Preoperative Patient and Lesion Features Are Valuable for Predicting the Prognosis of Resectable Peripheral Non-Small Cell Lung Cancer.

OBJECTIVE: The aim of the study was to investigate the preoperative factors affecting the survival of patients with resectable peripheral non-small cell lung cancer (NSCLC) to improve the management of NSCLC. METHODS: One hundred ninety-nine patients with peripheral NSCLC diagnosed clinically without lymph node metastasis were enrolled. The preoperative computed tomography characteristics of the tumors were retrospectively analyzed and the preoperative clinical data were collected. The size of the solid components for lung adenocarcinomas containing ground-glass opacity (GGO) component were measured. Kaplan-Meier method with log-rank test was used to compare overall survival (OS) between groups. Univariate and multivariate cox regression analyses were used to identify prognostic factors. RESULTS: Survival analysis showed that the OS of the group with a tumor of 3 cm or less was longer than that of the group with a tumor greater than 3 cm, the OS of the group with GGO component was superior to that of the group without GGO component, and the OS of the group with elevated carcinoembryonic antigen (CEA) levels was inferior to that of the group with normal CEA levels. Multivariate Cox regression analysis showed that tumor size, density, and preoperative CEA level were independent factors affecting OS, with hazard ratios of 2.401, 0.457, and 1.948, respectively. The analysis of lung adenocarcinomas with GGO component demonstrated that the mean size of the solid component in the nonsurviving group was significantly larger than that in the surviving group (mean, 23 ± 6.4 vs 8.6 ± 7.0 mm). The area under the receiver operating characteristic curve of the solid component size of lung cancer containing GGO component to predict postoperative death was 0.932. CONCLUSIONS: Tumor size, density, and preoperative CEA level were independent prognostic factors of patients with resectable peripheral NSCLCs. Preoperative computed tomography findings can be valuable for predicting the prognosis of patients with NSCLC after surgery.

Fabrication of 2D silicon nano-mold by side etch lift-off method.

Nano-imprint technology is a method of nano-pattern reproduction, has the characteristics of high resolution, high throughput, and low-cost. It can reduce the complexity and cost of the equipment while improving the resolution, which considered a promising industrial production technology. The key to nanoimprinting lies in the mold, and the quality of the mold directly determines the quality of the imprinted graphics. Here, a method for fabricating sub-100 nm concave 2D silicon nano-mold by side etch lift-off is proposed. The effects of different wet etching time and the metal deposition angle on the width of nanochannels were studied. The measurement result of dry etching shows that on the entire 4 inch silicon wafer, the width of the nanochannel varies by 4% and the depth by 2%. The width of the nanochannel between chips varies by 0.7%, and the depth variation is 1%. With this new method, high-precision and large-scale silicon nano-mold can be produced, which has great potential for realizing high-precision and low-cost manufacturing of nano devices.

The Effects of Inter-Set Recovery Time on Explosive Power, Electromyography Activity, and Tissue Oxygenation during Plyometric Training.

Performing continuous sets to failure is fatiguing during the plyometric training. Cluster sets have been used to redistribute total rest time to create short frequent sets so that muscle fatigue can be avoided. The purpose of the study was to investigate the effects of inter-set recovery time on lower extremity explosive power, neuromuscular activity, and tissue oxygenation during plyometric exercise and recovery. An integrated assessment of explosive power, muscle electrical activity, and tissue oxygenation was adopted in the present study to help understand local muscle metabolism and fatigue during plyometric exercise and recovery. Ten university male basketball players participated in this study. Subjects performed 4 groups of exercise, each group comprised of 3 sets of jumps: 1, 2, 3, or 5 min. Surface electromyography (sEMG) signals were collected from 9 lower extremity muscles; near-infrared spectroscopy (NIRS) was recorded on vastus lateralis; mechanical data during plyometric exercise were collected from a force plate. No significant differences among sets and among groups were found regarding explosive power, jump height, EMG intensity, mean power frequency, the rate of tissue saturation index, and HbO2 changes between baseline and recovery. The current study has shown no muscular fatigue induced during the 4 groups of exercise. The results of this study may help inform recommendations concerning the recovery time during plyometric exercises at low loads (30% 1 RM).

