Research on the intelligent internet nursing model based on the child respiratory and asthma control test scale for asthma management of preschool children.

BACKGROUND: Childhood asthma is a common respiratory ailment that significantly affects preschool children. Effective asthma management in this population is particularly challenging due to limited communication skills in children and the necessity for consistent involvement of a caregiver. With the rise of digital healthcare and the need for innovative interventions, Internet-based models can potentially offer relatively more efficient and patient-tailored care, especially in children. AIM: To explore the impact of an intelligent Internet care model based on the child respiratory and asthma control test (TRACK) on asthma management in preschool children. METHODS: The study group comprised preschoolers, aged 5 years or younger, that visited the hospital's pediatric outpatient and emergency departments between January 2021 and January 2022. Total of 200 children were evenly and randomly divided into the observation and control groups. The control group received standard treatment in accordance with the 2016 Guidelines for Pediatric Bronchial Asthma and the Global Initiative on Asthma. In addition to above treatment, the observation group was introduced to an intelligent internet nursing model, emphasizing the TRACK scale. Key measures monitored over a six-month period included the frequency of asthma attack, emergency visits, pulmonary function parameters (FEV1, FEV1/FVC, and PEF), monthly TRACK scores, and the SF-12 quality of life assessment. Post-intervention asthma control rates were assessed at six-month follow-up. RESULTS: The observation group had fewer asthma attacks and emergency room visits than the control group (P < 0.05). After six months of treatment, the children in both groups had higher FEV1, FEV1/FVC, and PEF (P < 0.05). Statistically significant differences were observed between the two groups (P < 0.05). For six months, children in the observation group had a higher monthly TRACK score than those in the control group (P < 0.05). The PCS and MCSSF-12 quality of life scores were relatively higher than those before the nursing period (P < 0.05). Furthermore, the groups showed statistically significant differences (P < 0.05). The asthma control rate was higher in the observation group than in the control group (P < 0.05). CONCLUSION: TRACK based Intelligent Internet nursing model may reduce asthma attacks and emergency visits in asthmatic children, improve lung function, quality of life, and the TRACK score and asthma control rate. The effect of nursing was significant, allowing for development of an asthma management model.

Can We See SEI Directly by Naked Eyes?

Stable solid electrolyte interface (SEI) is the key to improve the electrochemical performance of lithium metal batteries (LMBs). However, there are still many puzzles about SEI film that have not been well explained, due to the complexity of electrochemical reactions involving in SEI formation and the absence of direct observation methods for SEI. Here, this work realizes the direct observation of SEI by skillfully designed fluorescent tracers acting as an SEI film-forming additive for electrolytes. These fluorescent tracers have three important moieties: an olefin group for polymerization on anode surface so as to participate in SEI film formation during charge/discharge cycles, a polar group for Li-ion conduction, and an AIEgen for fluorescent tracing. Therefore, the tracers participate in SEI film-forming and result in a shining SEI film. This shining SEI film with intrinsic fluorescence signal allows direct observation and quantification on the distribution, relative abundance, and macro morphology of SEI. These fluorescent tracers can also reveal the SEI formation growth destruction regularity during charge/discharge cycles. Several summarized typical macro morphologies and evolution stages of SEI will enrich knowledge and understanding of SEI and help to gain insight into the interaction between electrolyte and anode, electrochemical performance, and cycle life of batteries.

CNN-based automatic segmentations and radiomics feature reliability on contrast-enhanced ultrasound images for renal tumors.

