Longitudinal assessment of plasma biomarkers for early detection of cognitive changes in subjective cognitive decline.

Background: Individuals experiencing subjective cognitive decline (SCD) are at an increased risk of developing mild cognitive impairment and dementia. Early identification of SCD and neurodegenerative diseases using biomarkers may help clinical decision-making and improve prognosis. However, few cross-sectional and longitudinal studies have explored plasma biomarkers in individuals with SCD using immunomagnetic reduction. Objective: To identify plasma biomarkers for SCD. Methods: Fifty-two participants [38 with SCD, 14 healthy controls (HCs)] underwent baseline assessments, including measurements of plasma Aß42, Aß40, t-tau, p-tau, and α-synuclein using immunomagnetic reduction (IMR) assays, cognitive tests and the Mini-Mental State Examination (MMSE). Following initial cross-sectional analysis, 39 individuals (29 with SCD, 10 HCs) entered a longitudinal phase for reassessment of these biomarkers and the MMSE. Biomarker outcomes across different individual categories were primarily assessed using the area under the receiver operating characteristic (ROC) curve. The SCD subgroup with an MMSE decline over one point was compared to those without such a decline. Results: Higher baseline plasma Aß1-42 levels significantly discriminated participants with SCD from HCs, with an acceptable area under the ROC curve (AUC) of 67.5% [95% confidence interval (CI), 52.7-80.0%]. However, follow-up and changes in MMSE and IMR data did not significantly differ between the SCD and HC groups (p > 0.05). Furthermore, lower baseline plasma Aß1-42 levels were able to discriminate SCD subgroups with and without cognitive decline with a satisfied performance (AUC, 75.0%; 95% CI, 55.6-89.1%). At last, the changes in t-tau and Aß42 × t-tau could differentiate between the two SCD subgroups (p < 0.05). Conclusion: Baseline plasma Aß42 may help identify people with SCD and predict SCD progression. The role of plasma Aß42 levels as well as their upward trends from baseline in cases of SCD that progress to mild cognitive impairment and Alzheimer's disease require further investigation.

Exploring Inter-Brain Electroencephalogram Patterns for Social Cognitive Assessment During Jigsaw Puzzle Solving.

Social interaction enables the smooth progression of our daily lives. Mounting evidence from recent hyperscanning neuroimaging studies indicates that key components of social behavior can be evaluated using inter-brain oscillations and connectivity. However, mapping out inter-brain networks and developing neurocognitive theories that explain how humans co-create and share information during social interaction remains challenging. In this study, we developed a jigsaw puzzle-solving game with hyperscanning electroencephalography (EEG) signals recorded to investigate inter-brain activities during social interactions involving cooperation and competition. Participants were recruited and paired into dyads to participate in the multiplayer jigsaw puzzle game with 32-channel EEG signals recorded. The corresponding event-related potentials (ERPs), brain oscillations, and inter-brain functional connectivity were analyzed. The results showed different ERP morphologies of P3 patterns in competitive and cooperative contexts, and brain oscillations in the low-frequency band may be an indicator of social cognitive activities. Furthermore, increased inter-brain functional connectivity in the delta, theta, alpha, and beta frequency bands was observed in the competition mode compared to the cooperation mode. By presenting comparable and valid hyperscanning EEG results alongside those of previous studies using traditional paradigms, this study demonstrates the potential of utilizing hyperscanning techniques in real-life game-playing scenarios to quantitatively assess social cognitive interactions involving cooperation and competition. Our approach offers a promising platform with potential applications in the flexible assessment of psychiatric disorders related to social functioning.

Cost-effectiveness analysis of tislelizumab in combination with chemotherapy for the first-line treatment of patients with metastatic or recurrent nasopharyngeal carcinoma in China.

