Evaluation of the Influence of Varied Juncao Grass Substrates on Physiological and Enzymatic Reactions of Pleurotus ostreatus.

Pleurotus ostreutus is one of the world's most commonly consumed mushrooms. The cultivation of mushrooms using wood resources usually results in environmental issues such as deforestation. Juncao grasses, namely (JJ) Cenchrus fungigraminus, (AR) Saccharum arundinaceum, and (MS) Miscanthus floridulus, supplemented with 20% wheat brain, 1% ground coffee, 1% gysum, and 1% lime, were used as the culture mediums in this research, which offers a composting system with a simple formulation that is cheap and feasible for small farms to use in cultivating oyster mushrooms. The present study assessed the different juncao grasses as substrates for growing Pleurotus ostreatus given their enzyme activities, growth, and yields. The results demonstrated that the yields of pleurotus ostreatus grown on JJ, AR, and MS substrates were significantly different at the level of 0.05 and were recorded as follows: 159.2 g/bag, 132 g/bag, and 65.1 g/bag on average, respectively. The biological efficiency of Pleurotus ostreatus cultivated in three different substrates was 75.2%, 63.4%, and 28.7%, respectively. Lignin peroxidase (LiP) was the most active enzyme in each culture material among the other enzyme activities expressed differently between the substrate and growing stages. At the same time, other enzyme activities were differently expressed between the substrate and different developmental stages. Nutrient analysis revealed significant variations, with differences in polysaccharides, proteins, and amino acids among substrates, as well as the presence of heavy metals such as arsenic, lead, mercury, and cadmium in all samples within safe limits. The obtained results indicated that Saccharum arundinaceum is a good substrate in place of Cenchrus fungigraminus, and that using Miscanthus floridulus is not productive. Moreover, the juncao grasses offer a sustainable approach that reduces reliance on wood-based substrates and enhances environmental sustainability.

Health-related quality of life in Chinese individuals with type 2 diabetes mellitus: a multicenter cross-sectional study.

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a chronic and life-threatening disease. Health-related quality of life (HRQoL) is vital for individuals with T2DM. However, little is known about the impact of psychological stability factors on HRQoL among individuals with T2DM in mainland China. METHODS: This multicenter cross-sectional study was conducted in five tertiary grade-A hospitals in Chongqing, China, from January to December 2019. A total of 385 individuals with T2DM were included by the convenient sample method. Fear of Progression (FOP) Questionnaire-short Form, Hypoglycemia Fear Survey II, diabetes-management self-efficacy scale, and EuroQol-5 Dimensions were used for data collection. RESULTS: The mean age of the 385 individuals was 57.65 (SD = 15.15) years, three-quarters of whom had a high school or above education level. The participants in our study had moderate HRQoL and were more likely to have poor scores in the pain/discomfort dimension. The FOP level was moderate on average, and 23.1% of individuals suffered from psychological dysfunction. The participants had higher levels of fear of hypoglycemia (FOH) and self-efficacy (SE). Multiple steppage-regression analysis predicted that higher levels of FOP and FOH, reduced SE, older age, longer duration since diagnosis, lower educational attainment, higher levels of HbA1c, and living with comorbid conditions were related to lower HRQoL. CONCLUSION: This study showed that the HRQoL among Chinese T2DM patients may be impaired by increased FOP and FOH, decreased SE, and poor glycemic control. In addition, as the patient's age and duration since diagnosis increase, their HRQoL further declines. We recommend improving HRQoL by encouraging individuals to attain more health education and resilience skills to enhance SE and reduce negative emotions among individuals with T2DM.

Collimating the growth of twisted crystals of achiral compounds.

A great proportion of molecular crystals can be made to grow as twisted fibrils. Typically, this requires high crystallization driving forces that lead to spherulitic textures. Here, it is shown how micron size channels fabricated from poly(dimethylsiloxane) (PDMS) serve to collimate the circular polycrystalline growth fronts of optically banded spherulites of twisted crystals of three compounds, coumarin, 2,5-bis(3-dodecyl-2-thienyl)-thiazolo[5,4-d]thiazole, and tetrathiafulvalene. The relationships between helicoidal pitch, growth front coherence, and channel width are measured. As channels spill into open spaces, collimated crystals "diffract" via small angle branching. On the other hand, crystals grown together from separate channels whose bands are out of phase ultimately become a single in-phase bundle of fibrils by a cooperative mechanism yet unknown. The isolation of a single twist sense in individual channels is described. We forecast that such chiral molecular crystalline channels may function as chiral optical wave guides.

