Self-care ability and associated factors in community-dwelling older adults living with oral frailty using the COM-B model.

BACKGROUND: Self-care can improve overall oral health. However, few studies have investigated this in community-dwelling older adults with oral frailty. The Capability, Opportunity, Motivation and Behaviour (COM-B) model may be an appropriate framework to identify factors that affect self-care ability. OBJECTIVES: The purpose of this study was to investigate the current status of and factors influencing self-care ability in community-dwelling older adults living with oral frailty, and to analyse the risk factors of low self-care ability. METHODS: Two hundred seventy-five community-dwelling older adults with oral frailty participated in this cross-sectional study from October 2022 to March 2023. Participants underwent evaluations of oral health knowledge and behaviour, oral health literacy, nutritional condition, social support, oral health-related quality of life, self-efficacy and self-care ability using questionnaires. The self-care ability of older adults was assessed using the Chinese version of self-care ability scale for the elderly (SASE). The influencing factors were evaluated by single-factor analysis, correlation analysis and multi-factor analysis. Furthermore, we conducted additional analysis, wherein self-care ability was analysed as a categorical variable. RESULTS: Of the participants, the SASE score was 62.43 ± 7.33, and 73.09% were inadequate at self-care ability. There was a positive correlation between the level of self-care ability and each variable (p < .001). Multiple linear regression showed that health literacy (p < .001), age (p < .001), nutritional condition (p = .001), gender (p = .003), quality of life (p = .014) and self-efficacy (p = .040) were significantly associated with decreased self-care ability (R2 = 0.444, F = 19.241). Binomial logistic regression analysis showed that gender, educational level, nutritional condition, oral health literacy and quality of life (all P<0.05) were risk factors for developing low levels of self-care ability. CONCLUSION: This study suggests that health literacy, age, nutritional condition, quality of life, gender and self-efficacy are important factors that influence self-care ability in community-dwelling older adults living with oral frailty.

Effects of exercise interventions on physical, psychological and social outcomes in frail older adults: An overview of systematic reviews.

AIMS: To comprehensively synthesise existing evidence from systematic reviews regarding the effects of exercise interventions on physical, psychological and social outcomes in frail older adults to provide reference for clinical practice. BACKGROUND: Frailty is highly prevalent in older adults and associated with increased adverse health outcomes. Some systematic reviews have assessed the effectiveness of exercise interventions in frail older adults with varied inclusion criteria, methodology quality, types of exercise and outcome measures. DESIGN: An overview of systematic reviews reported following the PRISMA checklist. METHODS: PubMed, Embase, CINAHL, Web of Science and Cochrane database were searched from inception until June 2023 to identify relevant systematic reviews with or without meta-analysis of randomised controlled trails. Two reviewers independently selected articles, extracted data, assessed quality and summarised findings. RESULTS: A total of 17 systematic reviews were included, with methodology quality varying from moderate to critically low. The most frequent types of exercise were multicomponent exercise and resistance-based exercise in community and long-term care facilities, respectively. Exercise interventions had positive effects on most physical outcomes and depression, but inconsistent effects on cognitive function and quality of life. The quality of the evidence for most outcomes was low and very low. CONCLUSIONS: This overview highlights the importance of exercise interventions to improve physical, psychological and social aspects in frail older adults and provides evidence on characteristics of exercise interventions for frailty in various settings. RELEVANCE TO CLINICAL PRACTICE: Multicomponent exercise and resistance-based exercise should be recommended for frail older adults. There is a need of more well-designed research with large sample size and validated definition of frailty. Long-term effects, adherence during and after exercise interventions, adverse events and cost-effectiveness should be emphasised in future studies. TRIAL AND PROTOCOL REGISTRATION: The overview protocol was registered on the International Prospective Register of Systematic reviews (CRD 42021281327). PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. REPORTING METHOD: The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were applied to report the results.

Intra-individual comparison of Sonazoid contrast-enhanced ultrasound and SonoVue contrast-enhanced ultrasound in diagnosing hepatocellular carcinoma.

