m6 A RNA methyltransferases METTL3/14 regulate immune responses to anti-PD-1 therapy.

An impressive clinical success has been observed in treating a variety of cancers using immunotherapy with programmed cell death-1 (PD-1) checkpoint blockade. However, limited response in most patients treated with anti-PD-1 antibodies remains a challenge, requiring better understanding of molecular mechanisms limiting immunotherapy. In colorectal cancer (CRC) resistant to immunotherapy, mismatch-repair-proficient or microsatellite instability-low (pMMR-MSI-L) tumors have low mutation burden and constitute ~85% of patients. Here, we show that inhibition of N6 -methyladenosine (m6 A) mRNA modification by depletion of methyltransferases, Mettl3 and Mettl14, enhanced response to anti-PD-1 treatment in pMMR-MSI-L CRC and melanoma. Mettl3- or Mettl14-deficient tumors increased cytotoxic tumor-infiltrating CD8+ T cells and elevated secretion of IFN-γ, Cxcl9, and Cxcl10 in tumor microenvironment in vivo. Mechanistically, Mettl3 or Mettl14 loss promoted IFN-γ-Stat1-Irf1 signaling through stabilizing the Stat1 and Irf1 mRNA via Ythdf2. Finally, we found a negative correlation between METTL3 or METTL14 and STAT1 in 59 patients with pMMR-MSI-L CRC tumors. Altogether, our findings uncover a new awareness of the function of RNA methylation in adaptive immunity and provide METTL3 and METTL14 as potential therapeutic targets in anticancer immunotherapy.

Green space and its types can attenuate the associations of PM2.5 and its components with prediabetes and diabetes-- a multicenter cross-sectional study from eastern China.

BACKGROUND: The effect of fine particulate matter (PM2.5) components on prediabetes and diabetes is of concern, but the evidence is limited and the specific role of different green space types remains unclear. This study aims to investigate the relationship of PM2.5 and its components with prediabetes and diabetes as well as the potential health benefits of different types and combinations of green spaces. METHODS: A multicenter cross-sectional study was conducted in eastern China by using a multi-stage random sampling method. Health screening and questionnaires for 98,091 participants were performed during 2017-2020. PM2.5 and its five components were estimated by the inverse distance weighted method, and green space was reflected by the Normalized Difference Vegetation Index (NDVI), percentages of tree or grass cover. Multivariate logistic regression and quantile g-computing were used to explore the associations of PM2.5 and five components with prediabetes and diabetes and to elucidate the potential moderating role of green space and corresponding type combinations in these associations. RESULTS: Each interquartile range (IQR) increment of PM2.5 was associated with both prediabetes (odds ratio [OR]: 1.15, 95%CI [confidence interval]: 1.10-1.20) and diabetes (OR: 1.18, 95% CI: 1.11-1.25), respectively. All five components of PM2.5 were related to prediabetes and diabetes. The ORs of PM2.5 on diabetes were 1.49 (1.35-1.63) in the low tree group and 0.90 (0.82-0.98) in the high tree group, respectively. In the high tree-high grass group, the harmful impacts of PM2.5 and five components were significantly lower than in the other groups. CONCLUSION: Our study suggested that PM2.5 and its components were associated with the increased risk of prediabetes and diabetes, which could be diminished by green space. Furthermore, the coexistence of high levels of tree and grass cover provided greater benefits. These findings had critical implications for diabetes prevention and green space-based planning for healthy city.

Heatwave characteristics complicate the association between PM2.5 components and schizophrenia hospitalizations in a changing climate: Leveraging of the individual residential environment.

