Laparoscopic Versus Open Nephroureterectomy for Upper Tract Urothelial Carcinoma: A Systematic Review and Meta-Analysis of Propensity-Score Matched Studies.

BACKGROUND: The effectiveness of laparoscopic nephroureterectomy (LNU) vs open nephroureterectomy (ONU) for upper tract urothelial carcinoma (UTUC) is unclear. METHODS: We conducted a meta-analysis of studies based on propensity score-matched cohorts to compare the surgical and oncological outcomes of LNU and ONU in UTUC patients. A literature search was conducted on PubMed, Embase, and Cochrane Library until July 12, 2023. The Newcastle-Ottawa Scale was utilized to assess the quality of eligible studies. Measurements of surgical and oncological outcomes were extracted and pooled including mean difference (MD), risk ratio (RR), hazard ratios (HR), and 95% confidence intervals (CI). RESULTS: Five high-quality retrospective studies were included, totaling 6422 patients; 2080 (32.4%) underwent LNU, and 4342 (67.6%) underwent ONU. With respect to surgical outcomes, patients in the LNU group experienced less estimated blood loss and had shorter hospital stay than those in the ONU group, but there was no significant difference in complication rates and operation time. In regard to oncological outcomes, there were no significant differences between the LNU and ONU groups in 3-year overall survival (OS) and cancer-specific survival (CSS). However, 3-year intravesical recurrence free survival (IVRFS) was worse in the LNU group compared to the ONU group. CONCLUSION: LNU was associated with less estimated blood loss and shorter hospital stays than ONU, but there were no differences in OS and CSS between the surgical modalities. Nonetheless, LNU might result in poorer IVRFS than ONU.

A pH-sensitive film based on chitosan/gelatin and anthocyanin from Zingiber striolatum Diels for monitoring fish freshness.

As a new type of packaging method, the anthocyanin-based pH-sensitive indicator film has gained much attention owing to low cost, small size, and visually informative property. In this study, an intelligent film based on chitosan/gelatin (CG) matrix with Zingiber striolatum Diels (ZSD) anthocyanin for fish freshness monitoring was developed. The film properties, including thickness, moisture content, color, mechanical properties, UV-vis light barrier property, as well as pH and ammonia sensitivity, were evaluated. The CG-ZSD films exhibited a more compact structure when compared with the CG film. The CG-ZSD20 film showed the highest elongation at break (6.33 ± 0.62%) and lowest tensile strength (20.0 ± 0.58 MPa). FTIR spectra revealed the strong hydrogen bond interactions between ZSD and polymer matrix. Film incorporated with 15% anthocyanin extract has increased melting temperature at 118.9 °C, and a lower weight loss (13.8%) at melting temperature. In pH 1-14 buffer, the color of CG-ZSD films underwent a significant change from red to yellow-green. The CG-ZSD15 film was utilized for monitoring fish freshness and showed visible color changes from deep purple to brown. The total volatile basic nitrogen content and pH value changes of fish were closely related to the visual color changes in film. This demonstrated that the film was a highly pH-sensitive film for quantifying fish freshness in real-time.

A programmable sensitive platform for pathogen detection based on CRISPR/Cas12a -hybridization chain reaction-poly T-Cu.

Rapid and sensitive detection of pathogenic bacteria is crucial for disease prevention and control. The CRISPR/Cas12a system with the DNA cleavage capability holds promise in pathogenic bacteria diagnosis. However, the sensitivity of CRISPR-based assays remains a challenge. Herein, we report a versatile and sensitive pathogen sensing platform (HTCas12a) based on the CRISPR/Cas12a system, hybridization chain reaction (HCR) and Poly T-copper fluorescence nanoprobe. The sensitivity is improved by HCR and the Poly-T-Cu reporter probe reduces the overall experiment cost to less than one dollar per sample. Our results demonstrate the specific recognition of target nucleic acid fragments from other pathogens. Furthermore, a good linear correlation between fluorescence intensity and target quantities were achieved with detection limits of 23.36 fM for Target DNA and 4.17 CFU/mL for S.aureus, respectively. The HTCas12a system offers a universal platform for pathogen detection in various fields, including environmental monitoring, clinical diagnosis, and food safety.

