Reducing postoperative hypothermia in infants: Quality improvement in China.

BACKGROUND: Unintended postoperative hypothermia in infants is associated with increased mortality and morbidity. We noted consistent hypothermia postoperatively in more than 60% of our neonatal intensive care (NICU) babies. Therefore, we set out to determine whether a targeted quality improvement (QI) project could decrease postoperative hypothermia rates in infants. OBJECTIVES: Our SMART aim was to reduce postoperative hypothermia (<36.5°C) in infants from 60% to 40% within 6 months. METHODS: This project was approved by IRB at Guangzhou Women and Children's Medical Center, China. The QI team included multidisciplinary healthcare providers in China and QI experts from Children's Hospital of Philadelphia, USA. The plan-do-study-act (PDSA) cycles included establishing a perioperative-thermoregulation protocol, optimizing the transfer process, and staff education. The primary outcome and balancing measures were, respectively, postoperative hypothermia and hyperthermia (axillary temperature < 36.5°C, >37.5°C). Data collected was analyzed using control charts. The factors associated with a reduction in hypothermia were explored using regression analysis. RESULTS: There were 295 infants in the project. The percentage of postoperative hypothermia decreased from 60% to 37% over 26 weeks, a special cause variation below the mean on the statistical process control chart. Reduction in hypothermia was associated with an odds of 0.17 (95% CI: 0.06-0.46; p <.001) for compliance with the transport incubator and 0.24 (95% CI: 0.1-0.58; p =.002) for prewarming the OR ambient temperature to 26°C. Two infants had hyperthermia. CONCLUSIONS: Our QI project reduced postoperative hypothermia without incurring hyperthermia through multidisciplinary team collaboration with the guidance of QI experts from the USA.

Combined dilute alkali and milling process enhances the functionality and gut microbiota fermentability of insoluble corn fiber.

In this study, we developed a process combining dilute alkali (NaOH or NaHCO3) and physical (disk milling and/or ball milling) treatments to improve the functionality and fermentability of corn fiber. The results showed that combining chemical with physical processes greatly improved the functionality and fermentability of corn fiber. Corn fiber treated with NaOH followed by disk milling (NaOH-DM-CF) had the highest water retention (19.5 g/g), water swelling (38.8 mL/g), and oil holding (15.5 g/g) capacities. Moreover, NaOH-DM-CF produced the largest amount (42.9 mM) of short-chain fatty acid (SCFA) during the 24-hr in vitro fermentation using porcine fecal inoculum. In addition, in vitro fermentation of NaOH-DM-CF led to a targeted microbial shifting to Prevotella (genus level), aligning with a higher fraction of propionic acid. The outstanding functionality and fermentability of NaOH-DM-CF were attributed to its thin and loose structure, decreased ester linkages and acetyl groups, and enriched structural carbohydrate exposure.

Preoperative T-staging of Colorectal Cancer by Dual-energy Computed Tomography: A Retrospective Study.

BACKGROUND: Preoperative T-staging is essential for planning optimal treatment and care for colorectal cancer (CRC). OBJECTIVE: To evaluate the accuracy of Dual-energy CT (DECT) in preoperative T-staging of CRC. METHODS: The clinical data and DECT images of 37 patients with 39 CRC lesions were retrospectively analyzed. The performance of the DECT quantitative parameters in CRC T-staging was evaluated. Postoperative pathologic results were used as a gold standard. Receiver operating characteristic curves were used to assess the diagnostic efficacy of DECT parameters. P < 0.05 was deemed significant. RESULTS: The overall accuracy of T-staging by DECT was 76.9%. The DECT parameters were significantly different between the T3 pericolic fat stranding, T4a pericolic fat stranding, and normal pericolic fat stranding. Arterial phase λHU had the best diagnostic performance with a cut-off value of ≥0.967, resulting in a 70.6% sensitivity and a 100% specificity in differentiating between T3 and T4a stages of CRC. CONCLUSION: DECT has high accuracy in the T-staging of CRC. Arterial phase λHU has the best diagnostic performance in differentiating between T3 and T4a stages of CRC.

Self-terminating, heterogeneous solid-electrolyte interphase enables reversible Li-ether cointercalation in graphite anodes.