BACKGROUND: The combination of tislelizumab and gemcitabine plus cisplatin (GP) in the first-line treatment of patients with recurrent or metastatic nasopharyngeal carcinoma (R/M NPC) has yielded significant results. However, it is not clear whether this treatment option is cost-effective in China. The purpose of this study is to evaluate the cost-effectiveness of tislelizumab plus GP for the first-line treatment of R/M NPC from the perspective of the Chinese healthcare system. METHODS: A partitioned survival model with three discrete health states was constructed to evaluate the cost-effectiveness of tislelizumab plus GP versus GP in patients with R/M NPC. The target population enrolled in the RATIONALE-309 trial had previously not treated for R/M NPC. Drug costs were obtained from relevant databases, and the remaining cost and health utility data were collected from the literature. The main outcomes include the expected life years, quality-adjusted life years (QALYs), total cost, and incremental cost-benefit ratio (ICER). RESULTS: The tislelizumab plus GP regimen produced an additional cost ($18392.76) and additional 1.57 QALYs compared with GP used alone. The ICER was $18392.75/QALYs. Sensitivity analysis showed that the analysis was robust and the utility of PD status was most sensitive to the model results. The possibility of tislelizumab plus GP being cost-effective at the willingness-to-pay (WTP) threshold of $37 653/QALY was 99.8%. Subgroup analysis showed that high PD-L1 expression had little impact on the ICER of this regimen. CONCLUSION: In patients with R/M NPC, the regimen of tislelizumab plus GP, as the first-line treatment, is more cost-effective than the GP regimen in China.

Development and assessment of a self-management intervention for urinary incontinence among patients with prostate cancer: protocol for a randomized feasibility study.

BACKGROUND: Urinary incontinence is a common complication among patients with prostate cancer who have undergone radical prostatectomy. Guided by social cognitive theory and a framework for the recovery of health and well-being, we propose to develop and test a self-management intervention for patients with prostate cancer who experience urinary incontinence after undergoing radical prostatectomy. METHODS: In this study, a self-management intervention for urinary incontinence (SMI-UI) is developed, comprising a mobile self-management application, a self-management handbook, and professional support. The feasibility, acceptability, and effectiveness of this intervention will be assessed. Patient data from the urology departments of two hospitals will be collected through convenience sampling by adopting an experimental, parallel, and random assignment research design. Patients experiencing urinary incontinence after undergoing radical prostatectomy will be invited to participate. After completing the pretest questionnaire, patients will be randomly divided into the experimental and attention control groups. The experimental group will undergo a 12-week SMI-UI, whereas the attention control group will receive an intervention consisting of a single dietetic education information package. The two groups will be tested 12 and 16 weeks after the pretest. In this study, we recorded the sociodemographic and clinical variables; recruitment rate; retention rate; satisfaction with the intervention; cancer-related self-efficacy; urination symptoms and disturbance; social participation and satisfaction; resilience; and demoralization. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT05335967 [date of registration 04-04-2022].

[Characteristics and Ecological Risk Assessment of Pharmaceutical Active Compounds in Guangdong Province].

Pharmaceutically active compounds(PhACs) have become a class of new pollutants in the environment after extensive production and use of PhACs in China. To investigate the pollution characteristics of PhACs in Guangdong Province, raw sewage was collected from 186 sewage treatment plants in 21 cities, including 178 townships and administrative districts in Guangdong Province. The pollution levels of ten typical PhACs in influent water of sewage treatment plants were analyzed using automatic solid phase extraction and high performance liquid chromatography-triple quadrupole mass spectrometry. The spatial distribution characteristics of PhACs in Guangdong Province were fully revealed, and the potential ecological risks of PhACs were evaluated. The results showed that PhACs were detected in all wastewater plants, and the mass concentration of PhACs ranged from 21.00 to 9558.25 ng·L-1. Metoprolo, acetaminophen, bezafibrate, and caffeine were the main pollutants. In terms of spatial distribution, the average mass concentration of ΣPhACs in various regions of Guangdong Province was in the following order:Pearl River Delta>North Guangdong>East Guangdong≈West Guangdong. When the mass concentration of ΣPhACs was over 2500 ng·L-1 in the influent water of sewage treatment plants, the concentration of PhACs in effluent was estimated according to the sewage disposal technology. The ecological risk of PhACs was carried out based on the effluent. The results revealed that the ecological risk of PhACs was low in Guangdong Province, and the risk of bezafibrate was moderate in the cities of Shaoguan, Jiangmen, and Shenzhen. The highest ecological risk of ΣPhACs was located in Shaoguan.

In Situ and Low-Cost Improvement of the Lithium Anode Interface in Garnet-Type Solid-State Electrolytes.

