Clearly fluorescent delineating ER+ breast tumor incisal edge and identifying tiny metastatic tumor foci at high resolution.

Fluorescence-image guided surgery (FGS) can intraoperatively provide real-time visualization of a tumor incisal edge and high-resolution identification of tumor foci to improve treatment outcomes. In this contribution, we report a fluorescent probe NB-TAM based on intramolecularly folded photoinduced electron transfer (PET), which displayed a prominent turn-on response in the near-infrared (NIR) window upon specific interaction with the estrogen receptor (ER). Significantly, NB-TAM could delineate a clear tumor incisal edge (tumor-to-normal tissue ratio > 5) in a 70-min time window, and was successfully used to guide the facile and precise resection of ER+ breast tumors in mice. To our surprise, NB-TAM was found to be capable of identifying very tiny lung metastatic ER+ breast tumor foci (0.4 × 0.3 mm), and this ultrahigh resolution was essential to effectively promote tumor resection precision and early diagnosis of tiny tumors. These results clearly elucidate the promising application of NB-TAM as a diagnostic agent for intraoperative fluorescence imaging of ER+ breast cancer.

Experimental validation of the accuracy of robotic-assisted radioactive seed implantation for tumor treatment.

An experimental validation of a robotic system for radioactive iodine-125 seed implantation (RISI) in tumor treatment was conducted using customized phantom models and animal models simulating liver and lung lesions. The robotic system, consisting of planning, navigation, and implantation modules, was employed to implant dummy radioactive seeds into the models. Fiducial markers were used for target localization. In phantom experiments across 40 cases, the mean errors between planned and actual seed positions were 0.98 ± 1.05 mm, 1.14 ± 0.62 mm, and 0.90 ± 1.05 mm in the x, y, and z directions, respectively. The x, y, and z directions correspond to the left-right, anterior-posterior, and superior-inferior anatomical planes. Silicone phantoms exhibiting significantly smaller x-axis errors compared to liver and lung phantoms (p < 0.05). Template assistance significantly reduced errors in all axes (p < 0.05). No significant dosimetric deviations were observed in parameters such as D90, V100, and V150 between plans and post-implant doses (p > 0.05). In animal experiments across 23 liver and lung cases, the mean implantation errors were 1.28 ± 0.77 mm, 1.66 ± 0.69 mm, and 1.86 ± 0.93 mm in the x, y, and z directions, slightly higher than in phantoms (p < 0.05), with no significant differences between liver and lung models. The dosimetric results closely matched planned values, confirming the accuracy of the robotic system for RISI, offering new possibilities in clinical tumor treatment.

2-Bromopalmitate inhibits malignant behaviors of HPSCC cells by hindering the membrane location of Ras protein.

Palmitoylation, which is mediated by protein acyltransferase (PAT) and performs important biological functions, is the only reversible lipid modification in organism. To study the effect of protein palmitoylation on hypopharyngeal squamous cell carcinoma (HPSCC), the expression levels of 23 PATs in tumor tissues of 8 HPSCC patients were determined, and high mRNA and protein levels of DHHC9 and DHHC15 were found. Subsequently, we investigated the effect of 2-bromopalmitate (2BP), a small-molecular inhibitor of protein palmitoylation, on the behavior of Fadu cells in vitro (50 µM) and in nude mouse xenograft models (50 µmol/kg), and found that 2BP suppressed the proliferation, invasion, and migration of Fadu cells without increasing cell apoptosis. Mechanistically, the effect of 2BP on the transduction of BMP, Wnt, Shh, and FGF signaling pathways was tested with qRT-PCR, and its drug target was explored with western blotting and acyl-biotinyl exchange assay. Our results showed that 2BP inhibited the transduction of the FGF/ERK signaling pathway. The palmitoylation level of Ras protein decreased after 2BP treatment, and its distribution in the cell membrane structure was reduced significantly. The findings of this work reveal that protein palmitoylation mediated by DHHC9 and DHHC15 may play important roles in the occurrence and development of HPSCC. 2BP is able to inhibit the malignant biological behaviors of HPSCC cells, possibly via hindering the palmitoylation and membrane location of Ras protein, which might, in turn, offer a low-toxicity anti-cancer drug for targeting the treatment of HPSCC.

Association between personality traits and smoking cessation among Chinese adults.

