In emergency situations, tracheal intubation replaces fiberoptic bronchoscopy to extract foreign bodies from the airway, a case report.

Introduction: Foreign bodies in the airways can cause significant morbidity and mortality. If emergency personnel are unable to clear an airway obstruction frequently results in cardiac arrest. Patient concerns: A 78-year-old man developed a persistent cough and dyspnoea after consuming alcohol. Fiberoptic bronchoscopy was performed, revealing complete blockage of the main airways on both sides by fish. Diagnosis: Endotracheal foreign body. Interventions: The foreign body was removed with an endotracheal tube under the guidance of a fiberoptic bronchoscope. Outcomes: The airway foreign body had been successfully removed and the man recovered uneventfully. Conclusion: When repeated attempts to extract airway foreign bodies under the guidance of bronchoscopy have failed, endotracheal intubation can be considered as a viable alternative in emergency situations.

Deploying a Dipole Electric Field at the CsPbI3 Perovskite/Carbon Interface for Enhancing Hole Extraction and Photovoltaic Performance.

Carbon-based CsPbI3 perovskite solar cells without hole transporter (C-PSCs) have achieved intense attention due to its simple device structure and high chemical stability. However, the severe interface energy loss at the CsPbI3/carbon interface, attributed to the lower hole selectivity for inefficient charge separation, greatly limits device performance. Hence, dipole electric field (DEF) is deployed at the above interface to address the above issue by using a pole molecule, 4-trifluoromethyl-Phenylammonium iodide (CF3-PAI), in which the ─NH3 group anchors on the perovskite surface and the ─CF3 group extends away from it and connects with carbon electrode. The DEF is proven to align with the built-in electric field, that is pointing toward carbon electrode, which well enhances hole selectivity and charge separation at the interface. Besides, CF3-PAI molecules also serve as defect passivator for reducing trap state density, which further suppresses defect-induced non-radiative recombination. Consequently, the CsPbI3 C-PSCs achieve an excellent efficiency of 18.33% with a high VOC of 1.144 V for inorganic C-PSCs without hole transporter.

Spatially selective defect management of CsPbI3 films for high-performance carbon-based inorganic perovskite solar cells.

Defects formed at the surface, buried interface and grain boundaries (GB) of CsPbI3 perovskite films considerably limit photovoltaic performance. Such defects could be passivated effectively by the most prevalent post modification strategy without compromising the photoelectric properties of perovskite films, but it is still a great challenge to make this strategy comprehensive to different defects spatially distributed throughout the films. Herein, a spatially selective defect management (SSDM) strategy is developed to roundly passivate various defects at different locations within the perovskite film by a facile one-step treatment procedure using a piperazine-1,4-diium tetrafluoroborate (PZD(BF4)2) solution. The small-size PZD2+ cations could penetrate into the film interior and even make it all the way to the buried interface of CsPbI3 perovskite films, while the BF4- anions, with largely different properties from I- anions, mainly anchor on the film surface. Consequently, virtually all the defects at the surface, buried interface and grain boundaries of CsPbI3 perovskite films are effectively healed, leading to significantly improved film quality, enhanced phase stability, optimized energy level alignment and promoted carrier transport. With these films, the fabricated CsPbI3 PSCs based on carbon electrode (C-PSCs) achieve an efficiency of 18.27%, which is among the highest-reported values for inorganic C-PSCs, and stability of 500 h at 85 °C with 65% efficiency maintenance.

How Do Tourists' Value Perceptions of Food Experiences Influence Their Perceived Destination Image and Revisit Intention? A Moderated Mediation Model.

The food experience is an important part of the tourism experience. Although it is crucial to comprehend the significance of tourists' perception of food experiences, there is a scarcity of research investigating the impact of tasting local food on tourists' perceptions and behaviors. This study employs structural equation modeling to empirically examine the relationship between tourists' value perceptions of food experiences, their perceived destination image, and their revisit intention. In addition, the moderating effects of tourists' genders on the aforementioned relationships are also explored. A renowned restaurant brand, Nanjing Impressions, which specializes in offering the unique cuisine of the city of Nanjing, China, is chosen as the research case. A grand total of 500 questionnaires were distributed, and, out of these, 458 questionnaires were deemed legitimate and kept for further analysis. The results indicate that the functional, social, emotional, cultural, and health values of local food experienced by tourists have significant positive impacts on their perceived destination image and revisit intention. Moreover, perceived destination image partially mediates the relationships between tourists' value perceptions of food experiences and their revisit intention. Gender is found to partially moderate the relationships between the proposed constructs. The current study offers noteworthy theoretical contributions and provides valuable practical suggestions for tourism destination managers.