Ether solvents are suitable for formulating solid-electrolyte interphase (SEI)-less ion-solvent cointercalation electrolytes in graphite for Na-ion and K-ion batteries. However, ether-based electrolytes have been historically perceived to cause exfoliation of graphite and cell failure in Li-ion batteries. In this study, we develop strategies to achieve reversible Li-solvent cointercalation in graphite through combining appropriate Li salts and ether solvents. Specifically, we design 1M LiBF4 1,2-dimethoxyethane (G1), which enables natural graphite to deliver ~91% initial Coulombic efficiency and >88% capacity retention after 400 cycles. We captured the spatial distribution of LiF at various length scales and quantified its heterogeneity. The electrolyte shows self-terminated reactivity on graphite edge planes and results in a grainy, fluorinated pseudo-SEI. The molecular origin of the pseudo-SEI is elucidated by ab initio molecular dynamics (AIMD) simulations. The operando synchrotron analyses further demonstrate the reversible and monotonous phase transformation of cointercalated graphite. Our findings demonstrate the feasibility of Li cointercalation chemistry in graphite for extreme-condition batteries. The work also paves the foundation for understanding and modulating the interphase generated by ether electrolytes in a broad range of electrodes and batteries.

Prognostic value of circulating tumor cells associated with white blood cells in solid cancer: a systematic review and meta-analysis of 1471 patients with solid tumors.

BACKGROUND: The clinical relevance of circulating tumor cell-white blood cell (CTC-WBC) clusters in cancer prognosis is a subject of ongoing debate. This study aims to unravel their contentious predictive value for patient outcomes. METHODS: We conducted a comprehensive literature search of PubMed, Embase, and Cochrane Library up to December 2022. Eligible studies that reported survival outcomes and examined the presence of CTC-WBC clusters in solid tumor patients were included. Hazard ratios (HR) were pooled to assess the association between CTC-WBC clusters and overall survival (OS), as well as progression-free survival (PFS)/disease-free survival (DFS)/metastasis-free survival (MFS)/recurrence-free survival (RFS). Subgroup analyses were performed based on sampling time, treatment method, detection method, detection system, and cancer type. RESULTS: A total of 1471 patients from 10 studies were included in this meta-analysis. The presence of CTC-WBCs was assessed as a prognostic factor for overall survival and PFS/DFS/MFS/RFS. The pooled analysis demonstrated that the presence of CTC-WBC clusters was significantly associated with worse OS (HR = 2.44, 95% CI: 1.74-3.40, P < 0.001) and PFS/DFS/MFS/RFS (HR = 1.83, 95% CI: 1.49-2.24, P < 0.001). Subgroup analyses based on sampling time, treatment method, detection method, detection system, cancer type, and study type consistently supported these findings. Further analyses indicated that CTC-WBC clusters were associated with larger tumor size (OR = 2.65, 95% CI: 1.58-4.44, P < 0.001) and higher alpha-fetoprotein levels (OR = 2.52, 95% CI: 1.50-4.22, P < 0.001) in hepatocellular carcinoma. However, no significant association was found between CTC-WBC clusters and TNM stage, depth of tumor invasion, or lymph node metastasis in the overall analysis. CONCLUSIONS: CTC-WBC clusters are negative predictors for OS and PFS/DFS/MFS/RFS in patients with solid tumors. Monitoring CTC-WBC levels may provide valuable information for predicting disease progression and guiding treatment decisions.

The differential associative relationship between early risk factors, neonatal morbidities and early neurodevelopmental outcome in preterm infants <29 weeks' gestation.

