Self-assembly synthesis of oxygen and sulfur co-doped porous graphitic carbon nitride nanosheets for boosting CO2 photoreduction.

Graphitic carbon nitride (CN) has garnered considerable attention in the field of visible-light CO2 photoreduction, but its efficiency remains limited by the intrinsic π-conjugated skeleton. Here, O and S were co-doped CN (O, S/CN) by a facile "hydrolysis + calcination" approach to modulate the physicochemical and electronic structure.  Distinctive from S doped CN (SCN), O, S/CN owned porous layer structure with several nanosheets and less SO42- groups on the surface. The amount of heteroatom-doping was achieved by changing the hydrothermal temperature. The optimum O, S/CN-80 achieved moderate CO production rate of 1.29 µmol g-1h-1, which was 3.79 times as much as SCN (0.34 µmol g-1h-1). The O and most S atoms were substitutionally doped and the effect of S doped state on the improved efficiency of CO generation in O, S/CN was also explored based on the theoretical calculations. This work provides an inspiration to develop efficient dual-doped CN photocatalysts for photocatalytic CO2 reduction.

Sensorimotor Synchronization and Neural Entrainment to Imagined Rhythms in Individuals With Proficient Imagery Ability.

Sensorimotor synchronization (SMS) is the temporal coordination of motor movements with external or imagined stimuli. Finger-tapping studies indicate better SMS performance with auditory or tactile stimuli compared to visual. However, SMS with a visual rhythm can be improved by enriching stimulus properties (e.g., spatiotemporal content) or individual differences (e.g., one's vividness of auditory imagery). We previously showed that higher self-reported vividness of auditory imagery led to more consistent synchronization-continuation performance when participants continued without a guiding visual rhythm. Here, we examined the contribution of imagery to the SMS performance of proficient imagers, including an auditory or visual distractor task during the continuation phase. While the visual distractor task had minimal effect, SMS consistency was significantly worse when the auditory distractor task was present. Our electroencephalography analysis revealed beat-related neural entrainment, only when the visual or auditory distractor tasks were present. During continuation with the auditory distractor task, the neural entrainment showed an occipital electrode distribution, suggesting the involvement of visual imagery. Unique to SMS continuation with the auditory distractor task, we found neural and sub-vocal (measured with electromyography) entrainment at the three-beat pattern frequency. In this most difficult condition, proficient imagers employed both beat- and pattern-related imagery strategies. However, this combination was insufficient to restore SMS consistency to that observed with visual or no distractor task. Our results suggest that proficient imagers effectively utilized beat-related imagery in one modality when imagery in another modality was limited.

Time course and neural locus of the Flashed Face Distortion Effect.

Viewing a rapid sequence of face images shown in the periphery can lead to large caricature-like distortions in the perceived images, a phenomenon known as the Flashed Face Distortion Effect (FFDE). The mechanisms underlying FFDE are poorly understood. Here we examined the timing and sites of the adaptation processes giving rise to the FFDE. To investigate the effects of presentation rate, we maintained consistent trial lengths while assessing how variations in the temporal frequencies of face presentation influenced the magnitude of face distortion and the averaging of facial expressions. Over a wide range of temporal frequencies (1.2-60 Hz) tested, we observed a decrease in FFDE strength as the presentation rate increased. To probe the neural sites of FFDE, we varied whether successive faces were presented to the same or different eyes using a dichoptic display. Distortion effects were comparable for monocular, binocular, and interocular conditions, yet much larger than a control condition where faces were presented with a temporal interval between successive images, suggesting a cortical locus for FFDE.

Clinical efficacy and immune response of neoadjuvant camrelizumab plus chemotherapy in resectable locally advanced oesophageal squamous cell carcinoma: a phase 2 trial.

