Deep Learning Radiomics Nomogram Based on Enhanced CT to Predict the Response of Metastatic Lymph Nodes to Neoadjuvant Chemotherapy in Locally Advanced Gastric Cancer.

BACKGROUND: We aimed to construct and validate a deep learning (DL) radiomics nomogram using baseline and restage enhanced computed tomography (CT) images and clinical characteristics to predict the response of metastatic lymph nodes to neoadjuvant chemotherapy (NACT) in locally advanced gastric cancer (LAGC). METHODS: We prospectively enrolled 112 patients with LAGC who received NACT from January 2021 to August 2022. After applying the inclusion and exclusion criteria, 98 patients were randomized 7:3 to the training cohort (n = 68) and validation cohort (n = 30). We established and compared three radiomics signatures based on three phases of CT images before and after NACT, namely radiomics-baseline, radiomics-delta, and radiomics-restage. Then, we developed a clinical model, DL model, and a nomogram to predict the response of LAGC after NACT. We evaluated the predictive accuracy and clinical validity of each model using the receiver operating characteristic curve and decision curve analysis, respectively. RESULTS: The radiomics-delta signature was the best predictor among the three radiomics signatures. So, we developed and validated a DL delta radiomics nomogram (DLDRN). In the validation cohort, the DLDRN produced an area under the receiver operating curve of 0.94 (95% confidence interval, 0.82-0.96) and demonstrated adequate differentiation of good response to NACT. Furthermore, the DLDRN significantly outperformed the clinical model and DL model (p < 0.001). The clinical utility of the DLDRN was confirmed through decision curve analysis. CONCLUSIONS: In patients with LAGC, the DLDRN effectively predicted a therapeutic response in metastatic lymph nodes, which could provide valuable information for individualized treatment.

An MRI-Based Radiomics Nomogram to Assess Recurrence Risk in Sinonasal Malignant Tumors.

BACKGROUND: Sinonasal malignant tumors (SNMTs) have a high recurrence risk, which is responsible for the poor prognosis of patients. Assessing recurrence risk in SNMT patients is a current problem. PURPOSE: To establish an MRI-based radiomics nomogram for assessing relapse risk in patients with SNMT. STUDY TYPE: Retrospective. POPULATION: A total of 143 patients with 68.5% females (development/validation set, 98/45 patients). FIELD STRENGTH/SEQUENCE: A 1.5-T and 3-T, fat-suppressed fast spin echo (FSE) T2-weighted imaging (FS-T2WI), FSE T1-weighted imaging (T1WI), and FSE contrast-enhanced T1WI (T1WI + C). ASSESSMENT: Three MRI sequences were used to manually delineate the region of interest. Three radiomics signatures (T1WI and FS-T2WI sequences, T1WI + C sequence, and three sequences combined) were built through dimensional reduction of high-dimensional features. The clinical model was built based on clinical and MRI features. The Ki-67-based and tumor-node-metastasis (TNM) model were established for comparison. The radiomics nomogram was built by combining the clinical model and best radiomics signature. The relapse-free survival analysis was used among 143 patients. STATISTICAL TESTS: The intraclass/interclass correlation coefficients, univariate/multivariate Cox regression analysis, least absolute shrinkage and selection operator Cox regression algorithm, concordance index (C index), area under the curve (AUC), integrated Brier score (IBS), DeLong test, Kaplan-Meier curve, log-rank test, optimal cutoff values. A P value < 0.05 was considered statistically significant. RESULTS: The T1 + C-based radiomics signature had best prognostic ability than the other two signatures (T1WI and FS-T2WI sequences, and three sequences combined). The radiomics nomogram had better prognostic ability and less error than the clinical model, Ki-67-based model, and TNM model (C index, 0.732; AUC, 0.765; IBS, 0.185 in the validation set). The cutoff values were 0.2 and 0.7 and then the cumulative risk rates were calculated. DATA CONCLUSION: A radiomics nomogram for assessing relapse risk in patients with SNMT may provide better prognostic ability than the clinical model, Ki-67-based model, and TNM model. EVIDENCE LEVEL: 3. TECHNICAL EFFICACY: Stage 5.

