Epidemiology of acute hepatitis C and hepatitis C virus-related cirrhosis in reproductive-age women, 1990-2019: An analysis of the Global Burden of Disease study.

Background: The current study uniquely focuses on the global incidence and temporal trends of acute hepatitis C (AHC) and hepatitis C virus (HCV)-related cirrhosis among women of reproductive age (15-49 years) from 1990-2019. The risk of vertical transmission and adverse perinatal outcomes associated with HCV infection underscores the importance of prioritising these women in HCV prevention efforts. Methods: Leveraging the Global Burden of Disease 2019 data, we calculated age-standardised incidence rates (ASIR) and assessed temporal trends via the average annual percent change from joinpoint regression. The age-period-cohort model was employed to understand further the effects of age, period, and birth cohort. Results: Over the 30 years, global incidences of AHC and HCV-related cirrhosis in reproductive-age women increased by 46.45 and 72.74%, respectively. The ASIR of AHC was highest in low sociodemographic index regions but showed a declining trend. Conversely, the ASIR of HCV-related cirrhosis displayed unfavourable trends in low, low-middle, and high sociodemographic index regions. Special attention is necessary for sub-Saharan Africa, high-income North America, Eastern Europe, and Central Asia due to their high incidence rates or increasing trends of AHC and HCV-related cirrhosis. Notably, the age-period-cohort model suggests a recent resurgence in AHC and HCV-related cirrhosis risk. Conclusions: The current study is the first to thoroughly evaluate the trends of AHC and HCV-related cirrhosis among reproductive-age women, shedding light on previously unexplored aspects of HCV epidemiology. Our findings identify critical areas where health care systems must adapt to the changing dynamics of HCV infection. The detailed stratification by region and nation further enables the development of localised prevention and treatment strategies.

Inhalation exposure to polystyrene nanoplastics induces chronic obstructive pulmonary disease-like lung injury in mice through multi-dimensional assessment.

Nanoplastics are widely distributed in indoor and outdoor air and can be easily inhaled into human lungs. However, limited studies have investigated the impact of nanoplastics on inhalation toxicities, especially on the initiation and progression of chronic obstructive pulmonary disease (COPD). To fill the gap, the present study used oronasal aspiration to develop mice models. Mice were exposed to polystyrene nanoplastics (PS-NPs) at three concentrations, as well as the corresponding controls, for acute, subacute, and subchronic exposure. As a result, PS-NPs could accumulate in exposed mice lungs and influence lung organ coefficient. Besides, PS-NPs induced local and systemic oxidative stress, inflammation, and protease-antiprotease imbalance, resulting in decreased respiratory function and COPD-like lesions. Meanwhile, PS-NPs could trigger the subcellular mechanism to promote COPD development by causing mitochondrial dysfunctions and endoplasmic reticulum (ER) stress. Mechanistically, ferroptosis played an important role in the COPD-like lung injury induced by PS-NPs. In summary, the present study comprehensively and systematically indicates that PS-NPs can damage human respiratory health and increase the risk for COPD.

Base editing enables duplex point mutagenesis in Clostridium autoethanogenum at the price of numerous off-target mutations.

Base editors are recent multiplex gene editing tools derived from the Cas9 nuclease of Streptomyces pyogenes. They can target and modify a single nucleotide in the genome without inducing double-strand breaks (DSB) of the DNA helix. As such, they hold great potential for the engineering of microbes that lack effective DSB repair pathways such as homologous recombination (HR) or non-homologous end-joining (NHEJ). However, few applications of base editors have been reported in prokaryotes to date, and their advantages and drawbacks have not been systematically reported. Here, we used the base editors Target-AID and Target-AID-NG to introduce nonsense mutations into four different coding sequences of the industrially relevant Gram-positive bacterium Clostridium autoethanogenum. While up to two loci could be edited simultaneously using a variety of multiplexing strategies, most colonies exhibited mixed genotypes and most available protospacers led to undesired mutations within the targeted editing window. Additionally, fifteen off-target mutations were detected by sequencing the genome of the resulting strain, among them seven single-nucleotide polymorphisms (SNP) in or near loci bearing some similarity with the targeted protospacers, one 15 nt duplication, and one 12 kb deletion which removed uracil DNA glycosylase (UDG), a key DNA repair enzyme thought to be an obstacle to base editing mutagenesis. A strategy to process prokaryotic single-guide RNA arrays by exploiting tRNA maturation mechanisms is also illustrated.