BACKGROUND: Neoadjuvant immunotherapy is under intensive investigation for esophageal squamous cell carcinoma (ESCC). This study assesses the efficacy and immune response of neoadjuvant immunochemotherapy (nICT) in ESCC. METHODS: In this phase II trial (ChiCTR2100045722), locally advanced ESCC patients receiving nICT were enrolled. The primary endpoint was the pathological complete response (pCR) rate. Multiplexed immunofluorescence, RNA-seq and TCR-seq were conducted to explore the immune response underlying nICT. RESULTS: Totally 42 patients were enrolled, achieving a 27.0% pCR rate. The 1-year, 2-year DFS and OS rates were 89.2%, 64.4% and 97.3%, 89.2%, respectively. RNA-seq analysis highlighted T-cell activation as the most significantly enriched pathway. The tumour immune microenvironment (TIME) was characterised by high CD4, CD8, Foxp3, and PD-L1 levels, associating with better pathological regression (TRS0/1). TIME was categorised into immune-infiltrating, immune-tolerant, and immune-desert types. Notably, the immune-infiltrating type and tertiary lymphoid structures correlated with improved outcomes. In the context of nICT, TIM-3 negatively influenced treatment efficacy, while elevated TIGIT/PD-1 expression post-nICT correlated positively with CD8+ T cell levels. TCR-seq identified three TCR rearrangements, underscoring the specificity of T-cell responses. CONCLUSIONS: Neoadjuvant camrelizumab plus chemotherapy is effective for locally advanced, resectable ESCC, eliciting profound immune response that closely associated with clinical outcomes.

Co(PO3)2@CoP Heterojunction in CoPO/GC/NF Nanoarrays Modulate Proton Hydrogen-Promoted Electrocatalytic Hydrodechlorination.

Cobalt phosphide has received much attention as an efficient catalyst for electrocatalytic hydrodechlorination (EHDC). However, the active species proton hydrogen (H*) is consumed by the hydrogen evolution reaction (HER). Herein, we report a crystal regulation strategy for cobalt phosphate/graphitic nanocarbon/nickel foam (CoPO/GC/NF) catalysts applied for the EHDC of 2,4-dichlorophenoxyacetic acid (2,4-D). Characterization revealed that during the high-temperature phosphatization process, CoPO/GC/NF catalysts developed Co(PO3)2@CoP heterojunctions, enhancing charge transfer at the electrolyte-catalyst interface and water dissociation. The interaction between Co(PO3)2 and CoP induced the reconstitution of CoP into the Co-OH species, which facilitated the production of H* by accelerating the Volmer step, enhancing EHDC activity. Furthermore, Co(PO3)2 species improve the catalyst tolerance, with CoPO/GC/NF(450) maintaining over 71% yield of phenoxyacetic acid (PA) in continuous testing for up to 80 h under high-salt conditions. This work clarifies the surface transformation process of CoP/GC/NF during hydrodechlorination and demonstrates great potential for chlorophenol wastewater remediation.

Clinicopathological characteristics and oncologic outcomes of patients with gestational trophoblastic neoplasia manifesting as isolated pulmonary lesions.

OBJECTIVE: To elucidate the clinicopathological characteristics and oncological outcomes of a special group of patients with gestational trophoblastic neoplasia (GTN) initially presenting with isolated lung lesions, elevated human chorionic gonadotropin (hCG) levels, and unobserved pelvic lesions. METHODS: Overall, 2358 patients with GTN treated at our hospital between 2000 and 2023 were retrospectively reviewed, and 40 patients were evaluated. The demographic characteristics, clinicopathological features, treatment data, and follow-up information of each patient were collected. The primary outcome was progression free survival. Kaplan-Meier analysis and univariate and multivariate Cox proportional hazard analyses were used to identify the risk factors. RESULTS: Among the 40 patients, 95.0 % had solitary lung lesions, with a median size of 1.9 cm. Moreover, 72.5 % of patients were pathologically confirmed as epithelioid trophoblastic tumors (ETT). During a median follow-up period of 53.5 months (range, 2-143), 11 patients experienced recurrence, including all patients who received chemotherapy alone as the initial treatment, and no death was observed. Relapse treatment involved lung segmentectomy and lobectomy combined with chemotherapy and immunotherapy. Univariate and multivariate Cox analyses identified comparing with surgery±chemotherapy, chemotherapy alone as the initial treatment (hazard ratio [HR] =7.738, 95 % confidence interval [CI] 1.698-35.269, P = 0.008) as independent risk factor for recurrence. CONCLUSIONS: In patients with a history of pregnancy exhibiting isolated pulmonary lesions, elevated hCG levels (mostly <1000 mIU/mL), and unobserved pelvic lesions, ETT should be considered first. Surgical resection of lung lesion is crucial for optimal management. When chemotherapy is considered, multidrug regimen is recommended.

