Ocular A-to-I RNA editing signatures associated with SARS-CoV-2 infection.

Ophthalmic manifestations have recently been observed in acute and post-acute complications of COVID-19 caused by SARS-CoV-2 infection. Our precious study has shown that host RNA editing is linked to RNA viral infection, yet ocular adenosine to inosine (A-to-I) RNA editing during SARS-CoV-2 infection remains uninvestigated in COVID-19. Herein we used an epitranscriptomic pipeline to analyze 37 samples and investigate A-to-I editing associated with SARS-CoV-2 infection, in five ocular tissue types including the conjunctiva, limbus, cornea, sclera, and retinal organoids. Our results revealed dramatically altered A-to-I RNA editing across the five ocular tissues. Notably, the transcriptome-wide average level of RNA editing was increased in the cornea but generally decreased in the other four ocular tissues. Functional enrichment analysis showed that differential RNA editing (DRE) was mainly in genes related to ubiquitin-dependent protein catabolic process, transcriptional regulation, and RNA splicing. In addition to tissue-specific RNA editing found in each tissue, common RNA editing was observed across different tissues, especially in the innate antiviral immune gene MAVS and the E3 ubiquitin-protein ligase MDM2. Analysis in retinal organoids further revealed highly dynamic RNA editing alterations over time during SARS-CoV-2 infection. Our study thus suggested the potential role played by RNA editing in ophthalmic manifestations of COVID-19, and highlighted its potential transcriptome impact, especially on innate immunity.

Dielectric-Enhanced, High-Sensitivity, Wide-Bandwidth, and Moisture-Resistant Noncontact Triboelectric Sensor for Vibration Signal Acquisition.

Noncontact triboelectric sensors (TESs) have the potential to enhance self-powered sensing performance by eliminating the need for physical contact. This study demonstrates a strategy to construct noncontact TES that enables self-powered sensing and vibration signal acquisition with high sensitivity and wide bandwidth. The incorporation of carbon nanotubes into nitrocellulose (CNTs/NC) endows the tribopositive layer with larger inner micro/nanocapacitances, consequently augmenting the charge storage capacity. As a result, the contactless sensing performance of CNTs/NC-based TES (CNTs/NC-TES) was enhanced by 146%. Correspondingly, the related theory and working mechanism of noncontact sensing were demonstrated. Furthermore, the CNTs/NC-TES exhibits optimal distance response sensitivity of 57.10 V mm-1, a wide-bandwidth response from 0.1 to 4000 Hz, and relative humidity (RH) stability. This contactless CNTs/NC-TES has the potential for high sensitivity and wide frequency vibration monitoring in a high-RH environment.

Reflecting on gamified learning in medical education: a systematic literature review grounded in the Structure of Observed Learning Outcomes (SOLO) taxonomy 2012-2022.

BACKGROUND: The acquisition of in-depth medical knowledge, skills, and competencies is of utmost importance when training future medical professionals. This systematic literature review delves into the empirical connection between gamified learning in medical education and the Structure of Observed Learning Outcomes (SOLO) taxonomy. METHODS: Following PRISMA guidelines, a systematic literature review was conducted in seven databases to identify empirical studies related to gamification and medical education. The literature search was limited to peer-reviewed articles published between January 2012 and December 2022. Articles focusing on games or learning technologies in a broader sense as well as research focusing on nursing or pharmacy education were excluded. RESULTS: Upon reviewing 23 qualified empirical studies that applied gamified learning strategies in medical education, 18 (78%) studies are associated with the second lowest level (uni-structural) of the SOLO taxonomy. The mid-level (multi-structural) learning outcomes are associated with three (13%) of the reviewed studies. There are five (22%) studies focusing on the second highest (relational) level of the SOLO. Only one study (4%) is associated with the highest SOLO level (extended-abstract). Finally, three (13%) studies were identified with multiple levels of the SOLO. In addition to the SOLO levels, the review found six (26%) studies emphasizing motivational and engagement support of gamified learning strategies in facilitating intended learning outcome attainment. A total of three (13%) studies, across three SOLO levels, suggested that gamified learning strategies can improve students' soft skills in medical education programs. CONCLUSION: These findings collectively emphasize the need for future research and development to design gamified learning experiences capable of fostering higher SOLO taxonomy attainment in medical education. Moreover, there is potential to extend the SOLO framework to encompass motivational and affective learning outcomes, providing a comprehensive understanding of the impact of gamified learning on medical students.