Incremental value of radiomics-based heterogeneity to the existing risk criteria in predicting recurrence of hepatocellular carcinoma after liver transplantation.

OBJECTIVES: The aim of the study was to evaluate the association between the radiomics-based intratumoral heterogeneity (ITH) and the recurrence risk in hepatocellular carcinoma (HCC) patients after liver transplantation (LT), and to assess its incremental to the Milan, University of California San Francisco (UCSF), Metro-Ticket 2.0, and Hangzhou criteria. METHODS: A multicenter cohort of 196 HCC patients were investigated. The endpoint was recurrence-free survival (RFS) after LT. A CT-based radiomics signature (RS) was constructed and assessed in the whole cohort and in the subgroups stratified by the Milan, UCSF, Metro-Ticket 2.0, and Hangzhou criteria. The R-Milan, R-UCSF, R-Metro-Ticket 2.0, and R-Hangzhou nomograms which combined RS and the four existing risk criteria were developed respectively. The incremental value of RS to the four existing risk criteria in RFS prediction was evaluated. RESULTS: RS was significantly associated with RFS in the training and test cohorts as well as in the subgroups stratified by the existing risk criteria. The four combined nomograms showed better predictive capability than the existing risk criteria did with higher C-indices (R-Milan [training/test] vs. Milan, 0.745/0.765 vs. 0.677; R-USCF vs. USCF, 0.748/0.767 vs. 0.675; R-Metro-Ticket 2.0 vs. Metro-Ticket 2.0, 0.756/0.783 vs. 0.670; R-Hangzhou vs. Hangzhou, 0.751/0.760 vs. 0.691) and higher clinical net benefit. CONCLUSIONS: The radiomics-based ITH can predict outcomes and provide incremental value to the existing risk criteria in HCC patients after LT. Incorporating radiomics-based ITH in HCC risk criteria may facilitate candidate selection, surveillance, and adjuvant trial design. KEY POINTS: • Milan, USCF, Metro-Ticket 2.0, and Hangzhou criteria may be insufficient for outcome prediction in HCC after LT. • Radiomics allows for the characterization of tumor heterogeneity. • Radiomics adds incremental value to the existing criteria in outcome prediction.

A comparative study of modern total ankle replacement and ankle arthrodesis for ankle osteoarthritis at different follow-up times: a systematic review and meta-analysis.

PURPOSE: Total ankle replacement (TAR) or ankle arthrodesis (AA) is the main surgical treatment for end-stage ankle osteoarthritis. However, the therapeutic effect of the two surgical procedures at different follow-up times remains controversial. The purpose of this meta-analysis is to compare the short-term, medium-term, and long-term safety and efficiency of the two modern surgical treatments. METHODS: We conducted a comprehensive search in PubMed, EMBASE, Cochrane library databases, Web of Science, and Scopus. The main results were the patient's reported outcome measure (PROM) score, satisfaction, complications, reoperation, and surgery success rate. Different follow-up times and implant designs were used to evaluate the source of heterogeneity. We used a fixed effects model for meta-analysis and I2 statistic for evaluating heterogeneity. RESULTS: Thirty-seven comparative studies were included. In the short term, TAR significantly improved clinical scores (AOFAS score: WMD = 7.07, 95% Cl: 0.41-13.74, I2 = 0.0%; SF-36 PCS score: WMD = 2.40, 95% Cl: 2.22-2.58, I2 = 0.0%; SF-36 MCS score: WMD = 0.40, 95% Cl: 0.22-0.57, I2 = 0.0%; VAS for pain: WMD = - 0.50, 95% Cl: - 0.56-0.44, I2 = 44.3%) and had the lower incidence of revision (RR = 0.43, 95% CI: 0.23-0.81, I2 = 0.0%) and complications (RR = 0.67, 95% Cl: 0.50-0.90, I2 = 0.0%). In the medium term, there were still higher improvements in both the clinical scores (SF-36 PCS score: WMD = 1.57, 95% Cl: 1.36-1.78, I2 = 20.9%; SF-36 MCS score: WMD = 0.81, 95% Cl: 0.63-0.99, I2 = 48.8%) and the patient satisfaction (RR = 1.24, 95% Cl: 1.08-1.41, I2 = 12.1%) in the TAR group, but its total complications rate (RR = 1.84, 95% Cl: 1.26-2.68, I2 = 14.9%) and revision rate (RR = 1.58, 95% CI: 1.17-2.14, I2 = 84.6%) were significantly higher than that of the AA group. In the long term, there was no significant difference in clinical score and satisfaction, and a higher incidence of revision (RR = 2.32, 95% Cl: 1.70-3.16, I2 = 0.0%) and complications (RR = 3.18, 95% Cl: 1.69-5.99, I2 = 0.0%) was observed in TAR than in AA. The result of the third-generation design subgroup was consistent with that of the above pooled results. CONCLUSION: TAR had advantages over AA in the short term due to better performance in terms of PROMs, complications, and reoperation rates, but its complications become a disadvantage in the medium term. In the long term, AA seems to be favored because of lower complications and revision rates, although there is no difference in clinical scores.

