Clinical and biochemical evaluation of rituximab as add on therapy in neuromyelitis optica spectrum disorders.

OBJECTIVE: This study assesses the efficacy of rituximab in the treatment of neuromyelitis optica spectrum disorders (NMOSD). METHODS: The study initially included 40 patients with NMOSD diagnosed, after excluding patients who did not meet the complete inclusion criteria. Patients in the conventional group received routine clinical treatment, while patients in the study group received additional treatment with rituximab on the basis of the conventional treatment. Baseline data and clinically relevant indicators were collected for all patients, and the efficacy was compared between the two groups. RESULTS: Baseline data were comparable between the two groups (p > 0.05). The EDSS scores after clinical treatment in the study group were lower than those in the conventional group, and the difference in EDSS scores before and after treatment was higher than that in the conventional group (p < 0.05). The difference in visual acuity correction before and after treatment was not significant between the two groups (p > 0.05). Laboratory indicators in the study group after clinical treatment were superior to those in the conventional group (all p < 0.05). The recurrence rate after clinical treatment in the study group was significantly lower than that in the conventional group (p < 0.05). Adverse reactions after clinical treatment in the study group were less than those in the conventional group (p < 0.05). CONCLUSION: This study found that rituximab demonstrated significant efficacy in the acute attacks and recurrence prevention of NMOSD, emphasizing its relatively good safety and tolerability. It highlights the potential of rituximab in treating NMOSD and provides valuable insights for future disease management.

An oncolytic herpes simplex virus type 1 strain expressing a single-chain variable region antibody fragment against PD-1 and a PI3K inhibitor synergize to elicit antitumor immunity in ovarian cancer.

Due to recurrence and resistance to chemotherapy, the current standard therapeutics are not fully effective against ovarian cancer. Therefore, we aimed to find an effective approach to improve the prognosis and therapy of ovarian cancer. NG34ScFvPD-1 is a modified oncolytic herpes simplex virus NG34 strain that expresses a single-chain antibody against programmed cell death protein 1 (PD-1) (ScFvPD-1). We assessed its efficacy and its regulatory mechanism in a mouse model of ovarian cancer. Enzyme-linked immunosorbent assay and western blot techniques were used to measure protein expression. Oncolysis caused by NG34ScFvPD-1 was examined using cytotoxicity and replication assays. The mechanism by which NG34ScFvPD-1 regulates apoptosis of ovarian cancer cells in vitro was also evaluated. We assessed the antitumor immunity and therapeutic potency of NG34ScFvPD-1 in combination with a phosphoinositide 3-kinase (PI3K) inhibitor. We found that NG34ScFvPD-1-infected ovarian cancer cells expressed and secreted ScFvPD-1, which bound mouse PD-1. The insertion of the ScFvPD-1 sequence did not inhibit the oncolytic activity of NG34ScFvPD-1, which induced apoptosis of ovarian cancer cells via the caspase-dependent pathway in vitro and activated the PI3K/AKT signaling pathway. Synergy was observed between NG34ScFvPD-1 and a PI3K inhibitor, and the combination was able to suppress tumor development, to prolong survival, and to elicit potent antitumor immunity. Thus, inhibition of PI3K enhanced the potent antitumor immunity induced by NG34ScFvPD-1 against ovarian cancer.

The Dunning-Kruger effect: subjective health perceptions on smoking behavior among older Chinese adults.

BACKGROUND: The intrinsic damage and external hazards of smoking are major risk factors for poorer health and are recognized as a global health issue of concern in geriatric health. This study aims to assess the Dunning-Kruger effect through the influence of subjective health perceptions on smoking behavior in older adults. METHODS: This study used data from the 2018 Chinese Longitudinal Healthy Longevity Survey (N = 9,683) provided by the Center for Healthy Aging and Development Studies at Peking University. A binary logistic model was used to examine whether the Dunning-Kruger effect affects smoking behavior in older adults, and a linear probability model was used as a commentary baseline model for logistic regression to prevent measurement bias. In addition, a mediating analysis was used to examine the mechanisms through which the Dunning-Kruger effect occurs. RESULTS: Older adults often overestimated their current health status and underestimated the health risks of smoking, causing the Dunning-Kruger effect to arise from their inadequate self-perceived health (i.e., older adults are more likely to smoke when they have better self-rated health or when hypertension, cardiopathy, stroke, and diabetes have little or no impact on their daily lives). These observations can be explained by the older adults' subjective health perceptions arising from their ingenuous understanding of their health, which indirectly influences their smoking behavior to some extent. CONCLUSION: Older adults' self-perceived health was associated with smoking behavior. Public health institutions should improve older adults' health perceptions so that they objectively understand their own health status.