BACKGROUND: Very preterm infants of <29 weeks' gestation are at high risk for adverse neurodevelopment due to multiple risk factors in the early stages of life. There is little information regarding the associative effects of risk factors in early life, neonatal morbidities and subsequent neurodevelopmental outcomes. AIMS: Investigate the association of early neurodevelopmental outcomes, neonatal complications and the risk factors in the early hours of life in a cohort of preterm infants <29 weeks' gestational age. METHODS: We enrolled all surviving preterm neonates born at gestation <29 weeks between January 2015 and June 2021 in the University of Hong Kong-Shenzhen Hospital. Demographic and clinical characteristics were collected from a database of the neonatal intensive care unit. Neurodevelopmental outcomes of the survivors were evaluated using the Ages and Stages Questionnaire (ASQ-3) which were measured at the adjusted age of 12 to 18 months. The multivariate linear regression model was used to determine correlation presented as ß coefficient (ß) with 95 % confidence intervals (CI). RESULTS: In this cohort of 56 survivors <29 weeks' gestation, urine output within the first 12 h of life and Apgar score at 5 min were positively associated with different domains of ASQ-3 score, however male sex and highest fraction of inspired oxygen (FiO2) in the first 12 h of life were negatively related with at least one of neurocognitive domains of ASQ-3 at adjusted age of 12 to 18 months. During hospitalization, in addition to the frequency of packed red cell transfusions, the development of severe necrotizing enterocolitis was inversely associated with both neuromotor and neurocognitive skills (gross motor domain: ß = -16.93, CI: -32.04, -1.82; fine motor domain: ß = -16.42, CI: -28.82, -4.02; problem solving domain: ß = -13.14, CI: -24.45, -1.83; all P < 0.05), whereas severe intraventricular hemorrhage had adverse effects on gross motor only (ß = -13.04, CI: -24.42, -1.65; P = 0.03). Bronchopulmonary dysplasia and retinopathy of prematurity were not related with ASQ-3. CONCLUSIONS: In this small cohort study of very preterm neonates born at <29 weeks' gestation, risk factors in the early hours of life and neonatal morbidities during hospitalization had differential associative relationships with ASQ-3 at 12-18 months adjusted age. This information may be important for parental counseling and management including early diagnosis and intervention.

Construction of high internal phase Pickering emulsions using cold plasma modified soy protein isolate-proanthocyanidin complex.

Protein-based high internal phase Pickering emulsions (HIPPEs) feature numerous multi-functionalities and widespread applications. However, the direct use of native proteins for the constructions of HIPPEs is limited since it is fragile under various conditions. Here, cold plasma was used to modify soy protein isolates (SPI) to improve their surficial properties. Meanwhile, proanthocyanidins (PA) were applied to interact with cold plasma-treated SPI to form complex. Furthermore, the well-prepared SPI-PA complex was used to construct novel HIPPEs. Results showed cold plasma treatment significantly improved the functionalities of SPI, which were confirmed by surface hydrophobicity (H0 ＜ 500), sulfhydryl (SH) groups and spectral analysis. Further, the emulsification and oxidation resistance of cold plasma treated SPI were enhanced after forming complex with PA. Soybean oils can be stabilized by SPI-PA complexes to form HIPPEs with a lipid oxidation inhibition rate of ＞ 65%, creaming index (CI) ＞ 80%, excellent rheological properties and better stability compared with conventional emulsion systems. Overall, this SPI-PA complexes provides a unique approach to improve the emulsification and oxidation resistance to engineer HIPPEs with versatile applications.

The Tribological and Mechanical Properties of PI/PAI/EP Polymer Coating under Oil Lubrication, Seawater Corrosion and Dry Sliding Wear.

To investigate the tribological performance of a copper alloy engine bearing under oil lubrication, seawater corrosion and dry sliding wear, three different PI/PAI/EP coatings consisting of 1.5 wt% Ce2O3, 2 wt% Ce2O3, 2.5 wt% Ce2O3 were designed, respectively. These designed coatings were prepared on the surface of CuPb22Sn2.5 copper alloy using a liquid spraying process. The tribological properties of these coatings under different working conditions were tested. The results show that the hardness of the coating decreases gradually with the addition of Ce2O3, and the agglomeration of Ce2O3 is the main reason for the decrease of hardness. The wear amount of the coating increases first and then decreases with the increase of Ce2O3 content under dry sliding wear. The wear mechanism is abrasive wear under the condition of seawater. The wear resistance of the coating decreases with the increase of Ce2O3 content. The wear resistance of the coating with 1.5 wt% Ce2O3 is the best under-seawater corrosion. Although Ce2O3 has corrosion resistance, the coating of 2.5 wt% Ce2O3 has the worst wear resistance under seawater conditions due to severe wear caused by agglomeration. Under oil lubrication conditions, the frictional coefficient of the coating is stable. The lubricating oil film has a good lubrication and protection effect.

Mucoadhesive Hydrogel with Anti-gastric Acid and Sustained-Release Functions for Amelioration of DSS-Induced Ulcerative Colitis.