The hepatotoxicity assessment of micro/nanoplastics: A preliminary study to apply the adverse outcome pathways.

Plastic pollution has become a significant global problem over the years, leading to the continuous decomposition and accumulation of micro/nanoplastics (MNPLs) in the environment. As a result, human exposure to these MNPLs is inevitable. The liver, in particular, is highly susceptible to potential MNPL toxicity. In this study, we systematically reviewed the current literature on MNPLs-induced hepatotoxicity and collected data on toxic events occurring at different biological levels. Then, to better understand the cause-mechanism causality, we developed an Adverse Outcome Pathway (AOP) framework for MNPLs-induced hepatotoxicity. The AOP framework provided insights into the mechanism of MNPL-induced hepatotoxicity and highlighted potential health risks such as liver dysfunction and inflammation, metabolism disorders and liver fibrosis. Moreover, we discussed the potential application of emerging toxicological models in the hepatotoxicity study. Liver organoids and liver-on-chips, which can simulate the structure and function of the liver in vitro, offer a promising alternative platform for toxicity testing and risk assessment. We proposed combining the AOP framework with these emerging toxicological models to improve our understanding of the hepatotoxic effects of MNPLs. Overall, this study performed a preliminary exploration of novel toxicological methodologies to assess the hepatotoxicity of MNPLs, providing a deeper understanding of environmental toxicology.

Life cycle assessment and cost analysis for copper hydrometallurgy industry in China.

Understanding the environmental and economic impacts of copper hydrometallurgy throughout the whole life cycle is necessary for sustainable development of the copper industry. In this study, the environmental impacts and economic costs throughout the two major copper hydrometallurgical routes in China, including heap leaching and heap-agitation leaching, are analyzed and compared using the life cycle assessment (LCA) and life cycle cost (LCC) technique. The life cycle inventory compiled from the annual statistics of the Muliashi Copper Mine, and the data regarding energy and materials process are based on the GaBi databases. The environmental impacts are quantified into 12 indicators. The results show that compared with heap leaching route, heap-agitation leaching route reduces 36.8% of abiotic depletion potential (ADP elements), but increases over half of cumulative energy demand (CED), marine aquatic ecotoxicity potential (MAETP) and human toxicity potential (HTP). Furthermore, the stage of electrowinning and agitation leaching contributes the largest environmental impact to heap leaching and heap-agitation leaching route, respectively. This is mainly due to huge consumption of electricity and sulfuric acid. The analysis of economic cost reveals that heap leaching route needs internal cost of $3225/t Cu and external cost of $426/t Cu. Compared with heap leaching route, heap-agitation leaching route increased the internal and external cost by 18.9% and 54.2%, respectively. But the economic return from heap-agitation leaching is double that from heap leaching. Together, these results indicate heap-agitation leaching has a larger environmental impact and higher economic benefit than heap leaching, which is helpful for the government to design ecological compensation policies in the balance between ecological environment and economic development.

Lung ultrasound for the assessment of lung recruitment in neonates with massive pneumothorax during extracorporeal membrane oxygenation: a case report.

Bedside lung ultrasound may be an effective method for the assessment of lung recruitment in newborns with extracorporeal membrane oxygenation (ECMO). We report a case of a neonate who had severe hypoxemia with persistent pulmonary hypertension and massive pneumothorax due to meconium aspiration syndrome and was treated with ECMO. Positive pressure mechanical ventilation resulted in persistent massive air leakage from the disrupted pulmonary tissue. When ECMO was initiated, a "total lung rest" ventilation strategy was used to facilitate healing of the lung rupture and absorption of the pneumothorax. After complete absorption of the pneumothorax, lung recruitment was performed by progressively increasing the positive end-expiratory pressure under the guidance of lung ultrasound. Bedside lung ultrasound was successfully used to assess pneumothorax absorption and improvement of pulmonary inflammation and successfully guided the recruitment of collapsed alveoli and the withdrawal of ECMO.

