[Homozygous Variant of FANCM of the Fanconi Anemia Pathway Causes Premature Ovarian Insufficiency: Investigation of the Pathogenic Mechanism]. / 范科尼贫血通路FANCMåŸºå› çº¯åˆçªå˜å¯¼è‡´æ—©å‘æ€§åµå·¢åŠŸèƒ½ä¸å ¨çš„è‡´ç— æœºåˆ¶.

Objective: Infertility affects approximately one-sixth of the people of childbearing age worldwide, causing not only economic burdens of treatment for families with fertility problems but also psychological stress for patients and presenting challenges to societal and economic development. Premature ovarian insufficiency (POI) refers to the loss of ovarian function in women before the age of 40 due to the depletion of follicles or decreased quality of remaining follicles, constituting a significant cause of female infertility. In recent years, with the help of the rapid development in genetic sequencing technology, it has been demonstrated that genetic factors play a crucial role in the onset of POI. Among the population suffering from POI, genetic studies have revealed that genes involved in processes such as meiosis, DNA damage repair, and mitosis account for approximately 37.4% of all pathogenic and potentially pathogenic genes identified. FA complementation group M (FANCM) is a group of genes involved in the damage repair of DNA interstrand crosslinks (ICLs), including FANCA-FANCW. Abnormalities in the FANCM genes are associated with female infertility and FANCM gene knockout mice also exhibit phenotypes similar to those of POI. During the genetic screening of POI patients, this study identified a suspicious variant in FANCM. This study aims to explore the pathogenic mechanisms of the FANCM genes of the FA pathway and their variants in the development of POI. We hope to help shed light on potential diagnostic and therapeutic strategies for the affected individuals. Methods: One POI patient was included in the study. The inclusion criteria for POI patients were as follows: women under 40 years old exhibiting two or more instances of basal serum follicle-stimulating hormone levels>25 IU/L (with a minimum interval of 4 weeks inbetween tests), alongside clinical symptoms of menstrual disorders, normal chromosomal karyotype analysis results, and exclusion of other known diseases that can lead to ovarian dysfunction. We conducted whole-exome sequencing for the POI patient and identified pathogenic genes by classifying variants according to the standards and guidelines established by the American College of Medical Genetics and Genomics (ACMG). Subsequently, the identified variants were validated through Sanger sequencing and subjected to bioinformatics analysis. Plasmids containing wild-type and mutant FANCM genes were constructed and introduced into 293T cells. The 293T cells transfected with wild-type and mutant human FANCM plasmids and pEGFP-C1 empty vector plasmids were designated as the EGFP FANCM-WT group, the EGFP FANCM-MUT group, and the EGFP group, respectively. To validate the production of truncated proteins, cell proteins were extracted 48 hours post-transfection from the three groups and confirmed using GFP antibody. In order to investigate the impact on DNA damage repair, immunofluorescence experiments were conducted 48 hours post-transfection in the EGFP FANCM-WT group and the EGFP FANCM-MUT group to examine whether the variant affected FANCM's ability to localize on chromatin. Mitomycin C was used to induce ICLs damage in vitro in both the EGFP FANCM-WT group and the EGFP FANCM-MUT group, which was followed by verification of its effect on ICLs damage repair using γ-H2AX antibody. Results: In a POI patient from a consanguineous family, we identified a homozygous variant in the FANCM gene, c.1152-1155del:p.Leu386Valfs*10. The patient presented with primary infertility, experiencing irregular menstruation since menarche at the age of 16. Hormonal evaluation revealed an FSH level of 26.79 IU/L and an anti-Müllerian hormone (AMH) level of 0.07 ng/mL. Vaginal ultrasound indicated unsatisfactory visualization of the ovaries on both sides and uterine dysplasia. The patient's parents were a consanguineous couple, with the mother having regular menstrual cycles. The patient had two sisters, one of whom passed away due to osteosarcoma, while the other exhibited irregular menstruation, had been diagnosed with ovarian insufficiency, and remained childless. Bioinformatics analysis revealed a deletion of four nucleotides (c.1152-1155del) in the exon 6 of the patient's FANCM gene. This variant resulted in a frameshift at codon 386, introducing a premature stop codon at codon 396, which ultimately led to the production of a truncated protein consisting of 395 amino acids. In vitro experiments demonstrated that this variant led to the production of a truncated FANCM protein of approximately 43 kDa and caused a defect in its nuclear localization, with the protein being present only in the cytoplasm. Following treatment with mitomycin C, there was a significant increase in γ-H2AX levels in 293T cells transfected with the mutant plasmid (P<0.01), indicating a statistically significant impairment of DNA damage repair capability caused by this variant. Conclusions: The homozygous variant in the FANCM gene, c.1152-1155del:p.Leu386Valfs*10, results in the production of a truncated FANCM protein. This truncation leads to the loss of its interaction site with the MHF1-MHF2 complex, preventing its entry into the nucleus and the subsequent recognition of DNA damage. Consequently, the localization of the FA core complex on chromatin is disrupted, impeding the normal activation of the FA pathway and reducing the cell's ability to repair damaged ICLs. By disrupting the rapid proliferation and meiotic division processes of primordial germ cells, the reserve of oocytes is depleted, thereby triggering premature ovarian insufficiency in females.