Enabling High Loading in Single-Atom Catalysts on Bare Substrate with Chemical Scissors by Saturating the Anchoring Sites.

Atomically dispersed metal catalysts often exhibit high catalytic performances, but the metal loading density must be kept low to avoid the formation of metal nanoparticles, making it difficult to improve the overall activity. Diverse strategies based on creating more anchoring sites (ASs) have been adopted to elevate the loading density. One problem of such traditional methods is that the single atoms always gather together before the saturation of all ASs. Here, a chemical scissors strategy is developed by selectively removing unwanted metallic materials after excessive loading. Different from traditional ways, the chemical scissors strategy places more emphasis on the accurate matching between the strength of etching agent and the bond energies of metal-metal/metal-substrate, thus enabling a higher loading up to 2.02 wt% even on bare substrate without any pre-treatment (the bare substrate without any pre-treatment generally only has a few ASs for single atom loading). It can be inferred that by combining with other traditional methods which can create more ASs, the loading could be further increased by saturating ASs. When used for CH3 OH generation via photocatalytic CO2 reduction, the as-made single-atom catalyst exhibits impressive catalytic activity of 597.8 ± 144.6 µmol h-1 g-1 and selectivity of 81.3 ± 3.8%.

Depth of field and resolution-enhanced integral imaging display system.

Depth of field (DOF) and resolution are mutually restricted in integral imaging (II) display. To overcome the trade-offs, we propose an II display system that simultaneously enhances the DOF and resolution. The system consists of a transmissive mirror device (TMD), a semi-transparent mirror (STM), and two II display units. Each II display unit consists of a 4K display screen and a micro-lens array (MLA). Benefiting from the parallel placement of the TMD and the STM, two central depth planes are reconstructed, which effectively enhances the DOF. Meanwhile, the resolution in the overlapping DOF region is increased to two times due to the interpolation of the light field information from two II display units. The impact of the distance between the two II display units and the TMD on the 3D image quality is analyzed. In geometric optics, a distance between the II two display units and the TMD is optimized to eliminate ghost images. In wave optics, a distance is optimized to eliminate 3D pixel gaps by exploiting the diffraction effect of the TMD. Both the geometric and wave optics are considered simultaneously to obtain a high-quality 3D image without ghost images and 3D pixel gaps. A DOF and resolution-enhanced II display system is developed, and the experimental results verify its feasibility.

Multi-parametric MRI-based radiomics signature for preoperative prediction of Ki-67 proliferation status in sinonasal malignancies: a two-centre study.

