Survival Outcomes of Sublobectomy and Lobectomy in Elderly Patients with Peripheral Solid-Dominant Non-small Cell Lung Cancer.

BACKGROUND: According to the JCOG0802 study, there were many non-cancer-related deaths in the lobectomy group. Meanwhile, the median age of the enrolled patients in the JCOG0802 study was 67 years old. Whether this difference in perioperative outcomes and survival outcomes is related to age remains unknown. We aim to investigate whether the sublobectomy was comparable to lobectomy in elderly (≥ 75 years old) patients with peripheral solid-dominant [50% ≤ consolidation tumor ratio (CTR) ≤ 1] and diameter ≤ 2 cm non-small cell lung cancer (NSCLC). METHODS: We retrospectively included 10,830 patients who underwent surgery treatment at two large-volume medical centers, Taizhou Hospital of Zhejiang Province and Shanghai Chest Hospital, from January 2016 to January 2018. Of these, 164 patients aged ≥ 75 years, tumor ≤ 2 cm, and 50% ≤ CTR ≤ 1 who received lobectomy or sublobectomy were included in our study. The perioperative outcomes, survival analyses, analysis of death patterns, tumor recurrence patterns, and Cox regression analyses were performed. RESULTS: On perioperative outcomes, sublobectomy was associated with a shorter operation time (p < 0.001), and in terms of survival outcomes, the 5-year overall survival (OS, p = 0.85) and 5-year disease-free surivial (DFS, p = 0.58) did not differ significantly between the two groups. The Cox regression analyses showed that CTR value, visceral pleural infiltration, and smoking were independent risk factors for worse OS. Furthermore, tumor recurrence pattern and death patterns between the two groups did not differ significantly. CONCLUSIONS: Sublobectomy could achieve superior perioperative outcomes and equivalent oncological efficacy in comparison with lobectomy in elderly patients (≥ 75 years old) with peripheral solid-dominant and diameter ≤ 2 cm NSCLC.

Risk factors for self-reported medication adherence in community-dwelling older patients with multimorbidity and polypharmacy: a multicenter cross-sectional study.

BACKGROUND: Medication nonadherence is a significant public health problem as it contributes to poor clinical outcomes and increased healthcare costs. Older patients with multimorbidity and polypharmacy often have low medication adherence. These patients also have a high prevalence of potentially inappropriate medication (PIM) use. AIM: To explore risk factors related to medication nonadherence in older patients with multimorbidity and polypharmacy and examine the association between medication nonadherence and PIM use. METHOD: A multicenter cross-sectional study was conducted from May to December 2019 in 16 tertiary hospitals from 12 provinces and cities in China. Data were collected from outpatients 65 years or older with multimorbidity and polypharmacy. The PIMs were evaluated using the 2019 Beers Criteria. Self-reported medication adherence was assessed using the Visual Analog Scale (VAS). RESULTS: A total of 773 outpatients were recruited. The prevalence of medication nonadherence was 31.8%. In the univariate analysis, nonadherence was significantly associated with sex, cognitive impairment, stroke, visiting the same physicians, self-administration of medication, the percentage of drug costs ≥ 10% of the medical expenses, and PIMs for the alimentary tract and metabolism. In the multivariate analysis, the results almost paralleled those of the univariate associations. Notably, the use of PIM was significantly associated with medication adherence. CONCLUSION: Several factors that influence medication adherence were identified. Targeted interventions can be implemented to improve medication adherence, such as encouraging self-administering medications and reducing medication expenses.

Comparative study on the clinical efficacy of small plate assisted anatomic plate and traditional double plate in the treatment of Rüedi and Allgöwer II - III pilon fracture.

