Comparison of consistency in acute stroke: Automated ASPECT score software tools and manual consensus scores.

PURPOSE: The Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is a standardized semi-quantitative scoring system. It is widely used to assess the extent of acute ischemic stroke (AIS). We evaluated the consistency of three automatic software packages with the overall and region-specific manual ASPECTS scores of AIS patients. METHODS: Retrospectively, we gathered patients who presented with stroke symptoms between February 2019 and June 2022, and 174 cases were eventually included in the trial. Two radiologists reviewed the NCCT images independently; After four weeks, the same two radiologists began randomly reviewing the DWI images, discussed different scores and give consistent results as ground truth. RESULTS: Median ASPECTS of the expert consensus reading was 7 (5-9). Good to excellent correlation of ASPECTS total scores among the three software tools (0.70, 0.74 and 0.83). Correlation among ground truth and Rapid-ASPECTS, RealNow-ASPECTS, ShuKun-ASPECTS (ICC = 0.51, Cronbach's α = 0.53), (ICC = 0.60, Cronbach's α = 0.70) and (ICC = 0.52, Cronbach's α = 0.64) respectively. The AUCs for Rapid, RealNow and ShuKun were 0.61, 0.67, and 0.62 respectively. The region-specific results showed a poor to good correlation. The correlations between the non-dominant and dominant cerebral hemispheres and the ground truth were statistically different (P < 0.05). CONCLUSIONS: Overall, the scoring consistency between the three automated scoring software and the ground truth is comparable, with RealNow-ASPECTS being no less consistent and effective than Rapid-ASPECTS and ShuKun-ASPECTS, and even better than both. But the consistency grade that still is developable.

Stromal interaction molecule 1/microtubule-associated protein 1A/1B-light chain 3B complex induces metastasis of hepatocellular carcinoma by promoting autophagy.

Metastasis is the leading cause of death in hepatocellular carcinoma (HCC) patients, and autophagy plays a crucial role in this process by orchestrating epithelial-mesenchymal transition (EMT). Stromal interaction molecule 1 (STIM1), a central regulator of store-operated calcium entry (SOCE) in nonexcitable cells, is involved in the development and spread of HCC. However, the impact of STIM1 on autophagy regulation during HCC metastasis remains unclear. Here, we demonstrate that STIM1 is temporally regulated during autophagy-induced EMT in HCC cells, and knocking out (KO) STIM1 significantly reduces both autophagy and EMT. Interestingly, STIM1 enhances autophagy through both SOCE-dependent and independent pathways. Mechanistically, STIM1 directly interacts with microtubule-associated protein 1A/1B-light chain 3B (LC3B) to form a complex via the sterile-α motif (SAM) domain, which promotes autophagosome formation. Furthermore, deletion of the SAM domain of STIM1 abolishes its binding with LC3B, leading to a decrease in autophagy and EMT in HCC cells. These findings unveil a novel mechanism by which the STIM1/LC3B complex mediates autophagy and EMT in HCC cells, highlighting a potential target for preventing HCC metastasis.

A new active bone-conduction implant: surgical experiences and audiological outcomes in patients with bilateral congenital microtia.

PURPOSE: First-generation bone bridges (BBs) have demonstrated favorable safety and audiological benefits in patients with conductive hearing loss. However, studies on the effects of second-generation BBs are limited, especially among children. In this study, we aimed to explore the surgical and audiological effects of second-generation BBs in patients with bilateral congenital microtia. METHODS: This single-center prospective study included nine Mandarin-speaking patients with bilateral microtia. All the patients underwent BCI Generation 602 (BCI602; MED-EL, Innsbruck, Austria) implant surgery between September 2021 and June 2023. Audiological and sound localization tests were performed under unaided and BB-aided conditions. RESULTS: The transmastoid and retrosigmoid sinus approaches were implemented in three and six patients, respectively. No patient underwent preoperative planning, lifts were unnecessary, and no sigmoid sinus or dural compression occurred. The mean function gain at 0.5-4.0 kHz was 28.06 ± 4.55-dB HL. The word recognition scores improved significantly in quiet under the BB aided condition. Signal-to-noise ratio reduction by 10.56 ± 2.30 dB improved the speech reception threshold in noise. Patients fitted with a unilateral BB demonstrated inferior sound source localization after the initial activation. CONCLUSIONS: Second-generation BBs are safe and effective for patients with bilateral congenital microtia and may be suitable for children with mastoid hypoplasia without preoperative three-dimensional reconstruction.