Development and validation of novel interpretable survival prediction models based on drug exposures for severe heart failure during vulnerable period.

BACKGROUND: Severe heart failure (HF) has a higher mortality during vulnerable period while targeted predictive tools, especially based on drug exposures, to accurately assess its prognoses remain largely unexplored. Therefore, this study aimed to utilize drug information as the main predictor to develop and validate survival models for severe HF patients during this period. METHODS: We extracted severe HF patients from the MIMIC-IV database (as training and internal validation cohorts) as well as from the MIMIC-III database and local hospital (as external validation cohorts). Three algorithms, including Cox proportional hazards model (CoxPH), random survival forest (RSF), and deep learning survival prediction (DeepSurv), were applied to incorporate the parameters (partial hospitalization information and exposure durations of drugs) for constructing survival prediction models. The model performance was assessed mainly using area under the receiver operator characteristic curve (AUC), brier score (BS), and decision curve analysis (DCA). The model interpretability was determined by the permutation importance and Shapley additive explanations values. RESULTS: A total of 11,590 patients were included in this study. Among the 3 models, the CoxPH model ultimately included 10 variables, while RSF and DeepSurv models incorporated 24 variables, respectively. All of the 3 models achieved respectable performance metrics while the DeepSurv model exhibited the highest AUC values and relatively lower BS among these models. The DCA also verified that the DeepSurv model had the best clinical practicality. CONCLUSIONS: The survival prediction tools established in this study can be applied to severe HF patients during vulnerable period by mainly inputting drug treatment duration, thus contributing to optimal clinical decisions prospectively.

Investigating the impact of early deafness on learned action-effect contingency for action linked to peripheral sensory effects.

Investigating peripheral visual processing in individuals with early auditory deprivation is a critical research area in the field of neuroscience, since it helps understanding the phenomenon of sensory adaptation and brain plasticity after sensory loss. Prior research has already demonstrated that the absence of auditory input, which is crucial to detect events occurring out of the central egocentric visual space, leads to an improved processing of visual and tactile stimuli occurring in peripheral regions of the sensory space. Nevertheless, no prior studies have explored whether such enhanced processing also takes place within the domain of action, particularly when individuals are required to perform actions that produce peripheral sensory outcomes. To test this hypothesis, we recruited 15 hearing (31 ± 3.3 years) and 15 early deaf adults (42 ± 2.6 years) for a neuro-behavioral experiment involving: 1) a behavioral task where participants executed a simple motor action (i.e., a button press) and received a visual feedback either in the center or in a peripheral region of the visual field, and 2) the electrophysiological recording of brain electrical potentials (EEG). We measured and compared neural activity preceding the motor action (the readiness potentials) and visual evoked responses (the N1 and P2 ERP components) and found that deaf individuals did not exhibit more pronounced modulation of neural responses when their motor actions resulted in peripheral visual stimuli compared to their hearing counterparts. Instead they showed a reduced modulation when visual stimuli were presented in the center. Our results suggest a redistribution of attentional resources from center to periphery in deaf individuals during sensorimotor coupling.

Real-world efficacy of second-line therapies for Helicobacter pylori: a population-based study.