BACKGROUND: In the era characterized by global environmental and climatic changes, understanding the effects of PM2.5 components and heatwaves on schizophrenia (SCZ) is essential for implementing environmental interventions at the population level. However, research in this area remains limited, which highlights the need for further research and effort. We aim to assess the association between exposure to PM2.5 components and hospitalizations for SCZ under different heatwave characteristics. METHODS: We conducted a 16 municipalities-wide, individual exposure-based, time-stratified, case-crossover study from January 1, 2017, to December 31, 2020, encompassing 160736 hospitalizations in Anhui Province, China. Daily concentrations of PM2.5 components were obtained from the Tracking Air Pollution in China dataset. Conditional logistic regression models were used to investigate the association between PM2.5 components and hospitalizations. Additionally, restricted cubic spline models were used to identify protective thresholds of residential environment in response to environmental and climate change. RESULTS: Our findings indicate a positive correlation between PM2.5 and its components and hospitalizations. Significantly, a 1 µg/m3 increase in black carbon (BC) was associated with the highest risk, at 1.58% (95%CI: 0.95-2.25). Exposure to heatwaves synergistically enhanced the impact of PM2.5 components on hospitalization risks, and the interaction varied with the intensity and duration of heatwaves. Under the 99th percentile heatwave events, the impact of PM2.5 and its components on hospitalizations was most pronounced, which were PM2.5 (2-4d: 4.59%, 5.09%, and 5.09%), sulfate (2-4d: 21.73%, 23.23%, and 25.25%), nitrate (2-4d: 17.51%, 16.93%, and 20.31%), ammonium (2-4d: 27.49%, 31.03%, and 32.41%), organic matter (2-4d: 32.07%, 25.42%, and 24.48%), and BC (2-4d: 259.36%, 288.21%, and 152.52%), respectively. Encouragingly, a protective effect was observed when green and blue spaces comprised more than 17.6% of the residential environment. DISCUSSION: PM2.5 components and heatwave exposure were positively associated with an increased risk of hospitalizations, although green and blue spaces provided a mitigating effect.

The impact of hazes on schizophrenia admissions and the synergistic effect with the combined atmospheric oxidation capacity in Hefei, China.

OBJECTIVES: Currently, most epidemiological studies on haze focus on respiratory diseases, cardiovascular diseases, etc. However, the relationship between haze and mental health has not been adequately explored. The purpose of this study was to investigate the influence of hazes on schizophrenia admissions and to further explore the potential interaction effect with the combined atmospheric oxidative indices (Ox and Oxwt). METHODS: We collected 5328 cases during the cold season from 2013 to 2015 in Hefei, China. By integrating the Poisson Generalized Linear Models with the Distributed Lag Non-linear Models, the association between haze and schizophrenia admissions was evaluated. The interaction between hazes and two combined oxidation indexes was tested by stratifying hazes and Ox, and Oxwt. RESULTS: Haze was found to be significantly linked to an increased risk of hospitalization for schizophrenia, and a 9-day lag effect on schizophrenia (lag 3-lag 11), with the largest effect on lag 6 (RR = 1.080, 95% confidence interval (CI): 1.046-1.116). Males, females, and <40 y (people under 40 years old) were sensitive to hazes. Furthermore, in the stratified analysis, we found synergies between two combined oxidation indexes and hazes. The interaction relative risk (IRR) and relative excess risk due to interaction (RERI) between Ox and hazes were 1.170 (95% CI: 1.071-1.277) and 0.149 (95% CI: 0.045-0.253), respectively. For Oxwt, the IRR and RERI were 1.179 (95% CI: 1.087-1.281) and 0.159 (95% CI: 0.056-0.263), respectively. It is noteworthy that this synergistic effect was significant in males and <40 y when examining the various subgroups in the interaction analysis. CONCLUSIONS: Our findings suggest that exposure to haze significantly increases the risk of hospitalization for schizophrenia. More significant public health benefits can be obtained by prioritizing haze periods with high combined atmospheric oxidation capacity.

The global burden of schizophrenia and the impact of urbanization during 1990-2019: An analysis of the global burden of disease study 2019.

BACKGROUND AND HYPOTHESIS: The burden of schizophrenia is increasing. Assessing the global distribution of schizophrenia and understanding the association between urbanization factors and schizophrenia are crucial. STUDY DESIGN: We conducted a two-stage analysis utilizing public data from GBD (global burden of disease) 2019 and the World Bank. First, the distribution of schizophrenia burden at the global, regional, and national levels as well as temporal trends was analyzed. Then, four composite indicators of urbanization (including demographic, spatial, economic, and eco-environment urbanization) were constructed from ten basic indicators. Panel data models were used to explore the relationship between urbanization indicators and the burden of schizophrenia. RESULTS: In 2019, there were 23.6 million people with schizophrenia, an increase of 65.85% from 1990, and the country with the largest ASDR (age-standardized disability adjusted life years rate) was the United States of America, followed by Australia, and New Zealand. Globally, the ASDR of schizophrenia rose with the sociodemographic index (SDI). In addition, six basic urbanization indicators including urban population proportion, employment in industry/services proportion, urban population density, the population proportion in the largest city, GDP, and PM2.5 concentration were positively associated with ASDR of schizophrenia, with the largest coefficients being urban population density. Overall, demographic, spatial, economic, and eco-environment urbanization all had positive effects on schizophrenia, and the estimated coefficients indicated that demographic urbanization was the most significant influence. CONCLUSIONS: This study provided a comprehensive description of the global burden of schizophrenia and explored urbanization as a factor contributing to the variation in the burden of schizophrenia, and highlighted policy priorities for schizophrenia prevention in the context of urbanization.

