Is Language a Barrier in the Management of Acute Appendicitis?

BACKGROUND: Language preference is a contributing factor for prolonged time from symptom onset to appendectomy within pediatrics, but is poorly characterized in adults. We aimed to investigate associations between language barriers and delays to assessment and treatment for adults with acute appendicitis. METHODS: In a multiethnic community, patients age ⪰18 years old who underwent appendectomy were identified between 1/2017-8/2022 at a single institution. Negative binomial regression was used to compare interval wait times to imaging, medication administration, and surgical evaluation between patients with limited English proficiency and those who are English proficient. RESULTS: Of the 1,469 patients included, 48% (n=699) had limited English proficiency. Average age was higher for patients with limited English proficiency (45 vs. 36, p<0.001) and majority were Asian (54%) and without private insurance (65%, p<0.001). Symptom duration, incidence of septic shock, and date/time of presentation to the Emergency Department were similar. Patients with limited English proficiency presented more frequently with gangrenous appendicitis (20% vs. 15%, p=0.013) but not perforated appendicitis (23% vs. 20%, p=0.065). They experienced longer wait times for surgical evaluation (376 vs. 348min, IRR 1.08, p=0.002) but similar times for imaging, and medications administered. On adjusted analysis for demographics, triage acuity, and hospital factors, longer wait times for surgical evaluation persisted (IRR adjusted 1.07, p=0.038). There was no significant difference in hospital length-of-stay, post-operative infection, or 30-day readmission rate. CONCLUSION: Adult patients with limited English proficiency may experience longer wait times for surgical evaluation for acute appendicitis, but this may not result in clinically significant delays in initiation of treatment.

Teleassessment using five times sit-to-stand test in older adults with and without Parkinson's disease: Guidelines and barriers.

BACKGROUND AND PURPOSE: Assessing lower limb strength, balance, and fall risk are crucial components of rehabilitation, especially for the older adult population. With the growing interest in telehealth, teleassessment has been investigated as an alternative when in-person assessments are not possible. The Five Times Sit-to-Stand test (5TSTS) provides a quick measure of balance during chair transfers, muscle power, endurance, and the hability to change and maintain body position, and is highly recommended by guidelines. However, the literature is unclear about the viability and safety of teleassessment using the 5TSTS in older adults with and without Parkinson's disease (PD). This study aimed to evaluate the reliability of teleassessment using the 5TSTS and to determine its feasibility and safety for older adults with and without PD. METHODS: This cross-sectional study included older adults with and without PD who were evaluated remotely through a videoconference platform. To ensure effective and comprehensive instructions for the test, we developed a guideline called OMPEPE (an acronym for: Objective; Materials; Position-Start; Execution; Position-End; Environment). We assessed the 5TSTS intra- and inter-rater reliability by comparing scores obtained from the same examiner and from different examiners, respectively. Participants and examiners completed online surveys to provide information about feasibility and safety. RESULTS: Twelve older adults with PD and 17 older adults without PD were included in this study (mean ages 69.0 and 67.6 years, respectively). Based on the participants' perspectives and the absence of adverse effects, teleassessment using the 5TSTS is feasible and safe for older adults with and without PD. Excellent intra- and inter-rater reliability (intraclass correlation coefficient >0.90) was found for all measurements of the 5TSTS. DISCUSSION: This study demonstrated the feasibility, safety, and reliability of teleassessment using the 5TSTS. The guidelines developed may help health professionals minimize barriers and safely conduct an online assessment that includes a physical test such as the 5TSTS in older adults with or without PD. In addition to addressing technological barriers, the OMPEPE guideline might ensure the optimal execution of evaluations. CONCLUSION: Teleassessment using the 5TSTS for older adults with and without PD is feasible and safe. Both synchronous (i.e., live) and asynchronous (i.e., recorded) online 5TSTS tests demonstrate excellent intra- and inter-rate reliability.

Physiotherapy Outcomes Are Associated With Shorter Waiting Times, More Treatment Sessions and Younger Age: Analysis of a Clinical Database.