PURPOSE: To assess whether the diagnostic performance of Sonazoid contrast-enhanced ultrasound (SZUS) is non-inferior to that of SonoVue contrast-enhanced ultrasound (SVUS) in diagnosing hepatocellular carcinoma (HCC) in individuals with high risk. MATERIALS AND METHODS: This prospective study was conducted from October 2020 to May 2022 and included participants with a high risk of HCC who underwent SZUS and SVUS. All lesions were confirmed by clinical or pathological diagnosis. Each nodule was classified according to the Contrast-Enhanced Ultrasound Liver Imaging Reporting and Data System version 2017 (CEUS LI-RADS v2017) for SVUS and SZUS and the modified CEUS LI-RADS (using Kupffer phase defect instead of late and mild washout) for SZUS. The diagnostic performance of both two modalities for all observations was compared. Analysis of the vascular phase and Kupffer phase imaging characteristics of CEUS was performed. RESULTS: One hundred and fifteen focal liver lesions from 113 patients (94 HCCs, 12 non-HCC malignancies, and 9 benign lesions) were analysed. According to CEUS LI-RADS (v2017), SVUS and SZUS showed similar sensitivity (71.3% vs. 72.3%) and specificity (85.7% vs. 81.0%) in HCC diagnosis. However, the modified CEUS LI-RADS did not significantly improve the diagnostic efficacy of Sonazoid compared to CEUS LI-RADS v2017, having equivalent sensitivity (73.4% vs. 72.3%) and specificity (81.0% vs. 81.0%). The agreement between SVUS and SZUS for all observations was 0.610 (95% CI 0.475, 0.745), while for HCCs it was 0.452 (95% CI 0.257, 0.647). CONCLUSION: Using LI-RADS v2017, SZUS and SVUS showed non-inferior efficacy in evaluating HCC lesions. In addition, adding Kupffer phase defects to SZUS does not notably improve its diagnostic efficacy.

Development and validation of a multi-modal ultrasomics model to predict response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer.

OBJECTIVES: To assess the performance of multi-modal ultrasomics model to predict efficacy to neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer (LARC) and compare with the clinical model. MATERIALS AND METHODS: This study retrospectively included 106 patients with LARC who underwent total mesorectal excision after nCRT between April 2018 and April 2023 at our hospital, randomly divided into a training set of 74 and a validation set of 32 in a 7: 3 ratios. Ultrasomics features were extracted from the tumors' region of interest of B-mode ultrasound (BUS) and contrast-enhanced ultrasound (CEUS) images based on PyRadiomics. Mann-Whitney U test, spearman, and least absolute shrinkage and selection operator algorithms were utilized to reduce features dimension. Five models were built with ultrasomics and clinical analysis using multilayer perceptron neural network classifier based on python. Including BUS, CEUS, Combined_1, Combined_2 and Clinical models. The diagnostic performance of models was assessed with the area under the curve (AUC) of the receiver operating characteristic. The DeLong testing algorithm was utilized to compare the models' overall performance. RESULTS: The AUC (95% confidence interval [CI]) of the five models in the validation cohort were as follows: BUS 0.675 (95%CI: 0.481-0.868), CEUS 0.821 (95%CI: 0.660-0.983), Combined_1 0.829 (95%CI: 0.673-0.985), Combined_2 0.893 (95%CI: 0.780-1.000), and Clinical 0.690 (95%CI: 0.509-0.872). The Combined_2 model was the best in the overall prediction performance, showed significantly better compared to the Clinical model after DeLong testing (P < 0.01). Both univariate and multivariate logistic regression analyses showed that age (P < 0.01) and clinical stage (P < 0.01) could be an independent predictor of efficacy after nCRT in patients with LARC. CONCLUSION: The ultrasomics model had better diagnostic performance to predict efficacy to nCRT in patients with LARC than the Clinical model.

Quality Evaluation of Metabolic-Associated Fatty Liver Disease Guidelines and Expert Consensus.

The purpose of this study is to evaluate and analyze the quality of guidelines and expert consensus on clinical practice regarding metabolically associated fatty liver disease (MAFLD) over the past five years. Data from the websites were retrieved using computers. We evaluated guidelines and expert consensus on MAFLD that were officially published between January 1, 2018 and March 24, 2023. Two evaluators independently examined the literature and extracted data. The included literature on guidelines and expert consensus was then subjected to quality review and analysis using assessment tools from Appraisal of Guidelines for Research and Evaluation (AGREE) II and the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) (2016). The intraclass correlation coefficient (ICC) values of all items on the AGREE II scale for the two evaluators were greater than 0.75, indicating a high degree of agreement between their assessments. Scope and purpose (48.90%), participants (49.21%), rigor in the formulation process (56.97%), clarity of expression (90.08%), applicability (66.08%), and independence of file compiling (60.12%) were the AGREE II scoring items with the standardized average scores. Apart from the participants, the average scores of all the scoring items in the guidelines from other countries other than China were higher than those from China (|Z|+>+2.272, p+<+0.05). MAFLD guidelines must be revised to enhance their methodological quality. When creating guidelines, it is recommended that the formulators strictly adhere to the formulation and drafting standards of AGREE II and elevate the quality of the guidelines.