Effect of empathy competence on moral sensitivity in Chinese student nurses: the mediating role of emotional intelligence.

BACKGROUND: Ethical issues may pose challenges to nursing students entering clinical practice. Moral sensitivity can assist them in recognising existing moral situations and then taking adequate action. Identifying the variables associated with moral sensitivity may be useful in preparing to improve nursing students' moral sensitivity. OBJECTIVES: This study investigated empathy, emotional intelligence, and moral sensitivity in Chinese student nurses to explore the association among these three factors and to verify the mediating function of emotional intelligence in determining the connection between empathy and moral sensitivity. DESIGN: This study used a cross-sectional correlational design. SETTING AND PARTICIPANTS: Through convenience sampling, 239 fourth-year nursing undergraduates at a university in Western China were enrolled in this study. METHODS: Nursing students who volunteered to participate in the study completed self-reported scales on empathy, emotional intelligence, and moral sensitivity between September and October 2022. The potential mediating effect was explored using the Process Macro and bootstrap method. RESULTS: The nursing students' average scores were 39.62 ± 5.27 on moral sensitivity, 108.21 ± 15.49 on empathy, and 124.41 ± 13.66 on EI. Moral sensitivity was positively correlated with emotional intelligence (r = 0.454, p < 0.001) and empathy (r = 0.545, p < 0.001). Furthermore, empathy exerted a substantial direct effect on nursing students' moral sensitivity (B = 0.1424, p < 0.001). Emotional intelligence could mediate the indirect path from empathy to moral sensitivity. (B = 0.0372, p < 0.001). CONCLUSION: Emotional intelligence mediated the association between empathy and moral sensitivity. Thus, educational activities and programmes placing an emphasis on empathy and emotional intelligence may offer an alternative way to promote moral sensitivity in Chinese student nurses. IMPLICATIONS: Nursing educators can organise programmes to improve nursing students' emotional competence and professional values. Early exposure to clinical practice benefits nursing students a lot in terms of building interactions with patients and increasing emotional resonance. In addition, nursing educators should develop situational teaching in nursing ethics courses to help students cope with ethical issues.

Diagnosis of cardiac abnormalities based on phonocardiogram using a novel fuzzy matching feature extraction method.

BACKGROUND: The diagnosis of cardiac abnormalities based on heart sound signal is a research hotspot in recent years. The early diagnosis of cardiac abnormalities has a crucial significance for the treatment of heart diseases. METHODS: For the sake of achieving more practical clinical applications of automatic recognition of cardiac abnormalities, here we proposed a novel fuzzy matching feature extraction method. First of all, a group of Gaussian wavelets are selected and then optimized based on a template signal. Convolutional features of test signal and the template signal are then computed. Matching degree and matching energy features between template signal and test signal in time domain and frequency domain are then extracted. To test performance of proposed feature extraction method, machine learning algorithms such as K-nearest neighbor, support vector machine, random forest and multilayer perceptron with grid search parameter optimization are constructed to recognize heart disease using the extracted features based on phonocardiogram signals. RESULTS: As a result, we found that the best classification accuracy of random forest reaches 96.5% under tenfold cross validation using the features extracted by the proposed method. Further, Mel-Frequency Cepstral Coefficients of phonocardiogram signals combing with features extracted by our algorithm are evaluated. Accuracy, sensitivity and specificity of integrated features reaches 99.0%, 99.4% and 99.7% respectively when using support vector machine, which achieves the best performance among all reported algorithms based on the same dataset. On several common features, we used independent sample t-tests. The results revealed that there are significant differences (p < 0.05) between 5 categories. CONCLUSION: It can be concluded that our proposed fuzzy matching feature extraction method is a practical approach to extract powerful and interpretable features from one-dimensional signals for heart sound diagnostics and other pattern recognition task.

Identification of prognostic alternative splicing signatures in hepatitis B or/and C viruses related hepatocellular carcinoma.