Role of early hearing aid experience in speech recognition in patients with bilateral congenital microtia following Bonebridge implantation: a retrospective cohort study.

PURPOSE: To identify audiological and demographic variables that predict speech recognition abilities in patients with bilateral microtia who underwent Bonebridge (BB) implantation. METHODS: Fifty patients with bilateral microtia and bilateral conductive hearing loss (CHL) who underwent BB implantation were included. Demographic data, preoperative hearing aid use experience, and audiological outcomes (including pure-tone hearing threshold, sound field hearing threshold [SFHT], and speech recognition ability) for each participant were obtained. The Chinese-Mandarin Speech Test Materials were used to test speech recognition ability. The word recognition score (WRS) of disyllabic words at 65 dB SPL signals was measured before and after BB implantation in quiet and noisy conditions. RESULTS: The mean preoperative WRS under quiet and noisy conditions was 10.44 ± 12.73% and 5.90 ± 8.76%, which was significantly improved to 86.38 ± 9.03% and 80.70 ± 11.34%, respectively, following BB fitting. Multiple linear regression analysis revealed that lower preoperative SFHT suggested higher preoperative WRS under both quiet and noisy conditions. Higher age at implantation predicted higher preoperative WRS under quiet conditions. Furthermore, patients with more preoperative hearing aid experience and lower postoperative SFHT were more likely to have higher postoperative WRS under both quiet and noisy testing conditions. CONCLUSIONS: This study represents the first attempt to identify predictors of preoperative and postoperative speech recognition abilities in patients with bilateral microtia with BB implantation. These findings emphasize that early hearing intervention before implantation surgery, combined with appropriate postoperative fitting, contributes to optimal benefits in terms of postoperative speech recognition ability.

Searching for desirable bodies: How recruiters value physically exertive extracurricular activities for graduate hiring at elite professional firms in China.

The field of research in evaluating and applying Bourdieu's theories has seen growing interests in studying how the formation and effect of cultural capital vary in different contexts and fields. While existing studies have increasingly focussed on evaluating the role of cultural capital in creating educational inequalities in the Chinese context, little is known about how activities and taste are valued in the Chinese labour market. Drawing on semi-structured interviews with 73 recruiters in elite professional firms in China, this article presents a study on how recruiters interpret physically exertive extracurricular activities (ECAs) for graduate hiring. It shows that these ECAs were valorised for assessing individual qualities and competences in job interviews, while other cultural activities, leisure or tastes carried little value. The notion of the body appeared central to this valorisation, conferring symbolic value onto physical exertive ECAs. The value of these activities was twofold, serving to convey candidates' possession of physical and embodied capital, which resonated to the normative dimension of elite professional firms. Recruiters thus used these activities to seek new professional bodies consumable for demanding professional work and resonating with the normative discourses of professionalism. This study provides more nuanced understandings of cultural capital in a non-Western context and the role of ECAs in elite hiring. It also contributes to the development of physical and embodied capital by integrating perspective that links the body with labour process and professional control.

VISTA as a prospective immune checkpoint in gynecological malignant tumors: A review of the literature.

V-domain Ig suppressor of T cell activation (VISTA), encoded by the human VSIR gene, is a B7 family checkpoint homologous to the programmed death-Ligand 1 sequence. In gynecologic malignancies, VISTA is abnormally expressed and regulates the tumor immune microenvironment, causing a high upregulation of VISTA expression in T-cells and myeloid cells in the tumor microenvironment and promoting tumor proliferation, progression, and immune tolerance. Here, we review the research progress of VISTA in ovarian, cervical, and endometrial cancers through its structure and immunomodulatory mechanism. The comprehensive study of VISTA is expected to improve the current problem of poor immunotherapeutic effects and provide new ideas for immune therapy in patients with gynecologic tumors.

STIM1 in tumor cell death: angel or devil?