[Impacts of Human Activities on the Net Primary Productivity of Vegetation in Chengde's Transitional Region from Plateau to Plain in the Context of Climate Change].

Chengde's transitional region from plateau to plain is located in the transition zone of agriculture and livestock and is extremely sensitive to climate change and human activities. This study used the net primary productivity(NPP) of vegetation as an evaluation index to quantify the degree impacts of climate change and human activities on vegetation change in the region. The Thornthwaite Memorial model was used to calculate the potential NPP, and the actual NPP was obtained based on MODIS NPP remote sensing images, using the difference between the actual and potential NPPs to express the amount of change in NPP owing to human activities. We used the slope trend and coefficient of variation method to analyze the trend and stability distribution of the actual NPP, potential NPP, and NPP influenced by human activities, and the correlation between actual NPP and annual precipitation and annual average temperature was analyzed using the correlation coefficient method. Finally, we quantified the impact of climate change and human activities on vegetation change in the region. The results showed that 99.87% of the vegetation in the region was improved and changed steadily, and the proportions of the areas showing positive correlation between actual NPP and annual precipitation and annual average temperature were 99.87% and 91.66%, respectively. The potential NPP showed an increasing trend from northwest to southeast, whereas the trend and stability of the potential NPP both showed an increasing trend from west to east. The area where climate change and human activities played a role in vegetation improvement accounted for 99.71%, and that affected by climate change accounted for 0.14%, with the proportion of human activities leading to vegetation degradation being 0.15%.

Clinical study of drug-loaded calcium sulfate in the treatment of hematogenous osteomyelitis in children.

BACKGROUND: At present, good results have been obtained in the treatment of hematogenous osteomyelitis(HO) in children by the use of drug-loaded calcium sulfate, but there are few clinical studies reported. The aim of this study was to investigate the clinical efficacy of radical debridement combined with drug-laden calcium sulphate antibiotics in paediatric haematogenous osteomyelitis. METHODS: In this study, we retrospectively analyzed the clinical data of 15 cases of pediatric hematogenous osteomyelitis admitted to our hospital in recent years. A total of 15 pediatric patients with HO treated in our hospital from January 2018 to February 2022 were included for evaluation. RESULTS: All 15 patients were treated with drug-laden calcium sulfate, and the antibiotic of choice was vancomycin in 14 cases and vancomycin combined with gentamicin in 1 case. The follow-up period ranged from 12 to 36 months, with a mean follow-up time of 24.73 months, and all children were treated with drug-laden calcium sulfate with satisfactory clinical outcomes. The results of serological examination showed that the preoperative white blood cell count level, C-reactive protein and erythrocyte sedimentation rate were higher than the postoperative ones, and the differences were statistically significant (P < 0.05).After the operation, referring to the treatment standard of McKee's osteomyelitis, 15 cases were cured without recurrence; According to the Lower Extremities Functional Scale, 12 cases were excellent, 2 cases were good and 1 case was moderate, with an excellent rate of 93.33%. Children with lower limb involvement could walk with full weight bearing, and gait was basically normal. CONCLUSION: Drug-loaded calcium sulfate is a good therapeutic method for the treatment of hematogenous osteomyelitis in children, with a effect of reducing complications and reducing recurrence.

Diagnostic Effect of MRI Diffusion-weighted Imaging Apparent Diffusion Coefficient Value on Postoperative Recurrence of Brain Glioma.