OBJECTIVE: The aim of this study was to investigate the clinical efficacy of small plate assisted anatomical plate and traditional double plate in the treatment of Rüedi and Allgöwer II - III pilon fracture. METHODS AND MATERIALS: The data of 68 patients with pilon fracture admitted to Hospital from June 2017 to June 2020 were retrospectively analyzed. Study group and control group were divided according to different operation methods, with 34 cases in each group. There were 28 cases of Rüedi and Allgöwer II type and 40 cases of Rüedi and Allgöwer III type. Perioperative period data, Ankle joint function score, visual analog scale (VAS) scores and the incidence of incision complications were analyzed between these two groups. RESULTS: There were no significant differences in full load time, fracture healing time between these two groups (P > 0.05). The operation time, intraoperative blood loss, length of hospital stay, Ankle joint function score and postoperative incision complication rate in observation group were lower than those in control group (P < 0.05). CONCLUSION: Small plate assisted anatomic plate is comparable to traditional double plate in the treatment of pilon fracture in terms of complete loading time, fracture healing time, but the former can shorten the operation time, reduce intraoperative blood loss and effectively reduce the incidence of postoperative complications.

The role of ferroptosis in esophageal cancer.

Esophageal cancer is one of the most common cancers with high mortality rate around the world. Although the treatment strategy of this disease has made great progress, the prognosis of advanced patients is not ideal. Ferroptosis, a novel regulatory cell death model, that is different from traditional apoptosis and characterized by increased Fenton reaction mediated by intracellular free iron and lipid peroxidation of cell membrane. Ferroptosis has been proved to be closely linked to a variety of diseases, especially cancer. This review aims to summarize the core mechanism of ferroptosis in esophageal cancer, the regulation of ferroptosis signaling pathway and its current application. At the same time, we emphasize the potential and prospect of ferroptosis in the treatment of esophageal cancer. Collectively, targeting ferroptosis pathway may provide new insights into the diagnosis, treatment and prognosis of esophageal cancer.

Effect of hip external rotator muscle contraction on pelvic floor muscle function and the piriformis.

INTRODUCTION AND HYPOTHESIS: There is a lack of in-depth understanding of the muscles surrounding the pelvic floor muscle (PFM). The study aimed to investigate the functional relationship between PFM and hip external rotator muscles by observing the piriformis muscle thickness and displacement of the bladder base under different contraction conditions of the hip external rotator and/or PFM. We hypothesized that PFM function would be the strongest when the hip external rotator and PFM contracted simultaneously and that during PFM contraction, the piriformis muscle would act as an auxiliary muscle and show coactivation. METHODS: The participants included 13 healthy adult women (mean age 23.8 ± 2.8 years). The three contraction conditions were PFM contraction, hip external rotator contraction, and simultaneous contraction of the hip external rotator and PFM. During the tasks, the piriformis muscle thickness and bladder base displacement were measured using ultrasonography and compared among the contraction conditions using one-way analysis of variance. RESULTS: Significant differences were noted in bladder base displacement among the three contraction conditions (P < 0.01), with PFM contraction having the highest value. The piriformis muscle thickness showed the greatest increase in simultaneous contraction. CONCLUSIONS: In our study, we showed PFM contraction positively influences piriformis contraction, while PFM function operationalized by bladder base displacement was highest during PFM contraction alone.

Fault Detection of Wind Turbine Electric Pitch System Based on IGWO-ERF.

It is difficult to optimize the fault model parameters when Extreme Random Forest is used to detect the electric pitch system fault model of the double-fed wind turbine generator set. Therefore, Extreme Random Forest which was optimized by improved grey wolf algorithm (IGWO-ERF) was proposed to solve the problems mentioned above. First, IGWO-ERF imports the Cosine model to nonlinearize the linearly changing convergence factor α to balance the global exploration and local exploitation capabilities of the algorithm. Then, in the later stage of the algorithm iteration, α wolf generates its mirror wolf based on the lens imaging learning strategy to increase the diversity of the population and prevent local optimum of the population. The electric pitch system fault detection method of the wind turbine generator set sets the generator power of the variable pitch system as the main state parameter. First, it uses the Pearson correlation coefficient method to eliminate the features with low correlation with the electric pitch system generator power. Then, the remaining features are ranked by the importance of the RF features. Finally, the top N features are selected to construct the electric pitch system fault data set. The data set is divided into a training set and a test set. The training set is used to train the proposed fault detection model, and the test set is used for testing. Compared with other parameter optimization algorithms, the proposed method has lower FNR and FPR in the electric pitch system fault detection of the wind turbine generator set.

Effect of the COVID-19 lockdown period on the physical condition, living habits, and physical activity of citizens in Beijing, China.