In recent years, the development of electric vehicles and environmental concerns have made necessary improvements in the energy density and safety of lithium-ion batteries. Therefore, the development of all-solid-state lithium-ion batteries (ASSLIBs) has become imperative. One advantage of ASSLIBs is their potential for downsizing with the use of lithium metal as the anode. However, in this study, a garnet-type solid electrolyte (Li6.75La3Zr1.75Ta0.25O12) was used, which has low reactivity with lithium metal. Thus, interface modification using CaCl2 was employed to form a Li-Ca-Cl composite anode. The interfacial resistance was remarkably reduced to 7 Ω cm2, and the symmetric cell exhibited stable cycling for 1200 h at room temperature and a current density of 0.1 mA cm-2. The voltage ranged from ±15 to ±16 mV. The full cell demonstrated a high initial discharge capacity of 149.2 mA h g-1 and a Coulombic efficiency of 98.0% while maintaining a discharge capacity retention of 91.3% after 100 cycles. These findings lay a solid foundation for future commercial applications as interface modification was achieved through a simple spin-coating process using low-cost CaCl2 (0.7 USD g-1).

Cost-effectiveness analysis of sintilimab plus IBI305 versus sorafenib for unresectable hepatic cell carcinoma in China.

BACKGROUND: Sintilimab combined with IBI305 treatment regimen had potential clinical benefits than sorafenib in the first-line treatment of patients with unresectable hepatic cell carcinoma (HCC). However, whether sintilimab plus IBI305 has economic benefits in China remains unclear. METHODS: From the perspective of Chinese payers, we used the Markov model to simulate patients with HCC receiving treatment with sintilimab plus IBI305 and sorafenib. The transition probability between health states was estimated using the parametric survival model, and the cumulative medical costs and utility of the two treatment methods were estimated. Considering the incremental cost-effectiveness ratios (ICERs) as the evaluation index, sensitivity analyses were performed to explore the impact of uncertainty on the results. RESULTS: Compared to sorafenib, sintilimab plus IBI305 generated an additional $17552.17 and 0.33 quality-adjusted life years, resulting in an ICER of $52817.89. The analysis outcomes were most sensitive to the total cost of sintilimab plus IBI305. With a willingness-to-pay threshold of $38,334, sintilimab plus IBI305 showed a 1.28% probability of being cost-effective. The total cost of sintilimab plus IBI305 should be reduced by at least 31.9% to be accepted by Chinese payers. CONCLUSIONS: Regardless of whether the price of sintilimab plus IBI305 and sorafenib is covered by Medicare, sintilimab plus IBI305 is unlikely to be cost-effective for first-line treatment of patients with unresectable HCC.

Immobilized horseradish peroxidase on boric acid modified polyoxometalate molecularly imprinted polymer for biocatalytic degradation of phenol in wastewater: Optimized immobilization, degradation and toxicity assessment.

The degradation of phenol from wastewater is crucial for environmental protection. Biological enzymes, such as horseradish peroxidase (HRP), have shown great potential in the degradation of phenol. In this research, we prepared a hollow CuO/Cu2O octahedron adsorbent with a carambola matrix shape through the hydrothermal method. The surface of the adsorbent was modified by silane emulsion self-assembly, where 3-aminophenyl boric acid (APBA) and polyoxometalate (PW9) were combined with silanization reagents and grafted onto the surface. The adsorbent was then molecularly imprinted with dopamine to obtain boric acid modified polyoxometalate molecularly imprinted polymer (Cu@B@PW9@MIPs). This adsorbent was used to immobilize HRP, which served as a biological enzyme catalyst from horseradish. The adsorbent was characterized, and its synthetic conditions, experimental conditions, selectivity, reproducibility, and reusability were evaluated. The maximum adsorption amount of HRP under optimized conditions was 159.1 mg g-1, as determined using high-performance liquid chromatography (HPLC). At pH 7.0, the immobilized enzyme showed a high efficiency of up to 90.0% in removing phenol, after 20 min of reaction with 25 mmol L-1 H2O2 and 0.20 mg mL-1 Cu@B@PW9@HRP. Growth tests of aquatic plants confirmed that the adsorbent reduced harm. Gas chromatography-mass spectrometry (GC-MS) tests revealed that the degraded phenol solution contained about fifteen phenol derivatives intermediates. This adsorbent has the potential to become a promising biological enzyme catalyst for dephenolization.

Self-Guided Optimization Semi-Supervised Method for Joint Segmentation of Macular Hole and Cystoid Macular Edema in Retinal OCT Images.

