Effect of the COVID-19 Pandemic on Gambling Behavior in Mainland Chinese Gamblers in Macau: Cross-Sectional Survey Study.

BACKGROUND: This study examined the effects of the COVID-19 pandemic on the gambling behavior of individuals who were already actively engaged in such pursuits. We aimed to uncover the intricate consequences of the pandemic on this specific demographic, emphasizing the importance of understanding the complex connection between public health concerns such as the COVID-19 pandemic and gambling behavior from a public health perspective. In addition to identifying immediate impacts, this study holds significance in assessing potential long-term public health implications for the broader gambling industry. OBJECTIVE: This study investigated how the COVID-19 pandemic has affected the gambling behavior of Mainland Chinese tourists in Macau from a public health perspective. We aimed to understand the changing patterns of gambling habits within this specific demographic by comparing their behavior before and during the pandemic, with a particular emphasis on the evolving dynamics of gambling and their public health consequences. This study provides a detailed exploration of the impact and implications of global health emergencies on this particular demographic's gambling behaviors and preferences. METHODS: This study used a robust cross-sectional analysis involving a sample of 334 Mainland Chinese gamblers with prior experiences in casinos in Macau. The sample deliberately encompassed individuals involved in gambling before and during the COVID-19 pandemic. Data were collected through carefully designed questionnaires to gather information on gambling habits, preferences, and observed behavioral changes in the sample. RESULTS: This study unveiled a notable shift in Mainland Chinese gamblers' behavior during the COVID-19 pandemic. A considerable number of participants opted for web-based platforms over traditional land-based casinos, resulting in reduced budgets, less time spent on gambling, and decreased participation in social gambling. Remarkably, there was a notable surge in online gambling, indicating a noteworthy adaptability of gamblers to changing circumstances. These findings emphasize the dynamic nature of gambling habits during global public health emergencies, revealing the resilient and evolving preferences of Mainland Chinese gamblers in response to the challenges posed by the pandemic. CONCLUSIONS: This study highlights the negative impact of the COVID-19 pandemic on casino gambling, notably evident in a significant decline in Mainland Chinese tourists visiting Macau for gambling. There is a noticeable shift from traditional gambling to web-based alternatives, with individuals seeking options within the pandemic constraints. Furthermore, the findings point out an increase in gambling among the younger generation and behavioral changes in individuals with mood disorders. The findings of this study emphasize the critical need for proactive measures to address evolving gambling preferences and associated risks during public health crises; furthermore, these findings underscore the importance of adaptive strategies within the gambling industry, as well as the necessity for effective public health interventions and regulatory frameworks to respond to unprecedented challenges with efficacy and precision.

DEVELOPMENT AND VALIDATION OF A NOMOGRAM FOR PREDICTING 28-DAY IN-HOSPITAL MORTALITY IN SEPSIS PATIENTS BASED ON AN OPTIMIZED ACUTE PHYSIOLOGY AND CHRONIC HEALTH EVALUATION II SCORE.

ABSTRACT: Purpose : The objective of this study is to establish a nomogram that correlates optimized Acute Physiology and Chronic Health Evaluation II (APACHE II) score with sepsis-related indicators, aiming to provide a robust model for early prediction of sepsis prognosis in clinical practice and serve as a valuable reference for improved diagnosis and treatment strategies. Methods : This retrospective study extracted sepsis patients meeting the inclusion criteria from the MIMIC-IV database to form the training group. An optimized APACHE II score integrated with relevant indicators was developed using a nomogram for predicting the prognosis of sepsis patients. External validation was conducted using data from the intensive care unit at Lanzhou University Second Hospital. Results : The study enrolled 1805 patients in the training cohort and 203 patients in the validation cohort. A multifactor analysis was conducted to identify factors affecting patient mortality within 28 days, resulting in the development of an optimized score by simplifying evaluation indicators from APACHE II score. The results showed that the optimized score (area under the ROC curve [AUC] = 0.715) had a higher area under receiver operating characteristic curve than Sequential Organ Failure Assessment score (AUC = 0.637) but slightly lower than APACHE II score (AUC = 0.720). Significant indicators identified through multifactor analysis included platelet count, total bilirubin level, albumin level, prothrombin time, activated partial thromboplastin time, mechanical ventilation use and renal replacement therapy use. These seven indicators were combined with optimized score to construct a nomogram based on these seven indicators. The nomogram demonstrated good clinical predictive value in both training cohort (AUC = 0.803) and validation cohort (AUC = 0.750). Calibration curves and decision curve analyses also confirmed its good predictive ability, surpassing the APACHE II score and Sequential Organ Failure Assessment score in identifying high-risk patients. Conclusions : The nomogram was established in this study using the MIMIC-IV database and validated with external data, demonstrating its robust discriminability, calibration, and clinical practicability for predicting 28-day mortality in sepsis patients. These findings aim to provide substantial support for clinicians' decision making.

