Evolution and chemical diversity of the volatile compounds in Salvia species.

INTRODUCTION: The plant essential oils are composed of volatile compounds and have significant value in preventing and treating neurological diseases, anxiety, depression, among others. The genus Salvia has been shown to be an important medicinal resource, especially the aerial parts of genus Salvia, which are rich in volatile compounds; however, the chemical diversity and distribution patterns of volatile compounds in Salvia species are still unknown. OBJECTIVE: The work is performed to analyse the chemical diversity and distribution patterns of volatile compounds in genus Salvia. METHODS: The genomic single nucleotide polymorphisms (SNPs) combined with gas chromatography-mass spectrometry (GC-MS) were used to explore the evolution and chemical diversity of Salvia volatile compounds. Initially, the genetic relationship of genus Salvia was revealed by phylogenetic tree that was constructed based on SNPs. And then, GC-MS was applied to explore the chemical diversity of volatile compounds. RESULTS: The results indicated that the volatile compounds were mainly monoterpenoids, sesquiterpenoids, and aliphatic compounds. The genomic SNPs divided species involved in this work into four branches. The volatile compounds in the first and second branches were mainly sesquiterpenoids and monoterpenoids, respectively. Species in the third branch contained more aliphatic compounds and sesquiterpenoids. And those in the fourth branch were also rich in monoterpenoids but had relatively simple chemical compositions. CONCLUSION: This study offered new insights into the phylogenetic relationships besides chemistry diversity and distribution pattern of volatile compounds of genus Salvia, providing theoretical guidance for the investigations and development of secondary metabolites.

Parastomal Hernia Following Ileal Conduit: Incidence, Risk Factors, and Health-Related Quality of Life.

PURPOSE: The purpose of this study was to measure the incidence of parastomal hernia (PH) after radical cystectomy and ileal conduit. Secondary aims were the identification of risk factors for PH and to compare the health-related quality of life (QOL) between patients with and without PH. DESIGN: Retrospective review of medical records combined with cross-sectional administration of the QOL instrument and telephone follow-up. SUBJECTS AND SETTING: The study sample comprised 219 patients who underwent radical cystectomy and ileal conduit for urothelial cancer between February 2014 and December 2018. The study setting was Peking University First Hospital (Beijing, China). METHODS: Demographic and pertinent clinical data, including development of PH, were gathered via the retrospective review of medical records. Participants were also asked to complete the traditional Chinese language version of the City of Hope Quality of Life-Ostomy Questionnaire (C-COH). Multiple linear regression analysis was used to identify the effect of PH on C-COH scores. Logistic regression analysis was used to identify risk factors for PH development. RESULTS: At a median follow-up of 34 months (IQR = 21-48), 43 of 219 (19.63%) patients had developed a PH. A body mass index (BMI) indicating overweight (OR = 3.548; 95% CI, 1.562-8.061; P = .002), a prior history of hernia (OR = 5.147; 95% CI, 1.195-22.159; P = .028), and chronic high abdominal pressure postdischarge (CHAP-pd) (OR = 3.197; 95% CI, 1.445-7.075; P = .004) were predictors of PH after operation. There was no significant difference between C-COH scores of patients with or without PH. No significant differences were found when participants with PH were compared to those without PH on 4 factors of the C-COH: physical scores (ß= .347, P = .110), psychological scores (ß= .316, P = .070), spiritual scores (ß=-.125, P = .714), and social scores (ß= .054, P = .833). CONCLUSION: Parastomal hernia is prevalent in patients undergoing radical cystectomy and ileal conduit urinary diversion. Overweight, hernia history, and CHAP-pd were predictors of PH development. No significant differences in QOL were found when patients with PH were compared to those without PH.

BN-Isosteres of Nonacene with Antiaromatic B2 C4 and N2 C4 Heterocycles: Synthesis and Strong Luminescence.