Cost-Efficient Micro-Well Array-Based Colorimetric Antibiotic Susceptibility Testing (MacAST) for Bacteria from Culture or Community.

Rapid and cost-efficient antibiotic susceptibility testing (AST) is key to timely prescription-oriented diagnosis and precision treatment. However, current AST methods have limitations in throughput or cost effectiveness, and are impractical for microbial communities. Here, we developed a high-throughput micro-well array-based colorimetric AST (macAST) system equipped with a self-developed smartphone application that could efficiently test sixteen combinations of bacteria strains and antibiotics, achieving comparable AST results based on resazurin metabolism assay. For community samples, we integrated immunomagnetic separation into the macAST (imacAST) system to specifically enrich the target cells before testing, which shortened bacterial isolation time from days to only 45 min and achieved AST of the target bacteria with a low concentration (~103 CFU/mL). This proof-of-concept study developed a high-throughput AST system with an at least ten-fold reduction in cost compared with a system equipped with a microscope or Raman spectrum. Based on colorimetric readout, the antimicrobial susceptibility of the bacteria from microbial communities can be delivered within 6 h, compared to days being required based on standard procedures, bypassing the need for precise instrumentation in therapy to combat bacterial antibiotic resistance in resource-limited settings.

Alteration of relative telomere length and telomerase reverse transcriptase expression in the granulosa cells of women during aging and assessment of in vitro fertilization outcomes.

Telomere attrition plays a critical role in the reproductive aging process in humans. Telomere length (TL) is typically regulated by telomerase, the main component of which is telomerase reverse transcriptase (TERT). The aim of the present study was to investigate the changes of relative TL (RTL) and TERT expression in granulosa cells (GCs) during aging and its association with reproduction. Clinical data on the frozen­thawed embryo transfer cycles of older (>35 year old) and younger (≤35 year old) women from a single center over a 3­year period were retrospectively analyzed. Preimplantation genetic testing for chromosome aneuploidies in older women during the same period was also analyzed. Following the analysis of the data, several biological characteristics of senescent GCs were explored. In addition, a total of 160 women who were undergoing their first fresh cycle of in vitro fertilization (IVF) or intracytoplasmic sperm injection were included in the study. GCs were collected from all participants. The changes of RTL and TERT expression in GCs during aging were investigated using quantitative PCR and western blotting. The associations of RTL and TERT with IVF outcomes were also assessed. The clinical data demonstrated that the pregnancy and live birth rates of women aged >35 years were ~20% lower than those of women aged ≤35 years, and the number of embryos with aneuploidy was 7­fold of that without euploidy in the older age group. An aging­induced change in follicle stimulating hormone receptor expression was observed. A shorter TL and increased TERT expression were detected in the older women. A significant inverse correlation between the expression levels of TERT and oocyte yield was identified. However, no association of RTL and TERT with blastocyst formation rate and the probability of clinical pregnancy was detected. It may be concluded that RTL and TERT alterations in GCs are potential determinants of ovarian aging. TERT expression in GCs appears to be a potential biomarker for the prediction of ovarian response, which provides a novel strategy for the assessment of female fertility.

Deduplication Improves Cost-Efficiency and Yields of De Novo Assembly and Binning of Shotgun Metagenomes in Microbiome Research.