Stromal interaction molecule 1 (STIM1) is involved in mediating the store-operated Ca2+ entry (SOCE), driving the influx of the intracellular second messenger calcium ion (Ca2+), which is closely associated with tumor cell proliferation, metastasis, apoptosis, autophagy, metabolism and immune processes. STIM1 is not only regulated at the transcriptional level by NF-κB and HIF-1, but also post-transcriptionally modified by miRNAs and degraded by ubiquitination. Recent studies have shown that STIM1 or Ca2+ signaling can regulate apoptosis, autophagy, pyroptosis, and ferroptosis in tumor cells and act discrepantly in different cancers. Furthermore, STIM1 contributes to resistance against antitumor therapy by influencing tumor cell death. Further investigation into the mechanisms through which STIM1 controls other forms of tumor cell death could aid in the discovery of novel therapeutic targets. Moreover, STIM1 has the ability to regulate immune cells within the tumor microenvironment. Here, we review the basic structure, function and regulation of STIM1, summarize the signaling pathways through which STIM1 regulates tumor cell death, and propose the prospects of antitumor therapy by targeting STIM1.

Architecting carbon-coated Mo2CTx/MoSe2 heterostructures enables robust potassium storage.

Herein, carbon-coated MoSe2 decorated Mo2CTx MXene heterostructures (MoSe2/Mo2CTx@C) have been fabricated. Mo2CTx works as a dual-function electron/ion conductor, which not only provides high conductivity and mechanical strength, but also prevents the severe self-aggregation of few layered MoSe2 nanosheets. The high reversible capacities of 405 mA h g-1 at 100 mA g-1 after 150 cycles and 258 mA h g-1 at 2000 mA g-1 after 400 cycles could be achieved for a potassium-ion battery.

Clinicopathological correlations of peritoneal endometriosis and deep infiltrating endometriosis.

OBJECTIVE: The present study aims to investigate the clinical and histopathological features of peritoneal endometriosis (PEM) and deep infiltrating endometriosis (DIE). METHODS: A total of 100 patients with PEM and DIE admitted to Dalian Women and Children's Hospital/Dalian Women and Children's Medical Center between October 2018 and December 2021 were selected as the study subjects. One hundred and thirty-one PEM specimens and 37 DIE were collected, 22 cases of these patients' eutopic endometrium were used as control (15 in PEM, seven in DIE). The present study mainly analysed the pelvic distribution, the histopathological and immunohistochemical features and peritoneal invasion of PEM and DIE. RESULTS: The main distribution of PEM and DIE was located in the posterior pelvic cavity (p < .001). The histopathological characteristics of different PEM forms were different: the contents of endometrioid glands, endometrioid stroma, smooth muscle, fibrous tissue and blood vessels in different lesions were statistically significant (all p < .050). Estrogen receptor (ER) of PEM and DIE was highly expressed in endometrioid glandular epithelium and endometrioid stroma, without statistical significance (p = .330/.113). Progesterone receptor (PR) was also highly expressed in endometrioid glandular epithelium and endometrioid stroma without statistical significance (p = .757/.798). Ki-67 expression of DIE in endometrioid glandular epithelium was significantly higher than that in brown and white lesions (p < .001), while its expression in the endometrioid stroma was not statistically significant in red lesions (p = .070), but higher than that in other PEM lesions (p < .001). Different morphological lesions had different invasiveness rates and depths of invasion to the peritoneum. White lesions had a deeper subperitoneal invasion level than transparent and vesicular lesions. CONCLUSIONS: Although different morphological appearance of PEM is a degenerative process, some active brown lesions of PEM have invasive effects during the process and may further develop into DIE. PEM and DIE may be different developmental stages of the same disease.

In summary, PEM is a progressive disease, and its different morphological appearance reflects different stages of lesion development.Ectopic endometrial cells have a destructive effect on the peritoneal structures; as the lesion progresses, it continuously infiltrates the subperitoneum.PEM and DIE are different development stages of the same disease. The homology of the two lesions has yet to be explored in terms of pathogenesis.

Mycorrhizae Enhance Soybean Plant Growth and Aluminum Stress Tolerance by Shaping the Microbiome Assembly in an Acidic Soil.