Wheelchair propulsion fatigue thresholds in electromyographic and ventilatory testing.

STUDY DESIGN: Qualitative study. OBJECTIVE: The objective of the present study are physiological processes occurring when the intensity of manual wheelchair propulsion approaches levels causing muscular fatigue. In particular, we set out to (1) detect the electromyographic (EMG) and ventilatory fatigue threshold during a single wheelchair incremental test, (2) examine the relationship between EMG threshold (EMGT) and ventilatory threshold (VT), and (3) detect the EMG threshold differences between the propulsive and recovery muscle synergies. SETTING: Biomechanics laboratory at the University of Alberta, Canada. METHODS: Oxygen uptake and EMG signals from ten wheelchair users (seven males and three females) were recorded as they were each performing an incremental propulsion bout in their own wheelchairs on a wheelchair ergometer. The V-slope method was used to identify the VT, and the EMGT of each of the eight muscles (anterior deltoid, middle deltoid, posterior deltoid, infraspinatus, upper trapezius, sternal head of pectoralis major, biceps brachii, and triceps brachii) was determined using the bisegmental linear regression method. RESULTS: For each participant, we were able to determine the EMGT and VT from a single incremental wheelchair propulsion bout. EMGT stands in good agreement with VT, and there was a high similarity in EMGT between push and recovery muscles (intraclass correlation coefficient = 0.91). CONCLUSION: The EMG fatigue threshold method can serve as a valid and reliable tool for identifying the onset of muscular fatigue during wheelchair propulsion, thus providing a foundation for automated muscle fatigue detection/prediction in wearable technology.

Spectral CT imaging parameters and Ki-67 labeling index in lung adenocarcinoma.

OBJECTIVE: To explore the correlation between the spectral computed tomography (CT) imaging parameters and the Ki-67 labeling index in lung adenocarcinoma. METHODS: Spectral CT imaging parameters [iodine concentrations of lesions (ICLs) in the arterial phase (ICLa) and venous phase (ICLv), normalized IC in the aorta (NICa/NICv), slope of the spectral HU curve (λHUa/λHUv) and monochromatic CT number enhancement on 40 keV and 70 keV images (CT40keVa/v, CT70keVa/v)] in 34 lung adenocarcinomas were analyzed, and common molecular markers, including the Ki-67 labeling index, were detected with immunohistochemistry. Different Ki-67 labeling indexes were measured and grouped into four grades according to the number of positive-stained cells (grade 0, ≤1%; 1%30%). One-way analysis of variance (ANOVA) was used to compare the four different grades, and the Bonferroni method was used to correct the P value for multiple comparisons. A Spearman correlation analysis was performed to further research a quantitative correlation between the Ki-67 labeling index and spectral CT imaging parameters. RESULTS: CT40keVa, CT40keVv, CT70keVa and CT70keVv increased as the grade increased, and CT70keVa and CT70keVv were statistically significant (P<0.05). These four parameters and the Ki-67 labeling index showed a moderate positive correlation with lung adenocarcinoma nodules. ICL, NIC and λHU in the arterial and venous phases were not significantly different among the four grades. CONCLUSIONS: The spectral CT imaging parameters CT40keVa, CT40keVv, CT70keVa and CT70keVv gradually increased with Ki-67 expression and showed a moderate positive correlation with lung adenocarcinomas. Therefore, spectral CT imaging parameter-enhanced monochromatic CT numbers at 70 keV may indicate the extent of proliferation of lung adenocarcinomas.

Primary yolk sac tumor of the endometrium: a case report and review of the literatures.