Embedding both boron and nitrogen into the backbone of acenes to generate their isoelectronic structures has significantly enriched the acene chemistry to offer appealing properties. However, only small BN-heteroacenes have been extensively investigated, with BN-heptacenes as the hitherto longest homologue. Herein, we report the synthesis of three new nonacene BN-isosteres via incorporating a pair of antiaromatic B2 C4 and N2 C4 heterocycles, representing a new length record for BN-heteroacenes. The distance between the B2 C4 and N2 C4 rings affects the contribution of the charge-separated resonance forms, leading to tunable antiaromaticity of the two heterocycles. The adjusted local antiaromaticity manifests substantial influence on the molecular orbital arrangement, and consequently, the radiative transition rate of BN-3 is greatly enhanced compared with BN-1 and BN-2, realizing a high fluorescence quantum yield of 92 %. This work provides a novel design concept of large acene BN-isosteres and reveals the importance of BN/CC isosterism on their luminescent properties.

A 2-oxoglutarate-dependent dioxygenase converts dihydrofuran to furan in Salvia diterpenoids.

Tanshinone ⅡA (TⅡA), a diterpene quinone with a furan ring, is a bioactive compound found in the medicinal herb redroot sage (Salvia miltiorrhiza Bunge), in which both furan and dihydrofuran analogs are present in abundance. Progress has been made recently in elucidating the tanshinone biosynthetic pathway, including heterocyclization of the dihydrofuran D-ring by cytochrome P450s; however, dehydrogenation of dihydrofuran to furan, a key step of furan ring formation, remains uncharacterized. Here, by differential transcriptome mining, we identified six 2-oxoglutarate-dependent dioxygenase (2-ODD) genes whose expressions corresponded to tanshinone biosynthesis. We showed that Sm2-ODD14 acts as a dehydrogenase catalyzing the furan ring aromatization. In vitro Sm2-ODD14 converted cryptotanshinone to TⅡA and thus was designated TⅡA synthase (SmTⅡAS). Furthermore, SmTⅡAS showed a strict substrate specificity, and repression of SmTⅡAS expression in hairy root by RNAi led to increased accumulation of total dihydrofuran-tanshinones and decreased production of furan-tanshinones. We conclude that SmTⅡAS controls the metabolite flux from dihydrofuran- to furan-tanshinones, which influences medicinal properties of S. miltiorrhiza.

Health-related quality of life (HRQoL), anxiety and depression in patients with ureteral stricture: a multi-institutional study.

PURPOSE: To evaluate health-related quality of life (HRQoL), anxiety and depression levels in patients with ureteral stricture (US) and to further investigate factors independently affecting this. METHODS: We prospectively recruited a cohort of 275 consecutive patients with US between June 2020 and April 2021. The participants were required to provide complete sociodemographic, clinical and pathologic information. All patients were administered questionnaires to evaluate HRQoL, anxiety and depression. Multivariate linear regression analyses were performed to assess the contribution of covariates on HRQoL, anxiety and depression. RESULTS: Patients with US, particularly iatrogenic US, scored significantly lower than the Chinese general population in all domains of the SF-36 (all p < 0.001), except SF. Increased age, female and high education attainment were independently associated with poor HRQoL. Interestingly, iatrogenic US, nephrostomy tube placement, urinary symptoms, high anxiety and depression level independently predicted poor HRQoL. Furthermore, the percentages of anxiety and depression cases in patients with US were 31.3% and 20.7%, respectively. Iatrogenic US and urinary symptoms, specifically waist discomfort, were the strongest predictors of increased levels of anxiety and depression. CONCLUSION: Patients with US exhibited poor quality of life and emotional status. Various factors independently predicted worse HRQoL and emotion, which provide potential targets for medical, lifestyle-related, psychological interventions.

Effect of Purslane (Portulaca oleracea L.) on Intestinal Morphology, Digestion Activity and Microbiome of Chinese Pond Turtle (Mauremys reevesii) during Aeromonas hydrophila Infection.