Strongly acidic soils are characterized by high aluminum (Al) toxicity and low phosphorus (P) availability, which suppress legume plant growth and nodule development. Arbuscular mycorrhizal fungi (AMF) stimulate rhizobia and enhance plant P uptake. However, it is unclear how this symbiotic soybean-AMF-rhizobial trio promotes soybean growth in acidic soils. We examined the effects of AMF and rhizobium addition on the growth of two soybean genotypes, namely, Al-tolerant and Al-sensitive soybeans as well as their associated bacterial and fungal communities in an acidic soil. With and without rhizobial addition, AMF significantly increased the fresh shoot and root biomass of Al-tolerant soybean by 47%/87% and 37%/24%, respectively. This increase in plant biomass corresponded to the enrichment of four plant growth-promoting rhizobacteria (PGPR) in the rhizospheric soil, namely, Chitinophagaceae bacterium 4GSH07, Paraburkholderia soli, Sinomonas atrocyanea, and Aquincola tertiaricarbonis. For Al-sensitive soybean, AMF addition increased the fresh shoot and root biomass by 112%/64% and 30%/217%, respectively, with/without rhizobial addition. Interestingly, this significant increase coincided with a decrease in the pathogenic fungus Nigrospora oryzae as well as an increase in S. atrocyanea, A. tertiaricarbonis, and Talaromyces verruculosus (a P-solubilizing fungus) in the rhizospheric soil. Lastly, the compartment niche along the soil-plant continuum shaped microbiome assembly, with pathogenic/saprotrophic microbes accumulating in the rhizospheric soil and PGPR related to nitrogen fixation or stress resistance (e.g., Rhizobium leguminosarum and Sphingomonas azotifigens) accumulating in the endospheric layer. IMPORTANCE Taken together, this study examined the effects of arbuscular mycorrhizal fungi (AMF) and rhizobial combinations on the growth of Al-tolerant and Al-sensitive soybeans as well as their associated microbial communities in acidic soils and concluded that AMF enhances soybean growth and Al stress tolerance by recruiting PGPR and altering the root-associated microbiome assembly in a host-dependent manner. In the future, these findings will help us better understand the impacts of AMF on rhizosphere microbiome assembly and will contribute to the development of soybean breeding techniques for the comprehensive use of PGPR in sustainable agriculture.

Vehicle crash simulations for safety: Introduction of connected and automated vehicles on the roadways.

Traffic accidents are one main cause of human fatalities in modern society. With the fast development of connected and autonomous vehicles (CAVs), there comes both challenges and opportunities in improving traffic safety on the roads. While on-road tests are limited due to their high cost and hardware requirements, simulation has been widely used to study traffic safety. To make the simulation as realistic as possible, real-world crash data such as crash reports could be leveraged in the creation of the simulation. In addition, to enable such simulations to capture the complexity of traffic, especially when both CAVs and human-driven vehicles co-exist on the road, careful consideration needs to be given to the depiction of human behaviors and control algorithms of CAVs and their interactions. In this paper, the authors reviewed literature that is closely related to crash analysis based on crash reports and to simulation of mixed traffic when CAVs and human-driven vehicles co-exist, for studying traffic safety. Three main aspects are examined based on our literature review: data source, simulation methods, and human factors. It was found that there is an abundance of research in the respective areas, namely, crash report analysis, crash simulation studies (including vehicle simulation, traffic simulation, and driving simulation), and human factors. However, there is a lack of integration between them. Future research is recommended to integrate and leverage different state-of-the-art transportation-related technologies to contribute to road safety by developing an all-in-one-step crash analysis system.

Optimal Choice for Improving the Hearing in Children with Unilateral Microtia and Atresia: Softband or Adhesive Adapter?