Association of outdoor artificial light at night with metabolic syndrome and the modifying effect of tree and grass cover.

BACKGROUND: Epidemiological studies show that outdoor artificial light at night (ALAN) is linked to metabolic hazards, but its association with metabolic syndrome (MetS) remains unclear. We aimed to investigate the association of outdoor ALAN with MetS in middle-aged and elderly Chinese. METHODS: From 2017-2020, we conducted a cross-sectional study in a total of 109,452 participants living in ten cities of eastern China. MetS was defined by fasting blood glucose (FG), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), blood pressure (BP), and waist circumference (WC). In 2021, we followed up 4395 participants without MetS at the baseline. Each participant's five-year average exposure to outdoor ALAN, as well as their exposure to green space type, were measured through matching to their address. Generalized linear models were used to assess the associations of outdoor ALAN with MetS. Stratified analyses were performed by sex, age, region, physical activity, and exposure to green space. RESULTS: In the cross-sectional study, compared to the first quantile (Q1) of outdoor ALAN exposure, the odds ratios (ORs) of MetS were 1.156 [95 % confidence interval (CI): 1.111-1.203] and 1.073 (95 %CI: 1.021-1.128) respectively in the third and fourth quantiles (Q3, Q4) of outdoor ALAN exposure. The follow-up study found that, compared to the first quantile (Q1) of outdoor ALAN exposure, the OR of MetS in Q4 of ALAN exposure was 1.204 (95 %CI: 1.019-1.422). Adverse associations of ALAN with MetS components, including high FG, high TG, and obesity, were also found. Greater associations of ALAN with MetS were found in males, the elderly, urban residents, those with low frequency of physical activity, and those living in areas with low levels of grass cover and tree cover. CONCLUSIONS: Outdoor ALAN exposure is associated with an increased MetS risk, especially in males, the elderly, urban residents, those lacking physical activity, and those living in lower levels of grass cover and tree cover.

Association between sequential extreme precipitation-heatwaves events and hospitalizations for schizophrenia: The damage amplification effects of sequential extremes.

OBJECTIVES: In the context of frequent global extreme weather events, there are few studies on the effects of sequential extreme precipitation (EP) and heatwaves (HW) events on schizophrenia. We aimed to quantify the effects of the events on hospitalizations for schizophrenia and compare them with EP and HW alone to explore the amplification effect of successive extremes on health loss. METHODS: A time-series Poisson regression model combined with a distributed lag non-linear model was applied to estimate the association between sequential EP and HW events (EP-HW) and schizophrenia hospitalizations. The effects of EP-HW with different intervals and intensities on the admission of schizophrenia were compared. In addition, we calculated the mean attributable fraction (AF) and attributable numbers (AN) per exposure of extreme events to reflect the amplification effect of sequential extreme events on health hazards compared with individual extreme events. RESULTS: EP-HW increased the risk of hospitalization for schizophrenia, with significant effects lasting from lag0 (RR and 95% CI: 1.150 (1.041-1.271)) to lag11 (1.046 (1.000-1.094)). Significant associations were found in the subgroups of male, female, married people, and those aged≥ 40 years old. Shorter-interval (0-3days) or higher-intensity EP-HW (both precipitation ≥ P97.5 and mean temperature ≥ P97.5) had a longer lag effect compared to EP-HW with longer intervals or lower intensity. We found that the mean AF and AN caused by each exposure to EP-HW (AF: 0.074% (0.015%-0.123%); AN: 4.284 (0.862-7.118)) were higher than those induced by each exposure to HW occurring alone (AF:0.032% (0.004%-0.058%); AN:1.845 (0.220-3.329)). CONCLUSIONS: Sequential extreme precipitation-heatwaves events significantly increase the risk of hospitalizations for schizophrenia, with greater impact and disease burden than independently occurring extremes. The impact of consecutive extremes is supposed to be considered in local sector early warning systems for comprehensive public health decision-making.