Security-Related Hardware Cost Optimization for CAN FD-Based Automotive Cyber-Physical Systems.

The introduction of various networks into automotive cyber-physical systems (ACPS) brings great challenges on security protection of ACPS functions, the auto industry recommends to adopt the hardware security module (HSM)-based multicore ECU to secure in-vehicle networks while meeting the delay constraint. However, this approach incurs significant hardware cost. Consequently, this paper aims to reduce security enhancing-related hardware cost by proposing two efficient design space exploration (DSE) algorithms, namely, stepwise decreasing-based heuristic algorithm (SDH) and interference balancing-based heuristic algorithm (IBH), which explore the task assignment, task scheduling, and message scheduling to minimize the number of required HSMs. Experiments on both synthetical and real data sets show that the proposed SDH and IBH are superior than state-of-the-art algorithm, and the advantage of SDH and IBH becomes more obvious as the increase about the percentage of security-critical tasks. For synthetic data sets, the hardware cost can be reduced by 61.4% and 45.6% averagely for IBH and SDH, respectively; for real data sets, the hardware cost can be reduced by 64.3% and 54.4% on average for IBH and SDH, respectively. Furthermore, IBH is better than SDH in most cases, and the runtime of IBH is two or three orders of magnitude smaller than SDH and state-of-the-art algorithm.

Assessment on effects of transplastomic potato plants expressing Colorado potato beetle ß-Actin double-stranded RNAs for three non-target pests.

RNA interference has been proved as an efficient technology for pest control through the silencing of essential genes of targeted insects. We had previously shown that the expression of double-stranded RNAs (dsRNAs) in plastids of plants offers a great potential for efficiently controlling Colorado potato beetle (CPB, Leptinotarsa decemlineata) (Coleoptera, Chrysomelidae). However, whether these transplastomic plants have an impact on other non-target pests was not investigated. In this study, we evaluated the potential effects of transplastomic plants expression dsRNAs target CPB ß-Actin (referred to as ACT plants) on three other potato pests: Myzus persicae (Hemiptera, Aphididae), Henosepilachna vigintioctopunctata (Coleoptera, Coccinellidae), and Spodoptera litura (Lepidoptera, Noctuidae). Although no effects on M. persicae or S. litura were observed by feeding ACT plants, we found that feeding H. vigintioctopunctata with ACT plants can result in its growth retardation and suppressing the gene expression of HvACT, which has 91.7% identity to CPB ß-Actin and shared 66 potential 21-mer matches. Taking together, these results indicated that ACT plants had cross-resistance to H. vigintioctopunctata, another coleopteran insect with the highly conserved nucleotide sequence of ß-Actin gene. It also provided an opportunity to simultaneously control L. decemlineata and H. vigintioctopunctata by RNAi induced by intermediate dsRNAs with optimized sequences.

Nanomaterials-induced toxicity on cardiac myocytes and tissues, and emerging toxicity assessment techniques.

The extensive production and use of nanomaterials have resulted in the continuous release of nano-sized particles into the environment, and the health risks caused by exposure to these nanomaterials in the occupational population and the general population cannot be ignored. Studies have found that particle exposure is closely related to cardiovascular disease. In addition, there have been many reports that nanomaterials can enter the heart tissue, accumulate and then cause damage. Therefore, in the present article, literature related to nanomaterials-induced cardiotoxicity in recent years was collected from the PubMed database, and then organized and summarized to form a review. This article mainly discusses heart damage caused by nanomaterials from the following three aspects: Firstly, we summarize the research 8 carbon nanotubes, etc. Secondly, we discuss in depth the possible underlying mechanism of the damage to the heart caused by nanoparticles. Oxidative stress damage, mitochondrial damage, inflammation and apoptosis have been found to be key factors. Finally, we summarize the current research models used to evaluate the cardiotoxicity of nanomaterials, highlight reliable emerging technologies and in vitro models that have been used for toxicity evaluation of environmental pollutants in recent years, and indicate their application prospects.

[Distribution, Sources, and Risk Assessment of Polyfluoroalkyl Substances in Main Rivers and Soils of Tianjin].