BACKGROUND: With the increasing prevalence of antibiotic resistance, real-world data on the optimal empirical second-line therapy for Helicobacter pylori are still limited. OBJECTIVES: To evaluate the real-world efficacy of various second-line therapies for H. pylori. PATIENTS AND METHODS: This was a retrospective population-based cohort study of all H. pylori-infected patients who had received the second-line treatment after the failure of primary clarithromycin triple therapy in Hong Kong between 2003 and 2018. The retreatment success rates of different second-line therapies were evaluated. RESULTS: A total of 7591 patients who received second-line treatment were included. Notably, the most commonly prescribed regimen was still clarithromycin triple therapy, but the frequency of use had decreased from 59.5% in 2003-06 to 28.7% in 2015-18. Concomitant non-bismuth quadruple therapy had emerged as the commonest regimen (from 3.3% to 43.9%). In a validation analysis, the sensitivity and specificity of retreatment-inferred second-line treatment failure were 88.3% and 97.1%, respectively. The overall success rate of second-line therapies was 73.6%. Bismuth quadruple therapy had the highest success rate of 85.6%, while clarithromycin triple therapy had the lowest success rate of 63.5%. Specifically, bismuth/metronidazole/tetracycline quadruple, metronidazole/tetracycline triple, levofloxacin/metronidazole/tetracycline quadruple, rifabutin/amoxicillin triple and amoxicillin/levofloxacin triple therapies had relatively higher success rates over 80%. Age, treatment duration, baseline conditions and first-line treatment used were associated with success rate. CONCLUSIONS: Bismuth quadruple therapy was the most effective second-line regimen for H. pylori in this real-world study. Despite a very low success rate, clarithromycin-containing triple therapies were still commonly used as second-line regimens.

Advances and Challenges in Interfacial Binding Forces for Electrocatalysts.

As a practical chemical energy conversion technology, electrocatalysis could be used in fields of energy conversion and environmental protection. In recent years, significant research efforts have been devoted to the design and development of high-performance electrocatalysts because the rational design of catalysts is crucial for enhancing electrocatalytic performance. Creating electrocatalysts by forming interactions between different components at the interface is an important means of controlling and improving performance. Therefore, several common interfacial binding forces used for synthesizing electrocatalysts was systematically summarized in this review for the first time. The discussion revolves around the crucial roles these binding forces play in various electrocatalytic reaction processes. Various characterization techniques capable of proving the existence of these interfacial binding forces was also involved in the review. Finally, some prospects and challenges for designing and researching materials through the utilization of interfacial binding forces were presented.

Crystal phase-driven performance of MnO2 in aqueous phase low-temperature thermal catalysis: Synergistic interactions between Mn3+ and surface lattice oxygen.

Catalytic oxidation at mild conditions is crucial for mitigating the high pressure and high temperature challenges associated with current catalytic wet air oxidation (CWAO) technologies in wastewater treatment. Among potential materials for catalytic oxidation reactions, polycrystalline MnO2 existed in natural minerals holds considerable promise. However, the relationships between different crystal phases of MnO2 and their catalytic activity sources in aqueous phase remain uncertain and subject to debate. In this research, we synthesized various MnO2 crystal phases, comprising α-, ß-, δ-, γ-, ε-, and λ-MnO2, and assessed their catalytic oxidation efficiency during low-temperature heating for treatment of organic pollutants. Our findings demonstrate that λ-MnO2 exhibits the highest catalytic activity, followed by δ-MnO2, γ-MnO2, α-MnO2, ε-MnO2, and ß-MnO2. The variations in catalytic activity among different MnO2 are attributed to variances in their oxygen vacancy abundance and redox activity. Furthermore, we identified the primary active species, which include Mn3+ and superoxide radicals (•O2-) generated by surface lattice oxygen of MnO2. This research highlights the critical role of crystal phases in influencing oxygen vacancy content, redox activity, and overall catalytic performance, providing valuable insights for the rational design of MnO2 catalysts tailored for effective organic pollutant degradation in CWAO applications.