BACKGROUND: Alternative splicing (AS) takes a crucial part in tumor process. We aim to analyze AS in Hepatitis B virus (HBV) or/and hepatitis C virus (HCV) related hepatocellular carcinoma (HCC). METHODS: Cox regression analysis was conducted to screen survival-associated AS events. The receiver operating characteristic curve used to evaluate the predictive accuracy. Splicing network was built to investigate the relationship between splicing factors and AS events. RESULTS: Ninety-six survival-associated AS events were obtained by univariate Cox regression. Final prognostic model could significantly distinguish the prognosis. We identified RBFOX2 as the hub gene in splicing network based on differentially expressed splicing factors, and obtained MAP3K13_AT as the key AS event in survival-related splicing network. CONCLUSION: Our results highlight the AS signatures in HCC patients with HBV or/and HCV infection. Meanwhile, AS events and splicing factors in different virus-infected HCC subgroups can provide novel perspectives as biomarkers and individualized therapeutic targets.

A new method for identification of traditional Chinese medicine constitution based on tongue features with machine learning.

BACKGROUND: The theory of Chinese medicine (TCM) constitution contributes to the optimisation of individualised healthcare programmes. However, at present, TCM constitution identification mainly relies on inefficient questionnaires with subjective bias. Efficient and accurate TCM constitution identification can play an important role in individualised medicine and healthcare. OBJECTIVE: Building an efficient model for identifying traditional Chinese medicine constitutions using objective tongue features and machine learning techniques. METHODS: The DS01-A device was applied to collect tongue images and extract features. We trained and evaluated five machine learning models: Support Vector Machine (SVM), Decision Tree (DT), Random Forest (RF), LightGBM (LGBM), and CatBoost (CB). Among these, we selected the model with the best performance as the base classifier for constructing our heterogeneous ensemble learning model. Using various performance metrics, including classification accuracy, precision, recall, F1 score, and area under curve (AUC), to comprehensively evaluate model performance. RESULTS: A total of 1149 tongue images were obtained and 45 features were extracted, forming dataset 1. RF, LGBM, and CB were selected as the base learners for the RLC-Stacking. On dataset 1, RLC-Stacking1 achieved an accuracy of 0.8122, outperforming individual classifiers. After feature selection, the classification accuracy of RLC-Stacking2 improved to 0.8287, an improvement of 0.00165 compared to RLC-Stacking1. RLC-Stacking2 achieved an accuracy exceeding 0.85 for identifying each TCM constitution type, indicating excellent identification performance. CONCLUSION: The study provides a reliable method for the accurate and rapid identification of TCM constitutions and can assist clinicians in tailoring individualized medical treatments based on personal constitution types and guide daily health care. The information extracted from tongue images serves as an effective marker for objective TCM constitution identification.

Global trends and hotspots of ulcerative colitis based on bibliometric and visual analysis from 1993 to 2022.

Ulcerative colitis (UC) has seen a significant increase over the past 3 decades. However, our understanding of its etiology, pathogenesis, and pharmacological treatment remains limited. This comprehensive review aims to address these gaps by analyzing trends, evaluating previous research, and providing insights for future investigations. We conducted a bibliometric analysis of UC-related papers indexed in the Web of Science from 1993 to 2022. The author, organization, country, and keyword networks in the field of UC were visualized. A total of 36,483 papers were included, showing a continuous upward trend. Most research on UC was conducted in universities, with hospitals leading in high-quality studies. The United States emerged as the primary contributor, followed by China and the United Kingdom. The overall quality of UC-related publications improved, indicating sustained interest in the field. The keywords related to UC was classified into 9 clusters. Keywords detection revealed that UC research focused mainly on the discovery of its etiology and exploration of treatment methods, with research directions evolving from initial treatment of UC and related diseases to clinical trials of UC and subsequently incorporating genomics and bioinformatics techniques to study UC and explore new therapeutic methods and drugs, including recent advances in gut microbiota. Our study identified gaps in understanding the etiology, pathogenesis, and treatment of UC. Future research in UC should focus on genomics, personalized treatment, microbial therapy and leveraging machine learning and artificial intelligence. These areas hold the potential for improving UC diagnosis, treatment, and management.