INTRODUCTION: A nonsurgical bone conduction hearing aid (BCHA) is a well-established treatment for children with congenital unilateral microtia and atresia (UMA). To date, limited studies have evaluated the audiological characteristics of the different wearing modes in the same nonsurgical BCHA. METHODS: Eighteen patients with UMA aged 5-24 years were included. Warble tones at frequencies of 0.5, 1, 2, and 4 kHz were presented to determine functional hearing gain (FHG) of hearing thresholds (in dB HL) in the sound field. The speech perception abilities were assessed by the speech discrimination score (SDS, in %) of monosyllables, disyllables, and sentences in quiet and noise using the Chinese Mandarin speech test materials. Hearing outcomes were evaluated with the ADHEAR™ worn on a softband and with an adhesive adapter. A correlational analysis was conducted to analyze the correlations between variables (e.g., age, height, weight, body mass index [BMI], bone conduction pure-tone threshold, and air conduction pure-tone threshold) and the differences in the two wearing modes. RESULTS: The mean FHG (standard deviation, SD) at 0.5-4 kHz was 20.63 (3.94) dB HL with the adhesive adapter and 26.39 (3.15) dB HL with the softband. When aided with the BCHA, significant improvements in SDS were revealed in all Mandarin speech test material lists either in quiet or noise for both wearing modes. Compared with the adapter mode, the softband provided higher aided SDS values. Correctional analyses revealed that higher BMI values were positively associated with larger delta outcomes between the two coupling methods of the softband and adhesive adapter in patients with UMA. Furthermore, a larger delta average FHG of 0.5-4 kHz was consistently associated with larger delta monosyllabic SDS in quiet, disyllabic SDS in quiet, and disyllabic SDS in noise. DISCUSSION: To the best of our knowledge, this is the first study to compare the hearing benefits of coupling methods using novel adhesive adapters and conventional softbands with the same audio processor (ADHEAR™). Under uniform internal settings, softband integration provided more hearing benefits than adhesive adapter integration, and the differences were more obvious in patients with higher BMI values. Besides, a brief measurement of FHG can be utilized to predict individualized speech perception levels.

A Nomogram Model for Predicting the Postoperative Recurrence of Localized Laryngeal Amyloidosis.

OBJECTIVE: To analyze the factors related to postoperative recurrence in patients with localized laryngeal amyloidosis (LocLA) and to construct a nomogram prediction model (NPM). METHODS: We collected the data for LocLA patients diagnosed from March 2000 to May 2019 and clinical characteristics data were extracted. Factors related to recurrence were analyzed using multivariate logistic regression. The NPM was constructed for predicting the recurrence risk of LocLA. The receiver operating characteristic (ROC) curve evaluated the distinguishing ability using the area under curve (AUC). The calibration curve was created to evaluate the consistency of the NPM. RESULTS: A total of 226 confirmed LocLA cases were included. One hundred seventy-five cases (77.4%) had localized single nodule, and 51 cases had more than one lesions. Sixty-three (27.9%) cases had no multinucleated giant cell (MGC) around amyloid, and 163 (72.1%) cases had MGC around amyloid. Multivariate logistic regression analysis showed that more than one lesions (odds ratio [OR] = 3.206 and 95% confidence interval [CI]: 1.492-6.888; P value: .003), subglottic involvement (OR = 2.926 and 95% CI: 1.300-6.585; P = .010), and no multinucleated giant cell (MGC) around amyloid (OR = 2.503 and 95% CI: 1.173-5.342; P = .018) had a statistically significant effect on postoperative LocLA recurrence (P < .05). The AUC of the ROC curve was 0.753 (95% CI: 0.667-0.832). The bias-corrected curve approached the ideal curve, with an average absolute error of 0.037. CONCLUSIONS: More than one lesions, subglottic involvement, and no MGC around amyloid are risk factors for postoperative recurrence of LocLA. The NPM constructed has good applicability.

Case study of cervical cancer prevention in two sub-Saharan African countries: Rwanda and Sierra Leone.

Background: Cervical cancer is a public health issue of global concern. It is a preventable disease but continues to threaten the lives of women, especially in developing countries in sub-Saharan Africa. Methods: We selected two African countries in sub-Saharan Africa (the Republic of Rwanda and the Republic of Sierra Leone) to show a good example of cervical cancer prevention and constrains hindering countries from effectively implementing cervical cancer programs. Secondary data were collected from the World Health Organization (WHO), the International Agency for Research on Cancer (IARC), the Global Burden of Cancer (GLOBOCAN), the United Nations Development Programme (UNDP), and the World Bank and from official websites of the selected countries. A descriptive analysis method was used to source data and compare variables such as the associated factors, disease burden, prevention programs, health workforce, success factors, and challenges. Results: Rwanda achieved 93.3% human papillomavirus (HPV) vaccination of the three doses vaccinating girls in class 6, as a result of effective school-based platform delivery system and community partnership to identify girls who are out of school. Rwanda reduced the historical two-decade gap in vaccine introduction between high- and low-income countries. The country also introduced a nationwide cervical cancer screening and treatment program. An impressive decreased cervical cancer incidence rate in Rwanda in recent years was observed. Sierra Leone lags behind in terms of almost all cervical cancer prevention programs. Therefore, Sierra Leone needs more efforts to implement cervical cancer intervention programs at the national level, including HPV vaccination, and train and increase the number of health professionals, treatment, and palliative care services to accelerate cervical cancer activities. Conclusion: The disease burden of cervical cancer for Rwanda and Sierra Leone is heavy. There remains huge room for improvement in preventing and controlling cervical cancer in these countries. The goal of cervical cancer elimination would not be feasible in countries without the awareness and will of the policymakers and the public, the compliance to fund cervical cancer programs, the prioritization of cervical cancer activities, the availability of resources, the adequate health workforce and infrastructure, the cross-sectional collaboration and planning, inter-sectorial, national, regional, and international partnerships.