Constructing and validating nomograms to predict risk and prognostic factors of distant metastasis in urothelial bladder cancer patients: a population-based retrospective study.

BACKGROUND: Urothelial carcinoma is the most common type of bladder cancer worldwide and it has a poor prognosis for patients with distant metastasis. Nomograms are frequently used in clinical research, but no research has evaluated the diagnostic and prognostic factors of distant metastasis in urothelial bladder cancer (UBC). METHODS: The Surveillance, Epidemiology, and End Results database was used to analyze all patients diagnosed with UBC between 2000 and 2017. Lasso regression was used to identify the potential risk predictive factors for distant metastasis in UBC. Univariate and multivariate Cox proportional hazard regression analyses were performed to determine independent prognostic factors for distant metastasis urothelial bladder cancer (DMUBC). Subsequently, two nomograms were constructed based on the above models. The receiver operating characteristic (ROC), and calibration curves were performed to evaluate the two nomograms. RESULTS: The study included 73,264 patients with UBC, with 2,129 (2.9%) having distant metastasis at the time of diagnosis. In the diagnostic model, tumor size, histologic type, and stage N and T were all important risk predictive factors for distant metastasis of UBC. In the prognostic model, age, tumor size, surgery, and chemotherapy were independent factors affecting the prognosis of DMUBC. DCA, ROC, calibration, and Kaplan-Meier (K-M) survival curves reveal that the two nomograms can effectively predict the diagnosis and prognosis of DMUBC. CONCLUSION: The developed nomograms are practical methods for predicting the occurrence risk and prognosis of distant metastasis urothelial bladder cancer patients, which may benefit the clinical decision-making process.

4-Methoxydalbergione is a potent inhibitor of human astroglioma U87 cells in vitro and in vivo.

Astroglioma is the most common primary tumor in the central nervous system without effective treatment strategies. Temozolomide (TMZ) is a chemotherapeutic drug to treat astroglioma but exhibits low potency and has side effects. Therefore, there is an urgent need to develop new compounds to treat astroglioma. Dalbergia sissoo Roxb was the source of Dalbergia odorifera in traditional Chinese medicine (TCM) and has been clinically used as an anti-tumor medicine. 4-Methoxydalbergione (4MOD) is purified from Dalbergia sissoo Roxb., and shows an inhibitory effect on osteosarcoma, but its effects on astroglioma have not been reported. Here, we evaluate its anti-astroglioma effects on both in vitro and in vivo models. In cultured astroglioma U87 cells, 4MOD inhibited cell proliferation and induced cell apoptosis in a time- and concentration-dependent manner. Compared with TMZ, 4MOD exhibited a tenfold greater potency of anti-astroglioma effects. 4MOD effectively stalled the cell cycle in G2 phase. Transcriptome sequencing (RNA-seq) showed that 4MOD upregulated 158 genes and downregulated 204 genes that are mainly enriched in cell membrane, cell division, cell cycle, p53, TNF, and MAPK signaling pathways, which may underlie its anti-tumor mechanisms. In a nude mouse xenograft model transplanted with U87 cells, 10 mg/kg 4MOD slowed down tumor growth rate, while at 30 mg/kg dose, it reduced tumor size. Collectively, this study demonstrates that 4MOD is a potent native compound that remarkably inhibits U87 astroglioma growth in both in vitro and in vivo models.

Mechanical properties of cemented tailings backfill containing alkalized rice straw of various lengths.