Coherence in Polycrystalline Thin Films of Twisted Molecular Crystals.

Helicoidal crystallites in rhythmically banded spherulites manifest spectacular optical patterns in small molecules and polymers. It is shown that concentric optical bands indicating crystallographic orientations typically lose coherence (in-phase twisting) with growth from the center of nucleation. Here, coherence is shown to increase as the twist period decreases for seven molecular crystals grown from the melt. This dependence was correlated to crystallite fiber thickness and length, as well as crystallite branching frequency, a parameter that was extracted from scanning electron micrographs, and supported by numerical simulations. Hole mobilities for 2,5-didodecyl-3,6-di(thiophen-2-yl)pyrrolo[3,4-c]pyrrole-1,4(2H,5H)-dione (DPP-C12) measured by using organic field-effect transistors demonstrated that more incoherent boundaries between optical bands in spherulites lead to higher charge transport for films with the same twist period. This was rationalized by combining our growth model with electrodynamic simulations. This work illustrates the emergence of complexity in crystallization processes (spherulite formation) that arises in the extra variable of helicoidal radial twisting. The details of the patterns analyzed here link the added complexity in crystal growth to the electronic and optical properties of the thin films.

Barriers and facilitators of nurse-led self-management support for adolescents with epilepsy: A mixed-methods study in transition preparation.

Aims: To gain insight into the readiness for evidence-based practice of self-management support during transition for adolescents with epilepsy among pediatric nurses, and to explore the promoting and hindering factors. Design: A mixed-methods design with an explanatory sequential approach was employed. Setting: Three specialty children's hospitals in southwest regions of China. Methods: In phase 1, a total of 126 participants were included in the Survey of Clinical Readiness of Evidence-Based Nursing Assessment (CREBNA) from Dec 2022 to Feb 2023. Total scale and subscale scores were calculated. In phase 2, we developed the interview outline based on the analysis of the quantitative results. In-depth interviews (n = 15) were conducted from Feb 2023 to Apr 2023 to explain and supplement the quantitative phase results. Results: The total score of CREBNA indicated that teams have good readiness and capacity for implementation of evidence-based nursing practice Compared with the norm. The scores of the three subscales of evidence factors, organizational environment, and promoting factors were normal. In subsequent interviews and integration, we extracted four themes based on the Knowledge-To-Action (KTA) framework: 1. organization barriers (incentive mechanism, interdisciplinary cooperation process, information aids); 2. operational barriers (Exemplary evidence-based practice, time pressure, gaps in patient and family understanding of evidence); 3. individual-level barriers (evidence-based and professional knowledge reserve, professional autonomy, shared decision-making roles, dependence on habitual clinical behaviors); and 4. facilitating factors (leadership commitment, self-management identity, transition service needs, patient- and family-centered care culture). A conceptual model was constructed based on the KTA. Conclusion: It is feasible to carry out evidence-based practice of nurse-led self-management support in transition preparation. Nursing researchers and managers should carry out knowledge selection and tailoring based on barriers at the organizational, operational, and individual levels to promote favorable factors and improve the smooth transition of adolescents with chronic diseases.

Leveling up Organic Semiconductors with Crystal Twisting.

The performance of crystalline organic semiconductors depends on the solid-state structure, especially the orientation of the conjugated components with respect to device platforms. Often, crystals can be engineered by modifying chromophore substituents through synthesis. Meanwhile, dissymetry is necessary for high-tech applications like chiral sensing, optical telecommunications, and data storage. The synthesis of dissymmetric molecules is a labor-intensive exercise that might be undermined because common processing methods offer little control over orientation. Crystal twisting has emerged as a generalizable method for processing organic semiconductors and offers unique advantages, such as patterning of physical and chemical properties and chirality that arises from mesoscale twisting. The precession of crystal orientations can enrich performance because achiral molecules in achiral space groups suddenly become candidates for the aforementioned technologies that require dissymetry.

Long-Term Benefits of Cenchrus fungigraminus Residual Roots Improved the Quality and Microbial Diversity of Rhizosphere Sandy Soil through Cellulose Degradation in the Ulan Buh Desert, Northwest China.