Macular hole (MH) and cystoid macular edema (CME) are two common retinal pathologies that cause vision loss. Accurate segmentation of MH and CME in retinal OCT images can greatly aid ophthalmologists to evaluate the relevant diseases. However, it is still challenging as the complicated pathological features of MH and CME in retinal OCT images, such as the diversity of morphologies, low imaging contrast, and blurred boundaries. In addition, the lack of pixel-level annotation data is one of the important factors that hinders the further improvement of segmentation accuracy. Focusing on these challenges, we propose a novel self-guided optimization semi-supervised method termed Semi-SGO for joint segmentation of MH and CME in retinal OCT images. Aiming to improve the model's ability to learn the complicated pathological features of MH and CME, while alleviating the feature learning tendency problem that may be caused by the introduction of skip-connection in U-shaped segmentation architecture, we develop a novel dual decoder dual-task fully convolutional neural network (D3T-FCN). Meanwhile, based on our proposed D3T-FCN, we introduce a knowledge distillation technique to further design a novel semi-supervised segmentation method called Semi-SGO, which can leverage unlabeled data to further improve the segmentation accuracy. Comprehensive experimental results show that our proposed Semi-SGO outperforms other state-of-the-art segmentation networks. Furthermore, we also develop an automatic method for measuring the clinical indicators of MH and CME to validate the clinical significance of our proposed Semi-SGO. The code will be released on Github 1,2.

[Spatial and Temporal Distribution Characteristics of Ozone Concentration and Population Health Benefit Assessment in the Yangtze River Delta Region from 2017 to 2020].

In recent years, the ozone (O3) concentration has showed a rising trend in China, becoming second only to PM2.5 as an important factor affecting air quality. To grasp the spatial-temporal variations characteristics of O3 and the associated health impacts during the implementation of the three-year plan on defending the blue sky in the Yangtze River Delta (YRD) region, data collected from 210 monitoring stations in the YRD from 2017 to 2020 were analyzed using the global Moran's index and Getis-Ord Gi* index methods, and the associated health benefits of reduced O3 exposure were evaluated using the health risk and environmental value assessment methods. The results showed that during the study period, the interquartile range (IQR) of the annual average O3 concentration and that of the warm season both presented a declining trend. The average O3 concentrations in both warm and cold seasons showed a similar spatial distribution pattern, with the northern part exhibiting the higher concentrations and the southern part showing the lower concentrations. Furthermore, the O3 concentrations in the warm season were characterized by high O3 concentrations clustering in the northern and central part of the region. The proportion of the population exposure to annual average O3 concentration over 160 µg·m-3 decreased from 72.3% in 2017 to 34.8% in 2020 in the YRD. Although the population-weighted annual mean O3 concentration in the whole YRD region showed a downward trend, some cities in western Anhui province, northern Jiangsu province, and central Jiangsu province showed fluctuations and even an increasing trend. In terms of health benefits, there were 3782 cases (95% CI:2050-5511 cases) of avoided premature deaths associated with reduced O3 concentrations in the warm season in 2020 compared to 2017. The total health benefit was 26198 million yuan (95% CI:14201-38175 million yuan). Compared to the cost of the main O3 precursor emission reduction, the cost-benefits ratio was 1:1.67 to 3.23.

Multi-dimensional safety risk assessment on coal mines under the profitability dilemma.

China is a major coal producer, with huge differences in coal production and safety situations between the South and the North. Taking province A as an example, its coal enterprises have low output, poor efficiency, backward equipment, and low-quality personnel. The output accounts for 0.08% of the country, and the number of deaths accounts for 2.2% of the country, the safety situation of coal enterprises in province A is severe. In order to study the safety risk situation of coal mines under difficult conditions, this paper screens 98 factor indexes including multiple subjects such as enterprise managers, front-line workers, government supervisors, external environment, work quality, stress factors, economic factors, and other dimensions. For different data, the indicator weights were calculated using triangular fuzzy number, entropy weight method, CRITIC method, and three rough set methods in a total of six methods. The comprehensive weights of the indicators were obtained using the proposed new comprehensive weight method. The current situation of safety work of four coal mining enterprises and three levels of government supervision departments was evaluated, and the evaluation results were compared with other existing data to verify the reliability of the evaluation system. The horizontal comparison of the evaluation results indicates the main problems of each subject; the longitudinal comparison points out the problems that need to be solved with the assistance of higher-level enterprises and the central government, and corresponding suggestions for coal mining enterprises and government departments are put forward to reduce the safety risks of troubled coal mining enterprises.

Urinary incontinence rehabilitation of after radical prostatectomy: a systematic review and network meta-analysis.