Is endoscopic mucosal ablation a valid option for treating colon polyps?

The present letter to editor is related to endoscopic mucosal ablation (EMA). EMA is safe and effective in the treatment of colonic polyps when endoscopic resection is not possible or available, but the indication of EMA should be determined for a further large number of studies. EMA should be used with caution for larger lesions.

Characteristics of sound localization in children with unilateral microtia and atresia and predictors of localization improvement when using a bone conduction device.

This study aimed to determine the characteristics of sound localization in children with unilateral microtia and atresia (UMA) and the influence of a non-surgical bone conduction device (BCD). Hearing benefits were evaluated by the word recognition score (WRS), speech reception threshold, the international outcome inventory for hearing aids (IOI-HA), and the Speech, Spatial, and Qualities of Hearing Test for Parent (SSQ-P). Sound localization was measured using broadband noise stimuli randomly played from seven loudspeakers at different stimulus levels [65, 70, and 75 dB sound pressure levels (SPLs)]. The average unaided WRS and speech-to-noise ratio (SNR) for UMA patients was 18.27 ± 14.63 % and -5 ± 1.18 dB SPL, and the average aided WRS and SNR conspicuously changed to 85.45 ± 7.38 % and -7.73 ± 1.42 dB SPL, respectively. The mean IOI-HA score was 4.57 ± 0.73. Compared to the unaided condition, the mean SSQ-P score in each domain improved from 7.08 ± 2.5, 4.86 ± 2.27, and 6.59 ± 1.4 to 8.72 ± 0.95, 7.61 ± 1.52, and 8.55 ± 1.09, respectively. In the sound localization test, some children with UMA were able to detect sound sources quite well and the sound localization abilities did not deteriorate with the non-surgical BCD. Our study concludes that for children with UMA, the non-surgical BCD provided a definite benefit on speech recognition and high satisfaction without deteriorating their sound localization abilities. It is an efficient and safe solution for the early hearing intervention of these patients.

Acceptance of clinical artificial intelligence among physicians and medical students: A systematic review with cross-sectional survey.

Background: Artificial intelligence (AI) needs to be accepted and understood by physicians and medical students, but few have systematically assessed their attitudes. We investigated clinical AI acceptance among physicians and medical students around the world to provide implementation guidance. Materials and methods: We conducted a two-stage study, involving a foundational systematic review of physician and medical student acceptance of clinical AI. This enabled us to design a suitable web-based questionnaire which was then distributed among practitioners and trainees around the world. Results: Sixty studies were included in this systematic review, and 758 respondents from 39 countries completed the online questionnaire. Five (62.50%) of eight studies reported 65% or higher awareness regarding the application of clinical AI. Although, only 10-30% had actually used AI and 26 (74.28%) of 35 studies suggested there was a lack of AI knowledge. Our questionnaire uncovered 38% awareness rate and 20% utility rate of clinical AI, although 53% lacked basic knowledge of clinical AI. Forty-five studies mentioned attitudes toward clinical AI, and over 60% from 38 (84.44%) studies were positive about AI, although they were also concerned about the potential for unpredictable, incorrect results. Seventy-seven percent were optimistic about the prospect of clinical AI. The support rate for the statement that AI could replace physicians ranged from 6 to 78% across 40 studies which mentioned this topic. Five studies recommended that efforts should be made to increase collaboration. Our questionnaire showed 68% disagreed that AI would become a surrogate physician, but believed it should assist in clinical decision-making. Participants with different identities, experience and from different countries hold similar but subtly different attitudes. Conclusion: Most physicians and medical students appear aware of the increasing application of clinical AI, but lack practical experience and related knowledge. Overall, participants have positive but reserved attitudes about AI. In spite of the mixed opinions around clinical AI becoming a surrogate physician, there was a consensus that collaborations between the two should be strengthened. Further education should be conducted to alleviate anxieties associated with change and adopting new technologies.