Temperature acclimation improves high temperature tolerance of rainbow trout (Oncorhynchus mykiss) by improving mitochondrial quality and inhibiting apoptosis in liver.

Global warming is threatening the survival and growth of cold-water fish, and the methods to improve the high-temperature adaptability of cold-water fish need to be explored urgently. This study aims to explore the mechanism of improving high temperature tolerance of rainbow trout by temperature acclimation (TA). Rainbow trout were acclimated by two modes at 22 °C, including fluctuating TA (FA) and constant TA (CA), and thereafter subjected to heat stress (HS) at 25 °C. Results showed that TA markedly increased the critical temperature maximum (CTmax) of rainbow trout. Secondly, the levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in serum and malondialdehyde (MDA) in liver of CA + HS group significantly decreased compared to those in HS group without TA, indicating the reduction of liver injury by CA. Moreover, HS significantly induced ROS production and reduced mitochondrial membrane potential (MMP) in rainbow trout liver, but TA reduced the levels of ROS and increased the MMP in liver of rainbow trout after HS, indicating the reduced oxidative stress and mitochondrial damage. Furthermore, TA up-regulated the expression of genes related to mitochondrial autophagy, fusion, fission and biogenesis, as well as the expression of marker proteins of autophagy (LC3II) and mitophagy (Parkin) in the liver, so as to maintain mitochondrial homeostasis. Moreover, TA also inhibited the occurrence of apoptosis (decrease in bax/bcl-2), which may be owing to the reduced ROS and mitochondrial damage by TA. Interestingly, CA significantly up-regulated the genes expression of methyltransferase in the liver, which may inhibit the genes or transcription factors related to oxidative stress and apoptosis by DNA methylation. In conclusion, TA increased the upper limit of heat tolerance of rainbow trout by improving mitochondrial quality and inhibiting apoptosis in liver. This study will provide an effective solution to the risk of high temperature in cold-water fish culture.

Estimating the Spatial Distribution and Future Conservation Requirements of the Spotted Seal in the North Pacific.

Local adaptation has been increasingly involved in the designation of species conservation strategies to response to climate change. Marine mammals, as apex predators, are climatechange sensitive, and their spatial distribution and conservation requirements are critically significant for designing protection strategies. In this study, we focused on an ice-breeding marine mammal, the spotted seal (Phoca largha), which exhibits distinct morphological and genetic variations across its range. Our objectives were to quantify the ecological niches of three spotted seal populations, construct the species-level model and population-level models that represent different regions in the Bering population (BDPS), Okhotsk population (ODPS) and southern population (SDPS), and conduct a conservation gap analysis. Our findings unequivocally demonstrated a clear niche divergence among the three populations. We predicted habitat contraction for the BDPS and ODPS driven by climate change; in particular, the spotted seals inhabiting Liaodong Bay may face breeding habitat loss. However, most spotted seal habitats are not represented in existing marine protected areas. Drawing upon these outcomes, we propose appropriate conservation policies to effectively protect the habitat of the different geographical populations of spotted seals. Our research addresses the importance of incorporating local adaptation into species distribution modeling to inform conservation and management strategies.

Bioassay and Whole-Genome Analysis of Bacillus velezensis FIO1408, a Biocontrol Agent Against Pathogenic Bacteria in Aquaculture.

