work with risk of CRC or CRA were included. We assessed the risk of bias on the basis of the Newcastle-Ottawa Scale. Results: A total of 18 observational studies were included. Of these studies, nine studies reported the effect of sleep duration on risk of colorectal neoplasms, five reported the effect of sleep apnea, and six reported the effect of shift work. The relative risk (RR) for colorectal neoplasms was 1.06 [95% confidence interval (CI): 0.94, 1.20] in the short sleep duration group compared with the moderate sleep duration group. Long sleep duration was associated with an increased risk of colorectal neoplasms (RR: 1.33, 95% CI: 1.07, 1.65). The pooled results showed that sleep apnea was associated with an increased risk of colorectal neoplasms (RR: 1.75, 95% CI: 1.56, 1.97). Furthermore, results showed that the association between shift work and the risk of colorectal neoplasms was not significant (RR: 1.06, 95% CI: 0.95, 1.17). No publication bias was observed in all the analyses (all P>0.05). The sensitivity analysis showed that no individual study substantially influenced the pooled RRs for colorectal neoplasms and CRC. Conclusions: Our findings suggest the significant positive association of long sleep duration and sleep apnea with risk of colorectal neoplasms and CRC. Given that sleep characteristics may be a potentially modifiable risk factor for colorectal neoplasms, further understanding of its role in carcinogenesis will provide valuable insight for cancer prevention.

Caridinastellata, a new species of atyid shrimp (Decapoda, Caridea, Atyidae) with the male description of Caridinacavernicola Liang & Zhou, 1993 from Guangxi, China.

Caridinastellata sp. nov. is described from streams in Guangxi, south-western China. The new species clearly belongs to "Caridinaserrata group" of the genus and shows a morphological similarity with C.cantonensis Yu, 1938, C.serrata Stimpson, 1860 and C.pacboDo et al. 2020. Caridinastellata is distinguished from congeners, based on differences in its male first pleopod and appendix masculina morphology, along with COI and 16S rRNA molecular evidence. The first pleopod endopod in male is rectangle, about 0.70 × length of exopod, about 3.7-3.9 × as long as proximally wide, inner margin concave, bearing nearly equal spine setae, outer margin bearing nearly equal long and dense spine setae; appendix interna well developed, arising from distal 1/5 of endopod, reaching to end of endopod, with cincinuli distally. The new species displays a unique and brightly coloured pattern and, therefore, can be easily recognised in the field. Liang & Zhou, 1993 described C.cavernicola from the Lenggu Cave, Du'an County, Guangxi. However, the description was based exclusively on two females. We have collected specimens of both sexes near the type locality and describe herein the previously unknown male and present morphological data on females. Data on the habitat, ecology and levels of threat of the two species are provided and suggest that they should be categorised as vulnerable (VU) under the current IUCN Criteria.

An instrument for evaluating the clinical applicability of guidelines.

OBJECTIVE: To establish an instrument for evaluating the clinical applicability of guidelines from the guideline-users' perspective. METHODS: We established this instrument through forming a working group, forming an initial list of items based on a qualitative systematic review, establishing initial instrument via two rounds of modified Delphi surveys, and external review the initial instrument. RESULTS: The results of modified Delphi surveys establishing appraisal aspects, appraisal items, general information of the evaluator met the preset requirements. The instrument includes three parts: general information of the evaluator (12 items), evaluation of clinical applicability (12 items, including items on the availability, readability, acceptability, feasibility, and overall applicability of guideline), and scoring scheme. CONCLUSIONS: The instrument for evaluating the clinical applicability of guidelines from the guideline-users' perspective provides criteria and methods for improving the clinical applicability of guidelines during development and updating.

Cytotoxicity and genotoxicity assays of halobenzoquinones disinfection byproducts using different human cell lines.

Recently, halobenzoquinones (HBQs) disinfection byproducts, including 2,6-dichloro-1, 4-benzoquinone (DCBQ), 2,6-dichloro-3-methyl-1, 4-benzoquinone (DCMBQ), 2,3,6-trichloro-1, 4-benzoquinone (TCBQ), and 2,6-dibromobenzoquinone (DBBQ), have been of increasing concern due to their reported ability to induce oxidative damage, and thus genotoxicity. However, data on the risk of genotoxicity due to chromosomal damage by HBQs are still scarce. Here, the cytotoxicity and genotoxicity of the four HBQs were assessed using human cell lines (bladder cancer 5637 cells, colon carcinoma Caco-2 cells, and gastric MGC-803 cells). The four HBQs exhibited significant concentration-response relationships in all the three cell lines. Cytotoxicity of DCBQ, DCMBQ, TCBQ, and DBBQ, represented by the 50% concentration of inhibition (IC50 ) values, were 80.8-99.5, 41.0-57.6, 122.1-146.6, and 86.9-93.8 µM, respectively. The lowest effective concentrations for cellular micronuclei induction in the cell lines by DCBQ, DCMBQ, TCBQ, and DBBQ were 50-75, 20-41.5, 87.4-100, and 50 µM, respectively. 5637 and Caco-2 cells were more sensitive to the cytotoxic and genotoxic effects of HBQs than MGC-803 cells. These results show that HBQs can induce chromosomal damage; DCMBQ induced the highest cytotoxicity and genotoxicity in all the cell lines, and TCBQ caused the least toxicity.