Mucoadhesive hydrogels with multifunctional properties such as gastric acid resistance and sustained drug release in the intestinal tract are highly desirable for the oral treatment of inflammatory bowel diseases (IBDs). Polyphenols are proven to have great efficacies compared with the first-line drugs for IBD treatments. We recently reported that gallic acid (GA) was capable of forming a hydrogel. However, this hydrogel is prone to easy degradation and poor adhesion in vivo. To tackle this problem, the current study introduced sodium alginate (SA) to form a gallic acid/sodium alginate hybrid hydrogel (GAS). As expected, the GAS hydrogel showed excellent antiacid, mucoadhesive, and sustained degradation properties in the intestinal tract. In vitro studies demonstrated that the GAS hydrogel significantly alleviated ulcerative colitis (UC) in mice. The colonic length of the GAS group (7.75 ± 0.38 cm) was significantly longer than that of the UC group (6.12 ± 0.25 cm). The disease activity index (DAI) value of the UC group was (5.5 ± 0.57), which was markedly higher than that of the GAS group (2.5 ± 0.65). The GAS hydrogel also could inhibit the expression of inflammatory cytokines, regulating macrophage polarization and improving the intestinal mucosal barrier functions. All these results indicated that the GAS hydrogel was an ideal candidate for oral treatment of UC.

Preoperative Non-Invasive Prediction of Breast Cancer Molecular Subtypes With a Deep Convolutional Neural Network on Ultrasound Images.

Purpose: This study aimed to develop a deep convolutional neural network (DCNN) model to classify molecular subtypes of breast cancer from ultrasound (US) images together with clinical information. Methods: A total of 1,012 breast cancer patients with 2,284 US images (center 1) were collected as the main cohort for training and internal testing. Another cohort of 117 breast cancer cases with 153 US images (center 2) was used as the external testing cohort. Patients were grouped according to thresholds of nodule sizes of 20 mm and age of 50 years. The DCNN models were constructed based on US images and the clinical information to predict the molecular subtypes of breast cancer. A Breast Imaging-Reporting and Data System (BI-RADS) lexicon model was built on the same data based on morphological and clinical description parameters for diagnostic performance comparison. The diagnostic performance was assessed through the accuracy, sensitivity, specificity, Youden's index (YI), and area under the receiver operating characteristic curve (AUC). Results: Our DCNN model achieved better diagnostic performance than the BI-RADS lexicon model in differentiating molecular subtypes of breast cancer in both the main cohort and external testing cohort (all p < 0.001). In the main cohort, when classifying luminal A from non-luminal A subtypes, our model obtained an AUC of 0.776 (95% CI, 0.649-0.885) for patients older than 50 years and 0.818 (95% CI, 0.726-0.902) for those with tumor sizes ≤20 mm. For young patients ≤50 years, the AUC value of our model for detecting triple-negative breast cancer was 0.712 (95% CI, 0.538-0.874). In the external testing cohort, when classifying luminal A from non-luminal A subtypes for patients older than 50 years, our DCNN model achieved an AUC of 0.686 (95% CI, 0.567-0.806). Conclusions: We employed a DCNN model to predict the molecular subtypes of breast cancer based on US images. Our model can be valuable depending on the patient's age and nodule sizes.

Co-assembling of natural drug-food homologous molecule into composite hydrogel for accelerating diabetic wound healing.

Diabetic wound healing is a major clinical challenge due to its vulnerability to bacterial infection and the prolonged inflammation in the wound. Traditional dressings for the healing of diabetic wounds are often suffered from unsatisfactory efficacy and frequent dressing changes which may cause secondary damage. Therefore, it is necessary to find a wound dressing that balances material functionality, degradation, safety, and tissue regeneration. Our recent studies demonstrated that gallic acid (GA) could spontaneously form supramolecular hydrogels at a relatively high concentration. However, a single network of GA hydrogel is prone to degradation, poor adhesion, and poor swelling, and may not be suitable for wound healing dressings. In this study, a composite hydrogel (GAK) was constructed by introducing konjac glucomannan (KGM) into the gel system of gallic acid (GA) and applied to promote diabetic wound healing. The composite hydrogel (GAK) with superior surface adhesion, stability, and swelling properties than the single-network of GA hydrogel. Moreover, in vitro experiments showed that GAK hydrogel had excellent biocompatibility and exhibited antibacterial activity against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus). Additionally, the GAK hydrogel could significantly accelerate angiogenesis, collagen deposition, and re-epithelialization during wound healing in diabetic mice, reducing the expression of related inflammatory proteins interleukin-1ß (IL-1ß), tumor necrosis factor-alpha (TNF-α), and cyclooxygenase-2 (COX-2), and improving the wound closure rate. The findings of this study suggest that this composite hydrogel (GAK) can be an ideal dressing material for accelerating diabetic wound healing.