Bacterial disease is one of the most critical problems in aquaculture. Probiotics represent a promising biological approach to control bacterial disease because it is effective against pathogens and environmentally friendly. This study assessed the antagonistic activities of a bacterial strain FIO1408 isolated from deep-sea water against many pathogenic bacteria in aquaculture, including Listonella anguillarum, Vibrio parahaemolyticus, Vibrio alginolyticus, Aeromonas hydrophila, Edwardsiella anguillarum, Edwardsiella tarda, and Edwardsiella piscicida. The complete genome of strain FIO1408 consisted of a circular chromosome of 4,137,639 bp and two plasmids of 16,439 bp and 24,472 bp. Phylogenetic analysis showed strain FIO1408 clustered with Bacillus velezensis strains. 12 genes/gene clusters responsible for the synthesis of secondary metabolites were identified in the FIO1408 genome, including three lipopeptides, three polyketides, three bacteriocins, one siderophore, one dipeptide, and one unknown type. Also identified were 273 unique orthologous genes primarily involved in phage resistance, protein hydrolysis, environmental survivability, and genetic stability compared to B. velezensis KACC 13105, B. velezensis FZB42T, and B. velezensis NRRL B-41580. The principal safety of FIO1408 was demonstrated by genetic analyses and feeding trials. These findings will contribute to studies on the biocontrol mechanisms of B. velezensis FIO1408 and facilitate its application as a potent biological control agent against bacterial pathogens in aquaculture.

Calculation of left ventricular ejection fraction using an 8-layer residual U-Net with deep supervision based on cardiac CT angiography images versus echocardiography: a comparative study.

Background: Accurate segmentation of the left ventricle (LV) is an important step in assessing cardiac function. Cardiac CT angiography (CCTA) has become an important means of clinical diagnosis of cardiovascular diseases (CVDs) because of its advantages of non-invasive, short examination time and low cost. In order to obtain the segmentation of LV in CCTA scans, we propose a deep learning method based on 8-layer residual U-Net with deep supervision. In this study we compared the left ventricular ejection fraction (LVEF) calculated by deep learning (DL) method (AccuLV) from CCTA to LVEF by conventional two-dimensional echocardiography (EC). Methods: This was a retrospective cross-sectional study, and consecutive patients who had undergone CCTA and EC in our hospital from February 2021 to May 2021 were recruited. The current study included 180 patients who had undergone CCTA and EC. To obtain LVEF, we used an 8-layer residual U-Net with deep supervision to segment LV contours from CCTA images and compute LVEF (DL-LVEF). The EC and DL-LVEF measurements were compared. A 50% EC-LVEF cut-off value was used as a reference standard to assess the diagnostic performance of AccuLV in assessing LV function. Results: The overall mean EC-LVEF and DL-LVEF values were 64.0% (52.3%, 69.0%) and 73.0% (52.3%, 77.0%), respectively. Three patient groups were studied: (I) hypertensive patients, (II) postmenopausal women, and (III) diabetes. EC-LVEF and DL-LVEF were found to be positively correlated for all of the included patients (r=0.82, P<0.001), with the detailed results for the three groups as follows: hypertensive patients (r=0.77, P<0.001), postmenopausal women (r=0.92, P<0.001) and diabetes (r=0.88, P<0.001). The diagnostic accuracy, sensitivity, and specificity of the DL method in predicting EC-LVEF <50% for all patients were 93.9%, 92.3%, and 94.3%, and for hypertensive patients were 95.4%, 93.8%, and 95.8%, for postmenopausal women were 87.0%, 100%, and 84.2%, for diabetes were 97.4%, 100%, and 96.6%. Conclusions: In comparison to echocardiography, which is commonly used in clinical setting, AccuLV may be a promising, fully automated tool for rapid and accurate quantification of LV function and thus for making reliable clinical decisions.

Preparation of lithium-containing magnesium phosphate-based composite ceramics having high compressive strength, osteostimulation and proangiogenic effects.