In the last decade, metagenomics has greatly revolutionized the study of microbial communities. However, the presence of artificial duplicate reads raised mainly from the preparation of metagenomic DNA sequencing libraries and their impacts on metagenomic assembly and binning have never been brought to attention. Here, we explicitly investigated the effects of duplicate reads on metagenomic assemblies and binning based on analyses of five groups of representative metagenomes with distinct microbiome complexities. Our results showed that deduplication considerably increased the binning yields (by 3.5% to 80%) for most of the metagenomic data sets examined thanks to the improved contig length and coverage profiling of metagenome-assembled contigs, whereas it slightly decreased the binning yields of metagenomes with low complexity (e.g., human gut metagenomes). Specifically, 411 versus 397, 331 versus 317, 104 versus 88, and 9 versus 5 metagenome-assembled genomes (MAGs) were recovered from MEGAHIT assemblies of bioreactor sludge, surface water, lake sediment, and forest soil metagenomes, respectively. Noticeably, deduplication significantly reduced the computational costs of the metagenomic assembly, including the elapsed time (9.0% to 29.9%) and the maximum memory requirement (4.3% to 37.1%). Collectively, we recommend the removal of duplicate reads in metagenomes with high complexity before assembly and binning analyses, for example, the forest soil metagenomes examined in this study. IMPORTANCE Duplicated reads in shotgun metagenomes are usually considered technical artifacts. Their presence in metagenomes would theoretically not only introduce bias into the quantitative analysis but also result in mistakes in the coverage profile, leading to adverse effects on or even failures in metagenomic assembly and binning, as the widely used metagenome assemblers and binners all need coverage information for graph partitioning and assembly binning, respectively. However, this issue was seldom noticed, and its impacts on downstream essential bioinformatic procedures (e.g., assembly and binning) remained unclear. In this study, we comprehensively evaluated for the first time the implications of duplicate reads for the de novo assembly and binning of real metagenomic data sets by comparing the assembly qualities, binning yields, and requirements for computational resources with and without the removal of duplicate reads. It was revealed that deduplication considerably increased the binning yields of metagenomes with high complexity and significantly reduced the computational costs, including the elapsed time and the maximum memory requirement, for most of the metagenomes studied. These results provide empirical references for more cost-efficient metagenomic analyses in microbiome research.

Facile sulfation of cellulose via recyclable ternary deep eutectic solvents for low-cost cellulose nanofibril preparation.

Here we present a new method to treat cellulose with a sulfamic acid-urea-choline chloride (ternary deep eutectic solvent) system, which can realize both swelling and sulfation of cellulose. This can greatly reduce the energy consumption in the process of cellulose nanoization, and use it to successfully prepare food packaging films for eliminating odors. We hope that due its simplicity and resource-efficiency, this method will have a widespread influence on currently used (nano) cellulose modification protocols.

Initial dietary risk assessment of chlorinated paraffins in edible fungi in Chinese markets.

Dietary intake is one of the main pathways for residents to become exposed to chlorinated paraffins (CPs). In China, due to the popularization of nutritional and medicinal edible fungi, consumption has increased on a yearly basis. Edible fungi have a variety of active substances and are consumed daily by residents. However, there is limited information on the concentration and source of chlorinated paraffins in edible fungi. In this study, the concentrations of short-chain chlorinated paraffins (SCCPs) and medium-chain chlorinated paraffins (MCCPs) in 105 edible fungi samples and 36 culture material samples were detected. The concentration range of SCCPs was 79.8 ng/g dw to 3879.3 ng/g dw, and the MCCPs was ND to 572.3 ng/g dw. Spearman correlation analysis indicated that the sources of SCCPs and MCCPs in edible fungi were similar (r = 0.57, p < 0.01). The preponderant SCCPs and MCCPs congener group profiles were C10 Cl7-8 and C14 Cl6-8 . CPs were detected in culture materials, the concentration range of SCCPs was 320.2 ng/g dw to 4326 ng/g dw, and the MCCPs was 333.4 ng/g dw to 4517.4 ng/g dw. And the preponderant SCCPs and MCCPs homologues in culture materials were C11-12 Cl6 and C14 Cl6 . The linear discriminant analysis results indicated different contamination models of CPs between edible fungi and culture materials. The mean estimated daily intake values of SCCPs and MCCPs were 308.1 ng/kg bw/d and 94.4 ng/kg bw/d, respectively, indicating no potential health risk posed by CP exposure in edible fungi.

Ecological Risk Assessment and Influencing Factors of Heavy-Metal Leaching From Coal-Based Solid Waste Fly Ash.