Circular RNA MTCL1 promotes advanced laryngeal squamous cell carcinoma progression by inhibiting C1QBP ubiquitin degradation and mediating beta-catenin activation.

BACKGROUND: Circular RNAs (circRNAs) are involved in regulatory processes of ubiquitination and deubiquitination in various tumors at post-transcriptional epigenetic modification level. However, the underlying mechanism and its biological functions of circRNAs in the advanced laryngeal squamous cell carcinoma (LSCC) remain obscure. METHODS: RNA sequencing and quantitative real-time PCR (qRT-PCR) assays were applied to screen for circRNAs differentially expressed in LSCC tissues and cell lines. The candidate RNA-binding proteins and target signalling pathway were detected by RNA pull-down and mass spectrometry, in situ hybridization (ISH), immunohistochemistry (IHC), qRT-PCR assays, and bioinformatics analysis. The functional roles of these molecules were investigated using in vitro and in vivo experiments including EdU, transwell, wound healing, western blot assays, and the xenograft mice models. The molecular mechanisms were identified using RNA pull-down assays, RNA immunoprecipitation (RIP), Co-IP, ISH, Ubiquitination assay, bioinformatics analysis, and the rescue experiments. RESULTS: Here, we unveil that microtubule cross-linking factor 1 circRNA (circMTCL1, circ0000825) exerts its critical oncogenic functions by promoting complement C1q-binding protein (C1QBP)-dependent ubiquitin degradation and subsequently activating Wnt/ß-catenin signalling in laryngeal carcinoma initiation and development. Specifically, circMTCL1 was remarkably up-regulated in the paired tissues of patients with LSCC (n = 67), which predicted a worse clinical outcome. Functionally, circMTCL1 exerted oncogenic biological charactersistics by promoting cell proliferative capability and invasive and migrative abilities. Ectopic circMTCL1 augumented cell proliferation, migration, and invasion of LSCC cells, and this effect could be reversed by C1QBP knocking down in vitro and in vivo. Mechanistically, circMTCL1 directly recruited C1QBP protein by harboring the specific recognized sequence (+ 159 - + 210), thereby accelerating the translation of C1QBP expression by inhibiting its ubiquitin-proteasome-mediated degradation. Importantly, the direct interaction of C1QBP with ß-catenin protein was enhanced via suppressing the ß-catenin phosphorylation and accelerating its accumulation in cytoplasm and nucleus. CONCLUSION: Our findings manifested a novel circMTCL1-C1QBP-ß-catenin signaling axis involving in LSCC tumorigenesis and progression, which shed new light on circRNAs-ubiquitous acidic glycoprotein mediated ubiquitin degradation and provided strategies and targets in the therapeutic intervention of LSCC.

Integrative analysis reveals a lineage-specific circular RNA landscape for adipo-osteogenesis of human mesenchymal stem cells.

BACKGROUND: The balance between osteogenesis and adipogenesis of mesenchymal stem cells (MSCs) is critical to skeletal development and diseases. As a research hotspot, circular RNAs (circRNAs) have expanded our understanding of a hidden layer of the transcriptome. Yet, their roles during adipo-osteogenesis remain poorly described. METHODS: The identity of human MSCs derived from bone marrow and adipose were first determined by flow cytometry, cellular staining, and quantitative polymerase chain reaction (qPCR). Multi-strategic RNA-sequencing was performed using Poly A, RiboMinus and RiboMinus/RNase R methods. Integrative analysis was performed to identify lineage-specific expressed circRNAs. The structural and expressional characteristics were identified by Sanger sequencing and qPCR, respectively. The regulatory effects of adipogenesis-specific circ-CRLF1 were confirmed using siRNA transcfection and qPCR. RESULTS: We generated a whole transcriptome map during adipo-osteogenesis based on 10 Poly A, 20 RiboMinus and 20 RiboMinus/ RNase R datasets. A total of 31,326 circRNAs were identified and quantified from ~ 3.4 billion paired-end reads. Furthermore, the integrative analysis revealed that 1166 circRNA genes exhibited strong lineage-specific expression patterns. Their host genes were enriched in distinct biological functions, such as cell adhesion, cytokine signaling, and cell division. We randomly selected and validated the back-spliced junction sites and expression patterns of 12 lineage-specific circRNAs. Functional analysis indicated that circ-CRLF1 negatively regulated adipogenesis. CONCLUSIONS: Our integrative analysis reveals an accurate and generally applicable lineage-specific circRNA landscape for adipo-osteogenesis of MSCs and provides a potential therapeutic target, circ-CRLF1, for the treatment of skeleton-related disease.