BACKGROUND: Musculoskeletal (MSK) conditions affect over 20.3 million people in the UK, presenting a substantial economic impact on health and social services. Physiotherapy can alleviate MSK conditions, especially if delivered in the acute or sub-acute period. However, patients often present after significant waiting times. OBJECTIVES: Our analysis examined how waiting times and the number of treatments influenced physiotherapy outcomes for MSK conditions. DESIGN: Retrospective analysis of the Data for Impact, Physio First dataset. METHODS: Logistic regression models assessed the effects of symptom duration, treatment frequency, and other variables on pain, Patient-Specific Functional Scores (PSFSs), and Goal Achievement (GA). RESULTS: Analysis of 15,624 patient records showed that patients treated within two weeks of symptom onset were more likely to have favourable outcomes in pain (odds ratio [OR] = 2.01, 95% Confidence Interval [95% CI] = 1.65-2.45), PSFS (OR = 1.80, 95% CI = 1.55-2.08), and GA (OR = 1.74, 95% CI = 1.51-2.01) compared to those treated after longer durations. Receiving four or more treatment sessions significantly improved outcomes compared with only one session (pain: OR = 4.64, PSFS: OR = 5.72, GA: OR = 1.94, all p's < 0.001), with no additional benefits beyond four sessions. Younger age was associated with better outcomes (approximately OR = 0.99 per year age difference). Other findings included better outcomes in males and in those with fewer previous episodes of the condition. CONCLUSIONS: Shorter waiting times, a greater number of treatments, and younger patient age are associated with better physiotherapy outcomes for MSK conditions.

Little alginates synthesized in EPS: Evidences from high-throughput community and metagenes.

As a significant structure in activated sludge, extracellular polymeric substances (EPS) hold considerable value regarding resource recovery and applications. The present study aimed to elucidate the relationship between the microbial community and the composition and properties of EPS. A biological nutrient removal (BNR) reactor was set up in the laboratory and controlled under different solid retention times (SRT), altering microbial species within the system. Then EPS was extracted from activated and analyzed by chemical and spectroscopic methods. High-throughput sequencing and metagenomic approaches were employed to investigate bacterial community and metabolic pathways. The results showed that lower SRT with a higher abundance of the family-level Proteobacteria (27.7%-53.5%) favored EPS synthesis, while another dominant group Bacteroidetes (20.0%-32.6%) may not significantly affect EPS synthesis. Furthermore, the abundance of alginates-producing bacteria including Pseudomonas spp. and Azotobacter vinelandii was only 2.53%-6.76% and 1.98%-6.34%, respectively. The alginate synthesis pathway genes Alg8 and Alg44 were also present at very low levels (0.05‱-0.11‱, 0.01‱-0.02‱, respectively). Another important gene related to alginates operons, AlgK, was absent across all the SRT-operated reactors. These findings suggest an impossible and incomplete alginate synthesis pathway within sludge. In light of these results, it can be concluded that EPS does not necessarily contain alginate components.

Comparison of Five-Day vs. Fourteen-Day Incubation of Cultures for Diagnosis of Periprosthetic Joint Infection in Hip Arthroplasty.

Background: Periprosthetic joint infections (PJI) are among the most morbid complications in total hip arthroplasty (THA). The ideal incubation time, however, for intraoperative cultures for PJI diagnosis remains unclear. As such, the aim of this study was to determine if any differences existed in culture-positive rates and organism detection between five-day and fourteen-day cultures. Methods: This retrospective cohort study consisted of THA cases diagnosed with PJI performed between May 2014 and May 2020 at a single tertiary-care institution. Analyses compared five-day and fourteen-day cultures and carried out a pre-specified subgroup analysis by organism and PJI type. Results: A total of 147 surgeries were performed in 101 patients (57.1% females), of which 65% (n = 98) obtained five-day cultures and 34% (n = 49) obtained fourteen-day cultures. The positive culture rate was 67.3% (n = 99) with Staphylococcus aureus being the most common pathogen identified (n = 41 specimens, 41.4%). The positive culture rate was not significantly different between groups (66.3% five-day, 69.4% fourteen-day, p = 0.852). Fourteen-day cultures had a significantly longer time-to-positive culture (5.0 days) than five-day cultures (3.0 days, p < 0.001), a higher rate of fungi (5.6% vs. 0%), and a lower rate of Gram-negatives (4.5% vs. 18.7%, p = 0.016). Conclusions: Fourteen-day cultures did not increase the positivity rate, had higher rates of slow-growth pathogens, and had a longer time-to-positivization than five-day cultures. Prolonged culture holds may provide more thorough organism detection for PJI without increasing the diagnostic culture yield.