Large-scale mortality due to Aeromonas hydrophila (A. hydrophila) infection has considerably decreased the yield of the Chinese pond turtle (Mauremys reevesii). Purslane is a naturally active substance with a wide range of pharmacological functions, but its antibacterial effect on Chinese pond turtles infected by A. hydrophila infection is still unknown. In this study, we investigated the effect of purslane on intestinal morphology, digestion activity, and microbiome of Chinese pond turtles during A. hydrophila infection. The results showed that purslane promoted epidermal neogenesis of the limbs and increased the survival and feeding rates of Chinese pond turtles during A. hydrophila infection. Histopathological observation and enzyme activity assay indicated that purslane improved the intestinal morphology and digestive enzyme (α-amylase, lipase and pepsin) activities of Chinese pond turtle during A. hydrophila infection. Microbiome analysis revealed that purslane increased the diversity of intestinal microbiota with a significant decrease in the proportion of potentially pathogenic bacteria (such as Citrobacter freundii, Eimeria praecox, and Salmonella enterica) and an increase in the abundance of probiotics (such as uncultured Lactobacillus). In conclusion, our study uncovers that purslane improves intestinal health to protect Chinese pond turtles against A. hydrophila infection.

Functional properties and formation mechanisms of dialdehyde polysaccharides crosslinked gliadin-films enforced by alkaline condition.

BACKGROUND: The usage of natural polysaccharides is attractive to researchers around the world. At the same time, non-/low-toxic crosslinkers prepared by polysaccharides are expected to fabricate protein-based films in many fields. Herein, different dialdehyde polysaccharides (DPs) were successfully synthesized and applied to prepare gliadin-films under alkaline conditions. The functional properties and formation mechanisms of the films were fully investigated. RESULTS: The results showed that the mechanical properties, water-resistant properties, thermal stability, and antibacterial properties of the gliadin-films were improved by DPs and alkali treatment. Particularly dialdehyde dextrin (DAD) crosslinked gliadin-films showed the highest tensile strength, but no additional effect on their elongation, or advancement on the other functional properties. The film-forming mechanisms indicated that Schiff base bonds, hydrophobic interactions, electrostatic interactions, and hydrogen bonds were the main forces in the films, supporting their improvement in functional properties. CONCLUSION: DPs, especially DAD, can be a promising crosslinker in fabricating gliadin-films. These findings have shown great promise to seek an effective crosslinker for fabricating gliadin/protein-based packaging. © 2023 Society of Chemical Industry.

Reduced Circulating Levels of miR-491-5p and miR-485-3p Are Associated with the Occurrence of Vertebral Fractures in Postmenopausal Women with Osteoporosis.

Objective: Postmenopausal women experiences osteoporotic structural damage and bone fragility resulting from reduced bone formation and increased bone resorption. Osteoporosis frequently affects the vertebral column and causes compression fractures. This study aims to characterize roles of miRNAs in osteoporosis and subsequent incidence risk of vertebral fractures for postmenopausal women. Methods. Differentially expressed miRNAs between osteoporotic patients with vertebral fractures and osteoporotic patients without fracture were identified. This retrospective study included 78 osteoporotic patients with vertebral fractures and 82 osteoporotic patients without vertebral fractures. The plasma levels of bone metabolic markers, 25-hydroxyvitamin D (25-(OH)VitD), propeptide of type I procollagen (PINP), and ß-Carboxyl terminal peptide (ß-CTx), were detected using the patented electro-chemiluminescence (ECLIA) method. The expression levels of miR-491-5p and miR-485-3p were determined by qRT-PCR. Pearson correlation analysis was carried out to assess the relationship between miR-491-5p, miR-485-3p, and bone metabolic markers. Receiver operating characteristic (ROC) curves and the area under the ROC curve (AUC) were used to evaluate the performance of miR-491-5p and miR-485-3p in diagnosing the occurrence of vertebral fractures in osteoporotic patients.Results: The plasma levels of PINP and ß-CTx were elevated but the plasma level of 25-(OH)VitD was declined in osteoporotic patients with vertebral fractures when comparable to those without (< 0.05). The plasma expression levels of miR-491-5p and miR-485-3p were declined osteoporotic patients with vertebral fractures when comparable to those without (< 0.001). Pearson correlation analysis revealed that the relative expression level of miR-491-5p was negatively correlated with the level of 25-(OH)VitD (r = -0.518, < 0.001) but positively correlated with the levels of PINP (r = 0.547, < 0.001) and ß-CTx (r = 0.380, < 0.001). We also observed a negative correlation between the relative expression level of miR-485-3p and 25-(OH)VitD (r = -0.388, < 0.001), a positive correlation between miR-485-3p and PINP (r = 0.422,< 0.001). ROC curves for prediction of vertebral fracture following osteoporosis in postmenopausal women by miR-491-5p expression yielded 0.866 AUC and by miR-485-3p expression produced 0.848 AUC. Conclusion: The data suggest that downregulated expressions of miR-491-5p and miR-485-3p may be involved in the occurrence of vertebral fractures in postmenopausal women with osteoporosis.