PURPOSE: Yolk sac tumor (YST) is a malignant tumor derived from germ cells and usually occurs in the gonads. Extra-gonadal YST is most commonly seen in the vagina of children, but rarely in the cervix, vulva and endometrium. Primary YST of endometrium was extremely rare, standard treatment was still controversial and no guideline was established so far. The aim of the present study was to provide a comprehensive understanding and systematic thought for the management of primary YST of endometrium. METHODS: A systematic research of the literature was conducted in Scopus, PubMed database and Cochrane Library, including case reports and case series. We summarized clinical characteristics, treatments and prognosis of all collected cases. We collected data regarding patients, serum AFP level, initial symptoms, surgical information, postoperative chemotherapy and radiotherapy. A new case was also discussed. RESULTS: We found only 26 cases have been reported previously. We reported a new case of primary endometrial YST in a 27-year-old woman, and in this case, we creatively performed bilaterally ovarian preservation and used DC (docetaxel and carboplatin) regimen of postoperative chemotherapy, we achieved a relatively good prognosis during the follow-up period of 14 months. CONCLUSION: Primary YST of endometrium, kind of highly malignant germ cell tumors, was extremely rare, of which initial symptom is usually abnormal vaginal bleeding. Standard treatment was still controversial and no guideline was established so far. Surgery combining with postoperative chemotherapy was considered effective for treatment of primary endometrial YST. Decision on whether to preserve ovaries in young patient with early stage needs careful consideration, comprehensive preoperative assessment and full communication. Intraoperative biopsy and strict postoperative follow-up are recommended. However, standard chemotherapy regimen and feasibility of postoperative radiotherapy remains to be discussed.

Discrimination of Malignant versus Benign Mediastinal Lymph Nodes Using Diffusion MRI with an IVIM Model.

OBJECTIVES: To investigate the value of an intravoxel incoherent motion (IVIM) diffusion model for discriminating malignant versus benign mediastinal lymph nodes (MLN). METHODS: Thirty-five subjects with enlarged MLN were scanned at 1.5 Tesla. Diffusion-weighted imaging was performed with eight b-values. IVIM parameters D, D*, and f, as well as apparent diffusion coefficient (ADC) from a mono-exponential model were obtained. 91 nodes (49 malignant and 42 benign) were analysed with pathologic (n=90) or radiologic (n=1) confirmations. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance. RESULTS: The mean values of D, ADC, and f for the malignant group were significantly lower than those for the benign group (p<0.001), while D* showed no significant difference (p=0.281). In the ROC analysis, the combination of D and f produced the largest area under the curve (0.953) compared to ADC or other individual IVIM parameters, leading to the best specificity (92.9%) and diagnostic accuracy (90.1%). CONCLUSION: This study demonstrates that the combination of IVIM parameters can improve differentiation between malignant and benign MLN as compared to using ADC alone. KEY POINTS: • Diffusion MRI is useful for non-invasively discriminating malignant versus benign lymph nodes. • A mono-exponential model is not adequate to characterise diffusion process in lymph nodes. • IVIM model is advantageous over mono-exponential model for assessing lymph node malignancy. • Combination of IVIM parameters improves differentiation of malignant versus benign lymph nodes.

Multivariate Analysis of Pleural Invasion of Peripheral Non-Small Cell Lung Cancer-Based Computed Tomography Features.

OBJECTIVE: The aim of this study was to comprehensively analyze computed tomography features to improve the diagnostic accuracy of visceral pleural invasion of peripheral non-small cell lung cancer. METHODS: The computed tomography features of 205 non-small cell lung cancer patients were retrospectively studied. The lesion's relation to the pleura was classified into 5 grades. A multivariate logistic regression analysis was conducted to identify independent factors predicting pleural invasion. RESULTS: The multivariate logistic regression analysis showed that sex (odds ratio [OR], 1.822; P = 0.080), pleural indentation (OR, 4.111; P < 0.001), tumor density (OR, 2.735; P = 0.008), and distance between the lesion and pleura (OR, 1.981; P = 0.048) were independent predictors of pleural invasion. A patient with a score of 10.6 had an 80% risk of pleural invasion, whereas a score lower than 2 was associated with a lower (20%) risk of pleural invasion. CONCLUSIONS: Comprehensive consideration of these factors of pleural indentation, sex, tumor density, and distance between the lesion and pleura might improve the diagnosis of pleural invasion.