Optimized microbial fuel cell-powered electro-Fenton processes to enhance electricity and bisphenol A removal by varying external resistance and electrolyte concentrations.

This study is the first to investigate the effects of external resistance and electrolyte concentration on the performance of a bioelectro-Fenton (BEF) system, involving measurements of power density, H2O2 generation, and bisphenol A (BPA) removal efficiency. With optimized operating conditions (external resistance of 1.12 kΩ and cathodic NaCl concentration of 1,657 mg/L), the BEF system achieved a maximum power density of 38.59 mW/m2, which is about 3.5 times higher than with 1 kΩ external resistance and no NaCl. This system featured a 71.7 % reduction in total internal resistance. The optimized BEF also accelerated the oxygen reduction reaction rate, increasing H2O2 generation by 4.4 times compared to the unoptimized system. Moreover, it exhibited superior BPA degradation performance, removing over 99 % of BPA within 14 hs, representing a 1.1 to 3.3-fold improvement over the unoptimized BEF. By the fifth cycle (70 h), the optimized BEF still removed 70 % of BPA. Optimizing the operating conditions significantly increased the abundance of electrochemically active bacteria (Pseudomonadaceae) from 2.2 % to 20 %, facilitating rapid acclimation. The study demonstrates the strong potential of an optimized BEF system for removing persistent pollutants.

Effects of cherries Sanitization methods and fermentation times on quality parameters of coffee beans.

For the first time, the dual effect of coffee cherry sanitization methods to control the microbial load in processing and the influence of fermentation time on coffee quality parameters was evaluated. Two assays were carried out by wet processing: I) Sanitization of the coffee cherry (ST1: Unclassified processed cherries; ST2: Classified and sanitized cherries with drinking water; ST3: Classified and sanitized cherries with a chemical agents and II) Fermentation times (FT1: 12 h; FT2: 24 h; FT3: 48 h; FT4: 72 h and FT5: 96 h). pH, temperature, and dissolved oxygen were monitored during fermentation. Counts of Lactic Acid Bacteria - LAB, mesophiles, and yeasts were carried out on the coffee mass before and after fermentation. Caffeine and chlorogenic acid contents were determined by HPLC-DAD and the sensory profile by methodology for specialty coffees (SCA). The main findings showed that: sanitization with Timsen® did not significantly influence the evolution of pH during fermentation (p > 0.05), but it can reduce to a small extent the action of LAB at the end of the process. It was observed that the temperature of the coffee mass tends to balance with the ambient temperature, with significant effects (p < 0.05) of sanitization (ST2 and ST3) on the stability of this variable during fermentation. Timsen® as a disinfectant affected microbial populations and improved the sensory profile in the cup. In prolonged coffee fermentations (FT3, FT4 and FT5), the pH of the coffee mass tended to stabilize after 36 h, regardless of the process time. Likewise, a correlation was evident between a higher microbial load correlated with better sensory profiles in FT4 and FT5. Neither the sanitization process nor the fermentation time significantly affected the caffeine and chlorogenic acid contents of the coffee, both in its green and roasted states. Consequently, the sanitization of cherry coffee with Timsen® and prolonged fermentation times favor the safety and coffee final quality in the cup.

Associated Factors of Patients' Survival in Out of Hospital Cardiac Arrest; a Cross-sectional Study.