Impact of the COVID-19 Pandemic on Pediatric Emergency Medicine: A Systematic Review.

(1) Background and Objectives: The COVID-19 pandemic has considerably affected clinical systems, especially the emergency department (ED). A decreased number of pediatric patients and changes in disease patterns at the ED have been noted in recent research. This study investigates the real effect of the pandemic on the pediatric ED comprehensively by performing a systematic review of relevant published articles. (2) Materials and Methods: A systematic review was conducted based on a predesigned protocol. We searched PubMed and EMBASE databases for relevant articles published until 30 November 2021. Two independent reviewers extracted data by using a customized form, and any conflicts were resolved through discussion with another independent reviewer. The aggregated data were summarized and analyzed. (3) Results: A total of 25 articles discussing the impact of COVID-19 on pediatric emergencies were included after full-text evaluation. Geographic distribution analysis indicated that the majority of studies from the European continent were conducted in Italy (32%, 8/25), whereas the majority of the studies from North America were conducted in the United States (24%, 6/25). The majority of the studies included a study period of less than 6 months and mostly focused on the first half of 2020. All of the articles revealed a decline in the number of pediatric patients in the ED (100%, 25/25), and most articles mentioned a decline in infectious disease cases (56%, 14/25) and trauma cases (52%, 13/25). (4) Conclusions: The COVID-19 pandemic resulted in a decline in the number of pediatric patients in the ED, especially in the low-acuity patient group. Medical behavior changes, anti-epidemic policies, increased telemedicine use, and family financial hardship were possible factors. A decline in common pediatric infectious diseases and pediatric trauma cases was noted. Researchers should focus on potential child abuse and mental health problems during the pandemic.

Physicochemical and nutritional properties of yogurt emulsion with lycopene during chilled storage.

Lycopene is a highly potent antioxidant that is prevalent among dietary carotenoids. However, its use in food formulations is restricted due to its poor water-solubility and proneness to oxidation. The aim of this research was to encapsulate lycopene in yogurt using emulsion technology for improving its stability during processing and storage, in order to diversify a widely consumed food product and enhance its nutritional value. Confocal laser microscopy data showed that the incorporation of oil droplets with emulsification did not have a negative effect on the formation and microstructure of yogurt. Syneresis of lycopene-fortified yogurt samples was approximately twice as high compared with plain yogurt at day 7; the ability to retain water was significantly improved with storage time for all emulsified samples. Additionally, storage reduced the Turbiscan Stability Indices (TSI) for all yogurt samples, which suggests that physical stability improved at 4 °C. Emulsification resulted in increased oxidation levels due to increased oil content. This effect was ameliorated by lycopene encapsulation, which effectively protected corn oil from oxidation and prevented degradation. This study indicates that emulsification is a promising method for lycopene encapsulation and can be used for developing yogurt with desirable nutritional properties.