Characterization of Secondary Metabolites from Mycelial Cultures of Black Morel Mushroom Morchella importuna (Ascomycota).

Species of the genus Morchella are highly prized worldwide for their excellent flavor and high medicinal value. In recent years, artificial cultivations of medicinal fungi with many advantages have elicited great interest as a promising alternative to produce certain valuable metabolites. Therefore, the secondary metabolites of fermented M. importuna belonging to the black morel clade isolated from China were investigated. The strain was cultured in a fermentation tank in PDB liquid medium by two-step method. The mycelia and fermentation broth were extracted by ethyl acetate. The secondary metabolites were separated and purified by repeated silica gel column chromatography. Structures of compounds were determined by NMR data and references. One new natural compound (1) and six known compounds (2-7) were obtained. Compounds 1, 2, 4, and 5 were first isolated from genus Morchella and compounds 3, 6, and 7 are first isolated from species M. importuna.

Extraction of flavonoids from Citri Reticulatae Pericarpium Viride using a deep eutectic solvent.

Flavonoids are the main active ingredient in Citri Reticulatae Pericarpium Viride (CRPV). In this study, a deep eutectic solvent (DES) was explored to extract the main flavonoids from CRPV, including narirutin (NAR) and hesperidin (HES). A total of 30 DESs were prepared, and DES-20 (proline : urea) was selected as the optimal solvent. According to the single factor and response surface methodology experiments, the optimal extraction conditions for the flavonoids included a molar ratio of 1 : 2, water content of 30%, extraction time of 28 min, extraction power of 240 W, and a liquid-to-solid ratio of 70 mL g-1 and the optimal extraction yields of NAR and HES were 21 ± 2 mg g-1 and 60 ± 2 mg g-1, respectively. The recovery rate of NAR and HES with macroporous resin SP825 were 88 ± 3% and 86 ± 4%, respectively. Compared with traditional extraction methods, this novel method greatly improved extraction efficiency and saved time. Scanning electron microscopy results showed that this novel method could destroy the plant cell wall to enhance the extraction efficiency. Then, 21 flavonoids were identified through an ultra-high-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS) technique and nine of them were discovered for the first time in CRPV extracts. Furthermore, a high-performance liquid chromatography (HPLC) method was simultaneously used to determine NAR and HES in CRPV extracts upon methodological validation. Finally, antioxidant and cytotoxic experiments in vitro showed that the flavonoids extracted from the CRPV exhibited certain antioxidant and cytotoxic activities. The above results indicated that the DES was a green solvent, which can effectively extract NAR and HES from CRPV.

Carbon-coated TiNb2O7 nanosheet arrays as self-supported high mass-loading anodes for flexible Li-ion batteries.

A TiNb2O7 anode constructed with carbon-coated nanosheet arrays on carbon cloth is prepared by a facile solvothermal process and post carbon-coating for the first time. With nanosized diffusion-length and reduced polarization resistance, this anode exhibits superior high-rate capability based on relatively high mass-loading. Meanwhile, it demonstrates excellent cycling stability and mechanical flexibility as expected from flexible Li-ion batteries.

Case report of narcolepsy in a six-year-old child initially misdiagnosed as atypical epilepsy.

SUMMARY: This report describes a case of first-onset narcolepsy in a six-year-old female that was misdiagnosed as atypical epilepsy and other diagnoses at eight different hospitals over a period of 10 months before the correct diagnosis was made. The diagnosis of narcolepsy is more difficult in children because very few of them experience all four cardinal symptoms of narcolepsy - paroxysmal sleep, cataplexy, hypnagogic hallucination, and sleep paralysis - and they often have a more prolonged onset and diverse symptoms. To decrease the time lag between initial presentation and accurate diagnosis, we recommend that in all cases in which children report excessive sleep of unknown etiology - regardless of the associated symptoms - that sleep monitoring and sleep latency tests be conducted to rule out the possibility of narcolepsy. The case highlights the wide variety of presentations of uncommon psychiatric conditions, particularly in children, and the need for clinicians to be aware of the atypical presentations of these conditions when collecting medical histories.