The tailings and rice straw that are produced in large quantities each year in the mining and agricultural industries, respectively, have significant effects on the ecological environment. This study aimed to explore the mechanical properties of cemented tailings backfill (CTB) mixed with alkalized rice straw (ARS) of different lengths. A series of uniaxial compressive strength (UCS) and indirect tensile strength (ITS) tests were conducted on the CTB. The results indicated that as the length of the ARS increased from 3 to 15 mm, the UCS and ITS values initially increased and then decreased. The critical length of the ARS was 12 mm, for which the effect of strength increase was the most significant. From the overall analysis, the UCS of CTB samples with ARS (9 and 12 mm) demonstrated the better improvement (increased by 10.0 and 14.7%, respectively) at 28 d curing age, and the improvement effect of the CTB samples with ARS of other lengths was not ideal. The ITS of CTB samples with ARS increased (except for an ARS length of 3 mm) regardless of the curing age; the maximum increase was approximately 24.2% at 28 d. The integrity, residual strength, and toughness of CTB sample with the ARS (12 mm) were the largest after the UCS test. Scanning electron microscopy (SEM) tests indicated that the surface of the ARS was covered with cement hydration products, and the interior of the ARS was filled with cement tailings, which produced stronger adhesion between the ARS (12 mm) and CTB matrix; the ARS performed a bridging role and suppressed crack propagation, which effectively improving the mechanical properties of CTB. Significantly short ARS exhibited a lower adhesive force with the matrix, and significantly long ARS exhibited a lower filling rate. Thus, while improving the mechanical properties of CTB, ARS provides a new method for treating rice straw and decreasing its combustion pollution.

Factors associated with insomnia among Chinese front-line nurses fighting against COVID-19 in Wuhan: A cross-sectional survey.

AIM: To investigate the prevalence of insomnia among front-line nurses fighting against COVID-19 in Wuhan, China, and analyse its influencing factors. BACKGROUND: Insomnia is an important factor that can affect the health and work quality of nurses. However, there is a lack of big-sample studies exploring factors that affect the insomnia of nurses fighting against COVID-19. METHOD: This cross-sectional study using the Ascension Insomnia Scale, Fatigue Scale-14 and Perceived Stress Scale took place in March 2020. Participants were 1,794 front-line nurses from four tertiary-level general hospitals. RESULTS: The prevalence of insomnia among participants was 52.8%. Insomnia was predicted by gender, working experience, chronic diseases, midday nap duration, direct participation in the rescue of patients with COVID-19, frequency of night shifts, professional psychological assistance during the pandemic, negative experiences (such as family, friends or colleagues being seriously ill or dying due to COVID-19), the degree of fear of COVID-19, fatigue and perceived stress. CONCLUSION: The level of insomnia among participants was higher than the normal level. Interventions based on influencing factors should be implemented to ensure nurses' sleep quality. IMPLICATIONS FOR NURSING MANAGEMENT: An in-depth understanding of the influencing factors of insomnia among front-line nurses can help nurse managers develop solutions to improve front-line nurses' sleep quality, which will enhance the physical and mental conditions of nurses and promote the quality of care.

Inhibition of the PI3K/Akt signaling pathway impedes the restoration of neurological function following hypoxic-ischemic brain damage in a neonatal rabbit model.

OBJECTIVE: Hypoxic-ischemic brain damage (HIBD), frequently occurring in infancy and childhood, is a major cause of mortality and severe neurologic impairment. This study was performed to examine the effect of the PI3K/Akt signaling pathway on HIBD in a neonatal rabbit model. MATERIALS AND METHODS: Uterine artery occlusion was used to establish HIBD models in neonatal rabbits, which were then subjected to sham operation, dimethyl sulfoxide (2 mL) or LY294002 (inhibitor of PI3K/Akt signaling pathway, 6.4 µg/kg). Behavioral neurological assessment was performed in neonatal rabbits delivered by cesarean section, after which serum neuron-specific enolase (NSE) level and cerebral water content were determined. The level of cleaved caspase-3 level and apoptosis of neurons were observed by immunohistochemistry and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) staining. Furthermore, the expression of PI3K/Akt signaling pathway- and apoptosis-related factors was examined. RESULTS: In neonatal rabbits, HIBD increased the fetal death rate; reduced neurological scores of posture, righting reflex, and deglutition reflex; elevated serum NSE levels, cerebral water content, cleaved caspase-3-positive expression in hippocampal CA1 region and apoptotic neurons; inactivated PI3K/Akt signaling pathway as well as reduced Bcl-2 expression and increased BAD and Bax expression. Notably, the treatment of LY294002 further aggravated neurological impairment in neonatal rabbits in response to HIBD. CONCLUSION: Following the HIBD caused by intrauterine asphyxia, the LY294002 administered through auricular vein infusion into pregnant rabbits exacerbates neurological impairment of neonatal rabbits, suggesting that inhibition of PI3K/Akt signaling pathway may serve as a candidate therapeutic target for neurological recovery.