Effects of hyperbaric oxygen therapy on postoperative recovery after incomplete cervical spinal cord injury.

STUDY DESIGN: A retrospective study of incomplete cervical spinal cord injury (SCI) treated with and without hyperbaric oxygen (HBO) therapy after operation. OBJECTIVE: To investigate the effects of hyperbaric oxygen therapy on patients' postoperative recovery after incomplete cervical spinal cord injury. SETTING: Shulan Hangzhou Hospital, Hangzhou, China. METHODS: We analyzed the clinical data of 78 patients admitted in the Orthopedic Department of our hospital from June 2014 to June 2016, due to trauma-induced incomplete cervical spinal cord injury. All study subjects underwent nerve decompression and internal fixation procedures within 2 weeks of injury. The patients were divided into hyperbaric oxygen therapy (HBO) group (n = 40) and non-hyperbaric oxygen therapy (NHBO) group (n = 38) according to the chosen treatment option. The NHBO group only receive the conventional treatment regimen while the HBO group received a combination of conventional treatment and hyperbaric oxygen therapy. The subsequent changes in spinal functions and activities of daily living (ADL) were assessed by The American Spinal Injury Association (ASIA) scale and the Barthel Index at different time points (pretreatment, 1 month and 3 months of treatment, as well as 6 months, 1 year, 2 years, and 3 years after the surgical procedure). RESULTS: There were no significant differences in age, gender, injury site, and disease condition between patients (p > 0.05). The results showed a significant difference in treatment total effectiveness rate between the HBO and NHBO groups (p < 0.05) (90% and 78.9%, respectively). Analyses of the ASIA scores and Barthel indices between the two groups indicated significant differences at 1 month and 3 months treatment time points, as well as 6 months and 1 year after the initial operation (p < 0.05). It showed that subjects in the HBO group had a better recovery than their NHBO counterparts, with the 1-month treatment time point being the most significant. In addition, the results indicated significant improvements in Barthel Index scores as well as ASIA sensory and motor function scores in both groups after a 1-month treatment, with the HBO group faring significantly better than the NHBO group (p < 0.01). CONCLUSIONS: Our results not only showed that hyperbaric oxygen therapy is safe and effective for the treatment of incomplete cervical spinal cord injury but also indicated that the longer the treatment lasts (therapy initiation within 3 months after the surgical operation), the better the effects. In addition, a correct hyperbaric oxygen therapy leads to a peak in recovery within the first postoperative 3 months and can effectively promote spinal cord functions, reduce the disabilities, and improve patients' quality of life.

Quality and efficiency of a standardized e-handover system for pediatric nursing: A prospective interventional study.

AIM: This study examined the effect on pediatric nursing handover quality and efficiency when a standardized e-handover system was implemented. BACKGROUND: Handover quality is an important aspect of nursing quality management; however, handover quality among nursing staff is poor. METHODS: A prospective interventional study was carried out in a general pediatrics ward from December 2019 to November 2020. The tools included a standardized e-handover system. The intervention strategies included workflow remodeling and employee training on oral handover using the standardized e-handover system. RESULTS: The omission frequency of critical handover elements decreased from 47.32% to 2.94% (p < .01), among which the omission frequencies of nine out of 16 key elements significantly decreased. Integrity also showed improvement. Specifically, the integrity of five types of critical information was significantly improved, including vital signs, signs and symptoms, laboratory test results, radiologic examination results, and treatment regimen (2.00 vs. 5.00, p < .01; 3.00 vs. 5.00, p < .01; 3.00 vs. 5.00, p < .01; 5.00 vs. 5.00, p = .009; 3.00 vs. 4.00, p < .01, respectively). Information accuracy was 100%. Workflow and efficiency significantly improved, communication duration with patient/family during work hours significantly increased (24.00 vs. 56.00, p < .01), and prehandover preparation duration significantly decreased (32.00 vs. 2.50, p < .01). Nurse handover satisfaction showed improvement (56.88 ± 15.08 vs. 74.31 ± 9.22, p < .01). CONCLUSION: The standardized e-handover system effectively improved nurse handover quality, optimized workflow, increased work efficiency, and promoted teamwork. IMPLICATIONS FOR NURSING MANAGEMENT: Standardized e-handover systems have great potential for ensuring the safety of pediatric patients and improving the quality of handover.

Artificial intelligence-assisted reduction in patients' waiting time for outpatient process: a retrospective cohort study.