Self-Assembly of Naturally Small Molecules into Supramolecular Fibrillar Networks for Wound Healing.

Self-assemblies of bioactively natural compounds into supramolecular hydrogels without structural modifications are of interest to improve their sustained releases and bioavailabilities in vivo. However, it is still a formidable challenge to dig out such a naturally small molecule with a meticulous structure which can be self-assembled to form a hydrogel for biomedical applications. Here, a new hydrogel consisting only of gallic acid (GA) via π-π stacking and hydrogen bond interactions, whereas none of GA analogues can form the similar supramolecular hydrogels, is reported. This interesting phenomenon is intriguing to further investigate the potential applications of GA hydrogels in wound healing. Notably, this GA hydrogel has rod-like structures with lengths varying from 10 to 100 µm. The biocompatibility and antibacterial tests prove that this well-assembled GA hydrogel has no cytotoxicity and excellent antibacterial activities against Escherichia coli and Staphylococcus aureus. Moreover, the GA hydrogel can significantly accelerate the process of wound healing with or without bacterial infections by mediation of inflammation signaling pathways. It is believed that the current study may shed a new light on the design of a supramolecular hydrogel based on self-assemblies of naturally small molecules to improve their bioavailabilities and diversify their uses in biomedical applications.

Resveratrol Triggered the Quick Self-Assembly of Gallic Acid into Therapeutic Hydrogels for Healing of Bacterially Infected Wounds.

Programing self-assembly of naturally bioactive molecules has been a wide topic of great significance for biomedical uses. Despite the fact that plant-derived polyphenols with catechol or pyrogallol moieties have been widely studied to construct nanocomplexes or nanocoatings via self-polymerization, there is no report on the self-assembly of these polyphenols into therapeutic hydrogels for potential applications. Here, we reported that adding a very small amount of resveratrol (Res) into the gallic acid (GA) aqueous solution could trigger the quick self-assembly of GA to form a fibrous hydrogel within 5 min through hydrogen bonds and π-π interactions. The length of GA/Res (GR) fibrils in gels varied from 100 to 1000 microns, with a diameter of around 1 µm. Notably, these GR hydrogels showed excellent colloid stability, providing better slow release and outstanding biocompatibility. Also, in vivo experiments indicated the hydrogels had high antibacterial effects and excellent wound healing capabilities in a total skin defect model via regulating the expression of inflammatory factors (IL-6, IL-1ß, and TNF-α) due to the release of therapeutic agents (GA and Res) into the matrix. Overall, our results provide a new strategy to accelerate self-assembly of GA by adding Res to form hydrogels, which is further proved as a promising therapeutic carrier for wound healing.

Four-quadrant fast compressive tracking of breast ultrasound videos for computer-aided response evaluation of neoadjuvant chemotherapy in mice.

BACKGROUND AND OBJECTIVE: Neoadjuvant chemotherapy (NAC) is a valuable treatment approach for locally advanced breast cancer. Contrast-enhanced ultrasound (CEUS) potentially enables the assessment of therapeutic response to NAC. In order to evaluate the response accurately, quantitatively and objectively, a method that can effectively compensate motions of breast cancer in CEUS videos is urgently needed. METHODS: We proposed the four-quadrant fast compressive tracking (FQFCT) approach to automatically perform CEUS video tracking and compensation for mice undergoing NAC. The FQFCT divided a tracking window into four smaller windows at four quadrants of a breast lesion and formulated the tracking at each quadrant as a binary classification task. After the FQFCT of breast cancer videos, the quantitative features of CEUS including the mean transit time (MTT) were computed. All mice showed a pathological response to NAC. The features between pre- (day 1) and post-treatment (day 3 and day 5) in these responders were statistically compared. RESULTS: When we tracked the CEUS videos of mice with the FQFCT, the average tracking error of FQFCT was 0.65 mm, reduced by 46.72% compared with the classic fast compressive tracking method (1.22 mm). After compensation with the FQFCT, the MTT on day 5 of the NAC was significantly different from the MTT before NAC (day 1) (p = 0.013). CONCLUSIONS: The FQFCT improves the accuracy of CEUS video tracking and contributes to the computer-aided response evaluation of NAC for breast cancer in mice.