Dynamics in Endolymphatic Hydrops & Symptoms in Meniere's Disease After Endolymphatic Duct Blockage, Preliminary Results.

Objective: The purpose of the present study was to evaluate the dynamics of endolymphatic hydrops (EH) and symptoms in a group of patients who underwent endolymphatic duct blockage (EDB) for treatment of intractable Meniere's Disease (MD), and to explore a metric for verifying the effectiveness of EDB procedure. Methods: A total of 22 patients with intractable MD patients who underwent EDB participated in the present study. EH was visualized using locally enhanced inner ear magnetic resonance imaging (MRI) prior to and following surgery. The vestibular hydrops ratio (VHR) in the second MRI examination was compared with the pre-surgery recordings. Results: Following EDB, 6 patients exhibited complete or partial reversal of EH, complete control of vertigo spells and reported improvement in hearing; 13 patients showed no changes in EH or hearing, but 5 of these patients exhibited complete control of vertigo attacks, and the other 8 patients exhibited improved control of vertigo attacks. The final 3 patients showed an increase in EH, but symptomatic worsening in 2 patients, and symptomatic improvement in 1 patient. There was a significant difference in the average VHR prior to and following EDB. Postoperative VHR was positively correlated with the frequency of vertigo spells in the latest 6 months of follow-up and improvement of postoperative average hearing threshold. Conclusion: The decreased EH accompanying the reduction in vertigo attacks and hearing preservation may provide a metric for verifying the effectiveness of EDB treatment in patients with MD.

Adaptive Chroma Subsampling-Binding and Luma-Guided Chroma Reconstruction Method for Screen Content Images.

In this paper, we propose a novel adaptive chroma subsampling-binding and luma-guided (ASBLG) chroma reconstruction method for screen content images (SCIs). After receiving the decoded luma and subsampled chroma image from the decoder, a fast winner-first voting strategy is proposed to identify the used chroma subsampling scheme prior to compression. Then, the decoded luma image is subsampled as the identified subsampling scheme was performed on the chroma image such that we are able to conclude an accurate correlation between the subsampled decoded luma image and the decoded subsampled chroma image. Accordingly, an adaptive sliding window-based and luma-guided chroma reconstruction method is proposed. The related computational complexity analysis is also provided. We take two quality metrics, the color peak signal-to-noise ratio (CPSNR) of the reconstructed chroma images and SCIs and the gradient-based structure similarity index (CGSS) of the reconstructed SCIs to evaluate the quality performance. Let the proposed chroma reconstruction method be denoted as `ASBLG'. Based on 26 typical test SCIs and 6 JCT-VC test screen content video sequences (SCVs), several experiments show that on average, the CPSNR gains of all the reconstructed UV images by 4:2:0(A)-ASBLG, SCIs by 4:2:0(MPEG-B)-ASBLG, and SCVs by 4:2:0(A)-ASBLG are 2.1, 1.87, and 1.87 dB, respectively, when compared with that of the other combinations. Specifically, in terms of CPSNR and CGSS, CSBILINEAR-ASBLG for the test SCIs and CSBICUBIC-ASBLG for the test SCVs outperform the existing state-of-the-art comparative combinations, where CSBILINEAR and CSBICUBIC denote the luma-aware based chroma subsampling schemes by Wang et al.

The effect of network template from normal subjects in the detection of network impairment.

This study aimed to provide a simple way to approach group differences by independent component analysis when researching functional connectivity changes of resting-state network in brain disorders. We used baseline resting state functional magnetic resonance imaging from the Alzheimer's disease neuroimaging initiative dataset and performed independent component analysis based on different kinds of subject selection, by including two downloaded templates and single-subject independent component analysis method. All conditions were used to calculate the functional connectivity of the default mode network, and to test group differences and evaluate correlation with cognitive measurements and hippocampal volume. The default mode network functional connectivity results most fitting clinical evaluations were from templates based on young healthy subjects and the worst results were from heterogeneous or more severe disease groups or single-subject independent component analysis method. Using independent component analysis network maps derived from normal young subjects to extract all individual functional connectivities provides significant correlations with clinical evaluations.

Mining association rules between abnormal health examination results and outpatient medical records.