Mechanosensitive Piezo1 protein as a novel regulator in macrophages and macrophage-mediated inflammatory diseases.

Macrophages are the most important innate immune cells in humans. They are almost ubiquitous in peripheral tissues with a large variety of different mechanical milieus. Therefore, it is not inconceivable that mechanical stimuli have effects on macrophages. Emerging as key molecular detectors of mechanical stress, the function of Piezo channels in macrophages is becoming attractive. In this review, we addressed the architecture, activation mechanisms, biological functions, and pharmacological regulation of the Piezo1 channel and review the research advancements in functions of Piezo1 channels in macrophages and macrophage-mediated inflammatory diseases as well as the potential mechanisms involved.

[Expert consensus on implementation strategy of awake prone positioning for non-intubated patients in China (2023)].

The awake prone position plays an important role in the treatment of hypoxemia and the improvement of respiratory distress symptoms in non-intubated patients. It is widely used in clinical practice because of its simple operation, safety, and economy. To enable clinical medical staff to scientifically and normatively implement prone position for awake patients without intubation, the committees of consensus formulation, guided by evidence-based methodology and Delphi method, conducted literature search, literature quality evaluation and evidence synthesis around seven topics, including indications and contraindications, evaluation, implementation, monitoring and safety management, termination time, complication prevention and health education of awake prone position. After two rounds of expert letter consultation, Expert consensus on implementation strategy of awake prone positioning for non-intubated patients in China (2023) was formulated, and provide guidance for clinical medical staff.

High-throughput metagenomics analysis in early and precise diagnosis of eosinophilic meningoencephalitis complicated with respiratory failure: A case report.

RATIONALE: Human infection with Angiostrongylus cantonensis is uncommon and has only been sporadically reported in the literature. Patients infected with A cantonensis usually have a delayed diagnosis and sometimes a poor prognosis. PATIENT CONCERNS: A 70-year-old woman presented to the respiratory department with complaints of headache, chest pain, myalgia, fatigue, and anorexia for 7 days. DIAGNOSES: Complete blood count showed eosinophilia. The serum was tested showing a positive finding of A cantonensis antibody. Cerebrospinal fluid was tested using high-throughput metagenomics analysis and 16 reads for A cantonensis were mapped. The patient was diagnosed with A cantonensis infection. INTERVENTIONS: The patient received a 7-day course of albendazole and 4-day course of prednisone. OUTCOMES: When discharged from the hospital, the patient still suffered from fatigue and poor memory. Aminotransferase levels were high due to albendazole's liver toxicity. In a post-discharge follow-up about 1 month later she had recovered completely both physically and mentally, and peripheral eosinophil count and aminotransferase levels were both normal. LESSONS: Because the direct identification of parasites is difficult, high-throughput metagenomics analysis may provide a reliable alternative tool for the diagnoses of infection with A cantonensis. When albendazole is prescribed, caution must be taken with respect to its liver toxicity.

Electrodeposition of High-Quality Ni/SiC Composite Coatings by Using Binary Non-Ionic Surfactants.

In order to increase the hardness, wear resistance and corrosion resistance of nickel-based coatings, pure nickel is often co-electrodeposited with silicon carbide (SiC) particles. However, SiC particles tend to agglomerate and precipitate in the bath, which reduces the amounts of nanoparticles and causes nonuniformity. Herein, we solve these problems by using binary non-ionic surfactants (Span 80 and Tween 60) to effectively disperse SiC particles (binary-SiC) in the bath, which suppresses nanoparticles agglomeration and leads to uniformly distributed SiC particles in the composite coatings. In comparison to the Ni/SiC coatings electrodeposited from the commonly used SDS-modified SiC, the coatings prepared with binary-SiC (Ni/binary-SiC) show finer crystallization and a smoother surface. In addition, the Ni/binary-SiC coatings exhibit higher hardness (556 Hv) and wear resistance (2.95 mg cm-2). Furthermore, higher corrosion resistance is also achieved by the Ni/binary-SiC coatings.

A wear and heat-resistant hydrophobic fluoride-free coating based on modified nanoparticles and waterborne-modified polyacrylic resin.