[Purpose] We aimed to explore the effects of the COVID-19-induced lockdown in Beijing. [Participants and Methods] We distributed a web-based questionnaire survey among 1,029 Beijing citizens to inquire about their physical condition, living habits, and physical activity before and during home isolation. [Results] In the context of forced home isolation due to COVID-19, both males and females reported reductions in daily steps and weekly exercise time and significant increases in daily physical activity time and daily sitting time. The proportions of smokers, patients with metabolic syndrome, and patients with internal diseases were higher in males than in females; females had lower daily step counts and spent more time sitting. [Conclusion] The COVID-19 lockdown affected the physical condition, living habits, and physical activity of both males and females; females were more affected than males. People should be cognizant of the various effects of COVID-19 lockdowns on the body. We recommend a reasonable diet and appropriate home exercise. There is a need to develop training methods and evaluation tools for home exercises in COVID-19 lockdowns.

Summary of respiratory rehabilitation and physical therapy guidelines for patients with COVID-19 based on recommendations of World Confederation for Physical Therapy and National Association of Physical Therapy.

[Purpose] To summarize the existing official guidelines issued by the World Confederation for Physical Therapy and Associations of Physical Therapy in various countries and to clarify the recommended methods of respiratory rehabilitation and physiotherapy for patients in different stages of the coronavirus disease of 2019 (COVID-19). [Methods] An introductory literature search was conducted using the keywords "COVID-19", "respiratory rehabilitation", "physical therapy", and others in the database of the Association of Physical Therapy. [Results] Using 12 coronavirus disease-2019 rehabilitation-related articles, we summarized data on physical therapy (PT) evaluation; treatment; indications; contraindications; and termination indicators for patients in acute, stable, and post-discharge stages. [Conclusion] PT for COVID-19 patients with coronavirus disease 2019 should be formulated according to the stage of the disease and condition of the patients.

Aqueous two-phase assisted by ultrasound for the extraction of anthocyanins from Lycium ruthenicum Murr.

In this study, an efficient ultrasound-assisted aqueous two-phase extraction method was used for the extraction of anthocyanins from Lycium ruthenicum Murr. An ethanol/ammonium sulfate system was chosen for the aqueous two-phase system due to its fine partitioning and recycling behaviors. Single-factor experiments were conducted to determine the optimized composition of the system, and the response surface methodology was used for the further optimization of the ultrasound-assisted aqueous two-phase extraction. The optimal conditions were as follows: a salt concentration of 20%, an ethanol concentration of 25%, an extraction time of 33.7 min, an extraction temperature of 25°C, a liquid/solid ratio of 50:1 w/w, pH value of 3.98, and an ultrasound power of 600 W. Under the above conditions, the yields of anthocyanins reached 4.71 mg/g dry sample. For the further purification, D-101 resin was used, and the purity of anthocyanins reached 25.3%. In conclusion, ultrasound-assisted aqueous two-phase extraction was an efficient, ecofriendly, and economical method, and it may be a promising technique for extracting bioactive components from plants.

Chinese cross-cultural adaptation and validation of the Oxford shoulder score.

BACKGROUND: The Oxford Shoulder Score (OSS) is a reliable and valid construct measuring non-specific shoulder pain, which are widely used to evaluate shoulder related quality of life. This study was to cross-culturally adapt and psychometrically validate a simplified Chinese version of the OSS (SC-OSS). METHODS: Cross-cultural adaptation was performed according to the international recognized guidelines. Consecutive patients with nonspecific shoulder pain were recruited to test the psychometric properties of SC-OSS. Item response trend and item-total correlation were evaluated to measure homogeneity. Principal component analysis (PCA) was used to evaluate the factorial structure. Cronbach's α and intra-class correlations were used to determine the reliability. Construct validity was analyzed by evaluating the correlations between SC-OSS and the Constant-Murley shoulder outcome score (CMSOS), the short form (36) health survey (SF-36) containing eight domains, and pain visual analogue scale (VAS). RESULTS: Overall, 121 patients were recruited. Each of the 12 items was properly responded and correlated with the total items. PCA extracted one factor for SC-OSS. SC-OSS had excellent reliability, with a Cronbach's α of 0.92 and intra-class correlation coefficient of 0.97 (95 % CI: 0.94-0.98). SC-OSS had a high correlation with CMSOS, physical functioning (PF) and bodily pain (BP) domains of SF-36 and VAS (r = -0.70, -0.65, -0.53, and -0.66, respectively). SC-OSS moderately correlated with role-physical (RP), social functioning (SF), general health perception (GH) and vitality (VT) (r = -0.45, -0.42, -0.39 and -0.36, respectively), but had a low correlation with role-emotional (RE) and mental health (MH) domains of SF-36 (r = -0.28 and -0.23, respectively). CONCLUSIONS: SC-OSS demonstrated excellent acceptability, internal consistency, reliability and construct validity, which can be recommended for application in mainland China.