BACKGROUND: Although the tobacco epidemic is one of the greatest public health threats, the smoking cessation rate among Chinese adults is considerably lower. Personality information may indicate which treatments or interventions are more likely to be effective. China is the largest producer and consumer of tobacco worldwide. However, little is known about the association between smoking cessation and personality traits in China. AIM: This study aimed to examine the association between successful smoking cessation and personality traits among Chinese adults. METHODS: This cross-sectional study used data from the 2018 China Family Panel Studies. Probit regression models were employed to analyze the association between successful smoking cessation and personality traits stratified by sex. RESULTS: Lower scores for neuroticism (Coef.=-0.055, p < 0.1), lower scores for extraversion (Coef.=-0.077, p < 0.05), and higher scores for openness to experience (Coef.=0.045, p < 0.1) predicted being a successful male quitter after adjusting for demographics. Moreover, lower scores for conscientiousness (Coef.=-0.150, p < 0.1) predicted being a successful female quitter after adjusting for demographics. CONCLUSION: The empirical findings suggested that among Chinese men, lower levels of neuroticism, lower levels of extraversion, and higher levels of openness to experience were associated with a higher likelihood of smoking cessation. Moreover, lower levels of conscientiousness were associated with successful smoking cessation among Chinese women. These results showed that personality information should be included in smoking cessation interventions.

Development and Validation of a Prognostic Model to Predict Hearing Recovery for Patients With Chronic Otitis Media.

OBJECTIVE: To explore the factors affecting postoperative hearing recovery in chronic otitis media (COM) patients, establish a clinical prediction model for hearing recovery, and verify the accuracy of the model. METHODS: Data of patients with COM who were admitted to our hospital between January 1, 2012 and September 30, 2020 were retrospectively analyzed. We collected data on relevant clinicopathological characteristics of patients. The patients were randomly divided into the development cohort and validation cohorts. A postoperative air-bone gap (ABG) ≤20 dB was defined as successful hearing recovery. Univariate and multivariable logistic regression analyses were used to investigate the association of several prognostic factors with hearing recovery. These factors were then used to establish a nomogram. The model was subjected to bootstrap internal validation and performance evaluation in terms of discrimination, calibration, and clinical validity. RESULTS: This study included 2146 patients with COM: the development cohort comprised 1610 patients (mean [standard deviation; SD] age, 44.1 [14.7] years; 733 men [45.5%]) and the validation cohort included 536 patients (mean [SD] age, 42.9 [14.4] years; 234 men [43.7%]). Multivariable logistic regression analysis showed that age, duration of onset, styles of surgery (tympanoplasty, canal wall up-CWU, or canal wall down-CWD), ossicular prosthesis, granulation or calcified blocks around the ossicular chain, ossicular chain integrity, duration of drilling, eustachian tube dysfunction, mixed hearing loss, semicircular canal fistula, and second surgery were associated with hearing recovery. A nomogram based on these variables was constructed. The area under the curve was 0.797 (95% confidence interval [CI], 0.778-0.812) in the development cohort and 0.798 (95% CI, 0.7605-0.8355) in the validation cohort. CONCLUSIONS: This study demonstrated the various clinical factors correlated with hearing recovery in patients with COM. The nomogram developed with these data could provide personalized risk estimates of hearing recovery to enhance preoperative counseling and help to set realistic expectations in patients.

Tobacco smoking and depressive symptoms in Chinese middle-aged and older adults: Handling missing values in panel data with multiple imputation.

Introduction: The high co-occurrence of tobacco smoking and depression is a major public health concern during the novel coronavirus disease-2019 pandemic. However, no studies have dealt with missing values when assessing depression. Therefore, the present study aimed to examine the effect of tobacco smoking on depressive symptoms using a multiple imputation technique. Methods: This research was a longitudinal study using data from four waves of the China Health and Retirement Longitudinal Study conducted between 2011 and 2018, and the final sample consisted of 74,381 observations across all four waves of data collection. The present study employed a multiple imputation technique to deal with missing values, and a fixed effects logistic regression model was used for the analysis. Results: The results of fixed effects logistic regression showed that heavy smokers had 20% higher odds of suffering from depressive symptoms than those who never smoked. Compared to those who never smoked, for short-term and moderate-term quitters, the odds of suffering from depressive symptoms increased by 30% and 22%, respectively. The magnitudes of the odds ratios for of the variables short-term quitters, moderate-term quitters, and long-term quitters decreased in absolute terms with increasing time-gaps since quitting. The sub-group analysis for men and women found that heavy male smokers, short-term and moderate-term male quitters had higher odds of suffering from depressive symptoms than those who never smoked. However, associations between smoking status and depressive symptoms were not significant for women. Conclusions: The empirical findings suggested that among Chinese middle-aged and older adults, heavy smokers and short-term and moderate-term quitters have increased odds of suffering from depressive symptoms than those who never smoked. Moreover, former smokers reported that the probability of having depressive symptoms decreased with a longer duration since quitting. Nevertheless, the association between depressive symptoms and smoking among Chinese middle-aged and older adults is not straightforward and may vary according to gender. These results may have important implications that support the government in allocating more resources to smoking cessation programs to help middle-aged and older smokers, particularly in men.