Objective and significance: Glioblastoma is a highly invasive brain tumor, and its treatment and management have long posed challenges in the fields of neurosurgery and oncology. This study aimed to explore the potential value of apparent diffusion coefficient (ADC) values in postoperative recurrent brain gliomas using magnetic resonance imaging (MRI) diffusion-weighted imaging (DWI), with the goal of providing clinicians with more precise decision-making tools. In the context of the therapeutic challenges posed by glioblastomas, this research holds significant importance. The treatment of glioblastomas typically involves surgical resection, radiotherapy, and chemotherapy; however, its recurrence rate remains relatively high. Early detection of recurrence is crucial for implementing timely interventions, as it can impact patient survival and quality of life. ADC values within DWI may serve as a non-invasive tool to aid in the identification of potential recurrent lesions, thereby facilitating earlier therapeutic actions. Methods: A retrospective analysis was conducted on clinical data from 52 patients diagnosed with brain gliomas. All patients underwent MRI scans, contrast-enhanced imaging, and DWI. Based on the pathology results from the second surgery or radiological follow-up, patients were categorized into two groups: the recurrent group (31 cases) and the non-recurrent group (21 cases). The MRI diagnostic criteria followed the Chinese Guidelines for Diagnosis and Treatment of Central Nervous System Gliomas (2015 edition), and gliomas were classified into grades I-IV according to the WHO (2007 edition) pathological grading standards. Inclusion criteria encompassed postoperative pathological diagnosis of brain gliomas, absence of intracranial surgeries, brain parenchymal injuries, or other relevant medical histories, and all patients received postoperative adjuvant radiotherapy with a total dose exceeding 50 Gy, coupled with chemotherapy. Exclusion criteria excluded patients diagnosed with cerebral infarction, those with other intracranial conditions such as intracranial hypertension, and individuals with hepatic or renal dysfunction or known contrast agent allergies. ADC values for both groups were separately calculated, and receiver operating characteristic (ROC) curves were constructed. ROC area under the curve (AUC) was employed to assess the diagnostic accuracy of the two methods, along with the calculation of sensitivity (Sen) and specificity (Spe). Results: The ADCmean values (1.05 ± 0.25 mmys) and relative ADC (rADC)mean values (1.17 ± 0.38 mmys) of the recurrent group were lower than those of the non-recurrent group (1.33 ± 0.21 mmys, 1.36 ± 0.24 mmys), while the ADCmin values (1.03 ± 0.18 mmys) and ADCmax values (1.19 ± 0.21 mmys) of the recurrent group were lower than those of the non-recurrent group (1.21 ± 0.12 mmys, 1.35 ± 0.17 mmys), with statistically significant differences (P < .05). The AUC of ADCmean was 0.785, with Sen and Spe of 93.75% and 55%, respectively. The AUC of rADCmean was 0.702, with Sen and Spe of 86.2% and 65.21%, respectively. The AUC of ADCmin was 0.824, with Sen and Spe of 86.66% and 68.18%, respectively. The AUC of ADCmax is 0.715, with Sen and Spe of 77.77% and 60%, respectively. Conclusion: The results of this study demonstrated the potential clinical utility of ADC values in the diagnosis of postoperative recurrence in gliomas. ROC analysis revealed that ADC values exhibited a high diagnostic accuracy, with the AUC reflecting their discriminative ability between the recurrence and non-recurrence groups. This finding may assist clinical practitioners in more precisely assessing patients' risk of recurrence, further optimizing treatment strategies, and enhancing both survival rates and quality of life. Nevertheless, it is important to acknowledge several limitations in this study. Firstly, the relatively small sample size may limit the generalizability of the results. Additionally, due to the observational nature of this study, larger-scale and multicenter research is still required to validate these findings. Lastly, ADC values are influenced by various factors, including technical parameters and equipment variations, which necessitate further standardization and calibration efforts. Thus, while the results of this study hold promise for improving the management of glioma patients, further research is warranted to fully understand their potential clinical value.

The Inferior Grain Filling Initiation Promotes the Source Strength of Rice Leaves.

Poor grain-filling initiation in inferior spikelets severely impedes rice yield improvement, while photo-assimilates from source leaves can greatly stimulate the initiation of inferior grain-filling (sink). To investigate the underlying mechanism of source-sink interaction, a two-year field experiment was conducted in 2019 and 2020 using two large-panicle rice cultivars (CJ03 and W1844). The treatments included intact panicles and partial spikelet removal. These two cultivars showed no significant difference in the number of spikelets per panicle. However, after removing spikelet, W1844 showed higher promotion on 1000-grain weight and seed-setting rate than CJ03, particularly for inferior spikelets. The reason was that the better sink activity of W1844 led to a more effective initiation of inferior grain-filling compared to CJ03. The inferior grain weight of CJ03 and W1844 did not show a significant increase until 8 days poster anthesis (DPA), which follows a similar pattern to the accumulation of photo-assimilates in leaves. After removing spikelets, the source leaves of W1844 exhibited lower photosynthetic inhibition compared to CJ03, as well as stronger metabolism and transport of photo-assimilates. Although T6P levels remained constant in both cultivars under same conditions, the source leaves of W1844 showed notable downregulation of SnRK1 activity and upregulation of phytohormones (such as abscisic acid, cytokinins, and auxin) after removing spikelets. Hence, the high sink strength of inferior spikelets plays a role in triggering the enhancement of source strength in rice leaves, thereby fulfilling grain-filling initiation demands.

Combined analysis of the proteome and metabolome provides insight into microRNA-1174 function in Aedes aegypti mosquitoes.