Long-term plant residue retention can effectively replenish soil quality and fertility. In this study, we collected rhizosphere soil from the residual roots of annual Cenchrus fungigraminus in the Ulan Buh Desert over the past 10 years. The area, depth, and length of these roots decreased over time. The cellulose content of the residual roots was significantly higher in the later 5 years (2018-2022) than the former 5 years (2013-2017), reaching its highest value in 2021. The lignin content of the residual roots did not differ across samples except in 2015 and reached its highest level in 2021. The total sugar of the residual roots in 2022 was 227.88 ± 30.69 mg·g-1, which was significantly higher than that in other years. Compared to the original sandy soil, the soil organic matter and soil microbial biomass carbon (SMBC) contents were 2.17-2.41 times and 31.52-35.58% higher in the later 3 years (2020-2022) and reached the highest values in 2020. The residual roots also significantly enhanced the soil carbon stocks from 2018-2022. Soil dehydrogenase, nitrogenase, and N-acetyl-ß-D-glucosidase (S-NAG) were significantly affected from 2019-2022. The rhizosphere soil community richness and diversity of the bacterial and fungal communities significantly decreased with the duration of the residual roots in the sandy soil, and there was a significant difference for 10 years. Streptomyces, Bacillus, and Sphigomonas were the representative bacteria in the residual root rhizosphere soil, while Agaricales and Panaeolus were the enriched fungal genera. The distance-based redundancy analysis and partial least square path model results showed that the duration of residual roots in the sandy soil, S-NAG, and SMBC were the primary environmental characteristics that shaped the microbial community. These insights provide new ideas on how to foster the exploration of the use of annual herbaceous plants for sandy soil improvement in the future.

Factors associated with caregiver burden among family caregivers of children with cerebral palsy: a systematic review.

OBJECTIVES: To identify caregiver and children factors associated with caregiver burden on primary caregivers of children with cerebral palsy (CP). DESIGN: Systematic review DATA SOURCES: Seven electronic databases, including PubMed, Cochrane Library, Scopus, PsycINFO, Web of Science, CINAHL and Embase, were systematically searched up to 1 February 2023. ELIGIBILITY CRITERIA: Original observational studies reporting caregiver burden and related factors among caregivers of children with CP. DATA ABSTRACTION AND SYNTHESIS: Two reviewers independently screened results and assessed the quality of studies. Title, abstract, full-text screening and data abstraction were done independently by two reviewers. Risk of bias was assessed using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies. The quality of evidence for factors was rated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS: 16 articles were included in the review. All studies were cross-sectional and examined caregiver-reported burden measures. The Zarit Burden Interview was the most commonly used questionnaire. Depression of caregiver and severity of illness in children with CP were moderate quality of evidence for factors contributing to caregiver burden. CONCLUSIONS: Higher caregiver burden is associated with more depressive feelings and worse life quality of the caregiver, and with more severe physical disability of the children. Future studies should focus on high-quality longitudinal research and appropriate assistance to reduce caregiver burden and improve the quality of caregiving for children with CP. PROSPERO REGISTRATION NUMBER: CRD42021268284.

Effectiveness of narrative pedagogy in developing nursing undergraduates' humanistic care ability for hospitalized children: A mixed-method study.

Background: The development of nursing students' ability to care for children is an important part of their nursing education. However, nursing students' understanding of children's experiences in healthcare is vague. The traditional lecture approach is not conducive to the cultivation of humanistic care competencies for hospitalized children. Objectives: This study aimed at exploring the effectiveness of narrative pedagogy on developing nursing students' ability to care for hospitalized children. Design: A quasi-experimental non-equivalent control group pre-test and post-test design. Setting: and participants: A purposive sampling method was used for this study. The study participants included 588 first-year nursing students in four classes at a university in western China. The students enrolled in a nursing humanistic curriculum were divided into an experimental group (295 students) and a control group (293 students). Methods: During the 5 weeks of hospitalized children's care program, the experimental group received narrative pedagogy, while the control group received traditional teaching with 2 credit hours per week. Data were collected quantitatively using the Caring Ability Inventory (CAI), as well as qualitatively through individual interviews and reflective diaries. Results: The average scores on the CAI and subscales significantly improved for both groups. As a result of controlling for the effect of pre-test scores, the experimental group had significantly higher post-test scores on the CAI than the control group. Qualitative content analysis demonstrated that narrative pedagogy enhanced nursing students' emotional experiences and facilitated their understanding of the caring practice for sick children. Conclusion: Narrative pedagogy has positive implications for improving students' care competencies for hospitalized children.