Ethosomes for skin delivery of ropivacaine: preparation, characterization and ex vivo penetration properties.

Ropivacaine, a novel long-acting local anesthetic, has been proved to own superior advantage. However, Naropin® Injection, the applied form in clinic, can cause patient non-convenience. The purpose of this study was to formulate ropivacaine (RPV) in ethosomes and evaluate the potential of ethosome formulation in delivering RPV transdermally. The RPV-loaded ethosomes were prepared with thin-film dispersion technique and the formulation was characterized in terms of size, zeta potential, differential scanning calorimetry (DSC) analysis and X-ray diffraction (XRD) study. The results showed that the optimized RPV-ethosomes displayed a typical lipid bilayer structure with a narrow size distribution of 73.86 ± 2.40 nm and drug loading of 8.27 ± 0.37%, EE of 68.92 ± 0.29%. The results of DSC and XRD study indicated that RPV was in amorphous state when encapsulated into ethosomes. Furthermore, the results of ex vivo permeation study proved that RPV-ethosomes could promote the permeability in a high-efficient, rapid way (349.0 ± 11.5 µg cm(-2) at 12 h and 178.8 ± 7.1 µg cm(-2) at 0.5 h). The outcomes of histopathology study forecasted that the interaction between ethosomes and skin could loosen the tight conjugation of corneocyte layers and weaken the permeation barrier. In conclusion, RPV-ethosomes could be a promising delivery system to encapsulate RPV and deliver RPV for transdermal administration.

Enhancing environmental sustainability in transferred farmlands through rural e-commerce: insights from China.

The issue of farmers neglecting environmental concerns in transferred farmlands poses a serious challenge, contradicting the long-term ecological goals of establishing resource-efficient and environment-friendly agriculture. Amidst the pivotal trend of moderately scaled agricultural operations, rural e-commerce holds promise as a catalyst and driving force for enhancing long-term environmental governance of transferred lands. The effectiveness and mechanisms of this potential, however, remain to be empirically examined. This study gathers panel data on environmental positive and negative externalities from six provinces in China, spanning the period from 2013 to 2022, encompassing 6372 farmers. A quasi-natural experiment of farmers' e-commerce participation is designed using difference-in-differences methodology (DID), propensity score matching (PSM), and moderating models. The primary findings are as follows: E-commerce participation increases farmers' positive environmental inputs on transferred lands, such as water-saving irrigation, adoption of social services, and preservation of traditional varieties. Simultaneously, it decreases negative environmental inputs, such as the consumption of fertilizers, pesticides, and agricultural films. The environmental sustainability effects of e-commerce vary across the eastern, central, and western regions of China. E-commerce has a more pronounced impact on agricultural social services and chemical pollutants in the eastern and central regions, while its influence is more significant on water-saving irrigation and variety preservation in the western region. Land transfer forms and supply order contracts do not directly promote farmers' environmentally friendly cultivation practices. Instead, they catalyze the environmental effects of e-commerce through a significant positive interaction term. These conclusions hold after matching for e-commerce participation propensity, while passing sensitivity tests, parallel trend tests, and placebo tests. Consequently, rural e-commerce, without compromising farmers' income, enhances the proactiveness of farmers in environmental conservation, transforms agricultural management practices, and effectively reduces rural non-point source pollution. Policy recommendations include reducing institutional barriers to rural e-commerce participation at the national level, encouraging the establishment of region-specific agricultural environmental sustainability goals, and leveraging the rural e-commerce industry chain to establish a nationwide environmental credit database and incentive mechanism.