Comparative analysis of millet bran nanocelluloses with various morphologies: Revealing differences in the formation mechanism and structure characteristics.

To investigate the differences of nanocelluloses with various morphologies, ammonium persulphate (APS) oxidation, H3PO4 dissolution and regeneration, and ball milling combined with 1-butyl-3-methylimidazolium chloride ([BMIM]Cl) as a medium were applied to isolate cellulose nanocrystals (MCNCs), cellulose nanospheres (MCNSs) and cellulose fibrils (MCNFs) from millet bran. The structure, properties, and formation mechanism of three nanocelluloses were comparatively investigated by Fourier transform infrared spectroscopy, X-ray diffraction, thermogravimetric analysis, atomic force microscope, scanning electronic microscope, and emulsifying ability evaluation. MCNCs had needle-like structures due to the removal of amorphous regions, MCNFs appeared fibrous structures due to swelling and mechanical force, and MCNSs displayed spherical structures through self-assembly. MCNCs and MCNFs were confirmed to exhibit cellulose I structures with crystallinities of 61.24 % and 50.09 %, respectively. MCNSs showed the highest crystallinity of 68.41 % with a cellulose II structure. MCNFs and MCNSs exhibited higher initial decomposition temperatures, while MCNCs showed the highest residual mass. MCNFs suspension showed the highest apparent viscosity, while MCNSs suspension demonstrated superior dispersion. MCNSs-emulsion displayed the smallest droplet size, and MCNFs-emulsion exhibited the highest viscosity. This study reveals the formation mechanisms and relationship between morphologies and properties of three millet bran nanocelluloses, providing a theoretical basis for their application.

Long-term outcome and fertility results of intraplacental choriocarcinoma: a retrospective study of 14 patients and literature review.

BACKGROUNDS: Intraplacental choriocarcinoma (IC) is an extremely rare subtype of gestational choriocarcinoma. The long-term follow-up and reproductive outcomes of IC patients remain unclear. Here, we report a series of 14 cases and conduct a literature review to assess the fertility and recurrence results of this rare disease. RESULTS: Fourteen patients with pathologically confirmed IC treated in Peking Union Medical College Hospital between January 2002 and July 2022 were included in this study. Half of them had metastatic IC and were treated by chemotherapy with or without surgery. Only 1 patient had chemoresistant disease, but she achieved complete remission after immunotherapy. The median follow-up time was 45.5 months (range 4-192), and no recurrence occurred. One metastatic IC patient who achieved remission after chemotherapy had a full-term delivery. Among the 5 patients with fertility demands, 3 abandoned their pursuit of pregnancy because of "fear and worry about choriocarcinoma recurrence". We reviewed a total of 89 cases of IC in English and Chinese literature from 1963 to 2022, and only 5 cases with subsequent pregnancy were reported, all of them were nonmetastatic IC cases. CONCLUSIONS: IC is sensitive to chemotherapy and has good long-term remission and a low recurrence rate. Patients with metastatic or nonmetastatic IC can have good pregnancy results after treatment. Doctors should pay more attention to the psychology of these patients. CLINICAL TRIAL REGISTRATION: N/A.

The contribution of auditory imagery and visual rhythm perception to sensorimotor synchronization with external and imagined rhythm.