The impact of current smoking, regular drinking, and physical inactivity on health care-seeking behavior in China.

BACKGROUND: People with lifestyle behaviors, such as current smoking, regular drinking, and physical inactivity, may experience a lack of or delayed health care, leading to severe sickness and higher health care expenditures in the future. Hence, the current study aims to ascertain the effects of current smoking, regular drinking, and physical inactivity on health care-seeking behavior among adults who report physical discomfort in China. METHODS: The data used in this study were obtained from the China Family Panel Studies (CFPS). The final sample consisted of 44,362 individuals who participated in all five waves of data collection. Logistic regression models were used for the analysis. RESULTS: The results of fixed effects logistic regression showed that among those who reported physical discomfort, adults who currently smoked cigarettes were 0.65 times less likely to seek health care than those who formerly smoked. Compared to nondrinkers, adults who regularly drank alcohol had a decreased likelihood of seeking health care. Adults who never engaged in physical exercise had 24% lower odds of seeking health care than those who engaged in physical exercise. CONCLUSIONS: Current smoking, regular drinking, and physical inactivity decreased the probability of seeking health care among adults who reported physical discomfort. Therefore, screening and brief advice programs should be delivered by primary-level care and should pay more attention to individuals who engage in lifestyle behaviors such as current smoking, regular drinking, and physical inactivity, thus avoiding missed opportunities to treat chronic conditions and detect new diseases early.

The effects of smoking, regular drinking, and unhealthy weight on health care utilization in China.

BACKGROUND: Preventive risk factors such as smoking, drinking, and unhealthy weight have contributed to the accelerated rise in noncommunicable chronic diseases, which are dominant drivers of health care utilization and spending in China. However, few studies have been conducted using a large longitudinal dataset to explore the impact of such preventive risk factors on health care utilization. Therefore, this study aimed to ascertain the effects of smoking, regular drinking, and unhealthy weight on health care utilization in China. METHODS: This research was a longitudinal study using data from five waves of the China Family Panel Studies (CFPS) conducted between 2010 and 2018, and the final sample consisted of 63,260 observations (12,652 participants) across all five waves of data collection. Health care utilization was measured from two perspectives: outpatient utilization and inpatient utilization. Smoking status was categorized as never smoker, former smoker, or current smoker. Unhealthy weight was classified based on the participants' body mass index. A fixed effects logistic regression model was used for the analysis. RESULTS: The results of fixed effects logistic regression showed that current and former smokers were approximately 1.9 times and 2.0 times more likely to use outpatient care than those who never smoked, respectively (odds ratio (OR) = 1.88, p < 0.05; OR = 2.03, p < 0.05). Obese people were approximately 1.3 times more likely to use outpatient care than healthy weight people (OR = 1.26, p < 0.05). Moreover, the results show that compared to those who never smoked, for current and former smokers, the odds of being hospitalized increased by 42.2 and 198.2%, respectively (OR = 1.42; p < 0.1, OR = 2.98; p < 0.05). Compared to healthy weight people, overweight and obese people were also more likely to be hospitalized (OR = 1.11; p < 0.1, OR = 1.18; p < 0.1, respectively). CONCLUSION: Among Chinese adults, current and former smokers were more likely to use outpatient and inpatient care than those who had never smoked. Moreover, compared to healthy weight people, obese people were more likely to use outpatient and inpatient care, and overweight people were more likely to use inpatient care. These results may have important implications that support the government in making health care resource allocation decisions.

Does smoking impact trust in physicians and satisfaction with the health system in China?