Effects of High-Velocity Versus Low-Velocity Resistance Training on Muscle Echo Intensity in Healthy Young Women: A Randomized Controlled Trial.

BACKGROUND: Improving muscle quality to prevent and treat muscle dysfunction is critical. However, effective measures to improve muscle quality remain poorly understood. We investigated the effects of high- and low-velocity resistance training (RT) on muscle quality, mass, and function before and after an 8-week intervention. HYPOTHESIS: High-velocity RT would improve muscle quality more effectively than low-velocity RT. STUDY DESIGN: Randomized controlled trial. LEVEL OF EVIDENCE: Level 1. METHODS: A total of 33 healthy young women (23.1 ± 2.2 years) were assigned randomly to high-velocity (n = 16) or low-velocity (n = 17) groups. Both groups underwent concentric knee extension RT with a 60% 1-repetition maximum (1RM) load, performing 10 repetitions of 4 sets, 3 times per week for 8 weeks. The high-velocity group was instructed to complete each repetition as quickly as possible (mean repetition duration of 0.5 seconds), while the low-velocity group was required to execute each repetition in 3 seconds. Before and after the 8-week intervention, quadriceps femoris echo intensity (EI), muscle thickness (MT), isokinetic peak torque (60 and 300 deg/s), rate of velocity development (RVD) at 300 deg/s, and 1RM were assessed. Split-plot factorial design analysis of variance was used to compare the group × time interaction. RESULTS: A group×time interaction was observed for EI (P < 0.01). Only the high-velocity group showed a significant reduction in EI after the intervention. MT revealed a main effect of time (P < 0.01), with both groups significantly increasing MT. RVD showed a group × time interaction (P < 0.05), with significant increase only in the high-velocity group. Isokinetic peak torque and 1RM showed main effects of time (P < 0.01), with significant increases in both groups. CONCLUSION: High-velocity RT may be superior to low-velocity RT in enhancing muscle quality and RVD. CLINICAL RELEVANCE: These results emphasize the importance of RT velocity for muscle quality improvement.

Magnetic Resonance Images Segmentation of Multifidus based on Dense-unet and Superpixel.

BACKGROUND: Lumbar disc herniation (LDH) is a common clinical condition causing lower back and leg pain. Accurate segmentation of the lumbar discs is crucial for assessing and diagnosing LDH. Magnetic resonance imaging (MRI) can reveal the condition of articular cartilage. However, manual segmentation of MRI images is burdensome for physicians and needs to be more efficient. OBJECTIVE: In this study, we propose a method that combines UNet and superpixel segmentation to address the problem of loss of detailed information in the feature extraction phase, leading to poor segmentation results at object edges. The aim is to provide a reproducible solution for diagnosing patients with lumbar disc herniation. METHODS: We suggest using the network structure of UNet. Firstly, dense blocks are inserted into the UNet network, and training is performed using the Swish activation function. The Dense-UNet model extracts semantic features from the images and obtains rough semantic segmentation results. Then, an adaptive-scale superpixel segmentation algorithm is applied to segment the input images into superpixel images. Finally, high-level abstract semantic features are fused with the detailed information of the superpixels to obtain edge-optimized semantic segmentation results. RESULTS: Evaluation of a private dataset of multifidus muscles in magnetic resonance images demonstrates that compared to other segmentation algorithms, this algorithm exhibits better semantic segmentation performance in detailed areas such as object edges. Compared to UNet, it achieves a 9.5% improvement in the Dice Similarity Coefficient (DSC) and an 11.3% improvement in the Jaccard Index (JAC). CONCLUSION: The experimental results indicate that this algorithm improves segmentation performance while reducing computational complexity.

A Cadaveric Study of the Optimal Isometric Region on the Anterolateral Surface of the Knee in Anterolateral Ligament Reconstruction.