Practices and Applications of Convolutional Neural Network-Based Computer Vision Systems in Animal Farming: A Review.

Convolutional neural network (CNN)-based computer vision systems have been increasingly applied in animal farming to improve animal management, but current knowledge, practices, limitations, and solutions of the applications remain to be expanded and explored. The objective of this study is to systematically review applications of CNN-based computer vision systems on animal farming in terms of the five deep learning computer vision tasks: image classification, object detection, semantic/instance segmentation, pose estimation, and tracking. Cattle, sheep/goats, pigs, and poultry were the major farm animal species of concern. In this research, preparations for system development, including camera settings, inclusion of variations for data recordings, choices of graphics processing units, image preprocessing, and data labeling were summarized. CNN architectures were reviewed based on the computer vision tasks in animal farming. Strategies of algorithm development included distribution of development data, data augmentation, hyperparameter tuning, and selection of evaluation metrics. Judgment of model performance and performance based on architectures were discussed. Besides practices in optimizing CNN-based computer vision systems, system applications were also organized based on year, country, animal species, and purposes. Finally, recommendations on future research were provided to develop and improve CNN-based computer vision systems for improved welfare, environment, engineering, genetics, and management of farm animals.

Postprostatectomy Incontinence and Self-management for Urinary Incontinence After Laparoscopic Radical Prostatectomy: A Cross-sectional Study.

PURPOSE: The purpose of this study was to describe postprostatectomy incontinence (PPI) after laparoscopic radical prostatectomy (LRP), self-management strategies for managing incontinence, and factors influencing self-management. DESIGN: A descriptive, cross-sectional study. SUBJECTS AND SETTING: The sample comprising 37 males with prostate cancer who underwent LRP was recruited within first 2 years. The study setting was a tertiary care hospital in Beijing, China. An additional 78 individuals who responded to a mailed invitation sent from September 2015 to October 2016 participated in the study. METHODS: Participants completed a questionnaire that queried demographic and pertinent clinical data. The questionnaire also included 2 validated instruments. The International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) was used to assess urinary incontinence (UI) following radical prostatectomy and its severity. The Strategy and Effectiveness of Symptom Self-Management questionnaire of Postprostatectomy Incontinence (SESSM-PPI) was used to evaluate self-management of UI, including strategies used and their perceived effectiveness. RESULTS: Data analysis was based on 115 respondents who completed all components of the questionnaire; 95 (82.6%) indicated having UI. Forty-one patients (43.2%) indicated mild UI, 47 (49.5%) indicated moderate UI, and 7 (7.4%) indicated severe UI. The mean score of the SESSM-PPI was 14.04 ± 7.92, indicating a low level of self-management.The top 5 strategies with moderate effectiveness were in the following order: "use pads or adult diapers"; "pelvic floor muscle training"; "avoid extracting heavy objects"; "avoid drinking"; and "eat more fruit to prevent constipation." The Spearman correlation analysis revealed a positive correlation between the frequency of use of self-management strategies and incontinence severity. CONCLUSIONS: Urinary incontinence is prevalent among males with prostate cancer managed by radical prostatectomy. Respondents tended to report mild to moderate UI severity. Self-management of UI among respondents is low.

Evaluating Convolutional Neural Networks for Cage-Free Floor Egg Detection.