Diffusion-tensor imaging as an adjunct to dynamic contrast-enhanced MRI for improved accuracy of differential diagnosis between breast ductal carcinoma in situ and invasive breast carcinoma.

OBJECTIVE: To determine the value of diffusion-tensor imaging (DTI) as an adjunct to dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for improved accuracy of differential diagnosis between breast ductal carcinoma in situ (DCIS) and invasive breast carcinoma (IBC). METHODS: The MRI data of 63 patients pathologically confirmed as breast cancer were analyzed. The conventional MRI analysis metrics included enhancement style, initial enhancement characteristic, maximum slope of increase, time to peak, time signal intensity curve (TIC) pattern, and signal intensity on FS-T2WI. The values of apparent diffusion coefficient (ADC), directionally-averaged mean diffusivity (Davg), exponential attenuation (EA), fractional anisotropy (FA), volume ratio (VR) and relative anisotropy (RA) were calculated and compared between DCIS and IBC. Multivariate logistic regression was used to identify independent factors for distinguishing IBC and DCIS. The diagnostic performance of the diagnosis equation was evaluated using the receiver operating characteristic (ROC) curve. The diagnostic efficacies of DCE-MRI, DWI and DTI were compared independently or combined. RESULTS: EA value, lesion enhancement style and TIC pattern were identified as independent factor for differential diagnosis of IBC and DCIS. The combination diagnosis showed higher diagnostic efficacy than a single use of DCE-MRI (P=0.02), and the area of the curve was improved from 0.84 (95% CI, 0.67-0.99) to 0.94 (95% CI, 0.85-1.00). CONCLUSIONS: Quantitative DTI measurement as an adjunct to DCE-MRI could improve the diagnostic performance of differential diagnosis between DCIS and IBC compared to a single use of DCE-MRI.

Diffusion-weighted images (DWI) without ADC values in assessment of small focal nodules in cirrhotic liver.

OBJECTIVE: To assess if diffusion-weighted magnetic resonance (MR) imaging without apparent diffusion coefficient (ADC) values provides added diagnostic value in combination with conventional MR imaging in the detection and characterization of small nodules in cirrhotic liver. METHODS: Two observers retrospectively and independently analyzed 86 nodules (≤3 cm) certified pathologically in 33 patients with liver cirrhosis, including 48 hepatocellular carcinoma (HCC) nodules, 13 high-grade dysplastic nodules (HDN), 10 low-grade dysplastic nodules (LDNs) and 15 other benign nodules. All these focal nodules were evaluated with conventional MR images (T1-weighted, T2-weighted and dynamic gadolinium-enhanced images) and breath-hold diffusion-weighted images (DWI) (b=500 s/mm(2)). The nodules were classified by using a scale of 1-3 (1, not seen; 3, well seen) on DWI for qualitative assessment. These small nodules were characterized by two radiologists. ADC values weren't measured. The diagnostic performance of the combined DWI-conventional images and the conventional images alone was evaluated using receiver operating characteristic (ROC) curves. The area under the curves (Az), sensitivity and specificity values for characterizing different small nodules were also calculated. RESULTS: Among 48 HCC nodules, 33 (68.8%) were graded as 3 (well seen), 6 (12.5%) were graded as 2 (partially obscured), and 9 weren't seen on DWI. Among 13 HDNs, there were 3 (23.1%) and 4 (30.8%) graded as 3 and 2 respectively. Five (50%) of 10 benign nodules were partially obscured and slightly hyperintense. For 86 nodules, the average diagnostic accuracy of combined DWI-conventional images was 82.56%, which was increased significantly compared with conventional MR images with 76.17%. For HCC and HDN, the diagnostic accuracy of combined DWI-conventional images increased from 78.69% to 86.07%. CONCLUSIONS: Diffusion-weighted MR imaging does provide added diagnostic value in the detection and characterization of HDN and HCC, and it may not be helpful for LDN and regenerative nodule (RN) in cirrhotic liver.