Simulation Analysis on the Characteristics of Aerosol Particles to Inhibit the Infrared Radiation of Exhaust Plumes.

Aerosol infrared stealth technology is a highly effective method to reduce the intensity of infrared radiation by releasing aerosol particles around the hot exhaust plume. This paper uses a Computational Fluid Dynamics (CFD) two-phase flow model to simulate the exhaust plume fields of three kinds of engine nozzles containing aerosol particles. The Planck-weighted narrow spectral band gas model and the Reverse Monte Carlo method are used for infrared radiation transfer calculations to analyze the influencing factors and laws for the suppression of the infrared radiation properties of exhaust plumes by four typical aerosol particles. The simulation calculation results show that the radiation suppression efficiency of aerosol particles on the exhaust plume reaches its maximum value at a detection angle (ϕ) of 0° and decreases with increasing ϕ, reaching its minimum value at 90°. Reducing the aerosol particle size and increasing the aerosol mass flux can enhance the suppression effect. In the exhaust plume studied in this paper, the radiation suppression effect is best when the particle size is 1 µm and the mass flux is 0.08 kg/s. In addition, the inhibition of aerosol particles varies among different materials, with graphite having the best inhibition effect, followed by H2O, MgO, and SiO2. Solid particles will increase the radiation intensity and change the spectral radiation characteristics of the exhaust plume at detection angles close to the vertical nozzle axis due to the scattering effect. Finally, this paper analyzed the suppression effects of three standard nozzle configurations under the same aerosol particle condition and found that the S-bend nozzle provides better suppression.

Roles of Critical Amino Acids Metabolism in The Interactions Between Intracellular Bacterial Infection and Macrophage Function.

Macrophages, as crucial participants in the innate immune system, respond to pathogenic challenges through their dynamic metabolic adjustments, demonstrating the intimate interplay between cellular metabolism and immune function. Bacterial infection of macrophages causes changes in macrophage metabolism, affecting both macrophage function and bacterial virulence and intracellular survival. This review explores the reprogramming of amino acid metabolism in macrophages in response to bacterial infection, with a particular focus on the influence of critical amino acids such as serine, glutamine, and arginine on the immune functions of macrophages; highlights the roles of these metabolic pathways in macrophage functions such as phagocytosis, inflammatory response, immune regulation, and pathogen clearance; reveals how pathogens exploit and manipulate the amino acid metabolism within macrophages to support their own growth and replication, thereby showcasing the intricate interplay between macrophages and pathogens. It provides a foundation for understanding the interactions between macrophages amino acid metabolism and pathogens, offering potential strategies and therapeutic targets for the development of novel anti-infection therapies.

Glutathione S-Transferase α4 Alleviates Hyperlipidemia-Induced Vascular Neointimal Hyperplasia in Arteriovenous Grafts via Inhibiting Endoplasmic Reticulum Stress.

ABSTRACT: Neointimal hyperplasia causes the failure of coronary artery bypass grafting. Our previous studies have found that endothelial dysfunction is 1 candidate for triggering neointimal hyperplasia, but which factors are involved in this process is unclear. Glutathione S-transferase α4 (GSTA4) plays an important role in metabolizing 4-hydroxynonenal (4-HNE), a highly reactive lipid peroxidation product, which causes endothelial dysfunction or death. Here, we investigated the role of GSTA4 in neointima formation after arteriovenous grafts (AVGs) with or without high-fat diet (HFD). Compared with normal diet, HFD caused endothelial dysfunction and increased neointima formation, concomitantly accompanied by downregulated expression of GSTA4 at the mRNA and protein levels. In vitro, overexpression of GSTA4 attenuated 4-HNE-induced endothelial dysfunction and knockdown of GSTA4 aggravated endothelial dysfunction. Furthermore, silencing GSTA4 expression facilitated the activation of 4-HNE-induced endoplasmic reticulum stress and inhibition of endoplasmic reticulum stress pathway alleviated 4-HNE-induced endothelial dysfunction. In addition, compared with wild-type mice, mice with knockout of endothelial-specific GSTA4 (GSTA4 endothelial cell KO) exhibited exacerbated vascular endothelial dysfunction and increased neointima formation caused by HFD. Together, these results demonstrate the critical role of GSTA4 in protecting the function of endothelial cells and in alleviating hyperlipidemia-induced vascular neointimal hyperplasia in arteriovenous grafts.