Objective: To investigate the feasibility and efficiency of automatic segmentation of contrast-enhanced ultrasound (CEUS) images in renal tumors by convolutional neural network (CNN) based models and their further application in radiomic analysis. Materials and methods: From 94 pathologically confirmed renal tumor cases, 3355 CEUS images were extracted and randomly divided into training set (3020 images) and test set (335 images). According to the histological subtypes of renal cell carcinoma, the test set was further split into clear cell renal cell carcinoma (ccRCC) set (225 images), renal angiomyolipoma (AML) set (77 images) and set of other subtypes (33 images). Manual segmentation was the gold standard and serves as ground truth. Seven CNN-based models including DeepLabV3+, UNet, UNet++, UNet3+, SegNet, MultilResUNet and Attention UNet were used for automatic segmentation. Python 3.7.0 and Pyradiomics package 3.0.1 were used for radiomic feature extraction. Performance of all approaches was evaluated by the metrics of mean intersection over union (mIOU), dice similarity coefficient (DSC), precision, and recall. Reliability and reproducibility of radiomics features were evaluated by the Pearson coefficient and the intraclass correlation coefficient (ICC). Results: All seven CNN-based models achieved good performance with the mIOU, DSC, precision and recall ranging between 81.97%-93.04%, 78.67%-92.70%, 93.92%-97.56%, and 85.29%-95.17%, respectively. The average Pearson coefficients ranged from 0.81 to 0.95, and the average ICCs ranged from 0.77 to 0.92. The UNet++ model showed the best performance with the mIOU, DSC, precision and recall of 93.04%, 92.70%, 97.43% and 95.17%, respectively. For ccRCC, AML and other subtypes, the reliability and reproducibility of radiomic analysis derived from automatically segmented CEUS images were excellent, with the average Pearson coefficients of 0.95, 0.96 and 0.96, and the average ICCs for different subtypes were 0.91, 0.93 and 0.94, respectively. Conclusion: This retrospective single-center study showed that the CNN-based models had good performance on automatic segmentation of CEUS images for renal tumors, especially the UNet++ model. The radiomics features extracted from automatically segmented CEUS images were feasible and reliable, and further validation by multi-center research is necessary.

A phase II clinical trial evaluating the safety and efficacy of durvalumab as first line therapy in advanced and metastatic non-small cell lung cancer patients with Eastern Cooperative Oncology Group performance status of 2.

Background: Approximately 30-40% of patients with advanced and metastatic non-small cell lung cancer (NSCLC) present with an impaired performance status (PS). There are limited prospective data on the safety and efficacy of durvalumab in these patients. Methods: In this single-arm phase II clinical trial (NCT02879617), patients with previously untreated Stage IIIB/IV NSCLC and ECOG PS of 2 received durvalumab 1500 mg every 28 days until progression or unacceptable toxicity. The primary endpoints were overall survival (OS) and safety determined by grade ≥3 treatment-related adverse events (TRAEs). Findings: Between April 2017 and March 2021, 50 patients were enrolled, of whom 47 received durvalumab. With a median follow-up of 28 months, median OS was 6 months (95% CI 4-10). TRAEs grade 3 occurred in nine of 47 patients (19%, 95% CI 9%-33%). OS in patients with a PD-L1 TPS of 0, 1-49%, and ≥50% was six months (95% CI 3-15), 11 months (95% CI 4-16), and 11 months (95% CI 0-not reached (NR)), respectively. Health related quality of life (HQRL) assessed at baseline and during therapy demonstrated no statistically significant change over the course of treatment. Interpretation: This study demonstrates that single agent durvalumab is safe and well tolerated in the 1st line treatment of patients with advanced NSCLC and ECOG PS of 2, with an encouraging OS benefit in patients with PD-L1 positive tumors. This trial is amongst the largest prospective studies evaluating durvalumab in the 1st line treatment of advanced stage NSCLC and a PS of 2. Funding: AstraZeneca, NCI P30CA047904.

The impact of job-related stress on township teachers' professional well-being: A moderated mediation analysis.