Introduction: Chinese populations have an increasingly high prevalence of cardiac arrest. This study aimed to investigate the prehospital associated factors of survival to hospital admission and discharge among out-of-hospital cardiac arrest (OHCA) adult cases in Macao Special Administrative Region (SAR), China. Methods: Baseline characteristics as well as prehospital factors of OHCA patients were collected from publicly accessible medical records and Macao Fire Services Bureau, China. Demographic and other prehospital OHCA characteristics of patients who survived to hospital admission and discharge were analyzed using multivariate logistic regression analysis. Results: A total of 904 cases with a mean age of 74.2±17.3 (range: 18-106) years were included (78%>65 years, 62% male). Initial shockable cardiac rhythm was the strongest predictor for survival to both hospital admission (OR=3.57, 95% CI: 2.26-5.63; p<0.001) and discharge (OR=12.40, 95% CI: 5.70-26.96; p<0.001). Being male (OR=1.63, 95% CI:1.08-2.46; p =0.021) and the lower emergency medical service (EMS) response time (OR=1.62, 95% CI: 1.12-2.34; p =0.010) were also associated with a 2-fold association with survival to hospital admission. In addition, access to prehospital defibrillation (OR=4.25, 95% CI: 1.78-10.12; p <0.001) had a 4-fold association with survival to hospital discharge. None of these associations substantively increased with age. Conclusion: The major OHCA predictors of survival were initial shockable cardiac rhythm, being male, lower EMS response time, and access to prehospital defibrillation. These findings indicate a need for increased public awareness and more education.

Evaluation of Methylene Blue as An Effective Antiseptic for Medicinal Leeches (Hirudo verbana).

Objective: Medicinal leeches (Hirudo spp.) have been used for therapeutic purposes in humans since ancient times. Because of their growth conditions, leeches carry certain bacteria and endosymbionts (e.g., Aeromonas spp). In both leech farms and hirudotherapy clinics, there are no reliable antiseptics that can be used with leeches. This study aimed to determine whether methylene blue (MB) is a safe antiseptic for medicinal leeches and assess its safe usage. Methods: This study evaluated the efficacy of MB by determining lethal concentrations (LC), effective concentrations (EC), and lethal times (LT) for the medicinal leech Hirudo verbena Carena, 1820. A total of 570 H. verbana specimens obtained from a local farm were used in this study. Eighteen different concentrations of MB (between 1 ppm and 512 ppm) were tested. Results: The LC50 and EC50 values for H. verbana were determined to be 60.381 (53.674-66.636) ppm and 2.013 (1.789-2.221) ppm, respectively. The LT50 durations for MB concentrations of 32 and 512 ppm were calculated as 212.92 h (138.43 h-1485.78 h) and 17.82 h (8.08 h-23.90 h), respectively. Conclusion: The results show that MB concentrations between 2 and 19 ppm can be safely used as antiseptics in hirudotherapy clinics and leech farms to address bacterial concerns caused by medicinal leeches.

Association of accelerometer measured sedentary behavior patterns with cognitive functions in sedentary office workers: Insights from SMART-STEP study.

BACKGROUND: High levels of sedentary behavior in workplaces are currently recognized as an independent risk factor for cognitive dysfunction and poor mental health. However, sedentary patterns vary between workdays and non-workdays, which may influence cognitive functions. OBJECTIVE: The present study aimed to quantify and compare work and nonwork device-measured sedentary time (ST) and its association with cognitive function in Indian office workers. METHODS: In an ongoing randomized controlled trial (SMART-STEP), the baseline data of 136 full-time office workers, including accelerometer-measured sedentary patterns and cognitive functions, were analyzed. The ST was measured using a hip-worn accelerometer (Actigraph wGT3X-BT) for seven days, and executive functions were measured using computer-based tests. Linear regression models were employed to analyze the relationships between ST and executive function measures. RESULTS: The median daily ST of Indian office workers was 11.41 hours. The ST was greater on both workdays (11.43 hrs.) and non-workdays (11.14 hrs.) though different (F = 6.76, p = 0.001, ηp2 = 0.032). Office workers accumulate more prolonged sitting bouts (+21.36 min) during work days than non-workdays. No associations between device-measured ST and executive functions were observed. CONCLUSION: Indian office workers exhibited high ST patterns, especially on workdays. Although lower than workdays, Indian office workers exhibited more ST patterns during non-workdays than did their Western counterparts. Culturally adaptable workplace and leisure time physical activity interventions are needed to address the high ST of Indian office workers.

In-situ electrochemical impedance analysis of a commercial SOFC stack fueled by real wood gas.