Protective role of pretreatment with Anisodamine against sepsis-induced diaphragm atrophy via inhibiting JAK2/STAT3 pathway.

There is an increasing tendency for sepsis patients to suffer from diaphragm atrophy as well as mortality. Therefore, reducing diaphragm atrophy could benefit sepsis patients' prognoses. Studies have shown that Anisodamine (Anis) can exert antioxidant effects when blows occur. However, the role of Anisodamine in diaphragm atrophy in sepsis patients has not been reported. Therefore, this study investigated the antioxidant effect of Anisodamine in sepsis-induced diaphragm atrophy and its mechanism. We used cecal ligation aspiration (CLP) to establish a mouse septic mode and stimulated the C2C12 myotube model with lipopolysaccharide (LPS). After treatment with Anisodamine, we measured the mice's bodyweight, diaphragm weight, fiber cross-sectional area and the diameter of C2C12 myotubes. The malondialdehyde (MDA) levels in the diaphragm were detected using the oxidative stress kit. The expression of MuRF1, Atrogin1 and JAK2/STAT3 signaling pathway components in the diaphragm and C2C12 myotubes was measured by RT-qPCR and Western blot. The mean fluorescence intensity of ROS in C2C12 myotubes was measured by flow cytometry. Meanwhile, we also measured the levels of Drp1 and Cytochrome C (Cyt-C) in vivo and in vitro by Western blot. Our study revealed that Anisodamine alleviated the reduction in diaphragmatic mass and the loss of diaphragmatic fiber cross-sectional area and attenuated the atrophy of the C2C12 myotubes by inhibiting the expression of E3 ubiquitin ligases. In addition, we observed that Anisodamine inhibited the JAK2/STAT3 signaling pathway and protects mitochondrial function. In conclusion, Anisodamine alleviates sepsis-induced diaphragm atrophy, and the mechanism may be related to inhibiting the JAK2/STAT3 signaling pathway.

N-Acetylcysteine Attenuates Sepsis-Induced Muscle Atrophy by Downregulating Endoplasmic Reticulum Stress.

(1) Background: Sepsis-induced muscle atrophy is characterized by a loss of muscle mass and function which leads to decreased quality of life and worsens the long-term prognosis of patients. N-acetylcysteine (NAC) has powerful antioxidant and anti-inflammatory properties, and it relieves muscle wasting caused by several diseases, whereas its effect on sepsis-induced muscle atrophy has not been reported. The present study investigated the effect of NAC on sepsis-induced muscle atrophy and its possible mechanisms. (2) Methods: The effect of NAC on sepsis-induced muscle atrophy was assessed in vivo and in vitro using cecal ligation and puncture-operated (CLP) C57BL/6 mice and LPS-treated C2C12 myotubes. We used immunofluorescence staining to analyze changes in the cross-sectional area (CSA) of myofibers in mice and the myotube diameter of C2C12. Protein expressions were analyzed by Western blotting. (3) Results: In the septic mice, the atrophic response manifested as a reduction in skeletal muscle weight and myofiber cross-sectional area, which is mediated by muscle-specific ubiquitin ligases-muscle atrophy F-box (MAFbx)/Atrogin-1 and muscle ring finger 1 (MuRF1). NAC alleviated sepsis-induced skeletal muscle wasting and LPS-induced C2C12 myotube atrophy. Meanwhile, NAC inhibited the sepsis-induced activation of the endoplasmic reticulum (ER) stress signaling pathway. Furthermore, using 4-Phenylbutyric acid (4-PBA) to inhibit ER stress in LPS-treated C2C12 myotubes could partly abrogate the anti-muscle-atrophy effect of NAC. Finally, NAC alleviated myotube atrophy induced by the ER stress agonist Thapsigargin (Thap). (4) Conclusions: NAC can attenuate sepsis-induced muscle atrophy, which may be related to downregulating ER stress.

Comparison of safety and efficacy of tubeless vs. conventional mini percutaneous nephrolithotomy in patients with Escherichia coli bacteriuria.