This study aimed to explore the relationship between job-related stress and township teachers' professional well-being. Based on Job Demand-Resource Model, this study examined the mediating role of teachers' professional identity and the moderating role of perceived organizational support in this relationship. A total of 24,276 township teachers in China responded to the Teacher Stress Scale, the Teachers' Professional Identity Scale, the Teachers' Professional Well-Being Structure Questionnaire, and the Perceived Organizational Support Scale. Results showed that: (1) the professional well-being of township teachers differed significantly in terms of school type and demographic characteristics like age and gender; (2) job-related stress negatively predicted township teachers' professional well-being, with teachers' professional identity playing a mediating role; (3) the relation between job-related stress and teachers' professional identity was moderated by perceived organizational support; and (4) in the moderated mediation analysis, job-related stress positively predicted township teachers' professional well-being. These findings indicated that township teachers' professional well-being was influenced by both organizational and individual factors, which provided a theoretical basis and intervention pathways for improving township teachers' professional well-being.

Significance of Antisolvents on Solvation Structures Enhancing Interfacial Chemistry in Localized High-Concentration Electrolytes.

Localized high-concentration electrolytes (LHCEs) provide a new way to expand multifunctional electrolytes because of their unique physicochemical properties. LHCEs are generated when high-concentration electrolytes (HCEs) are diluted by antisolvents, while the effect of antisolvents on the lithium-ion solvation structure is negligible. Herein, using one-dimensional infrared spectroscopy and theoretical calculations, we explore the significance of antisolvents in the model electrolyte lithium bis(fluorosulfonyl)imide/dimethyl carbonate (LiFSI/DMC) with hydrofluoroether. We clarify that the role of antisolvent is more than dilution; it is also the formation of a low-dielectric environment and intensification of the inductive effect on the C=O moiety of DMC caused by the antisolvent, which decrease the binding energy of the Li+···solvent and Li+···anion interactions. It also has beneficial effects on interfacial ion desolvation and Li+ transport. Furthermore, antisolvents also favor reducing the lowest unoccupied molecular orbital (LUMO) energy level of the solvated clusters, and FSI- anions show a decreased reduction stability. Consequently, the influence of antisolvents on the interfacial chemical and electrochemical activities of solvation structures cannot be ignored. This finding introduces a new way to improve battery performance.

Relationship of 24-Hour Movement Behaviors with Weight Status and Body Composition in Chinese Primary School Children: A Cross-Sectional Study.

24 h movement behaviors, specifically physical activity (PA), sedentary behavior, and sleep, play a crucial role in the prevention and intervention of childhood obesity. This study aimed to examine the association of 24 h movement behaviors with weight status and body composition among Chinese primary school children. Using a random stratified sampling, 978 eligible participants (9.1 ± 1.4 years, 53.2% boys) were recruited from 1 May to 15 July 2021. Demographics included children's age, gender, grade, parents' education level, and household income. Movement behaviors were measured by validated self-reported scales. Weight status and body composition (percent of body fat, PBF; fat-free mass, FFM; skeletal muscle mass, SMM) were measured objectively. Results indicated that participants who were younger, boys, and at lower grade showed higher guidelines adherence. PA was inversely associated with PBF, while screen time (ST) was positively associated with overweight/obesity risk and FFM. Sleep showed no association with any health indicators. Meeting the behavioral guidelines was associated with better weight status and lower PBF, yet not with FFM and SMM. Interventions to improve the Children's weight status and PBF should involve enhancing their overall movement behaviors and considering their demographic differences. More research on examining the association of movement guidelines adherence with body composition indicators is needed.

Simultaneously Blocking Chemical Crosstalk and Internal Short Circuit via Gel-Stretching Derived Nanoporous Non-Shrinkage Separator for Safe Lithium-Ion Batteries.