Corrigendum: How can the collaborative participation of regulators, whistleblowers, and parties effectively promote rumor management in public health emergencies?

[This corrects the article DOI: 10.3389/fpubh.2023.1290841.].

Vericiguat on C-reactive Protein Level and Prognosis in Patients with Hypertensive Heart Failure.

INTRODUCTION: Hypertensive heart failure (HHF) has a high incidence and poor prognosis. AIM: This article evaluated the efficacy and safety of Vericiguat in HHF and analyzed the relationship between C-reactive protein (CRP) levels and patient prognosis. METHODS: 110 HHF patients were divided into Placebo and Vericiguat groups. Cardiac function was assessed by echocardiography and 6-minute walk test (6MWT). Blood samples were collected to detect the levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), cardiac troponin I (cTnI), endothelin (ET-1), nitric oxide (NO), and CRP. RESULTS: Left ventricular end systolic diameter (LVESD) and left ventricular end diastolic dimension (LVEDD) were reduced, the left ventricular ejection fraction (LVEF) and 6MWT were increased, and the serum levels of NT-proBNP, cTnI, ET-1, NO, and CRP were decreased in Vericiguat group as against Placebo group; The total effective rate was 76.4% in Placebo group and 92.7% in Vericiguat group (P < 0.05). The adverse reaction rate was 10.9% and 9.1% (P > 0.05). The proportion of persons with poor prognosis and no improvement of cardiac function in patients with highly expressed CRP before treatment was higher as against patients with low expression of CRP (P < 0.05). Highly expressed CRP is an independent risk factor for poor prognosis. CONCLUSION: Vericiguat is safe and effective in improving cardiac function in HHF patients.

Positive effects of brisk walking and Tai Chi on cognitive function in older adults: An fNIRS study.

Exercise has shown to have beneficial effects on cognition in older adults. The purpose of this study was to investigate the cortical hemodynamic responses during the word-color Stroop test (WCST) prior and after acute walking and Tai Chi exercise by functional near-infrared spectroscopy (fNIRS). Twenty participants (9 males, mean age 62.8 ± 5.2), first underwent a baseline WCST test, after which they took three WCST tests in a randomized order, (a) after sitting rest (control), (b) after 6 minutes performing Tai Chi Quan, and (c) after a bout of 6 minutes brisk walking. During these four WCST tests cortical hemodynamic changes in the prefrontal area were monitored with fNIRS. Both brisk walking and Tai Chi enhanced hemodynamic activity during the Stroop incongruent tasks, leading to improved cognitive performance (quicker reaction time). Brisk walking induced a greater hemodynamic activity in the right dorsolateral prefrontal cortex (DLPFC) and ventrolateral prefrontal cortex (VLPFC) area, whereas Tai Chi induced a greater bilateral hemodynamic activity in the DLPFC and VLPFC areas. The present study provided empirical evidence of enhanced hemodynamic response in task- specific regions of the brain that can be achieved by a mere six minutes of brisk walking or Tai Chi in older adults.

Health-related quality of life after total knee arthroplasty and unicompartmental knee arthroplasty for unicompartmental osteoarthritis: A systematic review and meta-analysis.