The combination of solid oxide fuel cells (SOFCs) and wood gasification has the potential to significantly increase renewable electricity production and decrease emissions. Depending on the quality of the wood gas, degradation processes have a significant impact on the reliability and lifetime of the SOFC. Using electrochemical impedance spectroscopy (EIS) and subsequent distribution of relaxation times (DRT) analysis, the impact on the degradation of coupling wood gasification with a commercial SOFC stack is determined in this study. The thermal behavior of the SOFC stack under various operating conditions, as well as various synthetic wood gas mixtures classified by their hydrogen-to-carbon (H/C) ratio, was assessed. The decrease in the H/C ratio from 8 to 1, observed during syngas and real wood gas operation, leads to a rightward shift in the Nyquist plots, suggesting an increase in the SOFC stack's impedance. Correlations between variations in the H/C ratio and their effects on anodic electrooxidation, ionic conduction, gas transport, and diffusion were identified using DRT analysis to interpret the EIS results. By incorporating an upstream desulfurization system and ensuring an H/C ratio greater than 2, the coupling of biomass gasification with the SOFC stack was stable to degradation issues.

Metabolite T2 relaxation times decrease across the adult lifespan in a large multi-site cohort.

Purpose: Relaxation correction is crucial for accurately estimating metabolite concentrations measured using in vivo magnetic resonance spectroscopy (MRS). However, the majority of MRS quantification routines assume that relaxation values remain constant across the lifespan, despite prior evidence of T2 changes with aging for multiple of the major metabolites. Here, we comprehensively investigate correlations between T2 and age in a large, multi-site cohort. Methods: We recruited approximately 10 male and 10 female participants from each decade of life: 18-29, 30-39, 40-49, 50-59, and 60+ years old (n=101 total). We collected PRESS data at 8 TEs (30, 50, 74, 101, 135, 179, 241, and 350 ms) from voxels placed in white-matter-rich centrum semiovale (CSO) and gray-matter-rich posterior cingulate cortex (PCC). We quantified metabolite amplitudes using Osprey and fit exponential decay curves to estimate T2. Results: Older age was correlated with shorter T2 for tNAA, tCr3.0, tCr3.9, tCho, Glx, and tissue water in CSO and PCC; rs = -0.21 to -0.65, all p<0.05, FDR-corrected for multiple comparisons. These associations remained statistically significant when controlling for cortical atrophy. T2 values did not differ across the adult lifespan for mI. By region, T2 values were longer in the CSO for tNAA, tCr3.0, tCr3.9, Glx, and tissue water and longer in the PCC for tCho and mI. Conclusion: These findings underscore the importance of considering metabolite T2 changes with aging in MRS quantification. We suggest that future 3T work utilize the equations presented here to estimate age-specific T2 values instead of relying on uniform default values.

Relationship of total sagittal spinal alignment index of thoracic kyphosis and lumbar lordosis with physical function in community-dwelling older adults.

BACKGROUND: Overall spinal curvature is evaluated by calculating the difference between the angles of lumbar lordosis (LL) and thoracic kyphosis (TK) and is expressed as LL minus TK (LL-TK). It is unclear whether LL-TK is associated with physical function in community-dwelling older adults and whether it is more relevant than TK or LL alone. OBJECTIVE: This study aimed to identify whether LL-TK is associated with physical function in community-dwelling older adults, and whether it is strongly associated than TK or LL alone. METHODS: The participants comprised 1,674 community-dwelling older adults who underwent physical assessments (women, n = 1,099; mean age, 67.4 ± 5.3 years). As spinal alignment indices, TK and LL were measured using skin surface methods, and LL-TK was calculated as the difference between them. Decreased LL-TK indicated increased overall spinal curvature. Physical function was determined by measuring single-leg standing, five-times chair-stand, and usual gait speed. Stepwise multiple regression analyses were performed with each physical function as the dependent variable and spinal alignment indices as the independent variables, with adjustments. RESULTS: Multiple regression analyses showed that single-leg standing (ß = 0.092, 95% confidence interval [CI] = 0.071 to 0.214, p < .001) and five-times chair-stand (ß=-0.142, 95% CI = -0.037 to -0.019, p < .001) were significantly associated with LL-TK, but not LL. Both LL-TK (ß = 0.121, 95% CI = 0.001 to 0.004, p < .001) and LL (ß = 0.087, 95% CI = 0.001 to 0.003, p = .003) were significant determinants of usual gait speed. CONCLUSIONS: This study showed that decreased LL-TK may be associated with poor physical function. This association may be stronger than that observed for TK or LL alone.