Currently, interpretation of health examination reports relies primarily on the physician's own experience. If health screening data could be integrated with outpatient medical records to uncover correlations between disease and abnormal test results, the physician could benefit from having additional reference resources for medical examination report interpretation and clinic diagnosis. This study used the medical database of a regional hospital in Taiwan to illustrate how association rules can be found between abnormal health examination results and outpatient illnesses. The rules can help to build up a disease-prevention knowledge database that assists healthcare providers in follow-up treatment and prevention. Furthermore, this study proposes a new algorithm, the data cutting and sorting method, or DCSM, in place of the traditional Apriori algorithm. DCSM significantly improves the mining performance of Apriori by reducing the time to scan health examination and outpatient medical records, both of which are databases of immense sizes.

Efficacy of pulsed radiofrequency in the treatment of thoracic postherpetic neuralgia from the angulus costae: a randomized, double-blinded, controlled trial.

BACKGROUND: Postherpetic neuralgia (PHN) is often refractory to existing treatments. Pulsed radiofrequency (PRF) is known to be effective for treating neuropathic pain. In common, the targets of PRF treatment were the segmental dorsal root ganglion (DRG) neurons responsible for the pain. A potential complication that can occasionally occur with PRF treatment is damage to the adjacent tissue and organ. The effectiveness of the angulus costae as a puncture site for PRF has not been tested in thoracic PHN treatment. OBJECTIVE: The goal of this study was to investigate the therapeutic efficacy and safety of PRF for treating thoracic PHN through the puncture of the angulus costae. STUDY DESIGN: Prospective, randomized, double-blinded study. SETTING: Department of Anesthesiology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine. METHODS: Ninety-six patients with thoracic (T2-11) PHN were equally randomized assigned into 2 groups. The electrode needle punctured through the angulus costae of each patient guided by x-ray; PRF at 42° C for 120 seconds was applied after inducing paresthesia involving the affected dermatome area. PRF was applied in the PRF group (n = 48) twice. It was also applied in the sham group (n = 48) twice without radiofrequency energy output. The treatment was done once a week for 3 weeks. Tramadol was used for flare pain when the visual analog scale (VAS) ≥ 3. OUTCOMES ASSESSMENT: The therapeutic effect was evaluated by VAS, SF-36 health survey questionnaire, side effects (type, frequency, and onset time) before treatment, at days 3, 7, and 14, and at months one, 2, 3 and 6 after PRF. The average of tramadol (mg/d) administered within the first  month after treatment was also recorded. RESULTS: The postprocedure VAS scores in the PRF group were significantly lower than those in the sham group and lasted for 6 months after treatment (P < 0.05). The SF-36 score, such as physical functioning, physical role, bodily pain, general health perceptions, social function, emotional role, and mental health index were significantly improved until 6 months after treatment in the PRF group compared to the sham group (P < 0.01-0.05). The average dosage of tramadol  administrated (mg/d) within the first  month after treatment was also significantly reduced in the PRF group compared to the sham group (P < 0.05). There were no obvious signs of pneumothorax, bleeding, infection, or other severe side effects in either group (P > 0.05). LIMITATIONS: Single center study, relatively small number of patients. CONCLUSIONS: The strategy that the angulus costae be used as the PRF puncture point of an electrode needle and the final localization of the needle tip as determined by sensory testing is an effective and safe therapeutic alternative for thoracic PHN treatment. Benefits include that the procedure is minimally invasive, provides short-term pain relief, and improves quality of life. CLINICAL TRIAL REGISTRATION: NO ISRCTN25588650.

An optically pumped XeF(C-A) laser with repetitive rate of 10 Hz.

A novel XeF(C-A) laser which can be operated in repetition mode has been developed based on surface discharge optical pumping technique. Its maximum repetitive rate is up to 10 Hz. The influence of repetitive rate and gas flow rate on the stability of output energy is studied and the main factor which influences the stability of output energy is analyzed. The experimental results show that increasing the gas flow rate into laser chamber can improve the stability of the output energy. The ideal output energy results of 20 laser pulses under different repetitive rates and their optimal experimental conditions are presented. Output energies of more than 4 J and better stability can be obtained when the laser device operates at 1, 2, and 5 Hz, respectively. When the gas feed rate is larger than 53 l/s, the stability of output energy is improved obviously at the repetitive rate of 10 Hz, and the average energy of 20 laser pulses is up to 3.2 J.

Thermosensitive hydrogels composed of hyaluronic acid and gelatin as carriers for the intravesical administration of cisplatin.

