LncRNA-PCat19 acts as a ceRNA of miR-378a-3p to facilitate microglia activation and accelerate chronic neuropathic pain in rats by promoting KDM3A-mediated BDNF demethylation.

The pathogenesis of neuropathic pain (NP) is complex, and there are various pathological processes. Previous studies have suggested that lncRNA PCAT19 is abnormally expressed in NP conduction and affects the occurrence and development of pain. The aim of this study is to analyze the role and mechanism of PCAT19 in NP induced by chronic compressive nerve injury (CCI) in mice. In this study, C57BL/6 mice were applied to establish the CCI model. sh-PCAT19 was intrathecally injected once a day for 5 consecutive days from the second day after surgery. We discovered that PCat19 level was gradually up-regulated with the passage of modeling time. Downregulation of Iba-1-positive expression, M1/M2 ratio of microglia, and pro-inflammatory factors in the spinal cords of CCI-mice after PCat19 knock-downed was observed. Mechanically, the expression of miR-378a-3p was negatively correlated with KDM3A and PCat19. Deletion of KDM3A prevented H3K9me2 demethylation of BDNF promoter and suppressed BDNF expression. Further, KDM3A promotes CCI-induced neuroinflammation and microglia activation by mediating Brain-derived neurotrophic factor (BDNF) demethylation. Together, the results suggest that PCat19 may be involved in the development of NP and that PCat19 shRNA injection can attenuate microglia-induced neuroinflammation by blocking KDM3A-mediated demethylation of BDNF and BDNF release.

Development and Validation of a Nomogram for Prognosis Prediction in Patients with Synchronous Primary Thyroid and Breast Cancer Based on SEER Database.

This study aimed to develop prognostic prediction models for patients diagnosed with synchronous thyroid and breast cancer (TBC). Utilizing the SEER database, key predictive factors were identified, including T stage of thyroid cancer, T stage of breast cancer, M stage of breast cancer, patient age, thyroid cancer surgery type, and isotope therapy. A nomogram predicting 5-year and 10-year survival rates was constructed and validated, exhibiting strong performance (C-statistic: 0.79 in the development cohort (95% CI: 0.74-0.84), and 0.82 in the validation cohort (95% CI: 0.77-0.89)). The area under the Receiver Operator Characteristic (ROC) curve ranged from 0.798 to 0.883 for both cohorts. Calibration and decision curve analyses further affirmed the model's clinical utility. Stratifying patients into high-risk and low-risk groups using the nomogram revealed significant differences in survival rates (P < 0.0001). The successful development and validation of this nomogram for predicting 5-year and 10-year survival rates in patients with synchronous TBC hold promise for similar patient populations, contributing significantly to cancer research.

Consistency analysis of consciousness index and bispectral index in monitoring the depth of sevoflurane anesthesia in laparoscopic surgery.

Background: The Index of Consciousness (IoC) is a new monitoring index of anesthesia depth reflecting the state of consciousness of the brain independently developed by China. The research on monitoring the depth of anesthesia mainly focuses on propofol, and bispectral index (BIS) is a sensitive and accurate objective index to evaluate the state of consciousness at home and abroad. This study mainly analyzed the effect of IoC on monitoring the depth of sevoflurane anesthesia and the consistency and accuracy with BIS when monitoring sevoflurane maintenance anesthesia. Objective: To investigate the monitoring value of the Index of Consciousness (IoC) for the depth of sevoflurane anesthesia in laparoscopic surgery. Methods: The study population consisted of 108 patients who experienced elective whole-body anesthesia procedures within the timeframe of April 2020 to June 2023 at our hospital. Throughout the anesthesia process, which encompassed induction and maintenance using inhaled sevoflurane, all patients were diligently monitored for both the Bispectral Index (BIS) and the Index of Consciousness (IoC). We conducted an analysis to assess the correlation between IoC and BIS throughout the anesthesia induction process and from the maintenance phase to the regaining of consciousness. To evaluate the predictive accuracy of IoC and BIS for the onset of unconsciousness during induction and the return of consciousness during emergence, we employed receiver operating characteristic (ROC) curve analysis. Results: The mean difference between BIS and IoC, spanning from the pre-anesthesia induction phase to the completion of propofol induction, was 1.3 (95% Limits of Agreement [-53.4 to 56.0]). Similarly, during the interval from the initiation of sevoflurane inhalation to the point of consciousness restoration, the average difference between BIS and IoC was 0.3 (95% LOA [-10.8 to 11.4]). No statistically significant disparities were observed in the data acquired from the two measurement methodologies during both the anesthesia induction process and the journey from maintenance to the regaining of consciousness (P > 0.05). The outcomes of the ROC curve analysis disclosed that the areas under the curve (AUC) for prognosticating the occurrence of loss of consciousness were 0.967 (95% CI [0.935-0.999]) for BIS and 0.959 (95% CI [0.924-0.993]) for IoC, with optimal threshold values set at 81 (sensitivity: 88.10%, specificity: 92.16%) and 77 (sensitivity: 79.55%, specificity: 95.45%) correspondingly. For the prediction of recovery of consciousness, the AUCs were 0.995 (95% CI [0.987-1.000]) for BIS and 0.963 (95% CI [0.916-1.000]) for IoC, each associated with optimal cutoff values of 76 (sensitivity: 92.86%, specificity: 100.00%) and 72 (sensitivity: 86.36%, specificity: 100.00%) respectively. Conclusion: The monitoring of sevoflurane anesthesia maintenance using IoC demonstrates a level of comparability to BIS, and its alignment with BIS during the maintenance phase of sevoflurane anesthesia is robust. IoC displays promising potential for effectively monitoring the depth of anesthesia.