In order to promote and broaden the utilization of fly ash as a resource, the fly ash from a 2,660-MW coal-fired power plant in Huainan (China) was investigated. The physical and chemical properties of fly ash were characterized by scanning electron microscopy, energy spectrum analysis, and XRD. The content and different forms of the heavy metals Cd, Cr, Cu, Co, and Ni were determined by acid digestion, oscillation leaching, and Tessier five-step extraction. The effect of pH, temperature, and particle size on the leached amount of heavy metals was studied. Finally, the ecological risk index was calculated for each heavy metal via the risk assessment coding (RAC) method and Hakanson ecological risk assessment method, allowing the ecological risk of fly ash to be determined under different environmental conditions. Results showed that the average concentrations of Cd, Cr, Co, and Ni were all below the risk screening values reported for environmental pollutants (pH > 7.5). Under varying pH, temperature, and particle size conditions, the leached amounts (oscillation leaching) were below the soil risk screening values for agricultural land in China. An RAC-Cd value of >50% indicates a high ecological risk, while the RAC values of Co and Ni were between 10 and 30%, indicating a medium ecological risk, and the RAC values of Cr and Cu were <10%, indicating a low ecological risk. With increasing pH, the potential ecological risk index (RI) decreased, with a maximum RI of 59.62 observed at pH 2.8. With increasing temperature, the potential ecological RI increased initially to a maximum of 27.69 at 25°C and then decreased thereafter. With increasing particle size, the ecological RI decreased, with the highest RI of 4.06 occurring at <0.075 mm. The Hakanson ecological RI value was below 150, indicating a slight ecological risk. Therefore, fly ash can be considered as a soil additive and conditioner that is suitable for use in the improvement of reclamation soil in coal mining subsidence areas.

Low-cost synthesis of small molecule acceptors makes polymer solar cells commercially viable.

The acceptor-donor-acceptor (A-D-A) or A-DA'D-A structured small molecule acceptors (SMAs) have triggered substantial progress for polymer solar cells (PSCs). However, the high-cost of the SMAs impedes the commercial viability of such renewable energy, as their synthesis via the classical pyridine-catalyzed Knoevenagel condensation usually suffers from low reaction efficiency and tedious purifying work-up. Herein, we developed a simple and cheap boron trifluoride etherate-catalyzed Knoevenagel condensation for addressing this challenge, and found that the coupling of the aldehyde-terminated D unit and the A-end groups could be quantitatively finished in the presence of acetic anhydride within 15 minutes at room temperature. Compared with the conventional method, the high reaction efficiency of our method is related to the germinal diacetate pathway that is thermodynamically favorable to give the final products. For those high performing SMAs (such as ITIC-4F and Y6), the cost could be reduced by 50% compared with conventional preparation. In addition to the application in PSCs, our synthetic approach provides a facile and low-cost access to a wide range of D-A organic semiconductors for emerging technologies.

Application of Two Blastocyst Biopsy Strategies in Preimplantation Genetic Testing Treatment and Assessment of Their Effects.

Background: Blastocyst biopsy has become the most mainstream biopsy method. Currently, there are two blastocyst biopsy strategies. Many studies have compared the advantages and disadvantages between blastomere and blastocyst biopsy, but fewer articles have compared the two blastocyst biopsy strategies. For the moment, no published studies have explored the entire set of information on embryo development, next-generation sequencing results, and clinical outcomes, including the baby's health status with the two blastocyst biopsy strategies. Methods: A total of 323 preimplantation genetic testing cycles from April 2018 to May 2020, including 178 cycles with Strategy A and 145 cycles with Strategy B. Strategy A was to create a laser-assisted zona pellucid opening for cleavage embryo on the third day after insemination, but Strategy B was not. Strategy A performed a biopsy for artificially assisted hatching blastocysts, while Strategy B performed a biopsy for expanded blastocysts on day 5 or 6. In this study, embryo development, next-generation sequencing results, pregnancy outcomes, and offspring health of the two strategies were compared and analyzed. Results: There were no statistical differences between the two groups in the rate of fertilization, blastocyst and abortion. The rate of cleavage from Strategy A was slightly higher than Strategy B, and the rate of high-quality cleavage embryo was lower than Strategy B, while the rate of high-quality blastocyst was higher than Strategy B. The rate of no-results blastocyst was significantly lower than Strategy B. In particular, the rate of biochemical pregnancy, clinical pregnancy, and live birth of Strategy A were significantly lower than those of Strategy B. The average Apgar scores of newborns were ≥8 in both groups, and there was no significant difference in average height and weight. In Strategy A, a baby was born with thumb syndactyly, and Strategy B had no congenital disabilities. Conclusions: Blastocyst biopsy strategy without laser-assisted zona pellucid drilling on day 3 achieves better clinical treatment effects. Therefore, Strategy B is an optimal treatment regime for PGT.

China county-based prostate specific antigen screening for prostate cancer and a cost-effective analysis.