OBJECTIVE: To assess the predictive ability of a multi-parametric MRI-based radiomics signature (RS) for the preoperative evaluation of Ki-67 proliferation status in sinonasal malignancies. METHODS: A total of 128 patients with sinonasal malignancies that underwent multi-parametric MRIs at two medical centres were retrospectively analysed. Data from one medical centre (n = 77) were used to develop the predictive models and data from the other medical centre (n = 51) constitute the test dataset. Clinical data and conventional MRI findings were reviewed to identify significant predictors. Radiomics features were determined using maximum relevance minimum redundancy and least absolute shrinkage and selection operator algorithms. Subsequently, RSs were established using a logistic regression (LR) algorithm. The predictive performance of RSs was assessed using calibration, decision curve analysis (DCA), accuracy, and AUC. RESULTS: No independent predictors of high Ki-67 proliferation were observed based on clinical data and conventional MRI findings. RS-T1, RS-T2, and RS-T1c (contrast enhancement T1WI) were established based on a single-parametric MRI. RS-Combined (combining T1WI, FS-T2WI, and T1c features) was developed based on multi-parametric MRI and achieved an AUC and accuracy of 0.852 (0.733-0.971) and 86.3%, respectively, on the test dataset. The calibration curve and DCA demonstrated an improved fitness and benefits in clinical practice. CONCLUSIONS: A multi-parametric MRI-based RS may be used as a non-invasive, dependable, and accurate tool for preoperative evaluation of the Ki-67 proliferation status to overcome the sampling bias in sinonasal malignancies. KEY POINTS: • Multi-parametric MRI-based radiomics signatures (RSs) are used to preoperatively evaluate the proliferation status of Ki-67 in sinonasal malignancies. • Radiomics features are determined using maximum relevance minimum redundancy (mRMR) and least absolute shrinkage and selection operator (LASSO) algorithms. • RSs are established using a logistic regression (LR) algorithm.

Predictors for the risk of permanent pacemaker implantation after transcatheter aortic valve replacement: A systematic review and meta-analysis.

BACKGROUND: Transcatheter aortic valve replacement (TAVR) is a less invasive treatment than surgery for severe aortic stenosis. However, its use is restricted by the fact that many patients eventually require permanent pacemaker implantation (PPMI). This meta-analysis was performed to identify predictors of post-TAVR PPMI. METHODS: The PubMed, Embase, Web of Science, and Cochrane Library databases were systematically searched. Relevant studies that met the inclusion criteria were included in the pooling analysis after quality assessment. RESULTS: After pooling 67 studies on post-TAVR PPMI risk in 97,294 patients, balloon-expandable valve use was negatively correlated with PPMI risk compared with self-expandable valve (SEV) use (odds ratio [OR]: 0.44, 95% confidence interval [CI]: 0.37-0.53). Meta-regression analysis revealed that history of coronary artery bypass grafting and higher Society of Thoracic Surgeons (STS) risk score increased the risk of PPMI with SEV utilization. Patients with pre-existing cardiac conduction abnormalities in 28 pooled studies also had a higher risk of PPMI (OR: 2.33, 95% CI: 1.90-2.86). Right bundle branch block (OR: 5.2, 95% CI: 4.37-6.18) and first-degree atrioventricular block (OR: 1.97, 95% CI: 1.38-2.79) also increased PPMI risk. Although the trans-femoral approach was positively correlated with PPMI risk, the trans-apical pathway showed no statistical difference to the trans-femoral pathway. The approach did not increase PPMI risk in patients with STS scores >8. Patient-prosthesis mismatch did not influence post-TAVR PPMI risk (OR: 0.88, 95% CI: 0.67-1.16). We also analyzed implantation depth and found no difference between patients with PPMI after TAVR and those without. CONCLUSIONS: SEV selection, pre-existing cardiac conduction abnormality, and trans-femoral pathway selection are positively correlated with PPMI after TAVR. Pre-existing left bundle branch block, patient-prosthesis mismatch, and implantation depth did not affect the risk of PPMI after TAVR.

An Advanced Material with Synergistic Viscoelasticity Enhancement of Hydrophobically Associated Water-Soluble Polymer and Surfactant.

In order to prepare materials with controllable properties, changeable microstructure, and high viscoelasticity solution with low polymer and surfactant concentration, a composite is constituted by adding surfactant (sodium dodecyl sulfate, SDS) to hydrophobically associated water-soluble polymer (abbreviated as PAAC) solution. The viscoelasticity, aggregate microstructure, and interaction mechanism of the composite are investigated by rheometery, Cryo-transmission electron microscopy (Cryo-TEM), and fluorescence spectrum. The results show that when the mass ratio of polymer to surfactant is 15:1, the viscosity of the composite reaches the maximum. The viscosity of the composite system increases hundredfold. The viscosity plateau under dynamic shear is generated. The composite has the properties of high viscoelasticity, strong shear thinning behavior, and good salt tolerance, and temperature resistance. The maximum viscosity of the composite is shown at the salinity of 20000 mg L-1 . In addition, there is no phase separation in the composite with the increase of polymer and surfactant concentration, which indicates the good stability of the system. It is proposed a method to obtain a high viscoelasticity solution by adding surfactants without wormlike micelles to a hydrophobically associated water-soluble polymer solution.