Hydrophobic coatings have attracted extensive research due to their broad application prospects. However, hydrophobic coatings in practical applications are often limited by their insufficient stability and are difficult to be applied on a large scale. In this regard, wear and heat resistance are key aspects that must be considered. In this paper, a method for preparing a robust hydrophobic coating with modified ZrO2 particles as the core component and modified acrylic resin is proposed. First, γ-aminopropyltriethoxysilane (APTES) was used to silanize ZrO2 to obtain Si-ZrO2 nanoparticles, which were grafted with amino groups. Then, the nanoparticles reacted with isocyanates to be grafted with hydrophobic groups. A simple spray method was developed to deposit a hydrophobic (141.8°) coating using the mixture containing the modified nanoparticles and non-fluorinated water-based silicon-modified acrylic resin (WSAR) that was prepared by free radical polymerization. The obtained coating exhibited a rough surface and the particles and resin were closely combined. Compared with pure resin coating, the composite coating exhibited 150% enhancement in wear resistance and it could wear 45 meters at a pressure of 20 kPa. Moreover, the coating could maintain the hydrophobic property even when it lost 70% quality or after it was heated at 390 °C. The thermogravimetric results showed that the temperature could reach 400 °C before the quality of the fluorine-free coating dropped to 90%. In addition, the coating could easily take away graphite or silicon carbide powder under the impact of water droplets, showing excellent self-cleaning performance.

Dimethyl sulfoxide: a promising solvent for inorganic CsPbI3 perovskite.

Inorganic CsPbI3 perovskite is an important photovoltaic material due to its suitable band gap and high chemical stability. However, it is a challenge to grow high-quality CsPbI3 perovskite because the stability of perovskite phase is low and is sensitive to solvent. So far, most of CsPbI3 perovskites in high-performance perovskite solar cells (PSCs) were prepared from N,N-dimethylformamide, a highly toxic solvent, and no successful case has been reported for dimethyl sulfoxide (DMSO), which is environmentally-friendly with considerably higher complexation capability. Herein, we reveal that forming DMSO-based adduct is the main cause for limiting the quality of CsPbI3 perovskite from DMSO-based solutions, which would inhibit the formation of DMAPbI3 (DMA = dimethylammonium, (CH3)2NH2+) intermediate. Then, by introducing a vacuum treatment, DMSO molecules could be efficiently extracted from the adduct to induce the formation of DMAPbI3 intermediate. After annealing, the intermediate is transitioned to the CsPbI3 perovskite with enhanced crystallinity, high orientation, low defect density, and high uniformity. By using the CsPbI3 perovskite as a light absorber, the PSCs based on carbon electrode (C-PSCs) achieve an efficiency of 16.7%, a new record for inorganic C-PSCs.

LDHA: The Obstacle to T cell responses against tumor.

Immunotherapy has become a successful therapeutic strategy in certain solid tumors and hematological malignancies. However, this efficacy of immunotherapy is impeded by limited success rates. Cellular metabolic reprogramming determines the functionality and viability in both cancer cells and immune cells. Extensive research has unraveled that the limited success of immunotherapy is related to immune evasive metabolic reprogramming in tumor cells and immune cells. As an enzyme that catalyzes the final step of glycolysis, lactate dehydrogenase A (LDHA) has become a major focus of research. Here, we have addressed the structure, localization, and biological features of LDHA. Furthermore, we have discussed the various aspects of epigenetic regulation of LDHA expression, such as histone modification, DNA methylation, N6-methyladenosine (m6A) RNA methylation, and transcriptional control by noncoding RNA. With a focus on the extrinsic (tumor cells) and intrinsic (T cells) functions of LDHA in T-cell responses against tumors, in this article, we have reviewed the current status of LDHA inhibitors and their combination with T cell-mediated immunotherapies and postulated different strategies for future therapeutic regimens.

Electrodeposition of Polyporous Sn-Ni Coating in Deep Eutectic Solvents for Removing Organic Dyes.

Materials with a high specific surface area including a porous structure have been widely researched due to the applicability in the adsorption of various organic dyes. However, further application of porous materials is limited by the complicated and expensive preparation process. Herein, a Sn-Ni coating with a polyporous structure is successfully prepared via a simple and high-efficiency electrodeposition approach in deep eutectic solvents (DESs). The prepared Sn-Ni coating exhibits a uniform polyporous structure with a diameter of 15 µm. Furthermore, the coating shows excellent adsorption capacity in the removal of acid grain black organic dyestuff. With the rise of preparation temperature from 85 to 105 °C, the electrochemical active surface area and the ratio of nickel increase, which further enhance dye adsorption capacity.

Implementation of Evidence in Preventing Postoperative Sore Throat of Patients Undergoing General Anesthesia Intubation Using the i-PARIHS Framework.