BACKGROUND: While previous research has demonstrated potential advantages of unicompartmental knee arthroplasty (UKA) over total knee arthroplasty (TKA), particularly in terms of clinical outcomes such as function and pain relief, the specific impact on health-related quality of life (HRQOL) remains unclear. This systematic review and meta-analysis aim to address this gap by comparing HRQOL outcomes between UKA and TKA, providing valuable insights for clinical decision-making. METHODS: We conducted a literature search in the PubMed, Embase, Cochrane Controlled Register of Trials (CENTRAL), and Web of Science databases up to July 15, 2023. Eligible studies assessed HRQOL using EQ-5D, SF-36, or SF-12 and were assessed for methodological quality using the Newcastle-Ottawa Scale (NOS). RESULTS: Seven eligible studies were included, comprising a total of 64,585 patients with 35,809 undergoing TKA and 28,776 undergoing UKA. Patient age ranged from 52.0 to 67.7 years with an average BMI ranging from 27.2 to 31.0 kg/m2. Follow-up periods ranged from 6 months to 10 years. Five studies (63,829 patients) that evaluated HRQOL using EQ-5D showed significantly better outcomes for UKA compared to TKA (MD -0.04, 95% CI -0.05 to -0.02). Two studies (756 patients) that evaluated HRQOL using SF-36 showed no significant difference between TKA and UKA. Five studies (63,286 patients) that evaluated functional outcomes using Oxford Knee Score (OKS) showed significantly better functional scores for UKA compared to TKA (MD -1.29, 95% CI -1.86 to -0.72). Four studies (24,570 patients) that reported patient satisfaction showed no statistically significant difference between TKA and UKA (MD 0.97, 95% CI 0.90 to 1.05). Further subgroup analysis did not affect the conclusions. CONCLUSIONS: Our meta-analysis suggests that UKA is associated with better HRQOL and knee function, as well as similar patient satisfaction, compared to TKA for patients with unicompartmental osteoarthritis.

The differential diagnosis of lung precursor glandular lesions, micro-invasive adenocarcinoma, and invasive adenocarcinoma using low dose spectral computed tomography perfusion imaging.

Background: Few studies about the association between computed tomography (CT) perfusion imaging parameters and invasiveness in lung adenocarcinoma (LUAD) have been conducted using low dose spectral CT perfusion imaging. The purpose of this study was to investigate application of spectral revolution CT low-dose perfusion imaging in the differential diagnosis of different pathological subtypes of LUAD. Methods: This was a cross-sectional study based on historical data from January 2018 to May 2019 in Peking University Cancer Hospital & Institute. A total of 62 cases were enrolled, including 2 cases of atypical adenomatous hyperplasia (AAH), 3 cases of adenocarcinoma in situ (AIS), 4 cases of minimally invasive adenocarcinoma (MIA), and 53 cases of invasive adenocarcinoma (IAC), all confirmed with pathology. The inclusion and exclusion criteria were regulated. Using Revolution low-dose CT perfusion imaging (GE, USA), the CT perfusion parameters of hemodynamics were obtained: blood flow (BF), blood volume (BV), impulse residue function time of arrival (IRF TO), maximum slope of increase (MSI), mean transit time (MTT), permeability surface area product (PS), positive enhancement integral (PEI), and maximum enhancement time (Tmax). Univariate analysis of variance (ANOVA) or Kruskal-Wallis test was used to compare the differences of CT perfusion quantitative parameters among AAH, AIS, MIA, and IAC. Mann-Whitney test was used to compare the difference of CT perfusion imaging parameters between preinvasive lesions (AAH and AIS) and invasive lung cancer (MIA and IAC). Results: Statistically significant differences in IRF TO were observed in LUAD with different invasiveness, namely, among AIS, MIA, and IAC groups (0.56±0.74 vs. 0.54±1.08 vs. 4.39±2.19, P=0.004). Statistically significant differences in IRF TO were also observed between pre-invasive lesions group (AAH and AIS) and invasive lung cancer group (MIA and IAC) (1.12±1.27 vs. 3.75±2.79, P=0.031), and between AAH + AIS + MIA groups and IAC group (0.83±1.13 vs. 4.12±2.69, P<0.001). There were no statistically significant differences in other CT perfusion parameters of hemodynamics among different pathological subtypes of LUAD (P>0.05). Conclusions: The low-dose perfusion parameter IRF TO of revolution CT has the potential to be employed in the differential diagnosis of different pathological subtypes of LUAD.