Cognitive improvement among abstinent methamphetamine users: A 2-year prospective longitudinal study.

BACKGROUND AND OBJECTIVES: The adverse impact of chronic methamphetamine (MA) use on cognitive function has been described in previous studies, but limited evidence is available for abstinent users from prospective longitudinal studies. The aim of the present study was to assess cognitive function of varying abstinent duration. METHODS: This prospective longitudinal study was conducted with baseline and four follow-up interviews every 6 months over 2 years in 358 MA users in Guangdong province, China. The Montreal Cognitive Assessment (MoCA) was used to measure cognitive function. Generalized estimating equation (GEE) analysis was used to examine within-subjects relationships between abstinence and cognitive consequences over time. RESULTS: The repeated measure analysis of variance showed significant differences in the total MoCA score and all subscale scores (except Orientation) in the 24 months follow-up. The GEE model showed that abstinence from MA in the past 6 months predicted an increase of 0.66 (95% confidence interval [CI] = 0.29 to 1.05, p = .002) in MoCA score changes compared with the nonabstinence MA users. Abstinence in the past 12, 18, and 24 months predicted an increase in MoCA total score changes of 1.25 (95% CI = -0.23 to 2.74), 2.15 (95% CI = -0.79 to 5.09), and 5.28 (95% CI = -2.01 to 12.58), respectively, but none of these was statistically significant. DISCUSSION AND CONCLUSIONS: Cognitive function was potentially improved following 6 months of MA abstinence. SCIENTIFIC SIGNIFICANCE: This study extends prior research by long-term follow-up in big sample MA abstinence users. Findings from study support the need for a comprehensive measure to decrease MA use and promote the recovery of cognitive impairment.

Nomogram for Predicting Chemotherapy-Induced Nausea and Vomiting for Breast Cancer Patients.

Chemotherapy-induced nausea and vomiting (CINV) is a common side effect of cancer treatment. The factors influencing CINV in breast cancer patients remain unclear. In this study, we developed a nomogram for predicting the occurrence of CINV in this group using prospective clinical data. We pooled data from multiple studies which focused on the emetogenic chemotherapy. Then, we collected 334 breast cancer patients at Hunan Cancer Hospital (training set) to analyze the demographic and clinical variables. Using multivariate logistic regression, we identified the five significant factors that were associated with CINV: history of CINV, chemotherapy regimen, chemotherapy cycle, metastasis, and symptoms of distress. Then, we construct a prediction nomogram. The external validation set comprised an additional 66 patients. The reliability of the nomogram was assessed by bootstrap resampling. The C-index was 0.78 (95% confidence interval [CI], 0.73-0.85) for the training set and 0.74 (95% CI, 0.62-0.85) for the validation set. Calibration curves showed good concordance between predicted and actual occurrence of CINV. In conclusions, our nomogram model can reliably predict the occurrence of CINV in breast cancer patients based on five significant variables, which might be useful in clinical decision-making.

Prevalence and Clinical Significance of Portal Vein Thrombosis in Patients With Cirrhosis and Acute Decompensation.