Purpose: The aim of this study is to provide treatment for patients with urinary incontinence at different periods after radical prostatectomy. Methods: The PubMed, Embase, Cochrane, and Web of Science were searched for all literature on the effectiveness on urinary control after radical prostate cancer between the date of database creation and 15 November 2023 and performed a quality assessment. A network meta-analysis was performed using RevMan 5.3 and Stata 17.0 software and evaluated using the surface under the cumulative ranking curve. Results: The results of the network meta-analysis showed that pelvic floor muscle therapy including biofeedback with professional therapist-guided treatment demonstrated better results at 1 month to 6 months; electrical stimulation, biofeedback, and professional therapist guidance may be more effective at 3 months of treatment; professional therapist-guided recovery may be less effective at 6 months of treatment; and combined therapy demonstrated better results at 1 year of treatment. During the course of treatment, biofeedback with professional therapist-guided treatment may have significant therapeutic effects in the short term after surgery, but, in the long term, the combination of multiple treatments (pelvic floor muscle training+ routine care + biofeedback + professional therapist-guided treatment + electrical nerve stimulation therapy) may address cases of urinary incontinence that remain unrecovered long after surgery. Conclusion: In general, all treatment methods improve the different stages of functional recovery of the pelvic floor muscles. However, in the long term, there are no significant differences between the treatments. Given the cost-effectiveness, pelvic floor muscle training + routine care + biofeedback + professional therapist-guided treatment + electrical nerve stimulation therapy within 3 months and pelvic floor muscle + routine care after 3 months may be a more economical option to treat urinary incontinence. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=331797, identifier CRD42022331797.

Zebrafish (Danio rerio) Is an Economical and Efficient Animal Model for Screening Potential Anti-cataract Compounds.

Purpose: To develop a zebrafish cataract model for screening potential anti-cataract compounds. Methods: Living zebrafish were anesthetized and exposed to ultraviolet-C (UV-C) irradiation at a dosage of 3250 mJ/cm2/d until they developed severe cataracts. These cataracts were graded based on photographs analyzed with ImageQuant TL version 7.0. Fish with severe cataracts were used to evaluate a range of compounds for cataract treatment, including the previously demonstrated hit compound lanosterol. For the initial evaluation, fish were divided into four groups: no treatment, balanced salt solution, ß-cyclodextrin (ß-CD), and lanosterol dissolved in ß-CD. The treatments were performed for 10 days, and the clarity of lenses was evaluated. To assess the persistence of treatment, fish were treated with ß-CD and lanosterol dissolved in ß-CD for seven consecutive days followed by monitoring for three days without treatment. Results: The average time for zebrafish to develop severe cataracts using the present UV-C irradiation protocol was 7.8 days (range 4-15 days). Both study designs required only another 10 days to determine the effect of hit compounds. The total experimental period could be completed within one month, and the entire experiment was economical. Conclusions: We could assay a large number of hit compounds at a reasonable cost and within a short time using this newly developed zebrafish cataract model. These assays may allow development of an efficient platform for screening potential anti-cataract compounds. Translational Relevance: The results may facilitate the development of ani-cataract medication for humans after further experiments and investigations.

Assessment of quality of life and activities of daily living among elderly patients with hypertension and impaired physical mobility in home health care by antihypertensive drugs plus acupuncture: A CONSORT-compliant, randomized controlled trial.

BACKGROUND: To evaluate the efficacy of acupuncture in improving quality of life (QOL) and activities of daily living among elderly patients with hypertension and impaired physical mobility in home health care. METHODS: Seventy participants were allocated randomly to receive either acupuncture together with antihypertensive drugs (n = 35) or antihypertensive drugs only (n = 35). Acupuncture was conducted twice a week for 12 consecutive weeks, each lasting 30 minutes. Acupuncture points San Yin Jiao, Xue Hai, Taichong, Zusanli, and Hegu acupuncture points were used bilaterally. The primary outcome was change in QOL score, evaluating by Short-Form 36 Item Health Survey (SF-36). Secondary outcomes were changes in Barthel index score and blood pressure. Besides, pain evaluation by Visual analog scale, among acupuncture and control subgroups in participants with diagnosis with disease of the musculoskeletal system and connective tissue (ICD-9: 710-739). RESULTS: Thirty-one participants in each of the acupuncture group and the control group completed the study. After 12 weeks of treatment, compared with the control group, the combination of antihypertensive treatments and acupuncture helped to improve bodily pain (P = .03), physical component summary (P = .04), mental health (P < .001), mental component summary (P = .008), Barthel index (P = .02), and systolic blood pressure (P = .01). In contrast, the control group showed no significant changes. Change in pain score revealed that there were a significant between-group differences after 6weeks (P = .01) and 12weeks of treatment (P = .001). CONCLUSION: The results of the study suggested that in home health care elderly patients with hypertension and impaired physical mobility, antihypertensive drugs combined with acupuncture therapy will be more beneficial to improve QOL, activities of daily living, and blood pressure.