The separator, an ionic permeable and electronic insulating membrane between cathode and anode, plays a crucial role in the electrochemical and safety performance of batteries. However, commercial polyolefin separators not only suffer from inevitable thermal shrinkage at elevated temperature, but also fail to inhibit the hidden chemical crosstalk of reactive gases such as O2 , leading to often reported thermal runaway (TR) and hence preventing large-scale implementation of high-energy-density lithium-ion batteries. Herein, a nanoporous non-shrinkage separator (GS-PI) is fabricated via a novel gel-stretching orientation approach to eliminate TR. In situ synchrotron small angle X-ray scattering during heating clearly shows that the as-prepared thin GS-PI separator exhibits superior mechanical tolerance at high temperature, thus effectively preventing internal short circuit. Meanwhile, the unique nanoporous structure design further blocks chemical crosstalk and the associated exothermic reactions. Accelerating rate calorimetry tests reveal that the practical 1 Ah LiNi0.6 Co0.2 Mn0.2 O2 (NCM622)/graphite pouch cell using GS-PI nanoporous separator show a maximum temperature rise (dT/dtmax ) of only 3.7 °C s-1 compared to 131.6 °C s-1 in the case of Al2 O3 @PE macroporous separator. Moreover, despite the reduced pore size, the GS-PI separator demonstrates better cycling stability than conventional Al2 O3 @PE separator at high temperature without sacrificing specific capacity and rate capability.

Identifying an lncRNA-Related ceRNA Network to Reveal Novel Targets for a Cutaneous Squamous Cell Carcinoma.

A cutaneous squamous cell carcinoma (cSCC) derived from keratinocytes is the second most common cause of non-melanoma skin cancer. The accumulation of the mutational burden of genes and cellular DNA damage caused by the risk factors (e.g., exposure to ultraviolet radiation) contribute to the aberrant proliferation of keratinocytes and the formation of a cSCC. A cSCC encompasses a spectrum of diseases that range from recursor actinic keratosis (AK) and squamous cell carcinoma (SCC) in situ (SCCIS) to invasive cSCCs and further metastatic SCCs. Emerging evidence has revealed that lncRNAs are involved in the biological process of a cSCC. According to the ceRNA regulatory theory, lncRNAs act as natural miRNA sponges and interact with miRNA response elements, thereby regulating the mRNA expression of their down-stream targets. This study was designed to search for the potential lncRNAs that may become potential therapeutic targets or biomarkers of a cSCC. Considering the spirit of the study to be adequately justified, we collected microarray-based datasets of 19 cSCC tissues and 12 normal skin samples from the GEO database (GSE42677 and GSE45164). After screening the differentially expressed genes via a limma package, we identified 24 differentially expressed lncRNAs (DElncRNAs) and 3221 differentially expressed mRNAs (DEmRNAs). The miRcode, miRTarBase, miRDB and TargetScan databases were used to predict miRNAs that could interact with DElncRNAs and DEmRNAs. A total of 137 miRNA-lncRNA and 221 miRNA-mRNA pairs were retained in the ceRNA network, consisting of 31 miRNAs, 11 DElncRNAs and 155 DEmRNAs. For the functional analysis, the top enriched biological process was enhancer sequence-specific DNA binding in Gene Ontology (GO) terms. The FoxO signaling pathway, autophagy and cellular senescence were the top enrichment terms based on a Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis. The combination of a STRING tool and Cytoscape software (plug-in MCODE) identified five core mRNAs and built a core mRNA-associated ceRNA network. The expression for five identified core mRNAs and their related nine lncRNAs was validated using the external dataset GSE7553. Finally, one lncRNA HLA-F-AS1 and three mRNAs named AGO4, E2F1 and CCND1 were validated with the same expression patterns. We speculate that lncRNA HLA-F-AS1 may sponge miR-17-5p or miR-20b-5p to regulate the expression of CCND1 and E2F1 in the cSCC. The present study may provide potential diagnostic and therapeutic targets for cSCC patients.

Three-Dimensional Covalent Organic Framework with ceq Topology.