BACKGROUND & AIMS: Portal vein thrombosis (PVT) is a common and serious complication in patients with cirrhosis. However, little is known about PVT in patients with cirrhosis and acute decompensation (AD). We investigated the prevalence and clinical significance of PVT in nonmalignant patients with cirrhosis and AD. METHODS: We performed a retrospective study of 2 cohorts of patients with acute exacerbation of chronic liver disease who participated in the Chinese AcuTe on CHronic LIver FailurE study, established by the Chinese Chronic Liver Failure Consortium, from January 2015 through December 2016 (n = 2600 patients) and July 2018 through January 2019 (n = 1370 patients). We analyzed data on the prevalence, clinical manifestations, and risk factors of PVT from 2826 patients with cirrhosis, with and without AD. RESULTS: The prevalence of PVT in patients with cirrhosis and AD was 9.36%, which was significantly higher than in patients with cirrhosis without AD (5.24%) (P = .04). Among patients with cirrhosis and AD, 63.37% developed PVT recently (the first detected PVT with no indication of chronic PVT). Compared with patients without PVT, a significantly higher proportion of patients with PVT had variceal bleeding (47.33% vs 19.63%; P < .001) and patients with PVT had a significantly higher median serum level of D-dimer (2.07 vs 1.25; P < .001). Splenectomy and endoscopic sclerotherapy were independent risk factors for PVT in patients with cirrhosis and AD. The 1-year mortality rate did not differ significantly between patients with vs without PVT. CONCLUSIONS: In an analysis of data from 2826 patients with cirrhosis, a significantly higher proportion of those with AD had PVT than those without AD. PVT was associated with increased variceal bleeding, which would increase the risk for AD. Strategies are needed to prevent PVT in patients with cirrhosis, through regular screening, to reduce portal hypertension. ClinicalTrials.gov no: NCT02457637 and NCT03641872.

Twice daily short-message-based re-education could improve Helicobacter pylori eradication rate in young population: A prospective randomized controlled study.

BACKGROUND: To investigate the effects of twice daily short-message-based re-education (SMRE) before taking medicine for Helicobacter pylori (H pylori) eradication. MATERIALS AND METHODS: Treatment-naive patients with H pylori infection were prescribed 14-day quadruple regimen consisting of lansoprazole 30 mg, colloidal bismuth pectin 200 mg, amoxicillin 1000 mg, and clarithromycin 500 mg twice daily. Patients were randomly allocated to SMRE group or control group. Patients in control group received oral and written instructions at outpatient clinic. In contrast, patients in the SMRE group received extra short messages including dosage and time of administration twice daily. Successful H pylori eradication was assessed using the 13 C-urea breath test 6 weeks after treatment. The compliance, adverse events, and patient satisfaction were also analyzed. RESULTS: A total of 310 patients were enrolled in the intention-to-treat (ITT) and 283 in the per-protocol (PP) analysis. For young patients, the eradication rates were significantly higher in SMRE group than those in control group in PP analysis (88.6% vs 71.2%, P = 0.036), while for patients of all age groups, the eradication rate improvements were not statistically significant. The eradication rates in SMRE group and control group were 74.2% and 67.7% (P = 0.211) in ITT analysis and 82.1% and 73.4% (P = 0.078) in PP analysis, respectively. The compliance in SMRE group was significantly better than that in control group (84.8% vs 72.8%, P = 0.011). CONCLUSIONS: Twice daily SMRE could improve the eradication rate in young population, as well as the compliance with treatment during H pylori eradication.

[Preliminary estimating the burden of foodborne acute gastrointestinal illness in Beijing City].

OBJECTIVE: To estimate the burden of foodborne acute gastrointestinal illness(AGI) in community residents, and to provide the basis for prevention and control of foodborne diseases. METHODS: Muli-stage stratified random cluster sampling was used to select samples in community population. A retrospective cross-sectional face-to-face household interviews were conducted over a 12-month period. Respondents were asked questions about vomiting and diarrhea within the 28 days prior to the interviews, healthcare seeking behavior and the related cost due to AGI. RESULTS: There were 0. 15(95%CI 0. 13-0. 16)AGI episodes per person-year, foodboren infection resulted in 911975 AGI cases. About 290 190 cases sought healthcare, resulting in 9120 hospitallizations. The overall economic burden of foodborne AGI was 147 million Yuan per year, accounting for 0. 07᾿of the GDP. The direct cost of medical care was 107 million Yuan(medical costs and non-medical cost were 9. 4 million and 1. 2 million), and the direct cost was 4 million Yuan. CONCLUSION: The burden of foodborne AGI in Beijing should not be ignored. It is necessary to improve the foodborne disease surveillance system to more accurately assess the impact of foodborne disease on society and health.

Poly-Drug Use of Prescription Medicine among People with Opioid Use Disorder in China: A Systematic Review and Meta-Analysis.