OBJECTIVE: Isolated intra-articular anterior cruciate ligament (ACL) reconstruction is not capable of restoring instability in many cases leading some to recommend concomitant anterolateral ligament (ALL) reconstruction. The satisfactory fixation site and graft length change are crucial in ligament reconstruction to restore the ALL function and avoid some unwanted graft behavior. The purpose of this investigation is to determine the optimal isometric region on the anterolateral aspect of the knee for ALL reconstruction using a three-dimensional optical instrument and a suture similar to an intraoperative isometric test. METHODS: Six freshly frozen cadaveric human knees were used in this study. Data regarding the anterolateral surface were obtained using an optical measurement system to create a three-dimensional model. Nine points were selected on the femur (F1-F9) and tibia (Ta-Ti) respectively. The three-dimensional length change between each pair of tibial and femoral points was measured during passive knee flexion from 0° to 90° in 15° increments. Subsequently, five femoral points (A-E) were selected from the lateral femur, located in different areas relative to the lateral femoral epicondyle, and three tibial reference points (T1-T3) were selected in the isometric test. The changes in the length between each pair of reference points were measured using sutures. The 95% confidence interval for the rate of length change was estimated using the mean and standard deviation of the maximum rate of length change at different flexion angles, and the data were expressed as the mean (95% confidence interval) and compared with the maximum acceptable rate of change (10%). RESULTS: The maximum acceptable change rate for ligament reconstruction is 10%, and the mean maximum rates and the 95% confidence interval (CI) of length change for the point combinations were calculated. Among all the combined points measured using the optical measurement system and the suture, the qualified point combination for reconstruction was F3 (8mm posterior and 8mm proximal to the lateral femoral epicondyle)-Tb (8mm proximal to the midpoint between the center of Gerdy's tubercle and the fibula head), A (posterior and proximal to the lateral femoral epicondyle)-T2 (10mm below the joint line)and A-T3 (15 mm below the joint line). The position of F3-Tb and A-T2 are close to each other. CONCLUSION: The most isometric area of the femur for ALL reconstruction was posterior and proximal to the lateral femoral epicondyle. We recommend that the initial location of the femoral point be set at 8 mm posterior and 8 mm proximal to the lateral femoral epicondyle and the tibial point at approximately 10 mm below the joint line, midway between Gerdy's tubercle and fibular head, and subsequently adjusted to the most satisfactory position according to the isometric test.

Intramuscular fat infiltration influences mechanical properties during muscle contraction in older women.

Although evidence suggests that intramuscular fat infiltration may influence muscle strength, the precise mechanisms remain unclear. This study aimed to determine whether intramuscular fat infiltration affects muscle mechanical properties during contraction, and whether these mechanical properties mediate the relationship between intramuscular fat infiltration and muscle strength. Seventy-nine healthy older women aged 75.1±6.8 years were included in this study. The echo intensity (EI) of the vastus lateralis (VL) was measured as an intramuscular fat infiltration index using B-mode ultrasonography. Maximum voluntary isometric contraction strength (MVIC) was assessed using a dynamometer. The VL shear elastic modulus (G), a mechanical property index, was measured using ultrasound shear wave elastography under various muscle contraction conditions, at rest and at 15, 30, and 45% MVIC (G0, G15, G30, and G45). To evaluate the degree of increase in the shear elastic modulus with increasing muscle contraction intensity, the slope of the regression line (Gslope) between muscle contraction and shear elastic modulus was calculated for each participant. The results showed that EI was significantly associated with G30 and G45 but not with G0 or G15. The EI can significantly explain the inter-individual differences in Gslope. Mediation analysis revealed that the effect of EI on MVIC through Gslope was significant (indirect effect = -0.31, 95% confidence interval [-0.57, -0.12]). These findings suggest that a greater EI is associated with a lower G during muscle contraction. Furthermore, our results show that the relationship between EI and MVIC is mediated by Gslope.

Age-related change in gait efficacy and predictors of its decline: A 3-year longitudinal study.