To evaluate the safety and efficacy of tubeless percutaneous nephrolithotomy (PCNL) in patients with Escherichia coli (E. coli) bacteriuria. We conducted a retrospective review of 84 patients with E. coli bacteriuria who underwent PCNL. Patients were divided into two groups according to whether a nephrostomy tube is placed at the end of the procedure. Preoperative clinical data, surgical outcomes, and postoperative complications were compared. Then, regression analysis of factors predicting success rate of PCNL in patients with E. coli bacteriuria was performed. After PCNL, residual fragments ≤ 4 mm were considered as success. At baseline, the two groups were similar with regard to age, gender, BMI, underlying disease, hydronephrosis, stone characteristics, and urinalysis. Postoperative fever occurred in 1 patient (3.8%) in the tubeless PCNL group, and in 5 patients (8.6%) in the conventional PCNL group (p > 0.05). There were no significant differences in terms of successful rate, decrease in hemoglobin, pain scores, blood transfusion, and hospitalization expenses. However, the tubeless PCNL group had significantly shorter operative time (60 vs. 70 min, p = 0.033), indwelling time of catheter (2 vs. 4 days, p < 0.001), and hospital stays (3 vs. 5 days, p < 0.001) than the conventional PCNL group. In the analysis of factors predicting success, the stone diameter, stone burden, and operative time were associated with success rate of PCNL. It is safe and effective to perform tubeless PCNL in patients with E. coli bacteriuria. Compared to conventional PCNL, tubeless PCNL accelerates patient recovery and shortens hospital stays.

Cardiac resident macrophages: Spatiotemporal distribution, development, physiological functions, and their translational potential on cardiac diseases.

Cardiac resident macrophages (CRMs) are the main population of cardiac immune cells. The role of these cells in regeneration, functional remodeling, and repair after cardiac injury is always the focus of research. However, in recent years, their dynamic changes and contributions in physiological states have a significant attention. CRMs have specific phenotypes and functions in different cardiac chambers or locations of the heart and at different stages. They further show specific differentiation and development processes. The present review will summarize the new progress about the spatiotemporal distribution, potential developmental regulation, and their roles in cardiac development and aging as well as the translational potential of CRMs on cardiac diseases. Of course, the research tools for CRMs, their respective advantages and disadvantages, and key issues on CRMs will further be discussed.

Preference for diagnosing and treating renal colic during pregnancy: a survey among Chinese urologists.

To explore the preference for diagnosing and treating renal colic during pregnancy among Chinese urologists. A questionnaire was designed using the Sojump® platform. WeChat, the largest social networking platform in China, was used to distribute the questionnaire to urologists at hospitals of all levels in China. In total, 110 responses were included. Of the respondents, 100.0% used ultrasound to diagnose renal colic during pregnancy, followed by magnetic resonance imaging (17.3%) and low-dose CT (3.6%). Phloroglucinol (80.9%) and progesterone (72.7%) were the most commonly used antispasmodics and analgesics. Opioid analgesics were not commonly used (12.7%). Most of the respondents (63.6%) indicated that no more than 20% of the patients needed surgical intervention. If surgery was unavoidable, 95.5% preferred temporary renal drainage, including ureteral stenting (92.7%) and percutaneous nephrostomy (2.7%). However, some respondents still preferred definitive stone treatment, such as ureteroscopy lithotripsy (3.6%) and percutaneous nephrolithotomy (0.9%). Moreover, there were no differences in the choices of urologists with different professional titles regarding diagnostic tools, most therapeutic medications, or surgical methods (p > 0.05). Ultrasound is the preferred tool for diagnosing renal colic during pregnancy. Low-dose CT is still not widely accepted. Pregnant patients with renal colic are initially treated conservatively. Urologists prefer ureteral stenting when there are clinical indications for intervention.

The role of platelets in sepsis: A review.

Sepsis, a life-threatening condition characterized by organ dysfunction, results from a complex series of pathophysiological mechanisms including immune dysfunction, an uncontrolled inflammatory response, and coagulation abnormalities. It is a major contributor to global mortality and severe disease development. Platelets, abundant in the circulatory system, are sensitive to changes in the body's internal environment and are among the first cells to respond to dysregulated pro-inflammatory and pro-coagulant reactions at the onset of sepsis. In the initial stages of sepsis, the coagulation cascade, inflammatory response, and endothelial tissue damage perpetually trigger platelet activation. These activated platelets then engage in complex inflammatory and immune reactions, potentially leading to organ dysfunction. Therefore, further research is essential to fully understand the role of platelets in sepsis pathology and to develop effective therapeutic strategies targeting the associated pathogenic pathways. This review delves into the involvement of platelets in sepsis and briefly outlines the clinical applications of associated biomarkers.

