Study on the effect of different durations of decalcification and depigmentation on programmed death ligand 1 immunohistochemical staining.

Background: Programmed death ligand 1 (PD-L1) score is an important companion diagnosis to predict the response to immunotherapy. Immunohistochemistry can accurately assess the expression of PD-L1 in routine paraffin-embedded tissue. However, whether decalcified or depigmented tissue is still accurate and can be used as a companion diagnosis is controversial. This study attempts to resolve this controversy by analyzing the effects of decalcification and depigmentation at different times on PD-L1 expression. Methods: Placental tissues were selected for tissue microarray, decalcification was performed according to time gradients of 6, 12, 24, 36, and 48 h, and depigmentation was performed according to time gradients of 1, 5, 15, 30, and 60 min. The intensity of PD-L1 expression at different time points was observed and quantified. Ten PD-L1-positive esophageal squamous carcinoma samples were selected for decalcification treatment, and the PD-L1. Combined Positive Score (CPS), Tumor Proportion Score (TPS) and Immunocyte Proportion Score (IPS) and the positivity rates were compared before and after decalcification. Results: After the placenta was decalcified, the intensity of PD-L1 positivity diminished, and the average optical density (AOD) value decreased with the prolongation of decalcification time and decreased significantly (P<0.05) at 24 h compared with the control group, and significantly (P<0.01) at 36 and 48 h compared with the control group. The intensity of PD-L1 positivity was weakened considerably after the treatment with potassium permanganate depigmentation. In addition, the AOD value decreased significantly (P<0.01) after the depigmentation time reached 5 min compared with the control group. Ten cases of PD-L1 positive esophageal squamous carcinoma were treated with 24 h decalcification, although the PD-L1 score decreased to a certain degree (P>0.05), and the positivity rate could reach 90%. After 36 h treatment, PD-L1 scores decreased, the CPS and IPS scores decreased significantly (P<0.05), and the positive rate was only 50%. Conclusions: Potassium permanganate depigmentation significantly reduces PD-L1 expression, even for a shorter time, affecting the accuracy of the results. The accuracy of PD-L1 remained high within 24 h decalcification. The above results have certain reference value for clinical selection of immunotherapy.

A study on smart home use intention of elderly consumers based on technology acceptance models.

PURPOSE: Smart home devices have great potential to improve the quality of life and independence of older people, positively impacting their health, safety, and comfort. However, Chinese research in this field is still in its early stages. Therefore, more comprehensive and in-depth studies are needed to comprehend the various aspects influencing the acceptance and use of smart homes by older users. PATIENTS AND METHODS: This study adopted the Technology Acceptance Model (TAM) and included perceived usefulness, perceived ease of use, usage intention, intergenerational technology support, perceived value, and perceived risk as extension variables to delve deeper into the behavioral intentions of older users in smart home services. The study used a convenience sampling method to randomly distribute 236 questionnaires among older adults over the age of 60 in the school's community and neighboring urban communities who have experience in smart home use and who can complete human-computer interactions either independently or with the help of others, mainly focusing on the four sections: user characteristics, family situation, experience of use, and usage intention. The study used structural equation modeling (SEM) and factor analysis to analyze the completion of questionnaires. Finally, we conducted a validation analysis of the rationality and scientificity of the model and derived the six dimensions of the model of the influencing factors on the use of smart home products by the elderly and the weight sizes of their corresponding 13 influencing factors. RESULTS: The results show that perceived usefulness and perceived ease of use have a positive effect on users' intention to use smart homes. Perceived ease of use has a positive effect on the perceived usefulness of smart homes. In addition, intergenerational technology support, perceived value, and perceived risk impact users' perceived usefulness and perceived ease of use of the smart home. CONCLUSION: This research aims to describe the factors influencing older users' willingness to use smart homes. The findings are not only significant for the elderly in China but also of broad value to other regions and countries facing similar demographic challenges. The development of smart homes not only involves the elderly but is also closely related to all segments of society. The government should increase policy support and guide more social forces to participate in the development of the smart home industry. Service providers and designers should fully understand the demand situation and user experience of target users to develop easy-to-use smart home solutions. At the same time, smart homes, as intelligent products for the elderly, need to focus not only on the basic needs of the elderly such as material life and home safety, but also on the spiritual needs of elderly users. Children or caregivers should always pay attention to the psychological state of the elderly and actively guide them to use smart homes to help them realize their self-worth. We look forward to more research focusing on this area in the future and further exploring the specific issues and solutions involved.