BACKGROUND: Prostate cancer is one of the most common malignant tumors worldwide, and is the third-leading cause of cancer death in men. Nearly 70% of new prostate cancer patients in China are locally advanced or widely metastatic with poor prognosis. Providing active treatment to early stage prostate cancer patients can improve the prognosis of prostate cancer patients. Thus, this study sought to evaluate the economy of early prostate specific antigen (PSA) screening for high-risk prostate cancer. METHODS: Based on the data collected from the PSA screening activities of 11 county hospitals from October 2019 to April 2021, this study evaluated a high-risk prostate cancer population who received PSA screening and their quality of life and economy. The screening population comprised males aged over 50 years. All screening patients were tested for PSA. If the PSA value is unnormal, a further diagnosis based on magnetic resonance imagining (MRI) or a transrectal ultrasound-guided prostate biopsy were performed. The decision-tree and Markov model was used to simulate the process of disease development of high-risk prostate cancer patients who underwent screenings and those who did not, and the incremental cost-effectiveness ratio was also evaluated. RESULTS: A total of 13,726 men received a PSA screening. Of these, 1,062 men had abnormal PSA values, and 73 of these were diagnosed with prostate cancer. Of these 73 patients, 40, 21, and 12 had early stage, mid-stage, and late-stage prostate cancer, respectively. Compared to the patients unscreened, the 1,000 patients who received an early PSA screening increased their quality-adjusted life year (QALY) by 15.69 years; however, each QALY had an additional cost of 38,550 yuan, which was lower than the willingness to pay threshold of 72,447 yuan (per capita gross domestic product in 2020). CONCLUSIONS: For high-risk prostate cancer patients, early screenings have a cost-effective advantage over no screenings. Thus, early screening should be vigorously promoted for high-risk prostate cancer patients.

Comprehensive assessment of a clinic's experience of preimplantation genetic testing by a cumulative rate.

OBJECTIVE: This study aimed to investigate the outcomes of patients who had preimplantation genetic testing for chromosomal structural rearrangement (PGT-SR) or for aneuploidy screening (PGT-A) with different indications. METHODS: This was a retrospective study at a single center. Pregnancy outcomes of all couples who had PGT from 2014 to 2018 were retrospectively analyzed, and the cumulative pregnancy rates (CPR) and the cumulative live birth/ongoing pregnancy rate (CLB/OPR) per patient with at least one transfer cycle were calculated. RESULTS: A total of 313 PGT-SR cycles of 255 patients, 22 PGT-sexing cycles of 20 patients, and 190 PGT-A cycles of 168 patients were performed during the period. In PGT-SR, the overall CPR and the CLB/OPR were 68.04% and 59.79%, respectively. In PGT-A, the CPR and CLB/OPR were 67.52% and 58.12%, respectively. We also found that the CPR (93.75%) and CLB/OPR (87.50%) were highest in patients for PGT-sexing with a diagnosis of Y chromosomal microdeletion. In addition, we discovered a significant trend that aneuploidy rate significantly increased with maternal age (p = 0.000) in PGT-A population. No significant difference was found in the mosaicism rate or clinical outcomes among the age groups. Similarly, the significance was absent in the PGT-SR population. CONCLUSION: We reviewed the CPR and CLB/OPR for different indications since the 24-chromosome technique has been applied in the clinical setting for 4 years in our center. We hope that our results will provide some pointed guidance and a new perspective on outcomes for PGT in certain patients and clinicians.

Psychometric Properties of the Chinese Version of the Functional Assessment of Self-Mutilation (FASM) in Chinese Clinical Adolescents.

BACKGROUND: Functional Assessment of Self-Mutilation (FASM) is one of the most widely used tools assessing adolescent's non-suicidal self-injury. However, the Chinese version of FASM (C-FASM) is lacking. The present study aimed to adapt the FASM to the Chinese patients and examine its reliability and validity. METHODS: The original English version of the FASM was translated into Chinese following Brislin's model of cross-culture translation, and then, pilot study and cognitive interview were carried out with 15 adolescent patients to assess the acceptability and comprehensibility of all items. The items were subsequently tested in a sample of 621 Chinese adolescent patients recruited by 20 psychiatric or general hospitals in nine provinces across China. We examined the distribution of responses for each item. Factor analysis, Cronbach's α and McDonald's Ω, intraclass coefficient, and Spearman's rank correlations were deployed to assess the dimensional structure, internal consistency reliability, test-retest reliability, and criterion validity. RESULTS: The final adapted C-FASM included a 10-item method checklist and a 15-item function checklist of NSSI, and other characteristics of NSSI. C-FASM exhibited acceptable internal consistency (α = 0.81 and Ω = 0.80 for method checklist; α = 0.80 and Ω = 0.76 for function checklist) and test-retest reliability (method checklist: 0.79; function checklist: 0.87). Factor analysis for NSSI functions yielded a three-factor model with a good model fit. In addition, the instrument showed an expected correlation with the instrument of the Deliberate Self-Harm Behavior Inventory (r = 0.84, p < 0.001). CONCLUSIONS: The C-FASM has good content, structural validity, and reliability. The instrument can be helpful to Chinese adolescents as a comprehensive measure of NSSI behaviors.