Fairly high concentrations of magnesium and lithium are conducive to improving the osteogenic and angiogenic capacities. In the current study, lithium-containing magnesium phosphate-based ceramics (AMP/LMPGs) were prepared from amorphous magnesium phosphate (AMP) at a low sintering temperature (650 °C), and the lithium/magnesium-containing phosphate glasses (LMPGs) were utilized as sintering additives. During the sintering procedure of AMP/LMPGs, the AMP reacted with LMPGs, producing new compounds. The AMP/LMPGs displayed nano-size grains and plentiful micropores. The addition of LMPGs noticeably increased the porosity as well as compressive strength of the AMP/LMPGs ceramics. The AMP/LMPGs sustainedly released Mg, P and Li ions, forming Mg-rich ionic microenvironment, which ameliorated cellular proliferation, osteogenic differentiation and proangiogenic capacities. The AMP/LMPGs ceramics with considerably high compressive strength, osteostimulation and proangiogenic effects were expected to efficiently regenerate the bone defects.

Efficacy of early laparoscopic cholecystectomy compared with percutaneous transhepatic gallbladder drainage in treating acute calculous cholecystitis in elderly patients.

BACKGROUND: Acute calculous cholecystitis is a common acute disease in elderly patients. This study aimed to evaluate the efficacy of early laparoscopic cholecystectomy (ELC) compared to percutaneous transhepatic gallbladder drainage (PTGD) for treating acute calculous cholecystitis in elderly patients. METHODS: This retrospective study compared the clinical outcomes of two groups of elderly patients treated with ELC (group A) and PTGD (group B) from January 2018 to December 2021. Preoperative clinical characteristics and postoperative treatment outcomes were analyzed for both groups. RESULTS: There were no statistically significant differences in preoperative clinical characteristics between the ELC and PTGD groups. ELC took longer to perform (69.8 ± 15.9 min vs. 29.6 ± 5.3 min, p < 0.001) but resulted in a significantly shorter duration of pain (1.9 ± 0.9 days vs. 3.9 ± 1.0 days, p < 0.001) and hospital stay (6.3 ± 2.5 days vs. 9.9 ± 3.6 days, p < 0.001), and a lower rate of sepsis (3.4% vs. 16.9%, p < 0.019). Time to soft diet was faster in the ELC group (1.5 ± 0.9 days vs. 3.0 ± 1.6 days, p < 0.001). Fewer patients in the ELC group experienced surgical reintervention than in the PTGD group (0% vs. 5.6%, p = 0.043). The incidence of postoperative complications and readmission rates in the ELC group were significantly lower than those in the PTGD group (ELC, 3.6%; PTGD, 25.4%, p = 0.001). CONCLUSIONS: ELC is an effective treatment option for acute calculous cholecystitis in elderly patients, and has the added benefits of low postoperative complication rates, rapid recovery, shorter duration of pain, and excellent curative effects as compared to PTGD.

Edge Contacts to Atomically Precise Graphene Nanoribbons.

Bottom-up-synthesized graphene nanoribbons (GNRs) are an emerging class of designer quantum materials that possess superior properties, including atomically controlled uniformity and chemically tunable electronic properties. GNR-based devices are promising candidates for next-generation electronic, spintronic, and thermoelectric applications. However, due to their extremely small size, making electrical contact with GNRs remains a major challenge. Currently, the most commonly used methods are top metallic electrodes and bottom graphene electrodes, but for both, the contact resistance is expected to scale with overlap area. Here, we develop metallic edge contacts to contact nine-atom-wide armchair GNRs (9-AGNRs) after encapsulation in hexagonal boron-nitride (h-BN), resulting in ultrashort contact lengths. We find that charge transport in our devices occurs via two different mechanisms: at low temperatures (9 K), charges flow through single GNRs, resulting in quantum dot (QD) behavior with well-defined Coulomb diamonds (CDs), with addition energies in the range of 16 to 400 meV. For temperatures above 100 K, a combination of temperature-activated hopping and polaron-assisted tunneling takes over, with charges being able to flow through a network of 9-AGNRs across distances significantly exceeding the length of individual GNRs. At room temperature, our short-channel field-effect transistor devices exhibit on/off ratios as high as 3 × 105 with on-state current up to 50 nA at 0.2 V. Moreover, we find that the contact performance of our edge-contact devices is comparable to that of top/bottom contact geometries but with a significantly reduced footprint. Overall, our work demonstrates that 9-AGNRs can be contacted at their ends in ultra-short-channel FET devices while being encapsulated in h-BN.