Chinese families' knowledge, attitudes, and practices regarding seizure management for children with epilepsy: a mixed-methods study.

Objective: This study aimed to examine Chinese families' knowledge, attitudes, and practices regarding the management of acute seizures (AS) that occur outside the hospital in children with epilepsy (CWE) and factors that influence AS. Design: A mixed-methods sequential explanatory study was conducted, which was integrated at the design and methods levels. In phase 1, a questionnaire was developed for this study, and a family functioning assessment was administered from Nov 2021 to Apr 2022. Multivariate logistic regression was used to analyze the knowledge, attitudes, and practices (KAP) and factors that influence AS. In phase 2, family caregivers (FCGs) were recruited from Jul to Aug 2022 to participate in a qualitative exploration, using semi-structured interviews and a combination of inductive and deductive methods. Setting: The setting was five children's specialty hospitals in different regions of China. Participants: The participants were FCGs of CWE. A total of 645 participants were included in the quantitative phase, and 15 FCGs (eight parents, five grandparents, and two others) were recruited for the qualitative phase. Results: The FCGs' average total KAP score for AS management was 66.23 ± 15.12, with 45.42% of FCGs having a low level. Univariate and multivariate regression analyses showed that demographic factors, disease characteristics, and family function significantly predicted family management of AS. The three most salient themes and eight sub-themes from phase 2 were explored. The quantitative and qualitative databases were analyzed separately and combined through integration, and a conceptual model was constructed based on the individual and family self-management theory (IFSMT); the model consisted of context, knowledge, self-regulation, and promotion factors. Conclusion: Chinese families have a positive attitude toward the management of out-of-hospital AS in CWE, but lack practice and related knowledge. AS management for CWE families was associated with the demographic characteristics of FCGs, epilepsy, and family characteristics. The research findings expand the existing application requirements of an Acute Seizure Action Plan and patient safety. Our results also indicate a pressing need for localized development of AS emergency medicine in family medicine, the establishment of auxiliary information systems, the utilization of caregivers' positive psychological resources, and improvements in family function for intergenerational care.

Automatic segmentation of mandibular canal using transformer based neural networks.

Accurate 3D localization of the mandibular canal is crucial for the success of digitally-assisted dental surgeries. Damage to the mandibular canal may result in severe consequences for the patient, including acute pain, numbness, or even facial paralysis. As such, the development of a fast, stable, and highly precise method for mandibular canal segmentation is paramount for enhancing the success rate of dental surgical procedures. Nonetheless, the task of mandibular canal segmentation is fraught with challenges, including a severe imbalance between positive and negative samples and indistinct boundaries, which often compromise the completeness of existing segmentation methods. To surmount these challenges, we propose an innovative, fully automated segmentation approach for the mandibular canal. Our methodology employs a Transformer architecture in conjunction with cl-Dice loss to ensure that the model concentrates on the connectivity of the mandibular canal. Additionally, we introduce a pixel-level feature fusion technique to bolster the model's sensitivity to fine-grained details of the canal structure. To tackle the issue of sample imbalance and vague boundaries, we implement a strategy founded on mandibular foramen localization to isolate the maximally connected domain of the mandibular canal. Furthermore, a contrast enhancement technique is employed for pre-processing the raw data. We also adopt a Deep Label Fusion strategy for pre-training on synthetic datasets, which substantially elevates the model's performance. Empirical evaluations on a publicly accessible mandibular canal dataset reveal superior performance metrics: a Dice score of 0.844, click score of 0.961, IoU of 0.731, and HD95 of 2.947 mm. These results not only validate the efficacy of our approach but also establish its state-of-the-art performance on the public mandibular canal dataset.

Behavioral Dilemmas and Support Requirements of Self-Management for Chinese Adolescents with Epilepsy During Transition Readiness: A Mixed-Methods Study.