The safety and effectiveness of enhanced recovery after surgery (ERAS) in older patients undergoing orthopedic surgery: a systematic review and meta-analysis.

INTRODUCTION: To systematically review and analyze the safety and effectiveness of ERAS in older patients undergoing orthopedic surgeries. MATERIALS AND METHODS: We searched PubMed, EMBASE, CINAHL, MEDLINE (Ovid), Web of Science, the Cochrane Library, and other databases to identify all randomized controlled studies and cohorts. We used the Cochrane Risk of Bias Assessment Tool and the Newcastle‒Ottawa Scale to assess the study quality. A meta-analysis was performed using the inverse variance weighting method. RESULTS: This study included 15 studies involving a total of 2591 older patients undergoing orthopedic surgeries with 1480 in the ERAS group. The ERAS group had a lower incidence of postoperative complications than the control group (RR 0.52; 95% CI 0.42-0.65). Length of stay was 3.37 days lower in the ERAS group than in the control group (P < 0.01). And the ERAS protocol reduced the patient's postoperative VAS score (P < 0.01). Meanwhile, there was a lack of evidence of significant differences between the ERAS group and the control group in total bleeding and 30-day readmission rate. CONCLUSIONS: The implementation of the ERAS program in older patients undergoing orthopedic surgeries is safe and effective. However, there is still a lack of standardization of protocols across institutions and centers for orthopedic surgery for older patients. Identifying ERAS components that are beneficial to older patients and developing ERAS protocols that are appropriate for older adults may further improve outcomes.

The normal impact stiffness of a debris-flow flexible barrier.

This paper proposes a normal oriented impact stiffness of a three-supporting cable flexible barrier under a small pretension stress to estimate the structural load behaviour, and employs two categories of small-scale debris flows (coarse and fine) to explore the stiffness evolution through physical model experiments with high-speed photography and load sensing. Results suggest that the particle-structure contact is essential to the normal load effect. Coarse debris flow performs more frequent particle-structure contact and exerts evident momentum flux, while fine debris flows with few physical collisions impart much smaller one. The middle-sited cable that receives only tensile force from vertical equivalent cable-net joint system exhibits indirect load behaviour. The bottom-sited cable shows high load feedback due to the sum of direct contact of debris flow and tensile forces. The relationship between impact loads and maximum cable deflections can be explained by power functions according to quasi-static theory. The impact stiffness is not just affected by the particle-structure contact but by the flow inertia and particle collision effect. Savage number Nsav and Bagnold number Nbag manage to depict the dynamical effects on the normal stiffness Di. Experiments indicate that Nsav has positive linear correlation with the nondimensionalization of Di, whilst Nbag has positive power correlation with the nondimensionalization of Di. This idea is an alternative scope for the study on flow-structure interaction and may contribute to the parameter identification in numerical simulation of the debris flow-structure interaction and the optimization of the design standardization.

Boosting algorithm improves the accuracy of juvenile forensic dental age estimation in southern China population.