Rapid urbanization and industrialization may potentially impact the spatial distribution and transmission of polyfluoroalkyl substances (PFASs). Tianjin, a typical industrialized city with a high urbanization level around Bohai Bay, was selected to evaluate the spatial distribution and ecological risks of PFASs. Water and soil samples were systematically collected and analyzed by using solid-phase extraction and high-performance liquid chromatography-tandem mass spectrometry (HPLC/MS-MS) methods. The results showed that all 12 PFASs were detected in water and soils, and the detection rates of the other congeners were low. The concentrations of ΣPFASs in water ranged from 3.93 to 357.85 ng ·L-1, and the levels of ΣPFASs in soils ranged from 4.60 to 63.85 ng ·g-1. PFBA was the major component in water and soils, and the contribution of PFBA was 37% and 67% in water and soils, respectively. The spatial difference in ΣPFASs in the water bodies was significant. ΣPFAS concentrations in the surface water were higher in the north (mean value of 63.83 ng ·L-1) than in the south (mean value of 51.71 ng ·L-1) and higher in the eastern coastal area (mean value of 71.36 ng ·L-1) than in the western area (mean value of 36.08 ng ·L-1). ΣPFAS concentrations from upstream to downstream of the rivers showed an increasing trend. The highest PFAS concentration was found in the Chaobai River, and the lowest was detected in the South Canal. The spatial distribution of PFASs in soils was higher in the south (mean value of 13.33 ng ·g-1) than in the north (mean value of 6.38 ng ·g-1) and higher in the eastern coastal region (mean value of 11.45 ng ·g-1) than in the western region (mean value of 6.94 ng ·g-1). The soil concentrations of ΣPFASs in the Haihe River Basin were the highest. The source analysis results showed that the emulsification of rubber products, food packaging process, paper surface treatment, fire extinguishing agent use, and electrochemical fluorination process in industrial production were the main sources of PFASs in the soils in the study area. PFOS/PFOA, PFOA/PFNA, and PFHpA/PFOA analyses showed that the main source of PFASs in water bodies was the degradation of precursors. ΣPFASs in a few areas originated from the direct emissions from production, but the atmospheric deposition was small. The results of the ecological risk evaluation indicated that the exposure concentrations of PFASs in water and soils in the study area were at a low ecological risk level. However, the long-term ecological effects of PFASs cannot be ignored because of their long-distance transport capability and high food chain (web) accumulation capability.

An Exploration of a Synthetic Construction Land Use Quality Evaluation Based on Economic-Social-Ecological Coupling Perspective: A Case Study in Major Chinese Cities.

Recently, with the rapid increase of urban population and industrial agglomeration, the price of construction land has increased, and construction land has become increasingly scarce. Therefore, how to improve the construction land use quality (CLUQ) becomes more and more important. The purpose of the study is to evaluate CLUQ in China's major cities and to analyze the dominant obstacle factors for quality improvement in order to provide policy advice for construction land management. This study adapts the data from 2014 to 2016 and constructs the evaluation framework of CLUQ involving economic quality, social quality, and ecological quality of construction land to evaluate and analyze CLUQ with the synthetic evaluation model, coupling evaluation model, and obstacle diagnosis model (ECO model). This study shows that the synthetic CLUQ of 23 cities out of 36 major cities in China shows a general increasing state. The economic quality of 26 cities out of 36 major cities in China has increased, while the social and ecological quality of 20 out of 36 major cities in China has decreased. In terms of spatial characteristics, the synthetic quality in the east and southwest of China is relatively high; in terms of spatial trend, the synthetic quality in longitude increases from west to east, and it shows an inverted U-shaped state in latitude. Moreover, economic development is the main obstacle factor for the improvement of CLUQ in Hohhot, Lanzhou, Urumqi, and Changchun. Social development results in the CLUQ lagging in Beijing, Guiyang, Shanghai, Xining, and Chongqing. Ecological development has a negative impact in that of Harbin, Qingdao, and Wuhan. Furthermore. The improvement of CLUQ lies in the coupling and coordinated development of economic, social, and ecological quality. For those with a low coupling degree, the targeted suggestions are given for different types based on city's quadrant distribution.

Engineered Recombinant Escherichia coli Probiotic Strains Integrated with F4 and F18 Fimbriae Cluster Genes in the Chromosome and Their Assessment of Immunogenic Efficacy in Vivo.