Retrosigmoid approach assisted by high-resolution computed tomography: a cost-effective technique to identify the transverse and sigmoid sinus transition.

BACKGROUND: When utilizing the retrosigmoid approach (RA), accurately identifying the transverse and sigmoid sinus transition (TSST) is a key procedure for neurosurgeons, especially in developing countries restricted by the lack of expensive devices, such as the neural navigation system and the three-dimensional volumetric image-rendered system. Before operations, a computed tomography scan is a common and cost-effective method of checking patients who suffer lesions located at the cerebellopontine angle. Therefore, we present a technique using only high-resolution computed tomography to identify the transverse and sigmoid sinus transition. METHODS: This retrospective study included 35 patients who underwent retrosigmoid approach operations to resect an acoustic neurinoma with the assistance of our technique. In brief, our technique contains 4 steps: (1) All patients' 1-mm, consecutive, high-resolution computed tomographic images that clearly displayed landmarks, such as the inion, lambdoid suture, occipitomastoid suture, and the mastoid emissary foramen, were investigated initially. (2) We selected two particular slices (A and B) among all of these high-resolution computed tomographic images in which scanning planes were parallel with the line drawn from the root of the zygoma to the inion (LZI). Slice A contained both the root of the zygoma and the inion simultaneously, and slice B displayed the mastoid emissary foramen. (3) Four points (α, ß, γ, δ) were arranged on slices A and B, and point α was located at the inner surface of the skull, which represents the posterior part of the sulci of the sigmoid sinus. Point ß was located at the outer surface of the skull, and the line connecting them was perpendicular to the bone. Similarly, on slice B, we labeled point γ as the point that represents the posterior part of the sulci of the sigmoid sinus at the inner surface and point δ as the point located at the outer surface of the skull, and the line connecting them was also perpendicular to the bone. The distances between point ß and the lambdoid suture/occipitomastoid suture and between point δ and the mastoid emissary foramen were calculated for slices A and B, respectively. (4) During the operation, a line indicating the LZI was drawn on the bone with ink when the superficial soft tissue was pushed away, and this line would cross the lambdoid suture/occipitomastoid suture. With both the crosspoint and the distance obtained from the high-resolution CT images, we could locate point ß. We also used the same method to locate point δ after revealing the mastoid emissary foramen. The line connecting point ß and point δ indicated the posterior border of the sigmoid sinus, and the intersection between the line and LZI indicated the inferior knee of the transverse and sigmoid sinus transition (TSST). RESULTS: All 35 patients underwent the RA craniectomies that were safely assisted by our technique, and neither the sigmoid sinus nor the transverse sinus was lacerated during the operations. CONCLUSION: Our cost-effective technique is reliable and convenient for identifying the transverse and sigmoid sinus transition (TSST) which could be widely performed to guarantee the safety of RA craniectomy.

Understanding the Morphology of High-Performance Solar Cells Based on a Low-Cost Polymer Donor.

A low-cost and high-performance bulk heterojunction (BHJ) solar cell comprising an emerging polymer donor, poly[(thiophene)-alt-(6,7-difluoro-2-(2-hexyldecyloxy)quinoxaline)] (PTQ10), shows an efficiency of 12.7%. To improve the performance of the solar cells, a better understanding of the structure-property relationships of the PTQ10-based devices is crucial. Here, we fabricate PTQ10/nonfullerene and fullerene BHJ devices, including PTQ10/IDIC, PTQ10/ITIC, and PTQ10/PC71BM, processed with or without thermal annealing and additive and provide detailed descriptions of the relationships between the morphology and performance. PTQ10 is found to be highly miscible with nonfullerene IDIC and ITIC acceptors and poorly miscible with fullerene PC71BM acceptors. Thermal annealing promotes the crystallization of PTQ10 and phase separation of all PTQ10/IDIC, PTQ10/ITIC, and PTQ10/PC71BM devices, leading to an increased power conversion efficiencies (PCEs) of the PTQ10/IDIC and PTQ10/ITIC devices but a decreased PCE of PTQ10/PC71BM devices with 1,8-di-iodooctane (DIO) additive. Without thermal annealing, DIO greatly improves the morphology of PTQ10/PC71BM, leading to a higher PCE. The results show that the degree of phase separation and ordering in the PTQ10-based devices significantly influences device performance. The morphology-property correlations demonstrated will assist in the rational design of these low-cost polymer donor-based solar cells to achieve even higher performance.