The manual collection of eggs laid on the floor (or 'floor eggs') in cage-free (CF) laying hen housing is strenuous and time-consuming. Using robots for automatic floor egg collection offers a novel solution to reduce labor yet relies on robust egg detection systems. This study sought to develop vision-based floor-egg detectors using three Convolutional Neural Networks (CNNs), i.e., single shot detector (SSD), faster region-based CNN (faster R-CNN), and region-based fully convolutional network (R-FCN), and evaluate their performance on floor egg detection under simulated CF environments. The results show that the SSD detector had the highest precision (99.9 ± 0.1%) and fastest processing speed (125.1 ± 2.7 ms·image-1) but the lowest recall (72.1 ± 7.2%) and accuracy (72.0 ± 7.2%) among the three floor-egg detectors. The R-FCN detector had the slowest processing speed (243.2 ± 1.0 ms·image-1) and the lowest precision (93.3 ± 2.4%). The faster R-CNN detector had the best performance in floor egg detection with the highest recall (98.4 ± 0.4%) and accuracy (98.1 ± 0.3%), and a medium prevision (99.7 ± 0.2%) and image processing speed (201.5 ± 2.3 ms·image-1); thus, the faster R-CNN detector was selected as the optimal model. The faster R-CNN detector performed almost perfectly for floor egg detection under a wide range of simulated CF environments and system settings, except for brown egg detection at 1 lux light intensity. When tested under random settings, the faster R-CNN detector had 91.9-94.7% precision, 99.8-100.0% recall, and 91.9-94.5% accuracy for floor egg detection. It is concluded that a properly-trained CNN floor-egg detector may accurately detect floor eggs under CF housing environments and has the potential to serve as a crucial vision-based component for robotic floor egg collection systems.

An in vitro investigation of the inhibitory mechanism of ß-galactosidase by cinnamaldehyde alone and in combination with carvacrol and thymol.

BACKGROUND: Some antibacterial agents exert their antimicrobial action by targeting the cytoplasmic macromolecules, such as proteins or nucleic acids, to disturb the properties of macromolecules that may deeply influence their biological activities and functions. Cinnamaldehyde (CIN) is a natural antibacterial ingredient found in the bark and leaves of cinnamon trees. METHODS: The inhibitory mechanism of a typical enzyme, ß-galactosidase by CIN was investigated by UV-visible, fluorescence, 3-D spectroscopy, circular dichroism, atomic force microscopy and molecular modeling studies. RESULTS: CIN decreased the activity of ß-galactosidase by competitive inhibition through a multiphase kinetic process. 3-D spectroscopy and circular dichroism showed that the binding of CIN to ß-galactosidase resulted in changes in micro-environment of tryptophan and tyrosine residues, and conformation of ß-galactosidase. The molecular recognition was also analyzed through modeling which indicated that CIN was inserted into the active site pocket of ß-galactosidase and interacted with amino acid residues, such as Met502, Trp568, Phe601 and Trp999. Atomic force microscopy showed that a serious destabilization of the native conformation of ß-galactosidase occurred after binding with CIN, e.g., morphological changes and increased dimensions of the ß-galactosidase molecule. Moreover, it was found that the combinations of CIN, carvacrol and thymol exposure displayed synergistic effects on the inhibition of ß-galactosidase. GENERAL SIGNIFICANCE: This study exhibits a comprehensively understanding about the action mechanism of CIN that affects the conformation and activity of ß-galactosidase in biochemical processes and provides some new insights into the possible intracellular targeting behaviors of CIN at a molecular level.

The public attitude towards ChatGPT on reddit: A study based on unsupervised learning from sentiment analysis and topic modeling.

ChatGPT has demonstrated impressive abilities and impacted various aspects of human society since its creation, gaining widespread attention from different social spheres. This study aims to comprehensively assess public perception of ChatGPT on Reddit. The dataset was collected via Reddit, a social media platform, and includes 23,733 posts and comments related to ChatGPT. Firstly, to examine public attitudes, this study conducts content analysis utilizing topic modeling with the Latent Dirichlet Allocation (LDA) algorithm to extract pertinent topics. Furthermore, sentiment analysis categorizes user posts and comments as positive, negative, or neutral using Textblob and Vader in natural language processing. The result of topic modeling shows that seven topics regarding ChatGPT are identified, which can be grouped into three themes: user perception, technical methods, and impacts on society. Results from the sentiment analysis show that 61.6% of the posts and comments hold favorable opinions on ChatGPT. They emphasize ChatGPT's ability to prompt and engage in natural conversations with users, without relying on complex natural language processing. It provides suggestions for ChatGPT developers to enhance its usability design and functionality. Meanwhile, stakeholders, including users, should comprehend the advantages and disadvantages of ChatGPT in human society to promote ethical and regulated implementation of the system.