BACKGROUND: Many studies suggest that patient satisfaction is significantly negatively correlated with the waiting time. A well-designed healthcare system should not keep patients waiting too long for an appointment and consultation. However, in China, patients spend notable time waiting, and the actual time spent on diagnosis and treatment in the consulting room is comparatively less. METHODS: We developed an artificial intelligence (AI)-assisted module and name it XIAO YI. It could help outpatients automatically order imaging examinations or laboratory tests based on their chief complaints. Thus, outpatients could get examined or tested before they went to see the doctor. People who saw the doctor in the traditional way were allocated to the conventional group, and those who used XIAO YI were assigned to the AI-assisted group. We conducted a retrospective cohort study from August 1, 2019 to January 31, 2020. Propensity score matching was used to balance the confounding factor between the two groups. And waiting time was defined as the time from registration to preparation for laboratory tests or imaging examinations. The total cost included the registration fee, test fee, examination fee, and drug fee. We used Wilcoxon rank-sum test to compare the differences in time and cost. The statistical significance level was set at 0.05 for two sides. RESULTS: Twelve thousand and three hundred forty-two visits were recruited, consisting of 6171 visits in the conventional group and 6171 visits in the AI-assisted group. The median waiting time was 0.38 (interquartile range: 0.20, 1.33) hours for the AI-assisted group compared with 1.97 (0.76, 3.48) hours for the conventional group (p < 0.05). The total cost was 335.97 (interquartile range: 244.80, 437.60) CNY (Chinese Yuan) for the AI-assisted group and 364.58 (249.70, 497.76) CNY for the conventional group (p < 0.05). CONCLUSIONS: Using XIAO YI can significantly reduce the waiting time of patients, and thus, improve the outpatient service process of hospitals.

Transition-Metal-Free Three-Component Reaction: Additive Controlled Synthesis of Sulfonylated Imidazoles.

Two efficient transition-metal-free highly regioselective pathways for constructing sulfonylated imidazoles via three-component reactions of amidines, ynals, and sodium sulfonates have been developed. The generations of different sulfonylated imidazoles were simply controlled by additives. In addition, this method features environmental friendliness, good functional group tolerance, and high atom economy, which makes it practical.

Interventional therapy combined with tyrosine kinase inhibitors with or without immune checkpoint inhibitors as initial treatment for hepatocellular carcinoma with portal vein tumor thrombosis: a systematic review and meta-analysis.

BACKGROUND: Interventional therapy, in conjunction with tyrosine kinase inhibitors (TKIs), has shown promising outcomes for treating hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT). With the advent of immunotherapy, the combined use of immune checkpoint inhibitors (ICIs) has attracted great attention due to their potential effectiveness in advanced HCC. This study aims to compare the efficacy and safety of a triple therapy regimen (Interventional therapy, TKIs and ICIs, IT-TKI-ICI) with a dual therapy regimen (Interventional therapy and TKIs, IT-TKI) in the treatment of HCC and PVTT (HCC-PVTT). METHODS: A comprehensive search was carried out in PubMed, Web of Science, Embase, Scopus, and the Cochrane Library databases. Primary outcome measures were overall survival (OS) and progression-free survival (PFS), while secondary outcomes included tumor response rate, adverse event incidence as well as downstaging surgery rate. Statistical analysis was conducted using Revman 5.4 software. RESULTS: The meta-analysis finally included 6 cohort studies. The triple therapy group demonstrated significantly prolonged OS and PFS compared to the dual therapy group. Meanwhile, the former exhibited significantly higher rates of objective response rate (ORR), disease control rate (DCR) and better downstaging effects with a higher salvage surgery rate without significantly increasing adverse events. CONCLUSION: In comparison to dual therapy, the triple therapy with interventional therapy, TKIs, and ICIs demonstrates superior efficacy and equivalent safety for HCC-PVTT.

Feasibility and Diagnostic Performance of Functional SYNTAX Score Derived From Dynamic CT Myocardial Perfusion Imaging.