Objective: The study aimed to describe and explore the behavioral dilemmas and support-requirement characteristics of self-management for epileptic adolescents during transition readiness. Methods: A convergent mixed-methods study was conducted. Patients (N=654) in eight hospitals in China completed a demographic and disease characteristics questionnaire and measures of epilepsy transition readiness, self-management of epilepsy, and perceived social support, and 17 patients and family care-givers were interviewed simultaneously. Results: Adolescents with epilepsy (AWEs) had low levels of self-management and transition readiness, and moderate levels of social support. Multivariate linear regression showed that age, antiepileptic drug type, comorbidities, family structure, transition readiness, and social support were statistically significant in the regression model (p<0.05). Seven themes emerged in the qualitative analysis related to self-management behavioral dilemmas, and 11 themes emerged for support requirements. The findings from the qualitative and quantitative analyses were combined to create a conceptual model based on the SMART framework and the social cognitive theory. Conclusion: The findings indicate that the state of self-management behaviors of Chinese AWEs is not promising. The influential factors and characteristics are complex and systematic. Practice Implications: This study provides insights into the self-management practices of AWEs in China and expands previous self-management and transitional readiness strategies and models.

Advancements in oral and maxillofacial surgery medical images segmentation techniques: An overview.

OBJECTIVES: This article reviews recent advances in computer-aided segmentation methods for oral and maxillofacial surgery and describes the advantages and limitations of these methods. The objective is to provide an invaluable resource for precise therapy and surgical planning in oral and maxillofacial surgery. Study selection, data and sources: This review includes full-text articles and conference proceedings reporting the application of segmentation methods in the field of oral and maxillofacial surgery. The research focuses on three aspects: tooth detection segmentation, mandibular canal segmentation and alveolar bone segmentation. The most commonly used imaging technique is CBCT, followed by conventional CT and Orthopantomography. A systematic electronic database search was performed up to July 2023 (Medline via PubMed, IEEE Xplore, ArXiv, Google Scholar were searched). RESULTS: These segmentation methods can be mainly divided into two categories: traditional image processing and machine learning (including deep learning). Performance testing on a dataset of images labeled by medical professionals shows that it performs similarly to dentists' annotations, confirming its effectiveness. However, no studies have evaluated its practical application value. CONCLUSION: Segmentation methods (particularly deep learning methods) have demonstrated unprecedented performance, while inherent challenges remain, including the scarcity and inconsistency of datasets, visible artifacts in images, unbalanced data distribution, and the "black box" nature. CLINICAL SIGNIFICANCE: Accurate image segmentation is critical for precise treatment and surgical planning in oral and maxillofacial surgery. This review aims to facilitate more accurate and effective surgical treatment planning among dental researchers.

Acute pancreatitis as initial presentation of acute myeloid leukemia-M2 subtype: A case report.

BACKGROUND: Direct infiltration of the pancreas by acute myeloid leukemia (AML) with acute pancreatitis (AP) as an initial symptom is extremely rare. Only once in the literature, the leukemia cells in AML have been implicated as the cause of AP. Pancreatitis caused by a rare predisposing factor is often misdiagnosed as idiopathic pancreatitis or pancreatitis of other common causes. Severe AP (SAP) progresses rapidly with a high fatality rate. Therefore, it is important to identify the predisposing factors in the early stage of SAP, evaluate the condition, determine prognosis, formulate treatment plans, and prevent a recurrence. Here, we describe a case of SAP due to AML. CASE SUMMARY: A 61-year-old man presented to the hospital with fever and persistent abdominal pain. Blood analysis presented significantly elevated serum amylase and severe thrombocytopenia. Computed tomography examination of the abdomen revealed peripancreatic inflammatory effusion. The patient had no common etiologies and risk factors for AP, but the concurrent severe thrombocytopenia could not be explained by pancreatitis. Finally, the bone marrow aspirate and biopsy inspection revealed the underlying reason for pancreatitis, AML (M2 type based on the French-American-British classifications system). CONCLUSION: Direct infiltration of the pancrease by acute leukemia, particularly AML cells, is an infrequent cause of AP. Therefore, although AP is a rare extramedullary infiltration characteristic for AML patients, it should be considered when determining the etiology of AP.