BACKGROUND: Pathogenic viruses can be transmitted by female Aedes aegypti (Ae. aegypti) mosquitoes during blood-meal acquisition from vertebrates. Silencing of mosquito- and midgut-specific microRNA (miRNA) 1174 (miR-1174) impairs blood intake and increases mortality. Determining the identity of the proteins and metabolites that respond to miR-1174 depletion will increase our understanding of the molecular mechanisms of this miRNA in controlling blood-feeding and nutrient metabolism of mosquitoes. METHODS: Antisense oligonucleotides (antagomirs [Ant]) Ant-1174 and Ant-Ct were injected into female Ae. aegypti mosquitoes at 12-20 h posteclosion, and depletion of miR-1174 was confirmed by reverse transcription quantitative real-time PCR (RT-qPCR). Ant-1174-injected and control mosquitoes were collected before the blood meal at 72 h post-injection for tandem mass tag-based proteomic analysis and liquid chromatography-tandom mass spectrometry non-target metabolomic analysis to identify differentially expressed proteins and metabolites, respectively. RNA interference (RNAi) using double-stranded RNA (dsRNA) injection was applied to investigate the biological roles of these differentially expressed genes. The RNAi effect was verified by RT-qPCR and western blotting assays. Triglyceride content and ATP levels were measured using the appropriate assay kits, following the manufacturers' instructions. Statistical analyses were conducted with GraphPad7 software using the Student's t-test. RESULTS: Upon depletion of mosquito- and midgut-specific miR-1174, a total of 383 differentially expressed proteins (DEPs) were identified, among which 258 were upregulated and 125 were downregulated. Functional analysis of these DEPs using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment suggested that miR-1174 plays important regulatory roles in amino acid metabolism, nucleotide metabolism, fatty acid metabolism and sugar metabolism pathways. A total of 292 differential metabolites were identified, of which 141 were upregulated and 151 were downregulated. Integrative analysis showed that the associated differential proteins and metabolites were mainly enriched in a variety of metabolic pathways, including glycolysis, citrate cycle, oxidative phosphorylation and amino acid metabolism. Specifically, the gene of one upregulated protein in miR-1174-depleted mosquitoes, purine nucleoside phosphorylase (PNP; AAEL002269), was associated with the purine, pyrimidine and niacin-nicotinamide metabolism pathways. PNP knockdown seriously inhibited blood digestion and ovary development and increased adult mortality. Mechanically, PNP depletion led to a significant downregulation of the vitellogenin gene (Vg); in addition, some important genes in the ecdysone signaling and insulin-like peptide signaling pathways related to ovary development were affected. CONCLUSIONS: This study demonstrates differential accumulation of proteins and metabolites in miR-1174-depleted Ae. aegypti mosquitoes using proteomic and metabolomic techniques. The results provide functional evidence for the role of the upregulated gene PNP in gut physiological activities. Our findings highlight key molecular changes in miR-1174-depleted Ae. aegypti mosquitoes and thus provide a basis and novel insights for increased understanding of the molecular mechanism involved in a lineage-specific miRNA in mosquito vectors.

A High-Precision Real-Time Pose Measurement Method for the Primary Lens of Large Aperture Space Telescope Based on Laser Ranging.

The aperture of space telescopes increases with their required resolution, and the transmission optical systems with long focal length and diffractive primary lens are becoming increasingly popular. In space, the changes in the pose of the primary lens relative to the rear lens group have a significant impact on the imaging performance of the telescope system. The measurement of the pose of the primary lens in real-time and with high-precision is one of the important techniques for a space telescope. In this paper, a high-precision real-time pose measurement method for the primary lens of a space telescope in orbit based on laser ranging is proposed, and a verification system is established. The pose change of the telescope's primary lens can be easily calculated through six high-precision laser distance changes. The measurement system can be installed freely, which solves the problems of complex system structure and low measurement accuracy in traditional pose measurement techniques. Analysis and experiments show that this method can accurately obtain the pose of the primary lens in real-time. The rotation error of the measurement system is 2 × 10-5 degrees (0.072 arcsecs), and the translation error is 0.2 µm. This study will provide a scientific basis for high-quality imaging of a space telescope.

Association between serum LH levels on hCG trigger day and live birth rate after fresh embryo transfer with GnRH antagonist regimen in different populations.