F4 (K88) and F18 fimbriaed enterotoxigenic Escherichia coli (ETEC) are the predominant causes of porcine postweaning diarrhea (PWD), and vaccines are considered the most effective preventive approach against PWD. Since heterologous DNA integrated into bacterial chromosomes could be effectively expressed with stable inheritance, we chose probiotic EcNc (E. coli Nissle 1917 prototype cured of cryptic plasmids) as a delivery vector to express the heterologous F4 or both F4 and F18 fimbriae and sequentially assessed their immune efficacy of anti-F4 and F18 fimbriae in both murine and piglet models. Employing the CRISPR-cas9 technology, yjcS, pcadA, lacZ, yieN/trkD, maeB, and nth/tppB sites in the chromosome of an EcNc strain were targeted as integration sites to integrate F4 or F18 fimbriae cluster genes under the Ptet promotor to construct two recombinant integration probiotic strains (RIPSs), i.e., nth integration strain (EcNcΔnth/tppB::PtetF4) and multiple integration strain (EcNc::PtetF18x4::PtetF4x2). Expression of F4, both F4 and F18 fimbriae on the surfaces of two RIPSs, was verified with combined methods of agglutination assay, Western blot, and immunofluorescence microscopy. The recombinant strains have improved adherence to porcine intestinal epithelial cell lines. Mice and piglets immunized with the nth integration strain and multiple integration strain through gavage developed anti-F4 and both anti-F4 and anti-F18 IgG immune responses. Moreover, the serum antibodies from the immunized mice and piglets significantly inhibited the adherence of F4+ or both F4+ and F18+ ETEC wild-type strains to porcine intestinal cell lines in vitro, indicating the potential of RIPSs as promising probiotic strains plus vaccine candidates against F4+/F18+ ETEC infection.

Co-mutational assessment of circulating tumour DNA (ctDNA) during osimertinib treatment for T790M mutant lung cancer.

Osimertinib is designed to target the secondary resistant EGFR T790M mutant and has shown outstanding clinical efficacy. However, the prognostic prediction of osimertinib patients is a big problem in clinical practice. The resistance mechanism of osimertinib is also not fully understood. NGS and a 1021 gene capture panel were used to analyse the somatic mutation profile of thirty-six lung adenocarcinoma patients' serial ctDNA samples. Progression-free survival of subgroup patients is analysed. Patients harbour TP53 mutations and patients with higher TMB value in pre-treatment samples showed a shorter PFS. Moreover, compared to CT evaluation, ctDNA changes generally correlated with treatment responses in most patients. Novel resistance mechanisms are discovered including EGFR mutations and alternative activation pathway. Our results implied a broad potential of ctDNA as an adjuvant tool in practical clinical management of NSCLC patients. ctDNA could help with clinical practice during osimertinib treatment, regarding monitoring tumour response, detecting development of heterogeneity, identifying potential resistance mechanisms, predicting treatment efficacy and patient outcome.

Comparison and screening of different risk assessment models for deep vein thrombosis in patients with solid tumors.

To increase the detection rate of deep vein thrombosis (DVT) and to compare the predictive value of four different risk assessment scales (Caprini, Autar, Pauda, and Khorana scales) for DVT in patients with solid tumors by the receiver operating curve (ROC). A total of 361 patients with all kinds of malignant solid tumors, who accepted anti-tumor therapy in the cancer center between March 3, 2015 to April 13, 2018, were assigned to a group of 230 cases diagnosed with DVT and a control group of 131 cases without DVT. Data were recorded and summarized, and the predictive value of the above four risk assessment scales for DVT in solid tumor patients was compared based on the area under the ROC curve (AUC). The AUC values determined for the Caprini, Autar, Pauda, and Khorana scales were (0.631 ± 0.030), (0.686 ± 0.028), (0.654 ± 0.029), and (0.599 ± 0.032), respectively; maximum sensitivity, specificity, and Youden index were 80.9% for Khorana, 86.3% for Caprini, and 29.6% for Autar scale, respectively. We found no statistically significant differences in the AUC values between Autar and Caprini, Autar and Khorana, as well as Khorana and Pauda (p > 0.05). However, the AUC differences between Autar and Pauda, Caprini and Khorana, as well as Caprini and Pauda were statistically significant (p < 0.05). All four risk assessment models showed some value in the risk prediction of DVT in patients with solid tumors, but every model also exhibited its own restrictions; maximum sensitivity, specificity, and Youden index were 80.9% for Khorana, 86.3% for Caprini, and 29.6% for Autar scale, respectively. We confirmed that the detection rate can be improved by modifying the BMI cut-off value of the scale or by combining appropriate scales.