The pathways from disadvantaged socioeconomic status in childhood to edentulism in mid-to-late adulthood over the life-course.

BACKGROUND: This study aimed to examine the direct and indirect pathways from childhood socioeconomic status (SES) to the prevalence of edentulism in mid-to-late age Chinese individuals using structural equation modeling (SEM). METHODS: This study analyzed data from 17,032 mid- to-late age Chinese individuals in the 2014 and 2015 China Health and Retirement Longitudinal Study (CHARLS). Childhood SES was determined based on the parents' education and occupation, financial situation of the family, primary residence, food availability, and medical convenience. Adulthood SES was established according to educational achievements of the individuals. Edentulism is defined as the loss of all natural teeth. SEM was used to examine the statistical significance of the association between childhood SES and edentulism, mediated by childhood health, adulthood SES, and adult health. RESULTS: Childhood SES had significant indirect (ß = -0.026, p < 0.01), and total (ß = -0.040, p < 0.01) effects on edentulism. It was determined that 65% of the total effect of childhood SES on edentulism was indirect, and mainly mediated by adult SES. Also, the goodness-of-fit indices of the best-fitting model were acceptable. CONCLUSION: This study revealed that childhood health, adult health and adult SES are mediators that explain the relationship between childhood SES and edentulism. The global attention to alleviate the inequality in edentulism should focus on exploring recommendations and intervention strategies from childhood to adulthood, by considering adult SES, childhood and adult health.

Transplantation of hESCs-Derived Neural Progenitor Cells Alleviates Secondary Damage of Thalamus After Focal Cerebral Infarction in Rats.

Human embryonic stem cells-derived neural progenitor cells (hESCs-NPCs) transplantation holds great potential to treat stroke. We previously reported that delayed secondary degeneration occurs in the ventroposterior nucleus (VPN) of ipsilateral thalamus after distal branch of middle cerebral artery occlusion (dMCAO) in adult male Sprague-Dawley (SD) rats. In this study, we investigate whether hESCs-NPCs would benefit the neural recovery of the secondary damage in the VPN after focal cerebral infarction. Permanent dMCAO was performed with electrocoagulation. Rats were randomized into Sham, dMCAO groups with or without hESCs-NPCs treatment. HESCs-NPCs were engrafted into the peri-infarct regions of rats at 48 h after dMCAO. The transplanted hESCs-NPCs survive and partially differentiate into mature neurons after dMCAO. Notably, hESCs-NPCs transplantation attenuated secondary damage of ipsilateral VPN and improved neurological functions of rats after dMCAO. Moreover, hESCs-NPCs transplantation significantly enhanced the expression of BDNF and TrkB and their interaction in ipsilateral VPN after dMCAO, which was reversed by the knockdown of TrkB. Transplantated hESCs-NPCs reconstituted thalamocortical connection and promoted the formation of synapses in ipsilateral VPN post-dMCAO. These results suggest that hESCs-NPCs transplantation attenuates secondary damage of ipsilateral thalamus after cortical infarction, possibly through activating BDNF/TrkB pathway, enhancing thalamocortical projection, and promoting synaptic formation. It provides a promising therapeutic strategy for secondary degeneration in the ipsilateral thalamus post-dMCAO.