BACKGROUND: Opioid use disorder (OUD) causes substantial public health and social problems worldwide. Poly-drug use is common in people with OUD and increases morbidity and mortality. Investigation of the patterns and characteristics of poly-drug use of prescription medicine among opioid users is needed to develop appropriate prevention and intervention strategies. OBJECTIVES: To estimate the prevalence of poly-drug use of prescription medicine among people with OUD in China using meta-analysis. METHODS: We searched relevant epidemiological studies published before February 2017 in English and Chinese databases. The quality of included studies was assessed using the Agency for Healthcare Research and Quality scale. The pooled prevalences of prescription medicine use among people with OUD were estimated. RESULTS: We included 80 eligible studies in the meta-analysis. The main prescription medicines were benzodiazepines (BZDs) and prescription opioid analgesics. The pooled prevalence of unclassified BZDs and prescription opioids was 40.6% and 23.2%, respectively. Diazepam was the most frequently co-used BZD (32.6%), followed by triazolam (32.1%), and estazolam (9.2%). Tramadol was the most commonly used prescription opioid (27.3%), followed by methadone (16.8%), buprenorphine (12.6%), pethidine (8.9%), morphine (6.5%), dihydroetorphine (3.9%), and codeine-containing cough syrup (3.7%). BZDs were mainly used for self-medication (56.1%), whereas prescription opioids were primarily coused for nonmedical purposes (69.4%). CONCLUSIONS: The results demonstrate that prescription medicine use is widespread among opioid users in China. There needs to be more consideration of poly-drug use, and early interventions and management strategies are needed to prevent poly-drug use among opioid users in China.

Efficient near-infrared light-emitting diodes based on liquid PbSe quantum dots.

Recently, near-infrared light-emitting diodes (NIR LEDs) based on PbSe quantum dots (QDs) have attracted considerable attention due to their facilely tunable emission wavelength, as well as high quantum yield. However, the low external quantum efficiency (EQE) of these LEDs has restricted their actual applications because of the non-radiative recombination caused by the aggregation in the solid-state QD films. Therefore, we proposed in this work to employ the liquid-type structure in NIR LEDs base on PbSe QDs, which exhibited the main advantages relying on the fact that the liquid structure could prevent the active layer from self-aggregation and improve the device stability. The emission intensity of these NIR LEDs was optimized by tuning the concentration of PbSe QDs. Besides, the radiation power of PbSe QD-based devices with different emission wavelengths was analyzed under different biases, and the maximum EQE of NIR LEDs was confirmed to be 5.3%. This result represents the highest record among the reported NIR QD-LEDs, indicating this kind of liquid-type NIR LEDs is promising for commercial applications.

Pattern and related factors of cognitive impairment among chronic methamphetamine users.

BACKGROUND AND OBJECTIVES: Methamphetamine (MA) use is increasingly prevalent in East and Southeast Asia and commonly associated with cognitive impairment. The present study estimated the characteristics of cognitive impairment and explored the associated potential factors among chronic MA users. METHODS: The data were from the baseline visit of a longitudinal study among synthetic drug users. The baseline survey was conducted in detoxification and rehabilitation centers in Guangdong province, China, from September to December in 2013. A total of 528 participants were included in our analysis. Cognitive impairment was measured by the Montreal Cognitive Assessment (MoCA). Logistic regression was performed to explore the risk factors associated with cognitive impairment. RESULTS: Approximately 69.89% of the study participants exhibited cognitive impairment according to MoCA scores. Multiple logistic regression analyses indicated that older age (≥30 years old), a longer duration of MA use (>24 months), and a higher frequency of MA use (everyday) were associated with cognitive impairment, with adjusted odds ratios (ORs) of 1.58 (95% confidence interval [CI]: 1.07-2.34), 1.53 (95%CI: 1.01-2.31), and 1.55 (95%CI: 1.05-2.30), respectively. Methamphetamine users that had a higher level of education had a lower risk of cognitive impairment(OR = .59; 95%CI: .38-.93). CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: Cognitive impairment occurred frequently among chronic MA users. The causal relationship between cognitive impairment and MA use needs to be ascertained in longitudinal studies in future work. Our study provides evidence for the development of intervention strategies for the prevention of MA use and associated cognitive impairment. (Am J Addict 2017;26:145-151).