AIM: This study aimed to calculate the minimal clinically important difference (MCID) for a modified Gait Efficacy Scale (mGES) over 3 years and to clarify the predictors of mGES decline. METHODS: In total, 87 community-dwelling older adults were enrolled in this 3-year longitudinal study. The mGES, fall history and physical function (chair stand frequency, open-eyes one-leg stand, open-close stepping test, walking speed, walking endurance [shuttle stamina walk test] and physical activity) were assessed at baseline. After a 3-year follow-up period, the mGES and Global Rating of Change Scale were assessed. The MCID was calculated using anchor-based methods, with the Global Rating of Change Scale as an anchor. The participants were classified into the decline and keep groups based on whether the changes in the mGES were greater than the MCID. A logistic regression analysis was conducted using the mGES as the dependent variable and physical characteristics, fall history, and physical function as independent variables. RESULTS: The MCID for the mGES over 3 years was -7.38 points. A logistic regression analysis identified low open-close stepping (odds ratio, 0.87; 95% confidence interval, 0.782-0.985; P = 0.027) and the shuttle stamina walk test (odds ratio, 0.974; 95% confidence interval, 0.949-1.000; P = 0.049) as predictors of the mGES decline. CONCLUSION: These findings suggest that a change of 7.38 points in the mGES was clinically significant and that poor agility and walking endurance can predict future decline in the mGES. Geriatr Gerontol Int 2024; 24: 90-94.

Spatial distribution characteristics of perfluoroalkyl substances in bulk and grain size fractionated sediments in Shenzhen Bay.

Understanding Perfluoroalkyl substances (PFASs) spatial distribution in natural environments is crucial due to their environmental persistence and potential bioaccumulation. However, limited research has investigated PFASs spatial distribution at a high resolution, especially in the Guangdong-Hong Kong-Macao Greater Bay Area. Here, we examined the composition and concentration of PFASs in 36 bulk surface sediments and grain-size fractionated sediments from 9 representative sites to determine the spatial distribution characteristics in Shenzhen Bay. We found that ΣPFASs decreased gradually from nearshore area to offshore area (0.680 and 0.297 ng g-1 dw, respectively). Furthermore, PFASs are easily adsorbed on fine-grained sediments, likely due to their chain length and hydrophobicity. We argue that the lateral movement of sediments may transport fine-grained sediments associated with ΣPFASs out of the bay, resulting in the spatial difference in ΣPFASs in Shenzhen Bay. Our findings provide important insights into explore the mechanisms associated with preservation and transport of PFASs.

Spatial distance between tumor and lymphocyte can predict the survival of patients with resectable lung adenocarcinoma.

Background and objective: Spatial interaction between tumor-infiltrating lymphocytes (TILs) and tumor cells is valuable in predicting the effectiveness of immune response and prognosis amongst patients with lung adenocarcinoma (LUAD). Recent evidence suggests that the spatial distance between tumor cells and lymphocytes also influences the immune responses, but the distance analysis based on Hematoxylin and Eosin (H&E) -stained whole-slide images (WSIs) remains insufficient. To address this issue, we aim to explore the relationship between distance and prognosis prediction of patients with LUAD in this study. Methods: We recruited patients with resectable LUAD from three independent cohorts in this multi-center study. We proposed a simple but effective deep learning-driven workflow to automatically segment different cell types in the tumor region using the HoVer-Net model, and quantified the spatial distance (DIST) between tumor cells and lymphocytes based on H&E-stained WSIs. The association of DIST with disease-free survival (DFS) was explored in the discovery set (D1, n = 276) and the two validation sets (V1, n = 139; V2, n = 115). Results: In multivariable analysis, the low DIST group was associated with significantly better DFS in the discovery set (D1, HR, 0.61; 95 % CI, 0.40-0.94; p = 0.027) and the two validation sets (V1, HR, 0.54; 95 % CI, 0.32-0.91; p = 0.022; V2, HR, 0.44; 95 % CI, 0.24-0.81; p = 0.009). By integrating the DIST with clinicopathological factors, the integrated model (full model) had better discrimination for DFS in the discovery set (C-index, D1, 0.745 vs. 0.723) and the two validation sets (V1, 0.621 vs. 0.596; V2, 0.671 vs. 0.650). Furthermore, the computerized DIST was associated with immune phenotypes such as immune-desert and inflamed phenotypes. Conclusions: The integration of DIST with clinicopathological factors could improve the stratification performance of patients with resectable LUAD, was beneficial for the prognosis prediction of LUAD patients, and was also expected to assist physicians in individualized treatment.