Objective: The aim of the study was to assess the effectiveness of the implementation of the best evidence in preventing postoperative sore throat in patients undergoing general anesthesia intubation. Methods: The related topics of the postoperative sore throat of patients undergoing general anesthesia intubation were systematically searched in the database and evaluated using the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework. Combined with clinical needs and evidence-based professional judgment, 20 pieces of evidence and 6 examination standards on the management process and evidence implementation plan for the prevention of postoperative sore throat in patients with general anesthesia intubation are summarized, implementing the best evidence into clinical practice in anesthesiology, general surgery, orthopedics, thoracic surgery, and gynecology. Results: Nurses' knowledge scores and evidence compliance significantly improved after the implementation of the best evidence (P < 0.05); the incidence of the postoperative sore throat in patients undergoing general anesthesia intubation decreased from 41.7% to 28.1%. Conclusion: The i-PARIHS framework effectively prevents postoperative sore throat in patients, providing an effective case for translating evidence into practice based on the i-PARIHS framework.

Implementation of evidence in preventing medical device-related pressure injury in ICU patients using the i-PARIHS framework.

AIM: To examine the effectiveness of implementing the evidence in preventing medical device-related pressure injury (MDRPI) in intensive care patients. BACKGROUND: MDRPI is a common problem that significantly complicates patients' medical condition. However, evidence in preventing MDRPI is not properly implemented in clinical practice. METHODS: A pre- and post-implementation study was conducted using the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework. A baseline survey was implemented; barriers and enablers of evidence implementation were analysed to inform facilitation support strategies, such as training nursing staff and developing resources and tools. Changes in nurses, patients and the system were assessed after evidence implementation. RESULTS: Nurses' knowledge scores and evidence compliance significantly improved. The incidence of MDRPI in patients decreased from 24.39% to 4.26%. Standardized care and workflows to prevent MDRPI were established. CONCLUSION: The i-PARIHS framework supported effective implementation of the evidence in preventing MDRPI, narrowing the gap between evidence and clinical practice. IMPLICATIONS FOR NURSING MANAGEMENT: We provide an effective case of transforming evidence into practice based on the i-PARIHS framework. It can be used as a reference for colleagues in intensive care unit (ICU) or other settings to implement MDRPI prevention.

Risk characteristics with seven epithelial-mesenchymal transition-related genes are used to predict the prognosis of patients with hepatocellular carcinoma.

BACKGROUND: Epithelial-mesenchymal transition (EMT)-related genes (ERGs) have been shown to play an important role in cancer invasion, tumor resistance, and tumor metastasis of hepatocellular carcinoma. This study sought to examine the prognostic value of ERGs and other pre-hepatoma genes. METHODS: Relevant data from The Cancer Genome Atlas (TCGA) were analyzed and synthesized. Specifically, 1,014 ERGs were downloaded and subject to a gene set enrichment analysis; 318 different EAG expressions were found, and the possible molecular mechanism of EAG was predicted by GO analysis and KEGG analysis. To determine the prediction of ERGS, a Cox regression model was used to establish a risk hypothesis. Based on risk patterns, patients were divided into high- or low-risk groups. Kaplan-Meier and receiver operating characteristic (ROC) curves confirmed the predictive value of the model. RESULTS: Seven prognostically relevant ERGs (i.e., ECT2, EZH2, MYCN, ROR2, SPP1, SQSTM1, and STC2) were identified. Using Cox's regression analysis method, appropriate cases were selected to establish a new risk prediction model. Under the risk model, the overall survival rate of the low-risk group samples was higher than that of the high-risk group samples (P<0.00001). CONCLUSIONS: In short, we developed a risk model for liver cancer based on ERGs terminology. This model improve the postpartum treatment of patients with liver cancer.

SOX9 is a critical regulator of TSPAN8-mediated metastasis in pancreatic cancer.

Pancreatic ductal adenocarcinoma (PDAC) is the deadliest cancer mainly owing to its proclivity to early metastasis and the lack of effective targeted therapeutic drugs. Hence, understanding the molecular mechanisms underlying early invasion and metastasis by PDAC is imperative for improving patient outcomes. The present study identified that upregulation of TSPAN8 expression in PDAC facilitates metastasis in vivo and in vitro. We found SOX9 as a key transcriptional regulator of TSPAN8 expression in response to EGF stimulation. SOX9 modulation was sufficient to positively regulate endogenous expression of TSPAN8, with concomitant in vitro phenotypic changes such as loss of cell-matrix adherence and increased invasion. Moreover, increased SOX9 and TSPAN8 levels were shown to correlate in human pancreatic cancer specimens and downregulated in vitro by EGFR tyrosine kinase inhibitors. High expression of SOX9 and TSPAN8 has been associated with tumor stage, poor prognosis and poor patient survival in PDAC. In conclusion, this study highlights the importance of the EGF-SOX9-TSPAN8 signaling cascade in the control of PDAC invasion and implies that TSPAN8 may be a promising novel therapeutic target for the treatment of PDAC.