Use of natural language processing to improve predictive models for imaging utilization in children presenting to the emergency department.

OBJECTIVE: To examine the association between the medical imaging utilization and information related to patients' socioeconomic, demographic and clinical factors during the patients' ED visits; and to develop predictive models using these associated factors including natural language elements to predict the medical imaging utilization at pediatric ED. METHODS: Pediatric patients' data from the 2012-2016 United States National Hospital Ambulatory Medical Care Survey was included to build the models to predict the use of imaging in children presenting to the ED. Multivariable logistic regression models were built with structured variables such as temperature, heart rate, age, and unstructured variables such as reason for visit, free text nursing notes and combined data available at triage. NLP techniques were used to extract information from the unstructured data. RESULTS: Of the 27,665 pediatric ED visits included in the study, 8394 (30.3%) received medical imaging in the ED, including 6922 (25.0%) who had an X-ray and 1367 (4.9%) who had a computed tomography (CT) scan. In the predictive model including only structured variables, the c-statistic was 0.71 (95% CI: 0.70-0.71) for any imaging use, 0.69 (95% CI: 0.68-0.70) for X-ray, and 0.77 (95% CI: 0.76-0.78) for CT. Models including only unstructured information had c-statistics of 0.81 (95% CI: 0.81-0.82) for any imaging use, 0.82 (95% CI: 0.82-0.83) for X-ray, and 0.85 (95% CI: 0.83-0.86) for CT scans. When both structured variables and free text variables were included, the c-statistics reached 0.82 (95% CI: 0.82-0.83) for any imaging use, 0.83 (95% CI: 0.83-0.84) for X-ray, and 0.87 (95% CI: 0.86-0.88) for CT. CONCLUSIONS: Both CT and X-rays are commonly used in the pediatric ED with one third of the visits receiving at least one. Patients' socioeconomic, demographic and clinical factors presented at ED triage period were associated with the medical imaging utilization. Predictive models combining structured and unstructured variables available at triage performed better than models using structured or unstructured variables alone, suggesting the potential for use of NLP in determining resource utilization.

A fast algorithm for Bayesian multi-locus model in genome-wide association studies.

Genome-wide association studies (GWAS) have identified a large amount of single-nucleotide polymorphisms (SNPs) associated with complex traits. A recently developed linear mixed model for estimating heritability by simultaneously fitting all SNPs suggests that common variants can explain a substantial fraction of heritability, which hints at the low power of single variant analysis typically used in GWAS. Consequently, many multi-locus shrinkage models have been proposed under a Bayesian framework. However, most use Markov Chain Monte Carlo (MCMC) algorithm, which are time-consuming and challenging to apply to GWAS data. Here, we propose a fast algorithm of Bayesian adaptive lasso using variational inference (BAL-VI). Extensive simulations and real data analysis indicate that our model outperforms the well-known Bayesian lasso and Bayesian adaptive lasso models in accuracy and speed. BAL-VI can complete a simultaneous analysis of a lung cancer GWAS data with ~3400 subjects and ~570,000 SNPs in about half a day.

Oil Price Uncertainty, Transport Fuel Demand and Public Health.