Objective: To investigate whether serum LH levels on hCG trigger day are associated with live birth rate (LBR) after fresh embryo transfer with GnRH antagonist regimen in different populations. Methods: This study was a retrospective study. A total of 3059 fresh embryo transfers were divided into three populations: predicted normal ovarian responders (NOR) (n=2049), patients with PCOS (n=533), and predicted poor ovarian responders (POR) (n=477). Each population was stratified into three groups based on LH levels: < 25th percentile, 25-75th percentile, and > 75th percentile. The primary outcome of the study was LBR, and secondary outcomes included implantation, clinical pregnancy, and early pregnancy loss rates. Univariable and multivariable regression analyses were performed to adjust for potential confounders. Results: In NOR, compared to the reference group (>75th percentile), LBR was significantly lower in the < 25th percentile group (adjusted OR=0.662; 95%CI, 0.508-0.863) and 25-75th percentile group (adjusted OR=0.791; 95%CI, 0.633-0.988). In PCOS patients, LBR decreased significantly in the < 25th percentile group (41.4%) compared to the 25-75th percentile group (53.7%) and > 75th percentile group (56.1%). In addition, the LBR was lower in the < 25th percentile group (33.6%) compared with the 25-75th percentile group (43.4%) and the>75th percentile group (42.0%) in POR, but this was not statistically significant. Conclusions: High serum LH levels are associated with increased LBR after fresh embryo transfer in GnRH antagonist cycles, which may be attributable to higher implantation rate. LH may be a predictor of whether to schedule fresh embryo transfer in IVF cycles for better clinical outcomes.

Treatment of humeral shaft fractures with different treatment methods: a network meta-analysis of randomized controlled trials.

PURPOSE: Humeral shaft fractures (HSFs) can be treated non-operatively (Non-OP), with open reduction and plate osteosynthesis (ORPO), minimally invasive plate osteosynthesis (MIPO), or with intramedullary nails (IMN). However, the best treatment for HSFs still remains controversial.We performed a network meta-analysis to explore which should be the best method for HSFs. METHODS: The computerized search had been conducted on electronic databases PubMed, EMBASE, Cochrane Library, and Medline from the establishment of the database to the end of December 2022. The quality evaluation of the included literature had been completed by Review Manager (version 5.4.1). Stata 17.0 software (Stata Corporation, College Station, Texas, USA)was used for network meta-analysis.We included randomized controlled trials (RCTs) comparing different treatments to treating HSFs. RESULTS: The pairwise comparison results demonstrated that there was no statistical difference between IMN, MIPO, Non-OP, and ORPO in terms of radial nerve injury and infection, and Non-OP presented significantly more nonunion than ORPO, IMN, and MIPO. However, no statistically significant difference between ORPO, IMN, and MIPO was discovered. The results of the network meta-analysis displayed that surface under the cumulative ranking curve (SUCRA) probabilities of IMN, MIPO, Non-OP, and ORPO in radial nerve injury were 46.5%, 66.9%, 77.3%, and 9.3%, respectively, in contrast, that in infection were 68.6%, 53.3%, 62.4%, and 15.4%, respectively, and that in nonunion were 51.7%, 93.1%, 0.7%, and 54.5%, respectively. CONCLUSION: We came to the conclusion that MIPO is currently the most effective way to treat HSFs. TRIAL REGISTRATION: Name of the registry: Prospero, 2. Unique Identifying number or registration ID: CRD42023411293.

Can Modifications of LR-M Criteria Improve the Diagnostic Performance of Contrast-Enhanced Ultrasound LI-RADS for Small Hepatic Lesions up to 3 cm?

OBJECTIVE: To assess the diagnostic performance of the contrast-enhanced ultrasound liver imaging reporting and data system (CEUS LI-RADS) version 2017 for small hepatic lesions of ≤3 cm before and after changing the LR-M criteria. METHODS: We retrospectively analyzed the CEUS examination of 179 patients who were at high risk of hepatocellular carcinoma (HCC) with focal hepatic lesions ≤3 cm (194 lesions in total) and evaluated the diagnostic capability of the American College of Radiology and modified CEUS LI-RADS algorithms. RESULTS: Revision of the early washout time to 45 seconds increased the sensitivity of LR-5 in predicting HCC (P = .004), with no significant decrease in specificity (P = .118). It also made better the specificity of LR-M in predicting non-HCC malignancies (P = .001), with no significant decrease in sensitivity (P = .094). However, using within 3 minutes as the criterion for marked washout time improved the LR-5 sensitivity (P < .001) but decreased its specificity (P = .009) in predicting HCC, whereas the specificity of LR-M in predicting non-HCC malignancies increased (P < .001), but the sensitivity decreased (P = .027). CONCLUSIONS: CEUS LI-RADS (v2017) is a valid method for predicting HCC risk in high-risk patients. The diagnostic performance of LR-5 and LR-M could boost when the early washout time is revised to 45 seconds.

A prediction model for moderate to severe cancer-related fatigue in colorectal cancer after chemotherapy: a prospective case‒control study.