Efficacy of extended view totally extra peritoneal approach versus laparoscopic intraperitoneal on lay mesh plus for abdominal wall hernias: a single center preliminary retrospective study.

BACKGROUND: Laparoscopic minimally invasive surgery has become the primary treatment for ventral hernias. The laparoscopic intraperitoneal on lay mesh (IPOM) plus approach for abdominal wall hernias is the most used procedure, while extended view totally extraperitoneal (e­TEP) repair is a newer option. This study aimed to compare the effectiveness and complications of the 2 procedures for abdominal wall hernias repair. METHODS: This was a retrospective and comparative single-center study done at The Second Clinical Medical College, Jinan University Hospital (Shenzhen People's Hospital), Shenzhen, China. The study included patients with a 2 to 6 cm abdominal wall defect who underwent hernia repair from January 2022 to December 2022. Patients' baseline characteristics, hernia features, operative time, blood loss, postoperative pain level, and total hospitalization expenses were extracted from the medical records and compared between patients who underwent the IPOM plus and e-TEP repair. RESULTS: A total of 53 patients were included: 22 in the e-TEP group and 31 in IPOM plus group. Patient demographic characteristics were similar between the 2 groups. The operation time of the e-TEP groups was significantly longer than the IPOM plus (98.5 ± 10.7 min vs. 65.9 ± 7.3 min, P < 0.01). Postoperative pain levels (VAS; visual analog scale) (4.2 ± 0.9 vs. 6.7 ± 0.9, P < 0.01), analgesic requirements (Tramadol) (25.0 ± 37.0 mg vs. 72.6 ± 40.5 mg, P < 0.01), length of hospital stay (1.2 ± 0.5days vs. 2.2 ± 0.6days, P < 0.01), and total hospitalization expenses (19695.9 ± 1221.7CNY vs. 35286.2 ± 1196.6CNY, P < 0.01) were significantly lower in the e-TEP group. The mean intraoperative blood loss was similar between the 2 groups. No postoperative complications were observed in either group. CONCLUSION: The e-TEP approach for abdominal wall hernias appears to be better than IPOM plus with respect to postoperative pain levels(VAS: 4.2 ± 0.9 vs. 6.7 ± 0.9, P < 0.01), analgesic requirements(25.0 ± 37.0 mg vs. 72.6 ± 40.5 mg, P < 0.01), length of hospital stay(1.2 ± 0.5days vs. 2.2 ± 0.6days, P < 0.01), and hospitalization costs (19695.9 ± 1221.7CNY vs. 35286.2 ± 1196.6CNY, P < 0.01).

Effect of auricular acupuncture on neuroplasticity of stroke patients with motor dysfunction: A fNIRS study.

Cerebral Stroke is an acute cerebrovascular disease, a disease of brain tissue damage caused by the sudden rupture or blockage of blood vessels in the brain that prevents blood flow to the brain. Acupuncture has become a popular treatment for stroke, with auricular acupuncture providing a new idea for stroke treatment. However, the neuromodulatory mechanism of auricular acupuncture in the brain is still unclear. The aim of this study was to investigate the effect of auricular acupuncture in the treatment of upper limb dysfunction and the activation of specific brain regions in stroke patients. Forty patients with stroke hemiplegia who met the nerf criteria were included in the experiment and randomly assigned into two groups (20 patients in each group): the auricular acupuncture group and the control group. Fugl-Meyer score (FMA) assessment of upper limb motor function, motor evoked potential (MEP) measurement, and functional near-infrared brain function imaging (fNIRS) data acquisition in the primary motor M1 area of the brain at rest were performed before and after treatment, respectively. It was found that: 1) after auricular acupuncture treatment, the patients in the auricular acupuncture group showed significantly greater peak MEP and significantly higher oxyhemoglobin content in the M1 region of the brain compared with the control group, with a significant activation effect (MEP: P-value = 0.032, t = -2.22; HbO2; f = 4.225, p = 0.046); 2) in the clinical efficacy assessment, the FMA score in the auricular acupuncture group after treatment (p = 0.0122, t = 2.769). The results suggest that auricular acupuncture has an ameliorative effect on upper limb motor deficits after stroke and that activation of the M1 region of the brain may be a key node in auricular acupuncture for treating upper limb dysfunction in stroke patients, a finding that emphasizes the potential for clinical application of auricular acupuncture therapy for stroke patients with potential mechanisms influencing the outcome.