BACKGROUND: Computed tomography (CT) fractional flow reserve (FFR)-derived functional SYNTAX score (FSSCT-FFR) is a valuable method for guiding treatment strategy in patients with multivessel coronary artery disease. Dynamic CT myocardial perfusion imaging (CT-MPI) demonstrates higher diagnostic accuracy than CT-FFR in identifying hemodynamically significant coronary artery disease. We aimed to evaluate the feasibility of CT-MPI-derived FSS (FSSCT-MPI) with reference to invasive FSS. METHODS: In this retrospective study, patients with multivessel coronary artery disease who underwent dynamic CT-MPI+ coronary CT angiography and invasive coronary angiography or FFR within 4 weeks were consecutively included. Invasive (FSSinvasive) and noninvasive FSS (FSSCT-MPI and FSSCT-FFR) were calculated by an online calculator, which assigned points to lesions with hemodynamic significance (defined as FFRinvasive ≤0.80, invasive coronary angiography diameter stenosis ≥90%, CT-FFR ≤0.80, and myocardial ischemia on CT-MPI). Weighted κ value and net reclassification index were calculated to determine the consistency and incremental discriminatory power of FSSCT-MPI. Receiver operating characteristic curve analysis was used for the comparison of FSSCT-MPI and FSSCT-FFR in detecting intermediate- to high-risk patients. RESULTS: A total of 119 patients (96 men; 64.6±10.6 years) with 305 obstructive lesions were included. The average FSSCT-MPI, FSSCT-FFR, and FSSinvasive were 15.58±13.03, 16.18±13.30, and 13.11±12.22, respectively. The agreement on risk classification based on the FSSCT-MPI tertiles was good (weighted κ, 0.808). With reference to FSSinvasive, FSSCT-MPI correctly reclassified 27 (22.7%) patients from the intermediate- to high SYNTAX score group to the low-score group (net reclassification index, 0.30; P<0.001). In patients with severe calcification, FSSCT-MPI had better diagnostic value than FSSCT-FFR in detecting intermediate- to high-risk patients when compared with FSSinvasive (area under the curve, 0.976 versus 0.884; P<0.001). CONCLUSIONS: Noninvasive FSS derived from CT-MPI is feasible and has strong concordance with FSSinvasive. It allows accurate categorization of FSS in patients with multivessel coronary artery disease, in particular with severe calcification.

The correlation between selenium intake and lung function in asthmatic people: a cross-sectional study.

Objective: This study aimed to examine the correlation between selenium intake and lung function in asthmatic people. Methods: A total of 4,541 individuals in the US National Health and Nutrition Examination Survey (NHANES) were included in this study. Multivariate linear regression, variance inflation factor, restricted cubic splines and quantile regression were used to analyze the relationship between Se intake and lung function. We divided selenium intake into four levels based on quartiles: Q1: Se ≤ 76.75 mcg/d; Q2: 76.75-105.1 mcg/d; Q3: 105.1-137.65 mcg/d; and Q4: Se ≥137.65 mcg/d. Results: Asthma was negatively associated with the Ratio of Forced Expiratory Volume 1st Second to Forced Vital Capacity (FEV1/FVC) (ß = -0.04, 95% CI: -0.06 to -0.02) and FEV1 (ß = -215, 95% CI: -340 to -90). Se intake was positively associated with Forced Expiratory Volume 1st Second (FEV1) (ß =3.30 95% CI: 2.60 to 4.00) and Forced Vital Capacity (FVC) (ß =4.30, 95% CI: 3.50 to 5.10). In asthmatic individuals, the positive effects of Se intake on FVC were enhanced with increasing Se intake, while the positive effects of Se intake on FEV1 varied less dramatically. High Se intake (Q4 level, above 137.65 mcg/d) improved FVC (ß = 353, 95% CI: 80 to 626) and FEV1 (ß = 543, 95% CI: 118 to 969) in asthmatic patients compared to low Se intake (Q1 level, below 76.75 mcg/d). At the Q2 level (76.75-105.1 mcg/d) and Q4 level (Se ≥137.65 mcg/d) of Se intake, the correlation between FEV1 and asthma disappeared. Conclusion: Our research has revealed a positive correlation between selenium intake and lung function in asthma patients and the strength of this positive correlation is related to the amount of selenium intake. We recommend that asthma patients consume 137.65 mcg to 200 mcg of selenium daily to improve pulmonary function while avoiding the adverse effects of selenium on the human body.

Atrial Septal Defect Detection in Children Based on Ultrasound Video Using Multiple Instances Learning.