The Perspectives and Lived Experience of Postoperative Patients with Lung Cancer Participating in a Home-Based Exercise Intervention.

OBJECTIVES: Postoperative patients with lung cancer experience a cluster of symptoms and reduced quality of life. This study aimed to collect the pre- and postexercise intervention opinions of postoperative patients with lung cancer and to identify their perceptions of barriers, facilitators, and benefits of a home-based exercise intervention and its impact on their future exercise. DATA SOURCES: Fourteen participants (aged 53 to 78) were purposively recruited from a tertiary hospital to participate in a 4-week home-based walking exercise intervention after discharge. Semi-structured, one-on-one interviews were conducted to collect data. The interviews were transcribed verbatim, and the data were analyzed using a thematic analysis approach. Details regarding the exercise duration and intensity for each participant were collected using a sports watch app, and participants exercise diaries. CONCLUSION: Three main themes emerged: (1) participants' differing opinions preintervention, (2) barriers and facilitators encountered during the exercise period, and (3) the positive impact on participants' future exercise. Other results showed that 12 of the 14 participants reached the goal of exercise duration and intensity. Postoperative patients with lung cancer need an exercise intervention to motivate and guide them to perform exercise after discharge. This study showed that a home-based walking exercise intervention was feasible and acceptable; patients perceived benefits and became more active and confident about their future exercise plans. IMPLICATIONS FOR NURSING PRACTICE: Against the backdrop of inadequate staffing, insufficient funding, and lack of supervised exercise programs for this rapidly increasing population, this study of a nurse-led home-based exercise program provides a feasible and realistic approach and qualitative evidence to address these issues.

Hemidiaphragmatic paralysis related to extravasation of parenteral solution in very low birthweight neonates.

Central venous catheter (CVC) placement is common in the care of very low birthweight (VLBW) preterm neonates. Although it is generally considered to be safe, CVC placement is associated with complications, including extravasation that may lead to significant morbidity and mortality. We report the clinical course of an extremely preterm neonate born at 27 weeks gestation, and another 5 VLBW preterm neonates reported in the literature with hemidiaphragmatic paralysis related to extravasation of parenteral solution from CVC placement. In VLBW preterm neonates, spontaneous recovery of diaphragmatic paralysis related to extravasation of parenteral solution is possible.

Cancer-associated fibroblasts secreted miR-103a-3p suppresses apoptosis and promotes cisplatin resistance in non-small cell lung cancer.

BACKGROUND: The cisplatin resistance of non-small cell lung cancer (NSCLC) patients results in low response rate and overall survival rate. Exosomes contribute to pathological processes of multiple cancers. OBJECTIVE: In this study, we explored the function and mechanisms of exosomal miR-103a-3p derived from cancer-associated fibroblast (CAF) in cisplatin resistance in NSCLC. RESULTS: MiR-103a-3p was highly expressed in CAFs and CAF exosomes, and exosomal miR-103a-3p derived from CAFs in NSCLC. CAFs exosomes co-cultured with NSCLC cells promoted miR-103a-3p expression both in NSCLC cells and its exosomes. Functional experiments showed that exo-miR-103a-3p derived from CAFs promoted cisplatin resistance and inhibited apoptosis in NSCLC cells. Pumilio2 (Pum2) bound with miR-103a-3p in cytoplasm and nucleus, and facilitated packaging into CAF-derived exosomes in NSCLC cells. Further analysis showed Bak1 was a direct target of miR-103a-3p, and miR-103a-3p accelerated cisplatin resistance in NSCLC cells via Bak1 downregulation. In vivo tumorigenesis assay showed CAF-derived exosomal miR-103a-3p enhanced cisplatin resistance and inhibited cell apoptosis in NSCLC. CONCLUSION: Our study revealed that CAFs-derived exosomal miR-103a-3p promoted cisplatin resistance by suppressing apoptosis via targeting Bak1, which provided a potential therapeutic target for cisplatin resistance in NSCLC.