Effect of Mechanical Stirring on High-Speed GMAW Hump Bead.

High-speed GMAW tends to be accompanied by periodic humping defects, thereby reducing the weld bead quality. A new method was proposed to actively control the weld pool flow for eliminating humping defects. A high-melting point solid pin was designed and inserted into the weld pool to stir the liquid metal during the welding process. The characteristics of the backward molten metal flow were extracted and compared by a high-speed camera. Combined with particle tracing technology, the momentum of the backward metal flow was calculated and analyzed, and the mechanism of hump suppression in high speed GMAW was further revealed. The stirring pin interacted with the liquid molten pool, resulting in a vortex zone behind the stirring pin, which significantly reduced the momentum of the backward molten metal flow, and thus it inhibited the formation of humping beads.

Accuracy of intravascular ultrasound-derived virtual fractional flow reserve (FFR) and FFR derived from computed tomography for functional assessment of coronary artery disease.

BACKGROUND: Coronary computed tomography-derived fractional flow reserve (CT-FFR) and intravascular ultrasound-derived fractional flow reserve (IVUS-FFR) are two functional assessment methods for coronary stenoses. However, the calculation algorithms for these methods differ significantly. This study aimed to compare the diagnostic performance of CT-FFR and IVUS-FFR using invasive fractional flow reserve (FFR) as the reference standard. METHODS: Six hundred and seventy patients (698 lesions) with known or suspected coronary artery disease were screened for this retrospective analysis between January 2020 and July 2021. A total of 40 patients (41 lesions) underwent intravascular ultrasound (IVUS) and FFR evaluations within six months after completing coronary CT angiography were included. Two novel CFD-based models (AccuFFRct and AccuFFRivus) were used to compute the CT-FFR and IVUS-FFR values, respectively. The invasive FFR ≤ 0.80 was used as the reference standard for evaluating the diagnostic performance of CT-FFR and IVUS-FFR. RESULTS: Both AccuFFRivus and AccuFFRct demonstrated a strong correlation with invasive FFR (R = 0.7913, P < 0.0001; and R = 0.6296, P < 0.0001), and both methods showed good agreement with FFR. The area under the receiver operating characteristic curve was 0.960 (P < 0.001) for AccuFFRivus and 0.897 (P < 0.001) for AccuFFRct in predicting FFR ≤ 0.80. FFR ≤ 0.80 were predicted with high sensitivity (96.6%), specificity (85.7%), and the Youden index (0.823) using the same cutoff value of 0.80 for AccuFFRivus. A good diagnostic performance (sensitivity 89.7%, specificity 85.7%, and Youden index 0.754) was also demonstrated by AccuFFRct. CONCLUSIONS: AccuFFRivus, computed from IVUS images, exhibited a high diagnostic performance for detecting myocardial ischemia. It demonstrated better diagnostic power than AccuFFRct, and could serve as an accurate computational tool for ischemia diagnosis and assist in clinical decision-making.

Impacts of unifying urban and rural residents' medical insurance on the hospitalisation expenses of rural patients in eastern China: an interrupted time series analysis.