Thoracic echocardiography (TTE) can provide sufficient cardiac structure information, evaluate hemodynamics and cardiac function, and is an effective method for atrial septal defect (ASD) examination. This paper aims to study a deep learning method based on cardiac ultrasound video to assist in ASD diagnosis. We chose four standard views in pediatric cardiac ultrasound to identify atrial septal defects; the four standard views were as follows: subcostal sagittal view of the atrium septum (subSAS), apical four-chamber view (A4C), the low parasternal four-chamber view (LPS4C), and parasternal short-axis view of large artery (PSAX). We enlist data from 300 children patients as part of a double-blind experiment for five-fold cross-validation to verify the performance of our model. In addition, data from 30 children patients (15 positives and 15 negatives) are collected for clinician testing and compared to our model test results (these 30 samples do not participate in model training). In our model, we present a block random selection, maximal agreement decision, and frame sampling strategy for training and testing respectively, resNet18 and r3D networks are used to extract the frame features and aggregate them to build a rich video-level representation. We validate our model using our private dataset by five cross-validation. For ASD detection, we achieve 89.33 ± 3.13 AUC, 84.95 ± 3.88 accuracy, 85.70 ± 4.91 sensitivity, 81.51 ± 8.15 specificity, and 81.99 ± 5.30 F1 score. The proposed model is a multiple instances learning-based deep learning model for video atrial septal defect detection which effectively improves ASD detection accuracy when compared to the performances of previous networks and clinical doctors.

Impaired thyroid hormone sensitivity exacerbates the effect of PM2.5 and its components on dyslipidemia in schizophrenia.

BACKGROUND: Dyslipidemia in schizophrenia causes a serious loss of healthy life expectancy, making it imperative to explore key environmental risk factors. We aimed to assess the effect of PM2.5 and its constituents on dyslipidemia in schizophrenia, identify the critical hazardous components, and investigate the role of impaired thyroid hormones (THs) sensitivity in this association. METHODS: We collected disease data on schizophrenia from the Anhui Mental Health Center from 2019 to 2022. Logistic regression was constructed to explore the effect of average annual exposure to PM2.5 and its components [black carbon (BC), organic matter (OM), sulfate (SO42-), ammonium (NH4+), and nitrate (NO3-)] on dyslipidemia, with subgroup analyses for age and gender. The degree of impaired THs sensitivity in participants was reflected by the Thyroid Feedback Quantile-based Index (TFQI), and its role in the association of PM2.5 components with dyslipidemia was explored. RESULTS: A total of 5125 patients with schizophrenia were included in this study. Exposure to PM2.5 and its components (BC, OM, SO42-, NH4+, and NO3-) were associated with dyslipidemia with the odds ratios and 95 % confidence interval of 1.13 (1.04, 1.23), 1.16 (1.07, 1.26), 1.15 (1.06, 1.25), 1.11 (1.03, 1.20), 1.09 (1.00, 1.18), 1.12 (1.04, 1.20), respectively. Mixed exposure modeling indicated that BC played a major role in the effects of the mixture. More significant associations were observed in males and groups <45 years. In addition, we found that the effect of PM2.5 and its components on dyslipidemia was exacerbated as impaired THs sensitivity in the patients. CONCLUSIONS: Exposure to PM2.5 and its components is associated with an increased risk of dyslipidemia in schizophrenia, which may be exacerbated by impaired THs sensitivity. Our results suggest a new perspective for the management of ambient particulate pollution and the protection of thyroid function in schizophrenia.

Cross-subject EMG hand gesture recognition based on dynamic domain generalization.

Electromyography (EMG) signal based cross-subject gesture recognition methods reduce the influence of individual differences using transfer learning technology. These methods generally require calibration data collected from new subjects to adapt the pre-trained model to existing subjects. However, collecting calibration data is usually trivial and inconvenient for new subjects. This is currently a major obstacle to the daily use of hand gesture recognition based on EMG signals. To tackle the problem, we propose a novel dynamic domain generalization (DDG) method which is able to achieve accurate recognition on the hand gesture of new subjects without any calibration data. In order to extract more robust and adaptable features, a meta-adjuster is leveraged to generate a series of template coefficients to dynamically adjust dynamic network parameters. Specifically, two different kinds of templates are designed, in which the first one is different kinds of features, such as temporal features, spatial features, and spatial-temporal features, and the second one is different normalization layers. Meanwhile, a mix-style data augmentation method is introduced to make the meta-adjuster's training data more diversified. Experimental results on a public dataset verify that the proposed DDG outperforms the counterpart methods.

Clinical outcomes of robotic-assisted and manual total hip arthroplasty in the same patient: A case report.