AIMS: The study aims to develop a model to predict the risk of moderate to severe cancer-related fatigue (CRF) in colorectal cancer patients after chemotherapy. METHODS: The study population was colorectal cancer patients who received chemotherapy from September 2021 to June 2022 in a grade 3 and first-class hospital. Demographic, clinical, physiological, psychological, and socioeconomic factors were collected 1 to 2 days before the start of chemotherapy. Patients were followed up for 1 to 2 days after the end of chemotherapy to assess fatigue using the Piper Fatigue Scale. A random sampling method was used to select 181 patients with moderate to severe CRF as the case group. The risk set sampling method was used to select 181 patients with mild or no CRF as the control group. Logistic regression, back-propagation artificial neural network (BP-ANN), and decision tree models were constructed and compared. RESULTS: A total of 362 patients consisting of 241 derivation samples and 121 validation samples were enrolled. Comparing the three models, the prediction effect of BP-ANN was the best, with a receiver operating characteristic (ROC) curve of 0.83. Internal and external verification indicated that the accuracy of prediction was 70.4% and 80.8%, respectively. Significant predictors identified were surgery, complications, hypokalaemia, albumin, neutrophil percentage, pain (VAS score), Activities of Daily Living (ADL) score, sleep quality (PSQI score), anxiety (HAD-A score), depression (HAD-D score), and nutrition (PG-SGA score). CONCLUSIONS: BP-ANN was the best model, offering theoretical guidance for clinicians to formulate a tool to identify patients at high risk of moderate to severe CRF.

Satellite Rod Fixation around Rod-fracture Area in Revision Surgery after Three-column Osteotomy for Severe Kyphoscoliosis.

OBJECTIVE: Three-column osteotomy (3CO) is considered valuable and increasingly utilized in the surgical treatment of severe spine deformity while associated with high implant-related complications and revision risks. This study aims to evaluate the feasibility and clinical outcomes of satellite rod fixation used around the rod-fracture area in revision surgery due to rod fracture after 3CO. METHODS: Twenty-five patients applying satellite rod fixation in revision surgery from August 2012 to May 2016 were retrospectively reviewed as the SR group. Patients undergoing revision surgery with traditional strategy after 3CO due to rod-fracture were selected as the TR group. Cobb angle, distance between C7 plumb line and center sacral vertical line (C7 PL-CSVL), global kyphosis (GK) and sagittal vertical axis (SVA) were assessed. Patients were required to fulfill the Scoliosis Research Society-22 questionnaire (SRS-22) at pre-revision and the last follow-up. The paired t test was used to analyze the difference among pre-revision, post-revision and last follow-up. RESULTS: There was no statistical difference in terms of age, gender, body mass index (BMI), fusion level at 1st surgery, and follow-up period between SR and TR group (all P > 0.05). The operation time (1.5 ± 0.7 h vs 3.2 ± 0.9 h, P < 0.001) and intraoperative blood loss (178 ± 51 mL vs 324 ± 96 mL, P < 0.001) were significantly higher in the TR group. Patients in both groups obtained obvious deformity correction after revision surgery. For patients in SR group, the coronal Cobb angle significantly improved from 27.9 ± 21.5° at pre-revision to 21.8 ± 16.6° at post-revision (P = 0.034). The C7 PL-CSVL decreased from 22.6 ± 14.3 mm to 21.3 ± 10.9 mm (P = 0.719). Similarly, improvement was attained in post-revision GK (25.8 ± 17.0° vs 20.2 ± 15.1°, P = 0.061). SVA was corrected from 35.6 ± 33.9 mm to 30.8 ± 24.3 mm after revision (P = 0.182). At the last follow-up, no significant correction loss was observed in both coronal and sagittal parameters (all P > 0.05). All patients responded to the SRS-22 questionnaire and all the domains showed improvements in different levels. As compared to the TR group, the SR group had significantly better pain and management satisfaction scores (all P < 0.05). Additionally, there was no reoccurrence of implant failure during follow-up and all patients achieved solid bony fusion in SR group. CONCLUSION: Satellite rod fixation around rod-fracture area is indicated for patients in the requirement of revision surgeries due to rod fracture after 3CO. Compared with traditional revision strategies, revision surgery with satellite rods, if patients are selected adequately, is a simpler procedure with less intraoperative blood loss and shorter operating time.

Characterization of a fermented dairy, sour cream: Lipolysis and the release profile of flavor compounds.