Tenecteplase versus alteplase in treatment of acute ST-segment elevation myocardial infarction: A randomized non-inferiority trial.

BACKGROUND: A phase II trial on recombinant human tenecteplase tissue-type plasminogen activator (rhTNK-tPA) has previously shown its preliminary efficacy in ST elevation myocardial infarction (STEMI) patients. This study was designed as a pivotal postmarketing trial to compare its efficacy and safety with rrecombinant human tissue-type plasminogen activator alteplase (rt-PA) in Chinese patients with STEMI. METHODS: In this multicenter, randomized, open-label, non-inferiority trial, patients with acute STEMI were randomly assigned (1:1) to receive an intravenous bolus of 16 mg rhTNK-tPA or an intravenous bolus of 8 mg rt-PA followed by an infusion of 42 mg in 90 min. The primary endpoint was recanalization defined by thrombolysis in myocardial infarction (TIMI) flow grade 2 or 3. The secondary endpoint was clinically justified recanalization. Other endpoints included 30-day major adverse cardiovascular and cerebrovascular events (MACCEs) and safety endpoints. RESULTS: From July 2016 to September 2019, 767 eligible patients were randomly assigned to receive rhTNK-tPA ( n = 384) or rt-PA ( n = 383). Among them, 369 patients had coronary angiography data on TIMI flow, and 711 patients had data on clinically justified recanalization. Both used a -15% difference as the non-inferiority efficacy margin. In comparison to rt-PA, both the proportion of patients with TIMI grade 2 or 3 flow (78.3% [148/189] vs. 81.7% [147/180]; differences: -3.4%; 95% confidence interval [CI]: -11.5%, 4.8%) and clinically justified recanalization (85.4% [305/357] vs. 85.9% [304/354]; difference: -0.5%; 95% CI: -5.6%, 4.7%) in the rhTNK-tPA group were non-inferior. The occurrence of 30-day MACCEs (10.2% [39/384] vs. 11.0% [42/383]; hazard ratio: 0.96; 95% CI: 0.61, 1.50) did not differ significantly between groups. No safety outcomes significantly differed between groups. CONCLUSION: rhTNK-tPA was non-inferior to rt-PA in the effect of improving recanalization of the infarct-related artery, a validated surrogate of clinical outcomes, among Chinese patients with acute STEMI. TRIAL REGISTRATION: www.ClinicalTrials.gov (No. NCT02835534).

How can the collaborative participation of regulators, whistleblowers, and parties effectively promote rumor management in public health emergencies?

To effectively address the mental health risks associated with public health emergencies, it is crucial to actively manage rumors. This study explores the dynamic evolutionary process of rumor diffusion and its collaborative governance in public health emergencies. A game-theoretic model is constructed, involving three main actors: regulators, parties involved in public health emergencies (PIPHE), and whistle-blowers. The behaviors and game outcomes of each party are analyzed, and the effectiveness and feasibility of the model are validated through numerical simulations. The findings of this study reveal that various factors, such as regulatory costs, penalty income, reputation damage for regulators; image loss, reputation enhancement, penalty expenditure for PIPHE; and time costs, social responsibility, and reward income for whistle-blowers, all influence the behavioral choices and game equilibrium of each party. Optimization strategies for rumor governance are proposed in this study, including enhancing the sense of responsibility and capability among regulators, increasing transparency and credibility among PIPHE, and encouraging and protecting the participation of whistle-blowers. This study provides a comprehensive analytical framework for rumor governance in public health emergencies, contributing to improving the governance of public health emergencies and maintaining online public health orders for social sustainability.

Smartphone readable colorimetry and ICP-MS dual-mode sensing platform for ultrasensitive and label-free detection of Escherichia coli based on filter-assisted separation.