Influences of Vehicle Communication on Human Driving Reactions: A Simulator Study on Reaction Times and Behavior for Forensic Accident Analysis.

Cooperative intelligent transport systems (C-ITSs) are mass-produced and sold in Europe, promising enhanced safety and comfort. Direct vehicle communication, known as vehicle-to-everything (V2X) communication, is crucial in this context. Drivers receive warnings about potential hazards by exchanging vehicle status and environmental data with other communication-enabled vehicles. However, the impact of these warnings on drivers and their inclusion in accident reconstruction remains uncertain. Unlike sensor-based warnings, V2X warnings may not provide a visible reason for the alert, potentially affecting reaction times and behavior. In this work, a simulator study on V2X warnings was conducted with 32 participants to generate findings on reaction times and behavior for accident reconstruction in connection with these systems. Two scenarios from the Car-2-Car Communication Consortium were implemented: "Stationary Vehicle Warning-Broken-Down Vehicle" and "Dangerous Situation-Electronic Emergency Brake Lights". Volkswagen's warning concept was utilized, as they are the sole provider of cooperative vehicles in Europe. Results show that V2X warnings without visible reasons did not negatively impact reaction times or behavior, with average reaction times between 0.58 s (steering) and 0.69 s (braking). No significant distraction or search for warning reasons was observed. However, additional information in the warnings caused confusion and was seldom noticed by subjects. In this study, participants responded correctly and appropriately to the shown false-positive warnings. A wrong reaction triggering an accident is possible but unlikely. Overall, V2X warnings showed no negative impacts compared with sensor-based systems. This means that there are no differences in accident reconstruction regarding the source of the warning (sensors or communication). However, it is important that it is known that there was a warning, which is why the occurrence of V2X warnings should also be saved in the EDR in the future.

Evaluating the Sysmex DI-60 Integrated Slide Processing System's impact on hematology differential turnaround times and patient care: Real-world implementation experience in a large Veterans Affairs hospital.

OBJECTIVES: This quality improvement study conducted at the Kansas City VA Medical Center in Kansas City, Missouri, investigated the Sysmex DI-60 Integrated Slide Processing System's ability to improve hematology turnaround times when integrated into daily practices. It further addressed potential patient care factors associated with changes in turnaround times. METHODS: Three months of manual and Sysmex DI-60 patient data were examined between May 2022 and February 2023. White blood cell (WBC) ranges, turnaround times, working hours, and study months were analyzed using 2-tailed unpaired t testing and percentage change. The number of specimens in these categories was further analyzed using 2-tailed, 2-sample proportion testing. RESULTS: This quality improvement study indicated that the Sysmex DI-60 system produced a statisitcally significant reduction in turnaround times overall and for various ranges of WBCs plus work shifts. The most statistically significant improvement in turnaround times occurred for WBC concentrations less than 2.0 × 103/µL and concentrations within the reference range. In addition, the off shifts experienced a notable improvement in turnaround times. CONCLUSIONS: The Sysmex DI-60 system substantially decreases turnaround times for differentials, thus potentially benefiting patient care by providing prompt results. It is possible that reducing turnaround times could expedite emergency department admissions and discharges as well as enhance care for the oncology department's patients. It could also lead to more timely results for patients with false-positive flags by the Sysmex analyzer, which may also help with clinician decision-making.

Bioelectrical impedance phase angle combined with physical function predicts pre-frailty in maintenance hemodialysis patients: a prospective study.