The aim of this work was to evaluate the use of thermosensitive hydrogels for intravesical cisplatin delivery into the bladder. Poly(N-isopropylacrylamide) (PNIPAM) was grafted onto hyaluronic acid (HA) to synthesize an HPN copolymer, which was further grafted with gelatin to form an HPNG copolymer. A 3% concentration of HPN and HPNG was sufficient to exert a thermosensitive response, whereas a concentration of 8% was needed for PNIPAM to form the hydrogel. The physicochemical and drug delivery properties were examined by scanning electron microscopy (SEM), the lower critical solution temperature (LCST), hydration ratio, and in vitro cisplatin release. The incorporation of HA and gelatin produced a different microstructure compared to the parent PNIPAM hydrogel. Gelatin conjugation increased the fibrous structure in the matrix. The LCSTs of PNIPAM, HPN, and HPNG were 32.3, 32.0, and 30.7°C, respectively. The copolymers showed an eightfold increase in the hydration capacity compared to PNIPAM, with no significant difference in values between HPN and HPNG. The release of cisplatin from an aqueous solution (control) was nearly complete after 8 h, compared to 85, 80, and 52% release from PNIPAM, HPN, and HPNG, respectively. In vivo evaluation of cisplatin levels in bladder tissues was performed following intravesical instillation in rats. When the dwell time was extended to 6 h, PNIPAM showed a sevenfold enhancement in the drug concentration in the bladder wall. HPNG also showed a twofold increase in the drug concentration. The administration of cisplatin by the HPN carrier did not change the drug accumulation compared to the control. Confocal laser scanning microscopic results confirmed the trend of drug absorption from various systems. A histological examination showed no adverse change in the urothelium with HPN or HPNG application. PNIPAM caused partial desquamation of umbrella cells. The thermosensitive hydrogels prepared in this study may be promising carriers for targeted drug delivery to the bladder.

Intravesical delivery of 5-aminolevulinic acid from water-in-oil nano/submicron-emulsion systems.

The present work reports on the development of water-in-oil (w/o) emulsions for the intravesical administration of 5-aminolevulinic acid (ALA). The physicochemical properties of droplet size, zeta potential, and viscosity of the emulsions are characterized and the ability of the emulsions to release ALA following in vitro application is tested. The delivery systems are administered intravesically for 1 and 3 h in rats to examine the drug accumulation in bladder tissue. The mean size and zeta potential of the emulsions are 50-200 nm and -3 to -14 mV, respectively. The loading of ALA into the emulsions resulted in a slower and sustained release. The release extent was found to be inversely related to the droplet size of the emulsions. The emulsions did not increase the drug permeation into tissues during short exposure duration (1 h). When the dwell time was extended to 3 h, the systems showed a 2.7-fold increase in the ALA concentration in the bladder wall. Images of confocal laser scanning microscopy demonstrated a higher and deeper fluorescence signal, with emulsion administration, as compared to the aqueous control. Intravesical emulsion delivery provides a significant advantage for drugs targeting bladder tissues.

Permeation enhancer-containing water-in-oil nanoemulsions as carriers for intravesical cisplatin delivery.

PURPOSE: In the present work, we developed water-in-oil (w/o) nanoemulsions for the intravesical administration of cisplatin. METHODS: The nanoemulsions were made up of soybean oil as the oil phase and Span 80, Tween 80, or Brij 98 as the emulsifier system. alpha-Terpineol and oleic acid were incorporated as permeation enhancers. The physicochemical characteristics of droplet size, zeta potential, and viscosity were determined. Nanoemulsions were administered intravesically for 1 approximately 4 h to rats in vivo. Animals were subsequently sacrificed, and the bladders were harvested to examine drug accumulation and histology. RESULTS: Ranges of the mean size and zeta potential were 30 approximately 90 nm and -3.4 to -9.3 mV, respectively. The addition of enhancers further reduced the size of the nanoemulsions. The viscosity of all systems exhibited Newtonian behavior. The cisplatin-loaded nanoemulsions were active against bladder cancer cells. The nanoemulsions with Brij 98 exhibited the complete inhibition of cell proliferation. The encapsulation of cisplatin and carboplatin, another derivative of cisplatin, in nanoemulsions resulted in slower and more-sustained release. The amount of drug which permeated into bladder tissues significantly increased when using carriers containing Brij 98, with the alpha-terpineol-containing formulation showing the best result. The nanoemulsion with alpha-terpineol prolonged the duration of higher drug accumulation to 3 approximately 4 h. At the later stage of administration (3 approximately 4 h), this system increased the bladder wall deposition of cisplatin and carboplatin by 2.4 approximately 3.3-fold compared to the control solution. Histological examination of the urothelium showed near-normal morphology in rats instilled with these nanoemulsions. alpha-Terpineol possibly caused slight desquamation of umbrella cells. CONCLUSIONS: The nanoemulsions are feasible to load cisplatin for intravesical drug delivery.