Development and Validation of a Recurrence-Free Survival Prediction Model for Locally Advanced Esophageal Squamous Cell Carcinoma with Neoadjuvant Chemoradiotherapy.

BACKGROUND: A recurrence-free survival (RFS) prediction model was developed and validated for patients with locally advanced esophageal squamous cell carcinoma treated with neoadjuvant chemoradiotherapy (NCRT) in combination with surgery. PATIENTS AND METHODS: We included 282 patients with esophageal squamous cell carcinoma who received neoadjuvant chemoradiotherapy (NCRT) combined with surgery, constructed three models incorporating pathological factors, investigated the discrimination and calibration of each model, and compared the clinical utility of each model using the net reclassification index (NRI) and the integrated discrimination index (IDI). RESULTS: Multivariable analysis showed that pathologic complete response (pCR) and lymph node tumor regression grading (LN-TRG) (p < 0.05) were independent prognostic factors for RFS. LASSO regression screened six correlates of LN-TRG, vascular invasion, nerve invasion, degree of differentiation, platelet grade, and a total diameter of residual cancer in lymph nodes to build model three, which was consistent in terms of efficacy in the training set and validation set. Kaplan-Meier (K-M) curves showed that all three models were able to distinguish well between high- and low-risk groups (p < 0.01). The NRI and IDI showed that the clinical utility of model 2 was slightly better than that of model 1 (p > 0.05), and model 3 was significantly better than that of model 2 (p < 0.05). CONCLUSIONS: Clinical prediction models incorporating LN-TRG factors have high predictive efficacy, can help identify patients at high risk of recurrence after neoadjuvant therapy, and can be used as a supplement to the  AJCC/TNM staging system while offering a scientific rationale for early postoperative intervention.

Effect of different postures and loads on joint motion and muscle activity in older adults during overhead retrieval.

Introduction: Pain is a common health problem among older adults worldwide. Older adults tend to suffer from arm, lumbar, and back pain when using hanging cabinets. Methods: This study used surface electromyography to record muscle activity and a motion capture system to record joint motion to research effects of different loads and retrieval postures on muscle activity and joint range of motion when older adults retrieve objects from a high place, to provide optimised feedback for the design of hanging cabinet furniture. Results: We found that: 1) The activity of BB (Biceps brachii) on the side of the body interacting with the cabinet door was greater than that of UT (Upper trapezius) and BR (Brachial radius) when retrieving objects from a high place, the activity of UT on the side of the body interacting with a heavy object was greater than that of BB and BR. 2) The activity of UT decreases when the shoulder joint angle is greater than 90°, but the activity of BB increases as the angle increases. In contrast, increasing the object's mass causes the maximum load on the shoulder joint. 3) Among the different postures for overhead retrieval, alternating between the right and left hand is preferable for the overhead retrieval task. 4) Age had the most significant effect on overhead retrieval, followed by height (of person), and load changes were significantly different only at the experiment's left elbow joint and the L.BR. 5) Older adults took longer and exerted more effort to complete the task than younger adults, and static exercise in older adults may be more demanding on muscle activity in old age than powered exercise. Conclusion: These results help to optimise the design of hanging cabinet furniture. Regarding the height of hanging cabinets, 180 cm or less is required for regular retrieval movements if the human height is less than 150 cm. Concerning the depth of the hanging cabinets, different heights chose different comfort distances, which translated into the depth of the hanging cabinets; the greater the height, the greater the depth of the hanging cabinets to use.