Study on the Adsorption Behavior between an Imidazolium Ionic Liquid and Na-Montmorillonite.

Interactions between 1-butyl-3-methylimidazolium tetrafluoroborate (IL), an ionic liquid, and Na-montmorillonite (Na-MMT) were studied under different kinetic conditions to investigate the adsorption behavior of IL by Na-MMT. The adsorption of IL by Na-MMT was rapid, with a fast rate, reaching a capacity of 0.43 mmol/g, lower than Na-MMT's cation exchange capacity (CEC) of 0.90 mmol/g. Meanwhile, the highest adsorption rate occurred at the IL concentration of 1000 mg/L. The exchangeable cation of Na-MMT could not be completely substituted by the cation group of IL regardless of the IL concentration. Stoichiometric desorption experiments confirmed that the cation exchange was the dominating adsorption mechanism for the IL adsorption by Na-MMT. The pH value of the solution between 2 and 11 had a negligible effect on the adsorption amount of IL by Na-MMT. The cation group of IL interacted into the interlayer of Na-MMT successfully, resulting in the change in the wettability of Na-MMT. A bilayer formation of the cationic group should occur in the interlayer of the modified Na-MMT and the configuration of IL was dependent on the adsorption amount of IL. Furthermore, the thermal stability of the modified Na-MMT was also dependent on the adsorption amount of IL.

Photoelectrochemical immunoassay of lipoprotein-associated phospholipase A2 via plasmon-enhanced energy transfer between gold nanoparticles and CdS QDs/g-C3N4.

A facile and feasible photoelectrochemical (PEC) immunoassay based on plasmon-enhanced energy transfer between gold nanoparticles (AuNPs) and CdS quantum dots (QDs)/g-C3N4 nanosheets was developed for the ultrasensitive detection of lipoprotein-associated phospholipase A2 (Lp-PLA2). To construct such a sensing platform, the immunosensor was prepared by immobilizing Lp-PLA2 on a CdS QDs/g-C3N4-modified electrode. A competitive-type immunoreaction was utilized for Lp-PLA2 detection, with AuNP-labeled anti-Lp-PLA2 antibody used as the competitor. Introducing AuNPs with the specific antibody for the antigen target Lp-PLA2 led to heavy quenching of the photocurrent of CdS QDs/g-C3N4 due to the plasmon-enhanced energy transfer between AuNPs and CdS QDs. The quenching efficiency decreased with increasing target Lp-PLA2 concentration. Under optimal conditions, the PEC immunosensor presented a good photocurrent response to the target Lp-PLA2 in the dynamic linear range of 0.01-300 ng mL-1, with a low detection limit of 5.3 pg mL-1. Other biomarkers and natural enzymes did not interfere with response of this system. The reproducibility and accuracy of this method for the analysis of human serum specimens were evaluated, and the results given by the method developed here were found to closely correspond to the results obtained with commercial Lp-PLA2 ELISA kits. Importantly, this protocol offers promise for the development of exciton-plasmon interaction-based PEC detection systems. Graphical abstract ᅟ.

LncRNA FOXD3-AS1 Contributes to Glioblastoma Progression Via Sponging miR-3918 to Upregulate CCND1.