Community daytime noise pollution and socioeconomic differences in Chicago, IL.

Environmental noise may affect hearing and a variety of non-auditory disease processes. There is some evidence that, like other environmental hazards, noise may be differentially distributed across communities based on socioeconomic status. We aimed to a) predict daytime noise pollution levels and b) assess disparities in daytime noise exposure in Chicago, Illinois. We measured 5-minute daytime noise levels (Leq, 5-min) at 75 randomly selected sites in Chicago in March, 2019. Geographically-based variables thought to be associated with noise were obtained, and used to fit a noise land-use regression model to estimate the daytime environmental noise level at the centroid of the census blocks. Demographic and socioeconomic data were obtained from the City of Chicago for the 77 community areas, and associations with daytime noise levels were assessed using spatial autoregressive models. Mean sampled noise level (Leq, 5-min) was 60.6 dBA. The adjusted R2 and root mean square error of the noise land use regression model and the validation model were 0.60 and 4.67 dBA and 0.51 and 5.90 dBA, respectively. Nearly 75% of city blocks and 85% of city communities have predicted daytime noise level higher than 55 dBA. Of the socioeconomic variables explored, only community per capita income was associated with mean community predicted noise levels, and was highest for communities with incomes in the 2nd quartile. Both the noise measurements and land-use regression modeling demonstrate that Chicago has levels of environmental noise likely contributing to the total burden of environmental stressors. Noise is not uniformly distributed across Chicago; it is associated with proximity to roads and public transportation, and is higher among communities with mid-to-low incomes per capita, which highlights how socially and economically disadvantaged communities may be disproportionately impacted by this environmental exposure.

Valorization of sorghum distillery residue to produce bioethanol for pollution mitigation and circular economy.

This research aims to study the wet torrefaction (WT) and saccharification of sorghum distillery residue (SDR) towards hydrochar and bioethanol production. The experiments are designed by Box-Behnken design from response surface methodology where the operating conditions include sulfuric acid concentration (0, 0.01, and 0.02 M), amyloglucosidase concentration (36, 51, and 66 IU), and saccharification time (120, 180, and 240 min). Compared to conventional dry torrefaction, the hydrochar yield is between 13.24 and 14.73%, which is much lower than dry torrefaction biochar (yield >50%). The calorific value of the raw SDR is 17.15 MJ/kg, which is significantly enhanced to 22.36-23.37 MJ/kg after WT. When the sulfuric acid concentration increases from 0 to 0.02 M, the glucose concentration in the product increases from 5.59 g/L to 13.05 g/L. The prediction of analysis of variance suggests that the best combination to maximum glucose production is 0.02 M H2SO4, 66 IU enzyme concentration, and 120 min saccharification time, and the glucose concentration is 30.85 g/L. The maximum bioethanol concentration of 19.21 g/L is obtained, which is higher than those from wheat straw (18.1 g/L) and sweet sorghum residue (16.2 g/L). A large amount of SDR is generated in the kaoliang liquor production process, which may cause environmental problems if it is not appropriately treated. This study fulfills SDR valorization for hydrochar and bioenergy to lower environmental pollution and even achieve a circular economy.

Epidemiological characteristics of 561 cases of intracerebral hemorrhage in Chengdu, China.