Sensorimotor synchronization (SMS) refers to the temporal coordination of an external stimulus with movement. Our previous work revealed that while SMS with visual flashing patterns was less consistent than with auditory or tactile patterns, it was still evident in a sample of nonmusicians. Although previous studies have speculated the potential role of auditory imagery, its contribution to visual SMS performance is not well quantified. Utilizing a synchronization-continuation finger-tapping task with a visual stimulus that included implied motion, we aimed to examine how participants' imagery ability, musicality, and rhythm perception affected SMS performance. We quantified participants' SMS consistency in synchronization (with visual cues) and continuation (without visual cues) phases. Participants also performed a perception task assessing their ability to detect temporal perturbations in the visual rhythm and completed musical ability and imagery questionnaires. Our linear regression model for SMS consistency included the trial phase, self-reported auditory imagery control and musicality, and visual rhythm perception as predictors. Significant effects of trial phase and auditory imagery scores on SMS consistency suggested that participants performed SMS more consistently while the guiding visual stimulus was present and that the higher one's self-reported auditory imagery ability, the better their SMS when continuing with unguided rhythm. One's visual rhythm perception accuracy significantly correlated with SMS consistency during the synchronization phase, and there was no correlation between rhythm perception and auditory imagery control. Overall, our results suggested relatively independent contributions of auditory imagery and visual rhythm perception to SMS with visual rhythm. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Clinicopathological Characteristics and Risk Factors of Young-Onset Gastric Carcinoma: A Systematic Review and Meta-analysis.

INTRODUCTION: The characteristics of gastric carcinoma in young individuals differ from that in older individuals. We conducted a systematic review and meta-analysis to explore the clinicopathological features and risk factors associated with young-onset (younger than 50 years) gastric carcinoma. METHODS: We searched for studies published between January 1, 1990, and September 1, 2023, on patients with young-onset gastric carcinoma in PubMed, EMBASE, Web of Science, and MEDLINE to explore clinicopathological characteristics among this specific patient group. Extracted information included the proportion of patients with symptoms or family history of gastric cancer, tumor location, and histological features such as Lauren or World Health Organization histological classification and degree of differentiation. Additional analyses were conducted on risk factors such as positive family history, Helicobacter pylori infection, or high-risk nutritional or behavioral factors. The estimates were derived using random or fixed-effect models and included subgroup analyses based on different sex and age groups. This study was registered in PROSPERO (CRD42023466131). RESULTS: We identified 5,696 records, 1,292 were included in the quality assessment stage. Finally, 84 studies from 18 countries or regions including 89,447 patients with young-onset gastric carcinoma were included. Young-onset gastric carcinoma has slight female predominance (53.7%, 95% confidence interval [CI]: 51.6-55.7%), with most having symptoms (87.0%, 95% CI: 82.4%-91.7%). Family history was reported in 12.1% (95% CI: 9.5%-14.7%). H. pylori infection was detected in 60.0% of cases (95% CI: 47.1%-72.8%). Most of these carcinomas were in the non-cardia region (89.6%, 95% CI: 82.4%-96.8%), exhibiting Lauren diffuse-type histology (71.1%, 95% CI: 66.8%-75.3%) and poor/undifferentiated features (81.9%, 95% CI%: 79.7-84.2%). A positive family history of gastric cancer was the most important risk factor associated with the development of gastric carcinoma in young individuals (pooled odds ratios 4.0, 95% CI: 2.8-5.2), followed by H. pylori infection (odds ratio 2.3; 95% CI: 1.4-3.2) and dietary and other lifestyle risk factors. DISCUSSION: Young-onset gastric carcinoma exhibits specific clinicopathological characteristics, with positive family history being the most important risk factor. Most of the patients were symptomatic at diagnosis. These findings could help to inform future strategies for the early detection of gastric carcinoma among young individuals.

Association of serum soluble α­klotho with risk of kidney stone disease: a population-based cross-sectional study.

BACKGROUND: The aim of the study was to explore the association of serum soluble klotho with kidney stone disease (KSD) in the general population over the age of 40 years in the United States. METHODS: We integrated the data in National Health and Nutrition Examination Survey from 2007 to 2016 years. The relationship between serum soluble α­klotho and prevalence of KSD was analyzed by constructing weighted multivariable logistic regression model, restricted cubic spline (RCS) curve, and subgroup analyses. RESULTS: In the study, a total of 13,722 individuals were included in our study. A U-shaped association between serum soluble klotho and the risk of KSD was shown by the RCS curve (P value for nonlinear < 0.05). In the full adjusted model, compared with the lowest quartile of serum soluble α­klotho, the adjusted odd ratios (95% confidence intervals) for KSD across the quartiles were (0.999 (0.859, 1.164), 1.005 (0.858, 1.176), and 1.061 (0.911, 1.235)). Subgroup analyses also showed that the U-shaped association of serum soluble α­klotho with KSD was found among subjects who were age < 60 years, female or male, with or without hypertension, and BMI ≥ 30 kg/m2. CONCLUSIONS: Our findings suggested that serum klotho levels had a U-shaped correlation with risk of KSD. When the Klotho level is at 818.66 pg/mL, prevalence of KSD is lowest. Therefore, maintaining a certain level of serum soluble α­klotho could prevent the occurrence of KSD.