Association Between ABO Blood Group and Venous Thromboembolism Risk in Patients With Peripherally Inserted Central Catheters: A Meta-analysis and Systematic Review.

Background: Previous studies have evaluated the association between ABO blood group and venous thromboembolism (VTE) risk in patients with peripherally inserted central catheters (PICCs). However, it remains unclear whether ABO blood groups are associated with PICC-associated VTE risk. Therefore, we conducted a meta-analysis of related studies to elucidate the potential role of ABO blood group as a risk factor for PICC-associated VTE. Methods: All detectable case-control and cohort studies comparing the role of ABO blood group as a risk factor for PICC-associated VTE were collected for this analysis by searching PubMed, Embase, CNKI, Web of Science, and Wanfang. We conducted a meta-analysis of the eligible studies and computed the summary risk estimates with random or fixed effects models. Results: A total of four studies involving 7,804 patients were included. Meta-analysis of the studies showed that the risk of PICC-associated VTE was significantly higher in blood types A [odds ratio (OR)=1.54, 95% CI=1.17-2.03), p=0.002], B (OR=2.35, 95% CI=1.71-3.23, p<0.0001), and AB (OR=2.55, 95% CI=1.68-3.88, p<0.0001) and lower in blood types O (OR=0.58, 95% CI=0.45-0.74, p<0.0001). Subgroup analysis based on ethnicity demonstrated that blood type O may be a genetic protective factor for PICC-associated VTE in Asians. Among Caucasians, individuals with blood types B and AB have a higher risk of PICC-associated VTE. Blood types A, B, and AB are risk factors for PICC-associated VTE in Asians. Conclusions: Blood type O is associated with a decreased risk of PICC-associated VTE, especially in Asian populations. Moreover, blood types A, B, and AB are risk factors for PICC-associated VTE.

Total auricular reconstruction concomitant with BONEBRIDGE implantation using a retrosigmoid sinus approach.

BACKGROUND: Retrosigmoid sinus (RS) approach was not the dominant choice for BONEBRIDGE implantation. OBJECTIVE: To investigate the efficacy and safety of auricular reconstruction concomitant with BONEBRIDGE implantation using retrosigmoid approach for aural atresia patients. MATERIALS AND METHODS: A retrospective analysis was conducted of 15 children (28 ears) who underwent auricular reconstruction using a completely expanded postauricular flap with a skin expander concomitant with retrosigmoid BONEBRIDGE implantation from July 2019 to September 2020. RESULTS: All 15 patients healed well and had no bone conduction shift. Average SFT improvement was 27.1 dB HL (p < .001). Comparison between aided and unaided speech recognition rate in quiet and in noise showed significant improvements, respectively (p < .001). After a follow-up of 21-35 months, the hearing results were stable and the aesthetic outcomes were satisfying. CONCLUSIONS AND SIGNIFICANCE: For patients who undergo auricle reconstruction using expanded postauricular flap, retrosigmoid approach can avoid interfering the flap of reconstructed auricular without increasing the surgical risk or impact the clinical efficacy, and without significantly prolonging the total anesthesia time. The integrated surgical approach is a safe, and convenient option for patients who require simultaneous auricular reconstruction with BONEBRIDGE implantation.

Decolonizing global health: what should be the target of this movement and where does it lead us?

The current decolonizing global health movement is calling us to take a post-colonial perspective at the research and practice of global health, an area that has been re-defined by contemporary scholars and advocates with the purpose of promoting equity and justice. In this article, we summarize the main points of discussion from the Symposium organized by the editorial board of Global Health Research and Policy, convened in July 2021 in Wuhan, China. Experts participating in the symposium discussed what decolonizing global health means, how to decolonize it, and what criteria to apply in measuring its completion. Through the meeting, a consensus was reached that the current status quo of global health is still replete with various forms of colonial vestiges-ideologies and practices-, and to fully decolonize global health, systemic reforms must be taken that target the fundamental assumptions of global health: does investment in global health bring socioeconomic development, or is it the other way around? Three levels of colonial vestiges in global health were raised and one guiding principle was proposed when thinking of solutions for them. More theoretical discussion needs to be explored to guide practices to decolonize global health.