BACKGROUND: Total hip arthroplasty (THA) is an effective treatment for advanced osteonecrosis of the femoral head, which can significantly relieve pain and improve patients' quality of life. Robotic-assisted THA enhances the accuracy and stability of THA surgery and achieves better clinical outcomes than manual THA. CASE SUMMARY: We report the clinical outcomes of robotic-assisted THA and manual THA in the same patient with osteonecrosis of the femoral head. A 49-year-old male patient attended our hospital due to more than 3 years of pain in both hip joints. The left hip was treated with robotic-assisted THA. The patient underwent manual THA of the right hip 3 mo after robotic-assisted THA. We obtained postoperative radiograph parameters, Harris hip score and forgotten joint score of the patient 1 year after surgery. CONCLUSION: Compared with manual THA, the patient's left hip felt better 1 year after robotic-assisted THA. Robotic-assisted THA resulted in a better Harris hip score and forgotten joint score than manual THA in the same patient with osteonecrosis of the femoral head.

Young people exposure to antibiotics: Implication for health risk and the impact from eating habits of takeaway food.

Exposure to antibiotics, mainly from animal food ingestion, may have adverse effects on human health. Takeaway food is the preferred choice for the dietary of most Chinese young people nowadays, but the relationship between takeaway eating and antibiotic exposure is not yet adequately understood. In the present study, 297 young people were recruited to collect urine samples and questionnaires with an emphasis on their takeaway eating habits. The internal exposure to 16 antibiotics and three metabolites was measured in urine samples by high-performance liquid chromatography-tandem mass spectrometry, as well as a DNA oxidative damage marker, 8-hydroxydeoxyguanosine (8-OHdG). At least one kind of antibiotic was found in over 90 % of urine samples, with total concentrations from 0.667 to 3.02 × 104 ng/mL. High exposure levels of antibiotics were more likely to be found in individuals with a larger body mass index. The concentrations of six antibiotics were significantly different among people with different overall weekly eating frequencies, usually an upward trend. The estimated daily intakes of antibiotics were on the levels of 0.001-1.0 µg/kg/day, mainly contributed by clarithromycin, ciprofloxacin and oxytetracycline, indicating a potential health risk based on the microbiological effect. A significantly positive correlation was found between DNA oxidative damage and exposure for four categories of antibiotics, conformed by both Spearman correlation and multiple linear regression analysis. The levels of 8-OHdG were 355 %, 239 %, 234 %, and 334 % higher with elevated levels of phenicols, macrolides, tetracyclines and sulfonamides from quartiles 2 to 4. Our results suggest that high-frequency consumption of takeaways may exacerbate oxidative stress trends through human exposure to antibiotics.

Association of residential greenness with chronotype among children.

BACKGROUND: The association between residential greenness and chronotype remains unclear, especially among children. The current study aimed to explore the associations between residential greenness and chronotype parameters in children and examine potential pathways for these associations. METHODS: In this cross-sectional study, 16,421 children ages 3-12 were included. Two satellite-derived vegetation indices, i.e., the normalized difference vegetation index (NDVI) and the enhanced vegetation index (EVI), were used to estimate residential greenness. The mid-sleep point on a workday (MSW) and the mid-sleep point on free days (MSF) were considered. And mid-sleep time on free days adjusted for sleep debt (MSFsc) was used as an indicator of chronotype. In addition to multivariable linear regression models, subgroup analyses were conducted to explore effect modifiers, and mediation analyses were used to explore possible mediating mechanisms of air pollutants underlying the associations. RESULTS: An interquartile range (IQR) increase in both NDVI500-m and EVI500-m was significantly associated with an earlier MSFsc of -0.061 (95 % confidence interval (CI): -0.072, -0.049) and -0.054 (95 % CI: -0.066, -0.042), respectively. Non-linear dose response relationships were discovered between greenness indices and MSFsc and MSF. The results of stratified analyses showed the effect of residential greenness on MSW was stronger among primary school children and individuals with higher household income than among kindergarten children and those with lower household income. The joint mediation effects of PM2.5, PM1, PM10, NO2, and SO2 on the associations of NDVI500-m and EVI500-m with MSFsc were 89.6 % and 76.0 %, respectively. CONCLUSIONS: Higher levels of residential greenness may have beneficial effects on an earlier chronotype in the child population, by reducing the effects of air pollutants, especially PM2.5. Our research hopes to promote the deployment of green infrastructure and healthy urban design strategies.