Age estimation based on the mineralized morphology of teeth is one of the important elements of forensic anthropology. To explore the most suitable age estimation protocol for adolescents in the South China population, 1477 panoramic radiograph images of people aged 2-18 years in the South were collected and staged by the Demirjian mineralization staging method. The dental ages were estimated using the parameters of the Demirjian and Willems. Mathematical optimization and machine learning optimization were also performed in the data processing process in an attempt to obtain a more accurate model. The results show that the Willems method was more accurate in the dental age estimation of the southern China population and the model can be further optimized by reassigning the model through a nonintercept regression method. The machine learning model presented excellent results in terms of the efficacy comparison results with the traditional mathematical model, and the machine learning model under the boosting framework, such as gradient boosting decision tree (GBDT), significantly reduced the error in dental age estimation compared to the traditional mathematical method. This machine learning processing method based on traditional estimation data can effectively reduce the error of dental age estimation while saving arithmetic power. This study demonstrates the effectiveness of the GBDT algorithm in optimizing forensic age estimation models and provides a reference for other regions to use this parameter for age estimation model establishment, and the lightweight nature of machine learning offers the possibility of widespread forensic anthropological age estimation.

iPACK block (local anesthetic infiltration of the interspace between the popliteal artery and the posterior knee capsule) added to the adductor canal blocks versus the adductor canal blocks in the pain management after total knee arthroplasty: a systematic review and meta-analysis.

BACKGROUND: Several studies have suggested that the addition of iPACK block (the popliteal artery and the posterior knee capsule have been given interspace local anesthetic infiltration) might get better analgesia than adductor canal block (ACB) only after total knee arthroplasty (TKA). This paper compiles all available evidence on the effect of two analgesia regimens (ACB and iPACK + ACB) involving all sides. METHODS: We searched in eight major databases for all clinical trials discussing the effect of two analgesia regimens after TKA. Statistical analyses were conducted by Stata and RevMan Software. In addition, we performed GOSH analysis, subgroup analysis, meta-regression analysis to study the source of heterogeneity. Publication bias was checked using Egger's test. Trim-and-fill analysis was applied in terms of sensitivity analysis of the results. RESULTS: There are fourteen eligible studies for our meta-analysis. There are significant differences between the two groups in VAS score at rest and with activity, and the VAS scores were lower in the ACB + iPACK Group (VAS scores at rest: 95%CI [- 0.96, - 0.53], P < 0.00001. VAS scores with activity: 95%CI [- 0.79, - 0.43], P < 0.00001). A differential was discovered to support the ACB + iPACK Group when comparing the two groups on postoperative cumulative morphine consumption (95%CI: [- 0.52, - 0.14], P: 0.0007). The patients in the group of ACB + iPACK performed better in the postoperative range of knee movement (95%CI: [5.18, 10.21], P < 0.00001) and walking distance (95%CI: [0.15, 0.41], P < 0.00001). There were significant differences between the patients in the ACB + iPACK Group and ACB Group on the TUG test of POD1 and POD2. We found that patients' hospital stays in the ACB + iPACK Group were significantly shorter than in the ACB Group (95%CI: [- 0.78, - 0.16], P: 0.003). No difference was found between the patients in the ACB + iPACK Group and ACB Group on postoperative quadriceps muscle strength and the incidence of PONV. CONCLUSION: The addition of iPACK lowers postoperative VAS scores, cumulative morphine consumption, and hospital stays. Meanwhile, the addition of iPACK improves postoperative patients' activity performance without extra side effects. iPACK combined with ACB proves to be a suitable pain management technique after TKA.

Evidence-based practice dynamic capabilities: a concept derivation and analysis.

BACKGROUND: The environment of healthcare is complex and changeable, and the process of evidence-based practice is "dynamic". Nurses are required to have dynamic capabilities that adjust to changes. However, there is no clear concept of dynamic capabilities in the field of evidence-based practice. The concept of dynamic capabilities needs to be derived from the management field and defined in evidence-based practice. METHODS: A Boolean search of the Web of Science, ProQuest, CINAHL, PubMed, and Emerald databases was conducted, and 35 articles met the inclusion criteria. The concept derivation and analysis strategy of Walker and Avant was used to form and define the concept of evidence-based practice dynamic capabilities. This method includes: selecting a concept, determining the aims of the analysis, identifying usages of the concept, determining the defining attributes, identifying antecedents, consequences, and allied concepts. RESULTS: Sensing capability, learning capability, integration capability, and coordination capability are attributes of the concept. The antecedents include personal and infrastructure related factors. The consequences include improved patient outcomes, reduced medical costs, and increased nurse job satisfaction. The allied concept is evidence-based practice competence. CONCLUSIONS: An operational definition of the concept was developed. The concept compensates for the shortcomings of the existing "evidence-based practice competence" concept and helps nursing managers establish a new perspective on the effective implementation of evidence-based practice.