BACKGROUND: The prevalence of pre-frailty is notably high among maintenance hemodialysis (MHD) patients. Pre-frailty, an early and reversible condition between non-frailty and frailty, can lead to adverse outcomes such as increased unplanned hospital admissions and a higher risk of other chronic diseases. Early identification and intervention of pre-frailty in MHD patients are crucial. This study aimed to establish a simple and effective model for screening and identifying MHD patients at high risk of pre-frailty by using 50 kHz-Whole Body Phase Angle (PhA) measured by bioelectrical impedance analysis (BIA), hand grip strength (HGS), the Five-Times-Sit-to-Stand Test (FTSST), and laboratory parameters, with a specific focus on gender differences. METHODS: This prospective cross-sectional study was conducted from September to December 2023 at the Wenjiang Hemodialysis Center in the Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China. A total of 244 MHD patients, including 130 males and 114 females, were enrolled, comprising 128 non-frail and 116 pre-frail individuals. Data were collected prospectively, including demographic information, physical measurements, and laboratory test results. All participants provided informed consent before enrollment. The FRAIL scale (FS) was used to assess pre-frailty in MHD patients. Grip strength was measured using an electronic grip strength tester, physical function was assessed using the Five-Times-Sit-to-Stand Test, and whole-body phase angle was measured using the InBody S10 device. RESULTS: A total of 244 MHD patients with a mean age of 53.75 ± 0.90 years were enrolled, including 130 males with a mean age of 54.12 ± 1.26 years and 114 females with a mean age of 53.32 ± 1.29 years. ROC curve analysis showed that in male patients, the AUC of PhA for predicting pre-frailty was 0.919, with a sensitivity of 94.5% and specificity of 91.3%, and a cutoff value of 6.05°; in female patients, the AUC of PhA was 0.870, with a sensitivity of 70.5% and specificity of 90.6%, and a cutoff value of 5.25°. The AUC of FTSST for screening pre-frailty in male patients was 0.827, with a sensitivity of 62.3% and specificity of 96.2%, and a cutoff value of 12.95 s; in female patients, the AUC of FTSST was 0.784, with a sensitivity of 67.3% and specificity of 84.0%, and a cutoff value of 12.95 s. Additionally, in male patients, the combination of PhA and FTSST resulted in an AUC of 0.930, with a sensitivity of 96.4% and specificity of 81.3%; in female patients, the AUC was 0.911, with a sensitivity of 78.7% and specificity of 92.5%. CONCLUSION: PhA measured by BIA, in combination with the Five-Times-Sit-to-Stand Test, serves as an effective screening tool and predictor of pre-frailty in MHD patients. The combination of PhA and FTSST shows enhanced diagnostic value in female patients, while PhA alone is sufficient for predicting pre-frailty in male patients. TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR2100051111), registered on 2021-09-13.

Recent advances in measuring the effects of diet on gastrointestinal physiology: Sniffing luminal gases and fecal volatile organic compounds.

Despite the huge pool of ideas on how diet can be manipulated to ameliorate or prevent illnesses, our understanding of how specific changes in diet influence the gastrointestinal tract is limited. This review aims to describe two innovative investigative techniques that are helping lift the veil of mystery about the workings of the gut. First, the gas-sensing capsule is a telemetric swallowable device that provides unique information on gastric physiology, small intestinal microbial activity, and fermentative patterns in the colon. Its ability to accurately measure regional and whole-gut transit times in ambulant humans has been confirmed. Luminal concentrations of hydrogen and carbon dioxide are measured by sampling through the gastrointestinal tract, and such application has enabled mapping of the relative amounts of fermentation of carbohydrates in proximal-versus-distal colon after manipulation of the types and amounts of dietary fiber. Second, changes in the smell of feces, via analysis of volatile organic compounds, occur in response to the diet, and by the presence and therapy of irritable bowel syndrome and inflammatory bowel disease. Such information is likely to aid our understanding of what dietary change can do to the colonic luminal microenvironment, and may value-add to diagnosis and therapeutic design. In conclusion, such methodologies enable a more complete physiological profile of the gastrointestinal tract to be created. Systematic description in various cohorts and effects of dietary interventions, particularly when co-ordinated with the analysis of microbiome, are needed.

Mechanisms underlying the therapeutic effects of Gang Huo Qing wen granules in the treatment of influenza based on network pharmacology, molecular docking and molecular dynamics.