Ambulatory facial feminization surgery: a comparative analysis of outcomes and complications.

BACKGROUND: To date, there are no studies investigating the safety and outcomes of facial feminization surgery (FFS) as an outpatient procedure. This is the first study of its kind analyzing the outcomes of ambulatory FFS based on a comparison of complications, post-operative emergency department or urgent care (ED/UC) visits, and readmissions between patients who underwent FFS with admission versus same-day surgery. METHODS: A retrospective analysis was conducted on all patients who underwent FFS in a single integrated healthcare system. Patient charts were reviewed for operative details, complications, post-operative ED/UC visits, readmission, and demographic factors. Major outcomes including complications, readmissions, and ED/UC visits were compared between groups with same-day discharge and post-operative hospital admission. RESULTS: Of 242 patients included in the study, ED/UC visits were comparable between patients discharged same-day (18.2%) and patients admitted post-operatively (21.6%, p = 0.52). Logistic regression showed no significant difference in the composite outcomes of minor complications, major complications, and readmissions (15.6% for ambulatory versus 19.3% for admission, p = 0.46). Temporary nerve palsy, infection, and hematoma were the most common post-operative complications. However, covariates of a lower face procedure and operative time were shown to have significant differences in the composite complication outcome (p = 0.04 and p = 0.045, respectively). CONCLUSION: Ambulatory FFS is a safe practice with no associated increase in adverse outcomes including complications, ED/UC visits, and readmission when compared to post-operative admission. Adoption of same-day FFS should be considered by high-volume gender health centers to potentially benefit from increased scheduling flexibility and efficiency, increased access to care, and lower healthcare costs.

Effect of Histamine H2 Receptor Antagonists on All-Cause Mortality in Critically Ill Patients With Essential Hypertension: A Retrospective Cohort Study.

Previous studies found that histamine H2 receptor antagonists (H2RAs) had blood pressure lowering and cardioprotective effects, but the impact of H2RAs on the survival outcomes of critically ill patients with essential hypertension is still unclear. The aim of this study was to investigate the association of H2RAs exposure with all-cause mortality in patients with essential hypertension based on Medical Information Mart for Intensive Care III database. A total of 17,739 patients were included, involving 8482 H2RAs users and 9257 non-H2RAs users. Propensity score matching (PSM) was performed to improve balance between 2 groups that were exposed to H2RAs or not. Kaplan-Meier survival curves were used to compare the cumulative survival rates and multivariable Cox regression models were performed to evaluate the association between H2RAs exposure and all-cause mortality. After 1:1 PSM, 4416 pairs of patients were enrolled. The results revealed potentially significant association between H2RAs exposure and decreased 30-day, 90-day, and 1-year mortalities in multivariate analyses (HR = 0.783, 95% CI: 0.696-0.882 for 30-day; HR = 0.860, 95% CI: 0.778-0.950 for 90-day; and HR = 0.883, 95% CI: 0.811-0.961 for 1-year mortality, respectively). Covariate effect analyses showed that the use of H2RAs was more beneficial in essential hypertension patients with age ≥ 60, BMI ≥ 25 kg/m2, coronary arteriosclerosis, stroke, and acute kidney failure, respectively. In conclusion, H2RAs exposure was related to lower mortalities in critically ill patients with essential hypertension, which provided novel potential strategy for the use of H2RAs in essential hypertension patients.