Metformin protects ovarian granulosa cells in chemotherapy-induced premature ovarian failure mice through AMPK/PPAR-γ/SIRT1 pathway.

Premature ovarian failure (POF) caused by chemotherapy is a growing concern for female reproductive health. The use of metformin (MET), which has anti-oxidative and anti-inflammatory effects, in the treatment of POF damaged by chemotherapy drugs remains unclear. In this study, we investigated the impact of MET on POF caused by cyclophosphamide (CTX) combined with busulfan (BUS) and M1 macrophages using POF model mice and primary granule cells (GCs). Our findings demonstrate that intragastric administration of MET ameliorates ovarian damage and alleviates hormonal disruption in chemotherapy-induced POF mice. This effect is achieved through the reduction of inflammatory and oxidative stress-related harm. Additionally, MET significantly relieves abnormal inflammatory response, ROS accumulation, and senescence in primary GCs co-cultured with M1 macrophages. We also observed that this protective role of MET is closely associated with the AMPK/PPAR-γ/SIRT1 pathway in cell models. In conclusion, our results suggest that MET can protect against chemotherapy-induced ovarian injury by inducing the expression of the AMPK pathway while reducing oxidative damage and inflammation.

Childhood maltreatment and insomnia in college students: The role of alexithymia and psychological distress.

Insomnia, which is highly prevalent among college students, has been identified as one of the negative consequences of childhood maltreatment. While prior studies have uncovered distinct correlations between childhood maltreatment, insomnia, and other variables, the potential underlying mechanisms need to be further explored. This study focused on the chain-mediating role of alexithymia and psychological distress in the relationship between childhood maltreatment and insomnia. An online cross-sectional survey was conducted among Chinese college students, yielding 999 valid questionnaires that included demographic information, the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Toronto Alexithymia Scale (TAS), the 21-item Depression Anxiety Stress Scales (DASS-21), and the Insomnia Severity Index (ISI). A chain-mediating model was then tested. The results revealed significant positive correlations between each pair of the four variables. Alexithymia and psychological distress separately mediated the link between childhood maltreatment and insomnia (effect of alexithymia was 0.06 with 95 % CI [0.03, 0.09]; effect of psychological distress was 0.24 with 95 % CI [0.19, 0.29]). Additionally, a chain-mediating effect of alexithymia and psychological distress was observed (chain-mediating effect was 0.12 with 95 % CI [0.09, 0.15]). The findings suggest that emotional interventions may mitigate the long-term effect of childhood maltreatment on sleep problems among college students, by improving the ability to recognize emotions and decreasing emotional problems.

Aramid Nanodielectrics for Ultraconformal Transparent Electronic Skins.

On-skin electronics require minimal thicknesses and decent transparency for conformal contact, imperceptible wearing, and visual aesthetics. It is challenging to search for advanced ultrathin dielectrics capable of supporting the active components while maintaining bending softness, easy handling, and wafer-scale processability. Here, self-delaminated aramid nanodielectrics (ANDs) are demonstrated, enabling any skin-like electronics easily exfoliated from the processing substrates after complicated nanofabrication. In addition, ANDs are mechanically strong, chemically and thermally stable, transparent and breathable, therefore are ideal substrates for soft electronics. As demonstrated, compliant epidermal electrodes comprising silver nanowires and ANDs can successfully record high-quality electromyogram signals with low motion artifacts and satisfying sweat and water resistance. Furthermore, ANDs can serve as both substrates and dielectrics in single-walled carbon nanotube field-effect transistors (FETs) with a merely 160-nm thickness, which can be operated within 4 V with on/off ratios of 1.4 ± 0.5 × 105 , mobilities of 39.9 ± 2.2 cm2 V-1 s-1 , and negligible hysteresis. The ultraconformal FETs can function properly when wrapped around human hair without any degradation in performance.

A sequential Moken scaling approach to evaluate response quality in survey research.