AIM: To elucidate the pro-tumorigenic role of IncRNA FOXD3-AS1 in glioblastoma. MATERIAL AND METHODS: The expression of miR-3918, FOXD3-AS1, and CCND1 was measured in glioblastoma cells and tissues using reverse transcriptase quantitative PCR (RT-qPCR). The effect of FOXD3-AS1 silencing on the proliferation of glioblastoma cells was assessed in vitro using CCK-8 and colony formation assays and in vivo using xenograft mouse models. Additionally, the expression levels of the apoptosis-related proteins, Bcl-2 and Bax, were assessed using western blotting. Bioinformatic analysis and luciferase reporter assays assisted by RNA immunoprecipitation (RIP) and RNA pull-down experiments were conducted to validate the interactions among FOXD3-AS1, CCND1, and miR-3918. RESULTS: FOXD3-AS1 and CCND1 were highly expressed in glioblastoma tissues and cells, whereas miR-3918 was poorly expressed. The expressions of FOXD3-AS1 and CCND1 were inversely associated with miR-3918 levels in glioblastoma tissues. FOXD3-AS1 silencing weakened the proliferative capacity and accelerated apoptosis of glioblastoma cells in vitro and hampered tumor growth in vivo. Mechanical investigations showed that FOXD3-AS1 knockdown increased miR-3918 expression and inhibited glioblastoma cell growth. Meanwhile, the miR-3918 inhibitor restored CCND1 expression and induced the opposite outcome. CONCLUSION: FOXD3-AS1 facilitates the CCND1-driven progression of glioblastoma by serving as a competing endogenous RNA (ceRNA) for miR-3918. This suggests that FOXD3-AS1 may be a potential therapeutic target for the management of glioblastoma development.

Neuronavigation-assisted neuroendoscopy versus conventional craniotomy for hypertensive cerebellar hemorrhage: A comparative analysis of efficacy and outcomes.

OBJECTIVE: Hypertensive cerebellar hemorrhage is a severe condition in neurosurgery, associated with high disability and mortality rates. The present study compares the efficacy and outcomes of neuronavigation-assisted neuroendoscopy versus conventional microscope (craniotomy) in treating patients with hypertensive cerebellar hemorrhage. METHODS: A retrospective study was conducted by analyzing medical records of patients with hypertensive cerebellar hemorrhage treated at Wuhan No.1 Hospital between February 2015 and February 2019. The study included 65 patients who underwent either neuronavigation-assisted neuroendoscopy (n = 35) or conventional microscopy treatment (n = 30). All patients underwent standard neurological and clinical examinations, as well as routine laboratory tests upon admission. The diagnosis of hypertensive cerebellar hemorrhage was based on computed tomography (CT) findings. Basic parameters, clinical status on admission, imaging results, management, and outcome measures were evaluated and compared between the two groups. RESULTS: Neuronavigation-assisted neuroendoscopy showed advantages over craniotomy in terms of surgical procedure time and intraoperative blood loss ((81.91 ± 17.77) min vs (195.20 ± 31.97) min, (63.66 ± 12.42) ml vs (335.00 ± 104.26) ml, P < 0.01). The hematoma evacuation rate was higher in neuroendoscopy group ((94.37 ± 5.174)% compared to the craniotomy group ((90.80 ± 5.404)%, P < 0.01). Additionally, the time of ventricular drainage was shorter in the neuroendoscopy group ((4.83 ± 1.671) days) than in the craniotomy group ((7.70 ± 1.878) days, P < 0.01). Neuroendoscopy group also resulted in fewer surgical complications and a shorter hospital stay (P < 0.05). There was no significant difference in the risk of rebleeding and mortality between the neuroendoscopy and craniotomy group (P > 0.05). CONCLUSION: Neuronavigation-assisted neuroendoscopy is a rapid, safe, and effective minimally invasive technique for the treatment of hypertensive cerebellar hemorrhage. It offers potential benefits in reducing surgical complications and hospital stay compared to conventional craniotomy.

Treadmill exercise modulates the medial prefrontal-amygdala neural circuit to improve the resilience against chronic restraint stress.

Aerobic exercise effectively ameliorates mental disorders including anxiety and depression. Current findings mainly attribute its neural mechanism to the improvement of adult neurogenesis, while leaving the possible circuitry mechanism unclear. In the current study, we identify the overexcitation of the medial prefrontal cortex (mPFC) to basolateral amygdala (BLA) pathway under chronic restraint stress (CRS), and 14-day treadmill exercise selectively reverses such abnormalities. Using chemogenetic approaches, we find that the mPFC-BLA circuit is necessary for preventing anxiety-like behaviors in CRS mice. These results collectively suggest a neural circuitry mechanism by which exercise training improves the resilience against environmental stress.