INTRODUCTION: Trust and satisfaction play vital roles in how smokers react to smoking cessation treatment delivered by physicians. This paper aims to ascertain whether smoking status and pack-years of smoking affect trust in physicians and satisfaction with the health system in China. METHODS: The current study used the ordered probit model to evaluate how smoking status affects trust in physicians and satisfaction with the health system in China. Data from the China Family Panel Studies (CFPS) 2018 were used for the analysis, and the final sample consisted of 29500 adults. The CFPS is a nationally representative, comprehensive, high-quality, biennial longitudinal survey of Chinese communities, families, and individuals. The survey was conducted in 25 provinces and their administrative equivalents. The population of 25 provinces represents 95% of the total population in Mainland China. RESULTS: According to the ordered probit model, the results showed that current smokers were significantly negatively associated with trust in physicians, and more cigarette smoking was associated with decreased trust in physicians. Moreover, current smokers were also significantly negatively related to satisfaction with the health system. CONCLUSIONS: The present study found that current smokers would be more likely to rate trust in physicians lower, and less likely to rate greater satisfaction with the health system, than never smokers. These results may have important implications for regaining trust in physicians from smokers and supporting health-system reform for tobacco treatment.

Physician-Friendly Tool Center Point Calibration Method for Robot-Assisted Puncture Surgery.

After each robot end tool replacement, tool center point (TCP) calibration must be performed to achieve precise control of the end tool. This process is also essential for robot-assisted puncture surgery. The purpose of this article is to solve the problems of poor accuracy stability and strong operational dependence in traditional TCP calibration methods and to propose a TCP calibration method that is more suitable for a physician. This paper designs a special binocular vision system and proposes a vision-based TCP calibration algorithm that simultaneously identifies tool center point position (TCPP) and tool center point frame (TCPF). An accuracy test experiment proves that the designed special binocular system has a positioning accuracy of ±0.05 mm. Experimental research shows that the magnitude of the robot configuration set is a key factor affecting the accuracy of TCPP. Accuracy of TCPF is not sensitive to the robot configuration set. Comparison experiments show that the proposed TCP calibration method reduces the time consumption by 82%, improves the accuracy of TCPP by 65% and improves the accuracy of TCPF by 52% compared to the traditional method. Therefore, the method proposed in this article has higher accuracy, better stability, less time consumption and less dependence on the operations than traditional methods, which has a positive effect on the clinical application of high-precision robot-assisted puncture surgery.

The Impact of Tobacco Consumption on Rural Household Expenditure and Self-rated Health Among Rural Household Members in China.

OBJECTIVES: To estimate how tobacco consumption affects household expenditure on other goods and services in rural China and to assess the tobacco consumption affects self-rated health among rural household members in China. METHODS: A Seemingly Unrelated Regression was used to assess the impact of tobacco consumption on rural household expenditure. To detect tobacco consumption causing heterogeneity in self-rated health among adults in rural China, this study employed a random effects generalized ordered probit model. 2010-2014 China Family Panel Studies was used for the analysis. The data set included 3,611 households and 10,610 adults in each wave. RESULTS: Tobacco consumption households assign significantly lower budget shares to food, health care, dress, and education in rural China. Moreover, self-rated health factor has a significantly positive coefficient with respect to non-smokers and ex-smokers, that is, when the individuals is a non-smoker or ex-smoker, he/ she will be more likely to report his/her health status as positive. CONCLUSIONS: The first analysis showed that tobacco consumption crowds out expenditures on food, dress, health care, and education for rural households in China, and the second analysis indicated that non-smokers and ex-smokers are more likely to report their health status as better compared with last year. The results of the present study revealed that Chinese policymakers might consider controlling tobacco consumption since tobacco control can improve not only rural household welfare but also rural household members' health status. Therefore, the tobacco tax policy and brief clinical interventions by the doctor should be implemented in rural China.

SIFT algorithm-based 3D pose estimation of femur.

To address the lack of 3D space information in the digital radiography of a patient femur, a pose estimation method based on 2D-3D rigid registration is proposed in this study. The method uses two digital radiography images to realize the preoperative 3D visualization of a fractured femur. Compared with the pure Digital Radiography or Computed Tomography imaging diagnostic methods, the proposed method has the advantages of low cost, high precision, and minimal harmful radiation. First, stable matching point pairs in the frontal and lateral images of the patient femur and the universal femur are obtained by using the Scale Invariant Feature Transform method. Then, the 3D pose estimation registration parameters of the femur are calculated by using the Iterative Closest Point (ICP) algorithm. Finally, based on the deviation between the six degrees freedom parameter calculated by the proposed method, preset posture parameters are calculated to evaluate registration accuracy. After registration, the rotation error is less than l.5°, and the translation error is less than 1.2 mm, which indicate that the proposed method has high precision and robustness. The proposed method provides 3D image information for effective preoperative orthopedic diagnosis and surgery planning.