Careless responding, where participants do not fully engage with item content, is pervasive in survey research. Left undetected, carelessness can compromise the interpretation and use of survey results, including information about participant locations on the construct, item difficulty, and the psychometric quality of the instrument. We present and illustrate a sequential procedure for evaluating response quality in survey research using indicators from Mokken scale analysis (MSA). We use a real data illustration and a simulation study to compare a sequential procedure to a standalone procedure. We also consider how identifying and removing responses with evidence of poor measurement properties affects item quality indicators. Results suggest that the sequential procedure was effective in identifying potentially problematic response patterns that may not always be captured by traditional methods for identifying careless responders but was not always sensitive to specific carelessness patterns. We discuss implications for research and practice.

ceRNA networks in gynecological cancers progression and resistance.

Gynecological cancers are the second most common types of cancer in women. Clinical diagnosis of these cancers is often delayed or misdiagnosed due to lack of insight into their tumorigenesis mechanism and specific diagnostic biomarkers. Many studies have demonstrated that competing endogenous RNAs (ceRNAs) modulate the progression and resistance of gynecological cancer through microRNA (miRNA)-mediated mechanisms, which affect gene expression in multiple cancer-related pathways. Here we review studies on the involvement of the ceRNA hypothesis in the progression and resistance of gynaecological cancers to validate some ceRNAs as therapeutic targets and predictive biomarkers.

The Impact of Prompts and Feedback on the Performance during Multi-Session Self-Regulated Learning in the Hypermedia Environment.

The hypermedia environment is among the most prevalent contemporary self-regulated learning (SRL) environments; however, methods for improving the effectiveness of students' multi-session SRL in such environments remain under discussion. In this study, two experiments were conducted to explore whether and how prompts and feedback benefit performance during multi-session SRL in a hypermedia learning environment. A total of 76 senior students participated in Experiment 1, which used a mixed 2 (prompting condition: prompt, no prompt) × 2 (feedback condition: feedback, no feedback) × 2 (learning session: Session 1 and Session 2) design to explore the effects of prompting and feedback on the multi-session learning process in a hypermedia environment. The results indicated that, in learning Session 1, performance in the prompt condition was significantly better than in the unprompted condition, with or without feedback; in learning Session 2, participants in the prompt condition with feedback performed significantly better than those in the other three conditions. Students in the group with a prompt and feedback had the most accurate meta-comprehension absolute accuracy in both learning sessions. Experiment 2 recruited 94 secondary school students to further explore whether the combination of prompts and different types of feedback led to different learning outcomes according to the division of feedback timing. A mixed 2 (prompt condition: prompt, no prompt) × 3 (feedback condition: delayed feedback, immediate feedback, no feedback) × 2 (learning session: Session 1 and Session 2) design was used. The results indicated that, in learning Session 1, the prompt condition outperformed the unprompted condition with or without feedback; in learning Session 2, students with prompted delayed feedback outperformed the other five conditions. We also found that although there was no significant difference in meta-comprehension monitoring accuracy between delayed and immediate feedback, both groups performed significantly better than those in the no feedback condition. These results suggest that the combination of prompts and feedback in hypermedia environments facilitates student performance better than prompts or feedback alone; this improvement may be related to the correction of poor internal student feedback.

Supramolecular Gel-to-Gel Transition Induced by Nanoscale Structural Perturbation via the Rotary Motion of Feringa's Motor.

Supramolecular rather than covalent molecular engineering on Feringa motors can provide an alternative toolkit for tuning the properties of motorized materials through appropriate supramolecular structural perturbations, which are underexplored. Herein, a multicomponent supramolecular gel system is successfully prepared by employing an ultra-low molecular weight gelator and a modulator-Feringa motor. The electron microscopic, spectroscopic, and rheological data revealed that the morphology and mechanical properties of the gel can be tuned via a crystallographic mismatch branching (CMB) mechanism simply by adding varied amounts of motor modulators. Notably, the rotary motion of the motor is preserved in such a multicomponent gel system, and the morphology and rheology of the gel can be further altered by the motor's rotary motion that promotes the structural perturbation, resulting in seldomly seen gel-to-gel transition events. The work shown here offers prospects to utilize a supramolecular perturbation strategy to deliver responsiveness from molecular motors to the corresponding bulk materials.