Analysis of the effects of stent-induced deformation on the hemodynamics of MCA aneurysms.

The use of a stent to coil an aneurysm can alter the position of the main blood vessel and affect blood flow within the sac. This study thoroughly examines the impact of stent-induced changes on the risk of MCA aneurysm rupture. The research aims to assess the effects of coiling and vessel deformation on blood flow dynamics by comparing the OSI, WSS, and blood structure of two distinct MCA aneurysms to identify high-risk areas for hemorrhage. Computational fluid dynamics is used to model blood flow. The results indicate that aneurysm deformation does not always decrease the risk of rupture, and coiling is more effective in occluding blood flow than aneurysm deformation.

Mediating Role of Depression Between Diabetes Management Self-Efficacy and Diabetes Self-Care Behavior Among Elderly Type 2 Diabetes Mellitus Patients in China.

Objective: To investigate the current status of diabetes self-care behavior and the association between depression, self-efficacy and self-care in a sample of Chinese elderly type 2 diabetes mellitus (T2DM) patients. Methods: A cross-sectional study with a convenient sample including 240 elderly T2DM patients collected the data of demographic characteristics, diabetes self-care behavior, self-efficacy and depression status. The difference of self-care behavior in different sample characteristics was compared by independent t-test. The Personal correlation analysis was employed to examine the correlation of study variables. The method of bootstrap was used to analyze mediating role of depression. Results: Only 22.5% of patients reported better diabetes self-care behavior and depression partly mediated the association between self-efficacy and self-care behavior. The significant coefficient of path a (B = -0.052, p < 0.001) and path b (B = -0.423, p < 0.05) indicated negative associations of self-efficacy on depression, and depression on self-care behavior. The indirect effect (Path a × b) between self-efficacy and self-care behavior through depression was significant (B = 0.022, p < 0.05), the 95% bias-corrected bootstrap confidence interval was 0.004 to 0.006. Meanwhile, the mediating role of depression was not found significant among the participants reported 60-74 years old (B = 0.104, p < 0.001). But depression completely mediated this association among the participants reported 75-89 years old (B = 0.034, p > 0.05). Conclusion: The level of diabetes self-care behavior among the elderly T2DM patients in Dahu community of Anqing city was hardly optimistic. The self-efficacy focused intervention could be encouraged for community and clinicians to improve diabetes self-care behavior. Moreover, the prevalence of depression and T2DM is increasing in younger population. More work is needed to confirm these findings, especially conducting cohort studies on different populations.

Amygdala neural ensemble mediates mouse social investigation behaviors.

Innate social investigation behaviors are critical for animal survival and are regulated by both neural circuits and neuroendocrine factors. Our understanding of how neuropeptides regulate social interest, however, is incomplete at the current stage. In this study, we identified the expression of secretin (SCT) in a subpopulation of excitatory neurons in the basolateral amygdala. With distinct molecular and physiological features, BLASCT+ cells projected to the medial prefrontal cortex and were necessary and sufficient for promoting social investigation behaviors, whilst other basolateral amygdala neurons were anxiogenic and antagonized social behaviors. Moreover, the exogenous application of secretin effectively promoted social interest in both healthy and autism spectrum disorder model mice. These results collectively demonstrate a previously unrecognized group of amygdala neurons for mediating social behaviors and suggest promising strategies for social deficits.

A gut-brain axis mediates sodium appetite via gastrointestinal peptide regulation on a medulla-hypothalamic circuit.

Salt homeostasis is orchestrated by both neural circuits and peripheral endocrine factors. The colon is one of the primary sites for electrolyte absorption, while its potential role in modulating sodium intake remains unclear. Here, we revealed that a gastrointestinal hormone, secretin, is released from colon endocrine cells under body sodium deficiency and is indispensable for inducing salt appetite. As the neural substrate, circulating secretin activates specific receptors in the nucleus of the solitary tracts, which further activates the downstream paraventricular nucleus of the hypothalamus, resulting in enhanced sodium intake. These results demonstrated a previously unrecognized gut-brain pathway for the timely regulation of sodium homeostasis.