Based on the panel data of 306 cities in China from 2002 to 2012, this paper investigates China's road transport fuel (i.e., gasoline and diesel) demand system by using the Almost Ideal Demand System (AIDS) and the Quadratic AIDS (QUAIDS) models. The results indicate that own-priceelasticitiesfordifferentvehiclecategoriesrangefrom-1.215to-0.459(byAIDS)andfrom -1.399 to-0.369 (by QUAIDS). Then, this study estimates the air pollution emissions (CO, NOx and PM2.5) and public health damages from the road transport sector under different oil price shocks. Compared to the base year 2012, results show that a fuel price rise of 30% can avoid 1,147,270 tonnes of pollution emissions; besides, premature deaths and economic losses decrease by 16,149 cases and 13,817.953 million RMB yuan respectively; while based on the non-linear health effect model, the premature deaths and total economic losses decrease by 15,534 and 13,291.4 million RMB yuan respectively. Our study combines the fuel demand and health evaluation models and is the first attempt to address how oil price changes influence public health through the fuel demand system in China. Given its serious air pollution emission and substantial health damages, this paper provides important insights for policy makers in terms of persistent increasing in fuel consumption and the associated health and economic losses.

Assessment of Educational Needs and Quality of Life of Chronic Hepatitis Patients.

BACKGROUND: Patient education is crucial in improving the health-related quality of life (HRQOL) of patients. At the same, understanding the concerns and needs of patients is essential in providing appropriate education. This study assessed the educational needs and HRQOL experienced by chronic hepatitis patients. METHODS: We developed structured questionnaires with satisfactory validity and reliability to assess the educational needs of patients. HROQL was measured using a generic Short Form 36 (SF-36) and a liver disease-specific Chronic Liver Disease Questionnaire (CLDQ). Descriptive statistic measures and Pearson's correlation analysis were applied for data analysis. RESULTS: A total of 135 subjects were recruited from two regional teaching hospitals in Taiwan. "Disease characteristics and management" exhibited the highest mean score (3.17) among all the subscales of educational needs. In comparison with those without antiviral therapy, chronic hepatitis patients undergoing antiviral treatment scored significantly higher on all subscales of educational needs, especially on "side effects of antiviral treatment" (p < 0.010). The median range of the physical component summary score was 45.94, the mental component summary score was 49.37, and the mean CLDQ was 5.70. Several domains of educational needs were significantly inversely correlated with the CLDQ and SF-36 subscales. CONCLUSIONS: Education is highly required by chronic hepatitis patients, especially those receiving antiviral therapy and patients with poor HRQOL. These findings can serve as a useful reference for nursing personnel who perform needs assessment to develop individual nursing instruction and thereby improve the quality of care for chronic hepatitis patients.

Correlation between dual-axis rotational coronary angiography and intravascular ultrasound in a coronary lesion assessment.

The purpose of this study was to evaluate the accuracy of dual-axis rotational coronary angiography (DARCA) for coronary lesion assessment by directly comparing with intravascular ultrasound (IVUS). From October 2014 to December 2015, 40 patients (58 lesions) who had undergone both DARCA and IVUS were included in the image analysis. The minimum lumen diameter (MLD), lesion length, reference vessel diameter (RVD) and percent diameter stenosis at the same lesion, were identified and assessed. Significant correlation with IVUS was found for DARCA in either lesion length (r = 0.90, P < 0.001) or RVD (r = 0.81, P < 0.001) comparison. DARCA had fair correlation with IVUS for both MLD (r = 0.65, P < 0.001) and diameter stenosis (r = 0.48, P < 0.001). From the Bland-Altman plots, there was a good agreement between DARCA and IVUS regarding MLD (mean difference: -0.23 mm, 95 % limits of agreement: -0.96 to 0.50 mm) and RVD (mean difference: -0.15 mm, 95 % limits of agreement: -0.85 to 0.55 mm), while lesser agreement was found on lesion length (mean difference: -3.39 mm, 95 % limits of agreement: -12.63 to 5.85 mm) and diameter stenosis (mean difference: 4.82 %, 95 % limits of agreement: -17.05 to 26.68 %). There is an adequate correlation and agreement between DARCA and IVUS in coronary lesion assessment.

Shannon entropy method of small-scale self-focusing assessment in high-power laser systems.

Through analysis of near-field beam profiles, we propose a method using Shannon entropy to assess the development of small-scale self-focusing during laser propagation and amplification in high-power laser systems. In this method, the entropy curve that corresponds to increasing B integral displays an evident turning point at which small-scale self-focusing starts to rapidly develop. In contrast to classical methods using contrast, modulation, or power spectral density, the proposed method provides the B integral criterion more clearly and objectively. This approach is an optimization method that can be utilized in the design and operation of high-power laser systems.