LncRNA PCAT19 Regulates Neuropathic Pain via Regulation of miR-182-5p/JMJD1A in a Rat Model of Chronic Constriction Injury.

INTRODUCTION: Neuropathic pain (NP) is one of the most severe chronic pain types. In recent years, more and more studies have shown that long noncoding RNA (LncRNA) plays a key role in a variety of human diseases, including NP. However, the role of LncRNA prostate cancer-associated transcript 19 (PCAT19) in NP and its specific mechanism remain unclear. METHODS: A chronic constrictive injury (CCI) rat model was established. Rat paw withdrawal threshold and paw withdrawal latency were used to evaluate the neuronal pain behavior of rats in this model. mRNA expression of PCAT19, neuroinflammatory factor, microRNA (miR)-182-5p, and Jumonji domain containing 1A (JMJD1A) were detected by quantitative real-time PCR. ELISA analysis was used to detect inflammatory factor protein expression. Dual-luciferase reporter assay was used to evaluate the targeting relationship between genes. RESULTS: PCAT19 was continuously upregulated in CCI rats. miR-182-5p was the target of PCAT19, and miR-182-5p was increased after PCAT19 knockdown. NP behaviors such as mechanical ectopic pain and thermal hyperalgesia as well as neuroinflammation can be reduced by knocking down PCAT19. However, the injection of miR-182-5p antagomir significantly reversed the level of the NP behaviors and neuroinflammation caused by PCAT19 knockdown. Besides, dual-luciferase reporter assay showed that JMJD1A was the target gene of miR-182-5p. The level of JMJD1A in CCI rats increased with time. After PCAT19 knockdown, JMJD1A was significantly decreased, but inhibition of miR-182-5p can reverse its levels. CONCLUSION: This study shows that PCAT19 plays a role in NP by targeting the miR-182-5p/JMJD1A axis, and PCAT19 can be used as a new therapeutic target for NP.

Electric Field Enhances Shear Resistance of Polymer Melts via Orientational Polarization in Microstructures.

In this paper, we studied the alteration of viscoelastic properties of a neat poly(methyl methacrylate) (PMMA), induced by an applied external electric field. The rheological properties of PMMA are measured using a rotational rheometer at elevated temperatures. The electric field effect on the shear resistance of the polymer was studied by examining rheological responses under difference experimental scenarios. We find that the external electric field can remarkably enhance shear resistance and prevent flow of PMMA melt, enabling it to behave more predictably at high temperatures. Dynamic rheological analysis illustrates that the external electric field speeds up the recovery of mechanical properties of the PMMA melt after large deformations, whereas the PMMA melt exhibits thixotropic behaviors. The recovery velocity is influenced by the strength of the electric field, specifically, and is found to be proportional to the electric field strength. Our experimental characterization may provide new evidence on the tuning mechanical properties of polymer melts via controlling segmental polarization.

The properties of Irn (n = 2-10) clusters and their nucleation on γ-Al2O3 and MgO surfaces: from ab initio studies.

The structural stability and magnetic properties of iridium clusters Irn (n = 2-10) and their interaction on γ-Al2O3(001) and MgO(100) surfaces have been investigated from first principles calculations. It is found that the adsorption energy of Irn (n = 2-10)/γ-Al2O3(001) is lower than that of Irn/MgO(100); meanwhile, the strongest adsorption energy cluster for γ-Al2O3(001) is the tetrahedral Ir4 cluster, while for MgO(100) is a cubic Ir8 cluster. On the other hand, the nucleation of Irn (n = 2-10) clusters on both surfaces is thermodynamically favorable and exothermic. Moreover, the nucleation energy of Irn (n = 2-10) clusters on the γ-Al2O3(001) surface is close to the corresponding energy on the MgO(100) surface, except for Ir3, Ir4 and Ir6 clusters. Interestingly, the nucleation of Ir3 and Ir6 clusters on the MgO(100) surface is more favorable than that on the γ-Al2O3(001) surface, while the nucleation of the Ir4 cluster is reverse and very close to the gas phase Ir4 cluster. More importantly, deformation energy and charge density analysis show that the adsorbed Ir4 cluster on the γ-Al2O3(001) surface has obviously charge transfer between Ir atoms and surface Al, O atoms with negligible deformation. However, for the MgO(100) surface, the Ir4 cluster connects directly to three surface O atoms with severe distortion, which inhibits the activity of the tetrahedral Ir4 cluster as a catalyst.