ABSTRACT: To explore the epidemiology of patients with spontaneous intracerebral hemorrhage (sICH) in Chengdu, China, we retrieved the data of patients with spontaneous cerebral hemorrhage admitted to the First Affiliated Hospital of Chengdu Medical College from January 2017 to December 2019. We performed a comprehensive analysis of the location of hemorrhage, demographics, factors of hemorrhage, condition of body, severity of disturbance of consciousness, treatment, length of stay (days), inpatient costs, prognosis, and mortality rate in patients with sICH. In total, data of 561 in patients with sICH were included. The hemorrhage site was primarily located in the basal ganglia and thalamus (64.71%). The mean patient age was 63.2 ±â€Š12.4 years (64.17% men, 35.83% women). Male patients (mean age 62.3 ±â€Š12.5 year) were younger than female patients (mean age 64.9 ±â€Š12.1 year). The age of sICH onset in our sample was between 40 and 79 years; this occurred in 87.70% of the included cases. There were more males than females, which may be related to more daily smoking, longer drinking years, and overweight in males than in females. Cases occurred most frequently during the winter and spring months, and the relationship between sICH visits and hospitalizations appeared as a U-shape. The median time from illness onset to hospital admission was 3.0 hours. According to the Glasgow Coma Scale (GCS) score at admission, 20.50% of sICH cases were of mild intensity, 39.93% were moderate, and 39.57% were severe. Moderate disorder is the most common sICH severity. Factors influencing the disturbance of consciousness were blood glucose level at the time of admission as well as the number of years with hypertension. The lower the degree of disturbance of consciousness and the more they smoked per day indicated they had a higher likelihood of receiving surgical treatment while in hospital. The median hospital stay was 13.0 days, while the median inpatient cost was USD 3609. The 30-day mortality rate was 18.36%. sICH is an important public health problem in Chengdu, China. A governmental initiative is urgently needed to establish a sICH monitoring system that covers the Chengdu region to develop more effective and targeted measures for sICH prevention, treatment, and rehabilitation.

Oral Bioavailability Enhancement and Anti-Fatigue Assessment of the Andrographolide Loaded Solid Dispersion.

Andrographolide (AG), a major diterpene lactone isolated from Andrographis paniculata (Burm. f.) Nees (Acanthaceae), possesses a wide spectrum of biological activities. However, its poor water solubility and low bioavailability limit its clinical application. Therefore, this study aimed to develop a solid dispersion (SD) formulation to increase the aqueous solubility and dissolution rate of AG. Different drug-polymer ratios were used to prepare various SDs. The optimized formulation was characterized for differential scanning calorimetry, Fourier transform infrared spectroscopy, and powder X-ray diffraction. The analysis indicated that the optimized SD enhanced AG solubility and dissolution rates by changing AG crystallinity to an amorphous state. The dissolution behaviors of the optimum SD composed of an AG-polyvinylpyrrolidone K30-Kolliphor EL ratio of 1:7:1 (w/w/w) resulted in the highest accumulated dissolution (approximately 80%). Pharmacokinetic studies revealed that Cmax/dose and the AUC/dose increased by 3.7-fold and 3.0-fold, respectively, compared with AG suspension. Furthermore, pretreatment using the optimized AG-SD significantly increased the swimming time to exhaustion by 1.7-fold and decreased the plasma ammonia level by 71.5%, compared with the vehicle group. In conclusion, the optimized AG-SD formulation appeared to effectively improve its dissolution rate and oral bioavailability. Moreover, the optimized AG-SD provides a promising treatment against physical fatigue.

Minimally invasive adrenalectomy results in equivalent perioperative outcomes versus open adrenalectomy for adrenal mass larger than 6 cm: A retrospective propensity score-matched study.

INTRODUCTION: The indication for choosing the minimally invasive approach for large adrenal mass remains controversial. This study is to assess perioperative outcomes after minimally invasive adrenalectomy (MIA) versus open adrenalectomy (OA) for adrenal mass ≥ 6 cm. MATERIALS AND METHODS: A cohort of 173 patients underwent adrenalectomy for adrenal mass ≥ 6 cm in our urology center between May 2005 and April 2018 was included. MIA was performed in 96 patients, whereas 77 patients underwent OA. We performed a retrospective propensity score-matched study to compare MIA versus OA. RESULTS: After propensity score-matched, 58 matched pairs of patients identified from each group. There were no significant differences between the groups in postoperative morbidity (p = 0.146), operative time (p = 0.163), intraoperative hypertension (p = 0.248) and drainage time (p = 0.188). Estimated blood loss, the rate of blood transfusions postoperative hospital stay was less in MIA group (p < 0.0001; p = 0.007; p < 0.0001). Total expense was significantly more in the MIA group [49379.28 (38496.69, 68008.69) CNY vs 39951.48 (30666.33, 50292.03) CNY, p = 0.001]. CONCLUSIONS: MIA results in equivalent perioperative outcomes compared with OA and is an effective and safe surgical method for patients with an adrenal mass more than 6 cm in diameter.