Endangered status and threatened population ecological factors in Salvia daiguii, an endemic species from Hunan, China.

Many species of Salvia have excellent ornamental, culinary, and medicinal values. Salvia daiguii, is an ornamental and highly medicinal perennial herb endemic to the prefecture-level city of Zhangjiajie in Hunan Province, China, with a narrow geographical distribution. However, currently, it has only been assessed as a Critically Endangered species according to the IUCN classification criteria, but its conservation has not yet been studied. This study investigated the distribution and niche characteristics of S. daiguii, and compared the differences in growth, flowering characteristics, and soil nutrients between the wild and ex situ populations. We also analyzed the effects of soil nutrients on plant growth and flowering characteristics. During the survey, we found 274 individuals on a rock approximately 200 m from ZEFR1. Nevertheless, S. daiguii were still restricted in three populations, TNFP, TGM, and ZEFR in Zhangjiajie City, with a total of about 500 plants and less than 250 mature individuals. Our results show that aspects such as adverse environmental conditions, low seedling renewal rate, a lack of soil nutrients, and competition for the characteristic niche of this and other dominant plants in the natural community are the main ecological factors affecting the growth, flowering, and geographic distribution of S. daiguii. Based on the results of field surveys, we recommend that (1) S. daiguii be classified as Critically Endangered C2b and China's List of Plant Species with Extremely Small Populations. (2) Comprehensive conservation strategies were developed, such as the establishment of nature reserves, reintroduction, public education, and institutional development to provide management recommendations related to the conservation of S. daiguii and other endangered plants.

Safety and effectiveness of remdesivir for the treatment of COVID-19 patients with end-stage renal disease: A retrospective cohort study.

BACKGROUND: Remdesivir has been used to treat severe coronavirus 2019 (COVID-19); however, its safety and effectiveness in patients remain unclear. This study aimed to investigate the safety and effectiveness of remdesivir in patients with COVID-19 with end-stage renal disease (ESRD). METHODS: This retrospective study used the Chang Gung Research Database (CGRD) and extracted data from 21,621 adult patients with COVID-19 diagnosed between April 2021 and September 2022. The patients were divided into groups based on their remdesivir use and the presence of ESRD. The adverse effects of remdesivir and their outcomes were analyzed after propensity score matching. RESULTS: To compare the adverse effects of remdesivir, propensity scores were used for one-to-one matching between patients with and without ESRD treated with remdesivir (N = 110). There were no statistically significant differences in heart rates, blood glucose levels, variations in hemoglobin levels before and after remdesivir use, or liver function between the two groups after remdesivir use. A comparison was made between patients with ESRD using remdesivir and those not using remdesivir after propensity score matching (N = 44). Although a shorter length of stay (LOS), lower intensive care unit (ICU) admission rate, and lower intubation rate were noted in the ESRD group treated with remdesivir, the difference was not statistically significant. CONCLUSION: Remdesivir is safe for use in patients with COVID-19 and ESRD; no increased adverse effects were noted compared with patients without ESRD. However, the effectiveness of remdesivir use in patients with COVID-19 and ESRD remains uncertain.

Salvia guidongensis sp. nov.: unraveling a critical evolutionary link in East Asian Salvia from Central China integrating morphology, phylogeny, and plastid genomics.