Lipolysis and flavor development during fermentation of sour cream were studied by evaluating the physicochemical changes, sensory differences and volatile components. The fermentation caused significant changes in pH, viable count and sensory evaluation. The peroxide value (POV) decreased after reaching the maximum value of 1.07 meq/kg at 15 h, while thiobarbituric acid reactive substances (TBARS) increased continuously with the accumulation of secondary oxidation products. The Free fatty acids (FFAs) in sour cream were mainly myristic, palmitic and stearic. GC-IMS was used to identify the flavor properties. A total of 31 volatile compounds were identified, among which the contents of characteristic aromatic substances such as ethyl acetate, 1-octen-3-one and hexanoic acid were increased. The results suggest that lipid changes and flavor formation in sour cream are influenced by fermentation time. Furthermore, flavor compounds may be related to lipolysis such as 1-octen-3-one and 2- heptanol were also observed.

Spiribacter salilacus sp. nov., a novel moderately halophilic bacterium isolated from a saline lake in China.

A Gram-staining-negative, non-motile, rod-shaped or curved rod-shaped, moderately halophilic bacterium, designated C176T, was isolated from Yuncheng Salt Lake in Shanxi Province, P.R. China. The optimal temperature, salinity and pH for growth of strain C176T was 37 °C, 6% (w/v) NaCl and 7.5. Phylogenetic analysis using 16S rRNA gene sequences indicated strain C176T has the highest similarity with Spiribacter salinus LMG 27464 T (97.7%), following by the S. halobius E85T (97.6%), S. curvatus DSM 28542 T (97.2%), S. roseus CECT 9117 T (97.0%) and S. vilamensis DSM 21056 T (96.9%). The ANI and dDDH values between strain C176T and S. salinus LMG 27464 T were 69.8 and 17.7%, respectively. The DNA G + C content of genome for strain C176T was 54.1%. Summed feature 8 (C18:1 ω7c and/or C18:1 ω6c) and C16:0 were detected as its major fatty acids, with content of 38.7 and 28.6% respectively, while Q-8 was the predominant ubiquinone. The major polar lipids of strain C176T contained phospholipid, phosphatidylglycerol and phosphoglycolipid. In accordance with results of polyphasic taxonomy, strain C176T is considered as a novel species of the genus Spiribacter, for which the name Spiribacter salilacus sp. nov. is proposed. The type strain is C176T (= MCCC 1H00417T = KCTC 72692 T).

The relationship between cancer-related fatigue, quality of life and pain among cancer patients.

Objectives: This study aimed to select patients with cancer-related pain to further analyze the relationship between pain severity, fatigue severity, and quality of life. Methods: A cross-sectional study was conducted. A convenience sampling method was used to select 224 patients with cancer-related pain who were undergoing chemotherapy and met the inclusion criteria in two hospitals of two provinces from May to November 2019. All participants were invited to complete a general information questionnaire, the Brief Fatigue Inventory (BFI), the Numerical Rating Scale (NRS) for pain intensity, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Results: In the 24 h before completing the scales, 85 patients (37.9%) had mild pain, 121 (54.0%) had moderate pain, and 18 (8.0%) had severe pain. In addition, 92 (41.1%) patients had mild fatigue, 72 (32.1%) had moderate fatigue, and 60 (26.8%) had severe fatigue. Most patients with mild pain only experienced mild fatigue, and their quality of life was also at a moderate level. Patients with moderate and severe pain mostly had moderate or higher levels of fatigue and a lower quality of life. There was no correlation between fatigue and quality of life in patients with mild pain (r = -0.179, P = 0.104). There was a correlation between fatigue and quality of life in patients with moderate and severe pain (r = -0.537, P < 0.01; r = -0.509, P < 0.05). Conclusions: Patients with moderate and severe pain have more fatigue symptoms and lower quality of life than those with mild pain. Nurses should pay more attention to patients with moderate and severe pain, explore the interaction mechanism between symptoms, and carry out joint symptom intervention to improve the quality of life of patients.

Design, Fabrication and Analysis of a Hybrid-Order Monolithic Imaging Diffractive Lens on a Germanium Substrate.

Diffractive optical elements are gradually replacing some conventional optical elements and becoming a key component of optical systems due to their unique phase modulation function. However, the imaging performance will be reduced due to the fact that this single-sided microstructured lens still produces chromatic aberration. Therefore, the key issue for the application of diffractive optical elements in optical systems is the reduction of chromatic aberration, and diffractive lenses with double-sided microstructures are proposed as a solution. This research describes the design and analysis of a 70-mm-diameter, 296-mm-focal-length double-sided microstructured hybrid-order monolithic imaging diffractive lens operating in the mid-wave infrared region (3.7-4.7 µm). The design minimizes chromatic aberration by up to 30 times compared to a standard harmonic diffractive lens and improves the image performance of a single-lens optical system operating in the infrared range. Experiments indicate that this design is capable of achieving single-lens imaging with high sensitivity for optical systems with a measured NETD ≤ 50 mK. The analysis of the experiments yielded suggestions for future research.