Assessment of intracranial pressure monitoring in patients with moderate traumatic brain injury: A retrospective cohort study.

OBJECTIVES: intracranial pressure (ICP) monitoring has now been a standard technique for the treatment of severe traumatic brain injury (sTBI), while the effect of ICP monitoring for moderate traumatic brain injury (mTBI) is not clear. Moreover, evidence comparing the two types of ICP monitoring: ventricular drainage (VD) catheter and intraparenchymal (IP) catheter is scarce. PATIENTS AND METHODS: 91 patients with mTBI were reviewed retrospectively. They were divided into VD, IP and Non-ICP group. Baseline parameters were recorded. The clinical outcome was reflected by Glasgow Outcome Scale (GOS) and mortality at discharge and six months after injury. The rate of surgical decompression, refractory intracranial hypertension, neuroworsening, dose of mannitol and cranial CT were recorded. Meningitis and intracranial hematoma, two major complications of ICP monitoring, were also collected. RESULTS: the three groups showed no significant difference in GOS at discharge and six months after injury. The mortality was similar among the three groups at six months after injury, while the Non-ICP group had the highest mortality at discharge. The Non-ICP group was administered the most mannitol while the VD group was administered the least. The Non-ICP group also received the most cranial CT scans among the three groups. Incidence of meningitis and intracranial hematoma were not significantly different among the VD and IP group. CONCLUSION: use of ICP monitoring could hardly improve the functional outcome of mTBI, but may possibly reduce the in-hospital mortality. By using ICP monitoring, the dose of mannitol and cranial CT scan for mTBI patients may be decreased.

Research and Technological Advances Regarding the Study of the Spread of Antimicrobial Resistance Genes and Antimicrobial-Resistant Bacteria Related to Animal Husbandry.

The extensive use of antimicrobials in animal farms poses serious safety hazards to both the environment and public health, and this trend is likely to continue. Antimicrobial resistance genes (ARGs) are a class of emerging pollutants that are difficult to remove once introduced. Understanding the environmental transfer of antimicrobial-resistant bacteria (ARB) and ARGs is pivotal for creating control measures. In this review, we summarize the research progress on the spread and detection of ARB and ARG pollution related to animal husbandry. Molecular methods such as high-throughput sequencing have greatly enriched the information about ARB communities. However, it remains challenging to delineate mechanisms regarding ARG induction, transmission, and tempo-spatial changes in the whole process, from animal husbandry to multiple ecosystems. As a result, future research should be more focused on the mechanisms of ARG induction, transmission, and control. We also expect that future research will rely more heavily on metagenomic -analysis, metatranscriptomic sequencing, and multi-omics technologies.

Cost-effective and data size-adaptive OPM at intermediated node using convolutional neural network-based image processor.

A cost-effective and data size-adaptive optical performance monitoring (OPM) scheme is proposed, which is based on asynchronous delay-tap plot (ADTP) using convolutional neural network (CNN) from the perspective of image processing. First, we design an OPM framework, based on the electrical domain-processing technique for the future optical networks. These networks include coherent detection-based end-to-end channel monitoring at destination node and direct detection-based transmission link monitoring at intermediate node. Aiming at the link monitoring, CNN is applied to recognize and analyze ADTP images that are converted from two-dimension (2D) digital vectors, so that adaptive to the stable algorithm structure. In simulation system, three high-order modulation formats, 16 quadrature amplitude modulation (QAM), 32QAM, 64QAM, are investigated for optical signal-to-noise ratio (OSNR) estimation and modulation format identification (MFI). The 100% accuracies under different chromatic dispersions (CDs) at different iteration epochs are obtained. Compared with asynchronous amplitude histograms (AAH)-based method, the better accuracy and faster convergence rate are achieved, especially in terms of strong CDs. Additionally, the experimental system is also conducted of 16QAM and 64QAM signals. Based on the partially-trained CNN model from simulation, the OSNR estimation accuracies of 16QAM and 64QAM are 97.81% and 96.56%, respectively. The maximum standard deviation is less than 0.45 dB and the MFI accuracies is 99.84%, presenting the satisfactory results and proving the feasibility of ADTP-based image processor for link monitoring at intermediate nodes.

Simplified synthetic routes for low cost and high photovoltaic performance n-type organic semiconductor acceptors.