Introduction: Salvia L., representing the largest genus within the mint family, is noted for its global distribution of approximately 1000 species, with East Asia, and particularly China, recognized as a critical center of diversity for the genus. Methods: Our research was conducted through extensive fieldwork in Guidong County, Hunan Province, China, where we identified a previously undescribed species of Salvia. The identification process involved detailed morphological observations, phylogenetic analyses, and plastid genomics. Results: The newly discovered species, Salvia guidongensis, exhibits unique characteristics not commonly observed in the East Asian lineage of Salvia, including dual floral colors within natural populations-either pale purple or pale yellow. Morphologically, while it shares similarities with members of sect. Glutinaria, S. guidongensis is distinct in its floral morphology, stature, and specific foliar traits. Phylogenetic analysis places S. guidongensis in a unique clade within the East Asian lineage of Salvia, suggesting it may serve as an important evolutionary link. Additionally, we explored the plastome features of S. guidongensis, comparing them with those of closely related species. Discussion: The discovery of S. guidongensis not only entriches the taxonomic tapestry of Salvia but also provides critical insights into the biogeography and evolutionary pathways of the genus in East Asia. By integrating morphological and molecular data, we validate the novel status of S. guidongensis and highlight its significance in bridging taxonomic and evolutionary gaps within Sect. Glutinaria of Salvia.

Effectiveness of Blended Versus Traditional Refresher Training for Cardiopulmonary Resuscitation: Prospective Observational Study.

BACKGROUND: Generally, cardiopulmonary resuscitation (CPR) skills decline substantially over time. By combining web-based self-regulated learning with hands-on practice, blended training can be a time- and resource-efficient approach enabling individuals to acquire or refresh CPR skills at their convenience. However, few studies have evaluated the effectiveness of blended CPR refresher training compared with that of the traditional method. OBJECTIVE: This study investigated and compared the effectiveness of traditional and blended CPR training through 6-month and 12-month refresher sessions with CPR ability indicators. METHODS: This study recruited participants aged ≥18 years from the Automated External Defibrillator Donation Project. The participants were divided into 4 groups based on the format of the CPR training and refresher training received: (1) initial traditional training (a 30-minute instructor-led, hands-on session) and 6-month traditional refresher training (Traditional6 group), (2) initial traditional training and 6-month blended refresher training (an 18-minute e-learning module; Mixed6 group), (3) initial traditional training and 12-month blended refresher training (Mixed12 group), and (4) initial blended training and 6-month blended refresher training (Blended6 group). CPR knowledge and performance were evaluated immediately after initial training. For each group, following initial training but before refresher training, a learning effectiveness assessment was conducted at 12 and 24 months. CPR knowledge was assessed using a written test with 15 multiple-choice questions, and CPR performance was assessed through an examiner-rated skill test and objectively through manikin feedback. A generalized estimating equation model was used to analyze changes in CPR ability indicators. RESULTS: This study recruited 1163 participants (mean age 41.82, SD 11.6 years; n=725, 62.3% female), with 332 (28.5%), 270 (23.2%), 258 (22.2%), and 303 (26.1%) participants in the Mixed6, Traditional6, Mixed12, and Blended6 groups, respectively. No significant between-group difference was observed in knowledge acquisition after initial training (P=.23). All groups met the criteria for high-quality CPR skills (ie, average compression depth: 5-6 cm; average compression rate: 100-120 beats/min; chest recoil rate: >80%); however, a higher proportion (98/303, 32.3%) of participants receiving blended training initially demonstrated high-quality CPR skills. At 12 and 24 months, CPR skills had declined in all the groups, but the decline was significantly higher in the Mixed12 group, whereas the differences were not significant between the other groups. This finding indicates that frequent retraining can maintain high-quality CPR skills and that blended refresher training is as effective as traditional refresher training. CONCLUSIONS: Our findings indicate that 6-month refresher training sessions for CPR are more effective for maintaining high-quality CPR skills, and that as refreshers, self-learning e-modules are as effective as instructor-led sessions. Although the blended learning approach is cost and resource effective, factors such as participant demographics, training environment, and level of engagement must be considered to maximize the potential of this approach. TRIAL REGISTRATION: IGOGO NCT05659108; https://www.cgmh-igogo.tw.