Development and Validation of Prognostic Survival Nomograms for Patients with Anal Canal Cancer: A SEER-Based Study.

OBJECTIVE: Anal canal cancer is a rare malignancy with increasing incidence in recent times. This study aimed to develop two nomograms to predict the overall survival (OS) and cancer-specific survival (CSS) of patients with anal canal cancer. METHODS: Information of patients with anal canal cancer from 2004 to 2015 was extracted from the surveillance, epidemiology, and end results (SEER) database. Cox analysis was used to select the risk factors for prognosis, and nomograms were constructed using the R software. The C-index, area under the curve (AUC) of time-dependent receiver operating characteristic (ROC) curves, calibration plot and decision curve analysis (DCA) were used to assess the clinical utility of the nomograms. RESULTS: A total of 2458 patients with malignant tumours of the anal canal were screened out. Sex, age, marital status, histological type, grade, tumour size, AJCC stage, SEER stage and chemotherapy were independent prognostic factors for OS, whereas sex, age, race, histological type, grade, tumour size, AJCC stage, SEER stage and radiotherapy were independent prognostic factors for CSS. In the training cohort, the C-index value for OS nomogram was 0.73 (95% CI, 0.69-0.77), and the AUC values that predicted the 1-, 3- and 5-year survival rates were 0.764, 0.758 and 0.760, respectively, whereas the C-index value for CSS nomogram model was 0.74 (95% CI, 0.69-0.79), and the AUC values were 0.763, 0.769 and 0.763, respectively. The calibration plot and DCA curves demonstrated good prediction performance of the model in both the training and validation cohorts. CONCLUSION: The established nomogram is a visualisation tool that can effectively predict the OS and CSS of patients with anal canal cancer.

Facile fabrication of a Janus mesh for water fluid unidirectional transportation.

A Janus membrane/mesh is a type of functional membrane/mesh composed of opposing wetting properties formed into a single layer in order to achieve novel properties. Janus membranes/meshes have attracted increasing attention from materials scientists due to their promising applications in the fields of microfluid transportation, water-oil separation and cleaning energy applications. Herein, we report a simple method to fabricate a Janus mesh by combining opposite wettability functions into one copper mesh substrate. The superhydrophilicity is achieved by chemical etching and the superhydrophobicity is fabricated by hydrophobic SiO2 nanoparticle spraying. Due to its special composition and structure, the prepared mesh demonstrates distinct wetting properties on its two sides. Meanwhile, aqueous fluids can pass through the mesh from the hydrophobic side to the hydrophilic side spontaneously, whilst being blocked by the mesh when coming from the other direction. This unique property can realize unidirectional transportation of water fluids. The mechanism of the unique property based on Janus wettability is proposed and the stability of the prepared Janus mesh was also tested. The prepared Janus mesh can be used in the fields of microtidal energy, the chemical industry and in astronautics, demonstrating promising practical prospects.

Aquaculture Feeds Can Be Outlaws for Eutrophication When Hidden in Rice Fields? A Case Study in Qianjiang, China.

Water eutrophication caused by agricultural production has become one of the most important factors that impede sustainable rural environmental governance in China. As a result, the Chinese central and local governments want to reduce the use of nitrogen and phosphorus fertilizer and gain socioeconomical profit simultaneously by promoting crayfish and rice integrated system (CRIS) in the rural areas with abundant water resources. In this article, we investigated whether CRIS in Qianjiang, Hubei, the origin place of the system in China, contributes to fulfilling the governments' expectations. We found that CRIS efficaciously cuts the fertilizer rate in rice production and boosts farmers' incomes because crayfish has a demand for water quality and holds a large internal market requirement. However, higher profit encourages farmers to expand crayfish production and thus discourages the initiatives in rice production. The area of the ditch for crayfish production expands ceaselessly and exceeds the limit of regulation of CRIS. As a result, the CRIS in the areas has emerged as a practice of aquaculture but in farmland. This is a regulatory gap. The input-output analysis of CRIS by material balance method can also reveal that excessive feed for crayfish has become a new source of agricultural pollution. Beyond that, due to the changed irrigation system and increased water exchange frequency of CRIS, the pollution has transformed from passive distribution to active, which will increase the risk of water eutrophication on a large area.