Three-dimensional covalent organic frameworks (3D-COFs) are emerging as designable porous materials because of their unique structural characteristics and porous features. However, because of the lack of 3D organic building units and the less reversible covalent bonds, the topologies of 3D-COFs to date have been limited to dia, ctn, ffc, bor, rra, srs, pts, lon, stp, acs, tbo, bcu, and fjh. Here we report a 3D-COF with the ceq topology utilizing a D3h-symmetric triangular prism vertex with a planar triangular linker. The as-synthesized COF displays a twofold-interpenetrated structure with a Brunauer-Emmett-Teller surface area of 1148.6 m2 g-1. Gas sorption measurements revealed that 3D-ceq-COF could efficiently absorb CO2, CH4, and H2 under a moderate surface area. This work provides new building units and approaches for structural and application exploration of 3D-COFs.

Mucosal-Associated Invariant T Cell Dysregulation Correlates With Conjugated Bilirubin Level in Chronic HBV Infection.

BACKGROUND AND AIMS: Mucosal-associated invariant T (MAIT) cells are nonconventional T cells restricted to major histocompatibility complex class I-related protein 1 (MR1). They are highly abundant in human liver and activated by T-cell receptor (TCR)-dependent and TCR-independent mechanisms to exhibit rapid, innate-like effector responses. However, the roles of MAIT cells in chronic HBV infection are still open for study. This study aims to test their antiviral potential and investigate their dynamic changes and regulating factors during chronic HBV infection. APPROACH AND RESULTS: Blood samples from 257 chronic HBV-infected patients were enrolled, and nontumor liver specimens were collected from 58 HBV-infected HCC patients. Combining cell-culture experiments and human data, we showed that MAIT cells had strong cytotoxicity against HBV-transfected hepatocytes in an MR1-dependent way. However, circulating and hepatic MAIT cells in HBV-infected patients decreased significantly compared to controls. Correlation analysis suggested that MAIT cell frequency was associated with disease progression and inversely correlated with serum-conjugated bilirubin level. In particular, conjugated bilirubin not only directly promoted MAIT cell activation and apoptosis, but also impaired TCR-induced proliferation and expansion of MAIT cells, which could be partially rescued by IL-2 in the absence of conjugated bilirubin. Despite that MAIT cells from patients with high conjugated bilirubin levels showed decreased cytokine-producing capacity, the increased TCR-dependent antiviral cytokine production suggested MAIT cells as an important guardian of chronic HBV with high conjugated bilirubin. CONCLUSIONS: We reveal the MR1-dependent, anti-HBV potential of MAIT cells and identify conjugated bilirubin as a major factor dysregulating its frequency and function in chronic HBV-infected patients, suggesting a therapeutic target for MAIT-cell-based immunity against chronic HBV infection.

The Analysis of Gene Expression on Fertility Decline in Caenorhabditis elegans after the Treatment with 5-Fluorouracil.

BACKGROUND: 5-Fluorouracil could lead to a decline in fertility in Caenorhabditis elegans. The aim of this study was to describe the mechanisms underlying such an altered fertility phenotype and to illustrate the specific genes and pathways that are involved in the related phenotypic changes in C. elegans. METHODS: We isolated total RNA from the samples and used a new method called Digital Gene Expression (DGE), which can rapidly identify genes with altered transcript levels. The random genes were confirmed by real-time RT-PCR. RESULTS: We analyzed the results of two methods to draw conclusions based on a comparison between C. elegans and other harmful parasites. Compared with controls, 1147 genes were up-regulated, and 1067 were down-regulated. Overall, 101 up-regulated genes had a log2 ratio higher than 8, whereas the log2 ratio of 141 down-regulated genes was higher than 8. After mapping to the reference database, 4 pathways were confirmed to be involved in this phenomenon, with statistically significant participation from 19 genes. CONCLUSION: For the first time, the transcript sequence of 5-Fu-treated worms and controls was detected. We found that 4 possible pathways, i.e., ECM-receptor interaction pathway, TGF-beta signaling pathway, Focal adhesion and Hypertrophic cardiomyopathy, may be involved in the number decline in the embryos of C. elegans. Specifically, the ECM-receptor interaction pathway and Focal adhesion may be very important pathways that alter the reproduction of C. elegans.