The application of polymer solar cells (PSCs) with n-type organic semiconductor as acceptor requires further improving powder conversion efficiency, increasing stability and decreasing cost of the related materials and devices. Here we report a simplified synthetic route for 4,4,9,9-tetrahexyl-4,9-dihydro-s-indaceno [1,2-b:5,6-b'] dithiophene by using the catalyst of amberlyst15. Based on this synthetic route and methoxy substitution, two low cost acceptors with less synthetic steps, simple post-treatment and high yield were synthesized. In addition, the methoxy substitution improves both yield and efficiency. The high efficiency of 13.46% was obtained for the devices with MO-IDIC-2F (3,9-bis(2-methylene-5 or 6-fluoro-(3-(1,1-dicyanomethylene)-indanone)-4,4,9,9-tetrahexyl-5,10-dimethoxyl-4,9-dihydro-s-indaceno[1,2-b:5,6-b'] dithiophene) as acceptor. Based on the cost analysis, the PSCs based on MO-IDIC-2F possess the great advantages of low cost and high photovoltaic performance in comparison with those PSCs reported in literatures. Therefore, MO-IDIC-2F will be a promising low cost acceptor for commercial application of PSCs.

Highly-sensitive carbon disulfide on-line detection system based on deep ultraviolet absorption spectroscopy, and its application in liquid-seal reliability assessment.

This paper investigated a potential instrument for carbon disulfide in situ measurement with high precision and strong anti-interference capability. A compact and automated carbon disulfide detection system was developed using a fiber opto-electronic sensing device. A custom software interface based on LabVIEW was developed. The multi-wavelength least-squares method based on differential optical absorption spectroscopy was employed for improved detection and the anti-interference capabilities of the system. The detection limit of the system (signal-to-noise ratio=3) was determined to be 1 ppb per meter. Using this scheme, the reliability of a liquid-seal was verified to have carbon disulfide leakage. Although the liquid level of the liquid-sealed carbon disulfide showed no significant change over 24 h, a residue concentration of over 30 ppm remained detectable on the surface.

Impact of universal medical insurance system on the accessibility of medical service supply and affordability of patients in China.

BACKGROUND: China's universal medical insurance system (UMIS) is designed to promote social fairness through improving access to medical services and reducing out-of-pocket (OOP) costs for all Chinese. However, it is still not known whether UMIS has a significant impact on the accessibility of medical service supply and the affordability, as well as the seeking-care choice, of patients in China. METHODS: Segmented time-series regression analysis, as a powerful statistical method of interrupted time series design, was used to estimate the changes in the quantity and quality of medical service supply before and after the implementation of UMIS. The rates of catastrophic payments and seeking-care choices for UMIS beneficiaries were selected to measure the affordability and medical service flow of patients after the implementation of UMIS. RESULTS: China's UMIS was established in 2008. After that, the trending increase of the expenditure of the UMIS was higher than that of increase in revenue compared to previous years. Up to 2014, the UMIS had covered 97.5% of the entire population in China. After introduction of the UMIS, there were significant increases in licensed physicians, nurses, and hospital beds per 1000 individuals. In addition, hospital outpatient visits and inpatient visits per year increased compared to the pre-UMIS period. The average fatality rate of inpatients in the overall hospital and general hospital and the average fatality rate due to acute myocardial infarction (AMI) in general hospitals was significantly decreased. In contrast, no significant and prospective changes were observed in rural physicians per 1000 individuals, inpatient visits and inpatient fatality rate in the community centers and township hospitals compared to the pre-UMIS period. After 2008, the rates of catastrophic payments for UMIS inpatients at different income levels were declining at three levels of hospitals. Whichever income level, the rate of catastrophic payments for inpatients of Urban Employee's Basic Medical Insurance was the lowest. For the low-income patients, a single hospitalization at a tertiary hospital can lead to catastrophic payments. It is needless to say what the economic burden could be if patients required multiple hospitalizations within a year. UMIS beneficiaries showed the intention of growth to seek hospitalization services in tertiary hospitals. CONCLUSIONS: Introduction of the UMIS contributed to an increase in available medical services and the use thereof, and a decrease in fatality rate. The affordability of UMIS beneficiaries for medical expenses was successfully ameliorated. The differences in patients' affordability are mainly manifested in different medical insurance schemes and different seeking-care choices. The ability of the poor patients covered by UMIS to resist catastrophic medical payments is still relatively weak. Therefore, the current UMIS should reform the insurance payment model to promote the integration of medical services and the formation of a tiered treatment system. UMIS also should establish supplementary medical insurance packages for the poor.