OBJECTIVES: This study evaluated the impact of the Urban and Rural Residents' Basic Medical Insurance scheme on hospitalisation expenses of rural patients in eastern China, which unified separate healthcare systems for urban and rural residents. DESIGN: Monthly hospitalisation data from municipal and county hospitals were collected from the local Medicare Fund Database, covering the period from January 2018 to December 2021. The unification of insurance between urban and rural patients was implemented at different times for county and municipal hospitals. An interrupted time series analysis was used to assess the immediate and gradual effects of the integrated policy on the total medical expenses, out-of-pocket (OOP) expenses and effective reimbursement rate (ERR) among rural patients. SETTING AND PARTICIPANTS: This study included 636 155 rural inpatients over 4 years in Xuzhou City, Jiangsu Province, China. RESULTS: In January 2020, the policy of urban and rural medical insurance was initially integrated in county hospitals, after which the ERR decreased at a monthly rate of 0.23% (p=0.002, 95% CI -0.37% to -0.09%) compared with the preintervention period. After the insurance systems were unified in municipal hospitals in January 2021, OOP expenses decreased by ¥63.54 (p=0.002, 95% CI -102.48 to -24.61) and the ERR increased at a monthly rate of 0.24% (p=0.029, 95% CI 0.03% to 0.045%). CONCLUSIONS: Our results suggest that the unification of urban and rural medical insurance systems was an effective intervention to reduce the financial burden of illness for rural inpatients, especially OOP expenses for hospitalisation in municipal hospitals.

Recent Progress of Biomaterials-Based Epidermal Electronics for Healthcare Monitoring and Human-Machine Interaction.

Epidermal electronics offer an important platform for various on-skin applications including electrophysiological signals monitoring and human-machine interactions (HMI), due to their unique advantages of intrinsic softness and conformal interfaces with skin. The widely used nondegradable synthetic materials may produce massive electronic waste to the ecosystem and bring safety issues to human skin. However, biomaterials extracted from nature are promising to act as a substitute material for the construction of epidermal electronics, owing to their diverse characteristics of biocompatibility, biodegradability, sustainability, low cost and natural abundance. Therefore, the development of natural biomaterials holds great prospects for advancement of high-performance sustainable epidermal electronics. Here, we review the recent development on different types of biomaterials including proteins and polysaccharides for multifunctional epidermal electronics. Subsequently, the applications of biomaterials-based epidermal electronics in electrophysiological monitoring and HMI are discussed, respectively. Finally, the development situation and future prospects of biomaterials-based epidermal electronics are summarized. We expect that this review can provide some inspirations for the development of future, sustainable, biomaterials-based epidermal electronics.

Molecular characterization and analysis of drug resistance-associated protein enolase 2 of Eimeria tenella.

Eimeria tenella, an intestinal parasite, has brought huge economic losses to the poultry industry. The prevalence and severity of the development of drug resistance has increased the challenge of coccidiosis control. We previously identified the enolase 2 of E. tenella (EtENO2) was differentially expressed in drug-sensitive (DS) and drug-resistant strains using RNA-seq. In this study, the expression of EtENO2 in diclazuril-resistant (DZR), maduramicin-resistant (MRR), and salinomycin-resistant (SMR) strains was analyzed by quantitative real-time PCR (qRT-PCR) and western blots. EtENO2 was highly expressed in several drug-resistant strains compared with the DS strain. The qRT-PCR showed that the transcription level of EtENO2 in the field-isolated resistant strains was upregulated compared with the DS strain. The enzyme activity results indicated that the catalytic activity of EtENO2 in the drug-resistant strains was higher than in the DS strain. In addition, qRT-PCR and western blots showed that the expression level of EtENO2 was higher in second generation merozoites (SM) and unsporulated oocysts (UO) than that in sporozoites (SZ) and sporulated oocysts (SO). Immunofluorescence localization revealed that EtENO2 was distributed throughout SZ and SM and on the surface of the parasites. After the SZ invasion DF-1 cells, it was also observed on the parasitophorous vacuole membrane. Our secretion experiments found that EtENO2 could be secreted outside the SZ. This study indicated that EtENO2 might be related to the interaction between E. tenella and host cells and be involved in the development of E. tenella resistance to some anticoccidial drugs.