Planar cell polarity protein Celsr2 maintains structural and functional integrity of adult cortical synapses.

A few developmental genes remain persistently expressed in the adult stage, whilst their potential functions in the mature brain remain underappreciated. Here, we report the unexpected importance of Celsr2, a core Planar cell polarity (PCP) component, in maintaining the structural and functional integrity of adult neocortex. Celsr2 is highly expressed during development and remains expressed in adult neocortex. In vivo synaptic imaging in Celsr2 deficient mice revealed alterations in spinogenesis and reduced neuronal calcium activities, which are associated with impaired motor learning. These phenotypes were accompanied with anomalies of both postsynaptic organization and presynaptic vesicles. Knockout of Celsr2 in adult mice recapitulated those features, further supporting the role of Celsr2 in maintaining the integrity of mature cortex. In sum, our data identify previously unrecognized roles of Celsr2 in the maintenance of synaptic function and motor learning in adulthood.

Suctioning Versus Traditional Access Sheath in Mini-Percutaneous Nephrolithotomy: A Systematic Review and Meta-analysis.

PURPOSE: The suctioning access sheath (SAS) is a novel access sheath connected to a negative pressure suction device and absorbs fragments. Some comparative studies have reported SAS with a higher stone-free rate and lower operative time. However, no higher-level evidence was published to support SAS. Hence, this systematic review and meta-analysis aimed to assess the clinical safety and efficacy of SAS versus traditional access sheath (TAS) for the treatment of renal stones in mini-percutaneous nephrolithotomy (MPCNL). MATERIALS AND METHODS: A systematic review of the literature was conducted using Pubmed, Embase(Ovid), Medline（EBSCO）, Cochrane central register of controlled trials, and Sinomed to search comparative studies as recent as December 2020 that assessed the safety and effectiveness of SAS in PCNL. The quality of retrospective case-control studies (RCCs) and randomized controlled trials (RCTs) were evaluated by the Newcastle-Ottawa Scale (NOS) and the Cochrane risk of bias tool, respectively. The Oxford center set up evidence-based medicine was used to assess the level of evidence (LE). Statistical analyses were performed by the comprehensive meta-analysis program. RESULTS: Seven studies, with a total of 1655 patients, were included. Compared with the TAS group, the SAS group had a shorter operative time (MD= -17.30; 95%CI:-23.09,-11.51; P＜.00001), higher stone-free rate (OR=2.37;95%CI:1.56,3.61;P<.0001), fewer total complication rate (OR=0.50;95%CI:0.35,0.70;P<.0001), lower auxiliary procedures rate  (OR=0.48;95%CI:0.36,0.64; P<.00001), and lower postoperative fever rate (OR=0.46;95%CI:0.34,0.62;P＜.00001). CONCLUSION: The SAS can significantly improve MPCNL in the stone-free rate, operative time, and total complication rate, especially for auxiliary procedures and postoperative fever rates.

Ascertaining the Inconsistency of AEC Students' Perceptions and Behaviors Regarding Sustainability by Mixed Methods.

University students in architecture, engineering, and construction (AEC) are the main force and future leaders of the construction industry, and their values shape the model and direction of the industry's future development. The construction industry is the largest contributor of waste and greenhouse gas emissions. However, there is an inconsistency between AEC university students' perceptions and behaviors regarding sustainability, which has received little attention. This study attempts to shed light on the root causes of the inconsistency from the psychological perspective, incorporating construal level (CL) theory and psychological distance (PD) theory into situational settings of the experiment. We recruited 556 AEC students from 20 different universities to participate in data collection. Research findings revealed that PD has a significant influence on AEC students' recycling behavior with variance in the effect of different dimensions, even though CL has no significant impact. Furthermore, findings show that spatial distance poses the greatest impact on AEC student recycling behavior, followed by information distance, temporal distance, experience distance, hypothetical distance, and social distance. This study contributes to the body of knowledge by introducing CL and PD into sustainability perception and behavior research in construction and has practical implications for universities with sustainability curricula in AEC.