Global burden of young-onset gastric cancer: a systematic trend analysis of the global burden of disease study 2019.

BACKGROUND: While gastric cancer is generally declining globally, the temporal trend of young-onset (< 40 years) gastric cancer remains uncertain. We performed this analysis to determine the temporal trends of young-onset gastric cancer compared to late-onset cancer (≥ 40 years). METHODS: We extracted cross-sectional data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. The burden of gastric cancer from 1990 to 2019 was assessed through indicators including incidence and mortality rates, which were classified at global, national, and regional levels, and according to socio-demographic indexes (SDI) and age or sex groups. Joinpoint regression analysis was used to identify specific years with significant changes. The correlation between AAPC with countries' average SDI was tested by Pearson's Test. RESULTS: The global incidence rate of young-onset gastric cancer decreased from 2.20 (per 100,000) in 1990 to 1.65 in 2019 (AAPC: - 0.95; 95% confidence interval [CI] - 1.25 to - 0.65; P < 0.001). Late-onset cancer incidence also decreased from 59.53 (per 100,000) in 1990 to 41.26 in 2019 (AAPC: - 1.23; 95% CI - 1.39 to - 1.06, P < 0.001). Despite an overall decreasing trend, the incidence rate of young-onset cancer demonstrated a significant increase from 2015 to 2019 (annual percentage change [APC]: 1.39; 95% CI 0.06 to 2.74; P = 0.041), whereas no upward trend was observed in late-onset cancer. Mortality rates of young- and late-onset cancer both exhibited a significant decline during this period (AAPC: - 1.82; 95% CI - 2.15 to - 1.56; P < 0.001 and AAPC: - 1.69, 95% CI - 1.79 to - 1.59; P < 0.001). The male-to-female rate ratio for incidence and mortality in both age groups have been increasing since 1990. While countries with high SDI have had a greater decline in the incidence of late-onset gastric cancer (slope of AAPC change: - 0.20, P = 0.004), it was not observed in young-onset cancer (slope of AAPC change: - 0.11, P = 0.13). CONCLUSIONS: The global incidence and mortality rates of both young- and late-onset gastric cancer have decreased since 1990. However, the incidence rate of young-onset cancer has demonstrated a small but significant upward trend since 2015. There was disparity in the decline in young-onset gastric cancer among male and high SDI countries. These findings could help to inform future strategies in preventing gastric cancer in younger individuals.

Effects of Enteric-Coated Formulation of Sodium Bicarbonate on Bicarbonate Absorption and Gastrointestinal Discomfort.

Sodium bicarbonate is used as an ergogenic supplement to enhance people's performances in various exercises. This study aimed to evaluate the effects of intestinal delivery of sodium bicarbonate on bicarbonate absorption and associated side effects in an experimental human trial. After preparing and assessing enteric-coated and uncoated sodium bicarbonate tablet formulations, pharmacokinetic analysis and gastrointestinal symptom tests were performed after oral administration in the human body. The dose required to increase blood bicarbonate concentration over 5 mmol∙L-1 for the purpose of improving performance during high-intensity exercise was also determined. Enteric-coated tablet formulation protects sodium bicarbonate under acidic conditions and releases bicarbonate in the intestine. Enteric-coated tablet formulation also reduced the oral dose required to achieve a blood bicarbonate concentration over 5 mmol∙L-1 from 300 mg∙kg-1 of uncoated tablet formulation to 225 mg∙kg-1. Gastrointestinal discomfort was significantly decreased for the group given 225 mg∙kg-1 enteric-coated tablets compared to that given 300 mg∙kg-1 uncoated tablets. These results suggest that enteric-coated tablet formulation could reduce the oral dose required in order to achieve a blood bicarbonate concentration over 5 mmol∙L-1 by 25%, from 300 mg∙kg-1 to 225 mg∙kg-1, along with its ability to reduce gastrointestinal discomfort associated with the dosage.