Influenza (Flu) is a severe health, medical, and economic problem, but no medication that has excellent outcomes and lowers the occurrence of these problems is now available. GanghuoQingwenGranules (GHQWG) is a common Chinese herbal formula for the treatment of influenza (flu). However, its methods of action remain unknown. We used network pharmacology, molecular docking, and molecular dynamics simulation techniques to investigate the pharmacological mechanism of GHQWG in flu. TCMSP and various types of literature were used to obtain active molecules and targets of GHQWG. Flu-related targets were found in the Online Mendelian Inheritance in Man (OMIM) database, the DisFeNET database, the Therapeutic Target Database (TTD), and the DrugBank database. To screen the key targets, a protein-protein interaction (PPI) network was constructed. DAVID was used to analyze GO and KEGG pathway enrichment. Target tissue and organ distribution was assessed. Molecular docking was used to evaluate interactions between possible targets and active molecules. For the ideal core protein-compound complexes obtained using molecular docking, a molecular dynamics simulation was performed. In total, 90 active molecules and 312 GHQWG targets were discovered. The PPI network's topology highlighted six key targets. GHQWG's effects are mediated via genes involved in inflammation, apoptosis, and oxidative stress, as well as the TNF and IL-17 signaling pathways, according to GO and KEGG pathway enrichment analysis. Molecular docking and molecular dynamics simulations demonstrated that the active compounds and tested targets had strong binding capabilities. This analysis accurately predicts the effective components, possible targets, and pathways involved in GHQWG flu treatment. We proposed a novel study strategy for future studies on the molecular processes of GHQWG in flu treatment. Furthermore, the possible active components provide a dependable source for flu drug screening.

Scaling relationships between the total number of leaves and the total leaf area per culm of two dwarf bamboo species.

Total leaf area per plant is an important measure of the photosynthetic capacity of an individual plant that together with plant density drives the canopy leaf area index, that is, the total leaf area per unit ground area. Because the total number of leaves per plant (or per shoot) varies among conspecifics and among mixed species communities, this variation can affect the total leaf area per plant and per canopy but has been little studied. Previous studies have shown a strong linear relationship between the total leaf area per plant (or per shoot) (A T) and the total number of leaves per plant (or per shoot) (N T) on a log-log scale for several growth forms. However, little is known whether such a scaling relationship also holds true for bamboos, which are a group of Poaceae plants with great ecological and economic importance in tropical, subtropical, and warm temperate regions. To test whether the scaling relationship holds true in bamboos, two dwarf bamboo species (Shibataea chinensis Nakai and Sasaella kongosanensis 'Aureostriatus') with a limited but large number of leaves per culm were examined. For the two species, the leaves from 480 and 500 culms, respectively, were sampled and A T was calculated by summing the areas of individual leaves per culm. Linear regression and correlation analyses reconfirmed that there was a significant log-log linear relationship between A T and N T for each species. For S. chinensis, the exponent of the A T versus N T scaling relationship was greater than unity, whereas that of S. kongosanensis 'Aureostriatus' was smaller than unity. The coefficient of variation in individual leaf area increased with increasing N T for each species. The data reconfirm that there is a strong positive power-law relationship between A T and N T for each of the two species, which may reflect adaptations of plants in response to intra- and inter-specific competition for light.

CsPbI3 Perovskite Quantum Dot-Based WORM Memory Device with Intrinsic Ternary States.

The migration of mobile ionic halide vacancies is usually considered detrimental to the performance and stability of perovskite optoelectronic devices. Taking advantage of this intrinsic feature, we fabricated a CsPbI3 perovskite quantum dot (PQD)-based write-once-read-many-times (WORM) memory device with a simple sandwich structure that demonstrates intrinsic ternary states with a high ON/OFF ratio of 103:102:1 and a long retention time of 104 s. Through electrochemical impedance spectroscopy, we proved that the resistive switching is achieved by the migration of mobile iodine vacancies (VIs) under an electric field to form conductive filaments (CFs). Using in situ conductive atomic force microscopy, we further revealed that the multilevel property arises from the different activation energies for VIs to migrate at grain boundaries and grain interiors, resulting in two distinct pathways for CFs to grow. Our work highlights the potential of CsPbI3 PQD-based WORM devices, showcasing intrinsic multilevel properties achieved in a simple device structure by rationally controlling the drift of ionic defects.