The development and application of portable and user-friendly biosensing technology for rapid detection of pathogenic bacteria are essential for human and environmental care. In this work, based on the phenomenon that the filter membrane can selectively separate MnO2 nanosheets (MnO2 NSs) and Mn2+, a novel label-free sensing platform was developed to detect the Escherichia coli (E. coli) using ß-galactosidase (ß-Gal) as a marker. MnO2 NSs were utilized as a dual-mode signal molecule of smartphone-based colorimetric analysis and inductively coupled plasma mass spectrometry (ICP-MS). ß-Gal can catalyze the 4-Aminophenyl ß-D-galactopyranoside (PAPG) to produce p-aminophenol (PAP), which could reduce MnO2 NSs to Mn2+. After selective separation of MnO2 NSs and Mn2+ by the filter, colorimetric detection was achieved with a smartphone by identifying the RGB value of the MnO2 NSs coated membrane, while the Mn2+ in the filtrate was detected by ICP-MS. Under optimal conditions, the limits of detection (LODs) of E. coli by smartphone-based RGB analysis and ICP-MS were 5.6 × 103 CFU mL-1 and 35 CFU mL-1, respectively. This method was successfully used for E. coli assay in meat, vegetables, and fruit samples with the advantages of sensitivity, simplicity, and short incubation time (within 1 h).

Miniaturized point discharge optical emission spectrometry coupling with solid phase extraction: A robust approach for sensitive quantification of total mercury in mung bean sprout growth.

In this work, a portable chemical vapor generation point discharge optical emission spectrometry (CVG-PD-OES) system was designed for trace Hg2+ monitoring in mung bean sprout samples. The system incorporated selective solid phase extraction (SPE) to enhance the detection sensitivity. Gold nanoparticles (AuNPs) were prepared and utilized to extract trace amounts of Hg2+ by forming gold amalgam. Subsequently, the amalgam was desorbed using 5% HCl and introduced into a low-power PD-OES system analysis via CVG. A low limit of detection (LOD) of 0.16 ng mL-1 was obtained with a linear range of 0.5-6 ng mL-1. The well-designed system was successfully utilized for monitoring trace Hg2+ in the growth of mung beans. The results indicated that the Hg2+ in mung bean sprouts was continuously decreased during growth based on the metabolism. Furthermore, the risk assessment conducted implied a negligible hazard quotient, suggesting that the observed levels of exposure posed minimal risk.

Optimal selection of b-values for differential diagnosis of mediastinal lymph nodes using diffusion-weighted imaging.

This study proposed to investigate the optimal selection of b-values in diffusion-weighted imaging for distinguishing malignant from benign mediastinal lymph nodes. Diffusion-weighted imaging with six b-values was performed on 35 patients at 1.5 T. Image quality score, signal-to-noise ratio, and relative contrast ratio of lymph node to chest muscle were compared between the diffusion-weighted images with a b-value up to 800 and 1000 s/mm2. Using a lower and an upper b-value in the range of 0-1000 s/mm2, eight apparent diffusion coefficient maps were obtained from a mono-exponential model. Receiver operating characteristic analysis was employed to evaluate the performance of the apparent diffusion coefficients for distinguishing malignant from benign mediastinal lymph nodes by using the area under the curve as a criterion. The mean image quality score and the relative contrast ratio showed no difference between b-values of 800 and 1000 s/mm2. In the receiver operating characteristic analysis, the areas under the curve of apparent diffusion coefficient with b-value pairs of (0, 800), (0, 1000), and (50, 800) s/mm2 were significantly higher than those from the other b-value pairs. No significant difference was observed among the three b-value pairs. Apparent diffusion coefficient obtained from b-value pairs of (0, 800), (0, 1000), and (50, 800) s/mm2 showed superior diagnostic performance compared to the other b-value combinations. Based on several practical considerations, the b-value pair of (50, 800) s/mm2 is recommended for differential diagnosis of mediastinal lymph nodes.