Alcohol drinking, smoking, and cutaneous melanoma risk: Mendelian randomization analysis.

OBJECTIVE: To investigate the causal relationship between poor lifestyle habits, such as smoking and drinking, and cutaneous malignant melanoma. METHOD: In the present study, alcohol consumption and smoking were used as exposure factors, and single nucleotide polymorphisms closely associated with alcohol consumption and smoking were used as instrumental variables, while cutaneous melanoma was set as an outcome variable. Two-sample Mendelian randomization analyses were run between alcohol consumption and melanoma and smoking and melanoma to investigate their causal associations, respectively. RESULTS: We found a positive and statistically significant causal effect of alcohol intake on the risk of cutaneous malignant melanoma (OR: 2.23; 95%CI: 1.11-4.47; p=0.02). The present study showed no significant causal relationship between cigarettes per day and cutaneous melanoma (OR: 0.85; 95%CI: 0.54-1.35; p=0.50) or smoking initiation and cutaneous melanoma (OR: 1.02; 95%CI: 0.74-1.39; p=0.88). CONCLUSIONS: This study provides Mendelian randomization evidence supporting alcohol consumption as a risk factor for cutaneous malignant melanoma. And the causal relationship between smoking and cutaneous malignant melanoma still needs to be further investigated.

Evaluation of vital genes correlated with CD8 + T cell infiltration as prognostic biomarkers in stomach adenocarcinoma.

BACKGROUND: Infiltration of CD8 + T cells in the tumor microenvironment is correlated with better prognosis in various malignancies. Our study aimed to investigate vital genes correlated with CD8 + T cell infiltration in stomach adenocarcinoma (STAD) and develop a new prognostic model. METHODS: Using the STAD dataset, differentially expressed genes (DEGs) were analyzed, and co-expression networks were constructed. Combined with the CIBERSORT algorithm, the most relevant module of WGCNA with CD8 + T cell infiltration was selected for subsequent analysis. The vital genes were screened out by univariate regression analysis to establish the risk score model. The expression of the viral genes was verified by lasso regression analysis and in vitro experiments. RESULTS: Four CD8 + T cell infiltration-related genes (CIDEC, EPS8L3, MUC13, and PLEKHS1) were correlated with the prognosis of STAD. Based on these genes, a risk score model was established. We found that the risk score could well predict the prognosis of STAD, and the risk score was positively correlated with CD8 + T cell infiltration. The validation results of the gene expression were consistent with TCGA. Furthermore, the risk score was significantly higher in tumor tissues. The high-risk group had poorer overall survival (OS) in each subgroup. CONCLUSIONS: Our study constructed a new risk score model for STAD prognosis, which may provide a new perspective to explore the tumor immune microenvironment mechanism in STAD.

After the pandemic is before the pandemic: Rethinking urban priorities, assumptions and planning approaches.

The global covid-pandemic had significant impacts upon cities and city planning in the short, medium and longer term. Early severe disruptions to city living and working patterns prompted interventions from planners and the suspension of plans, largely based on projections of pre-pandemic data and trends. Longer term thinking has begun to settle into a pattern of reactions and approaches depending upon the characteristics of the city. This paper explores some of the responses to the pandemic and how cities are adapting and evolve towards a 'new normal' and what this might mean for planning and planners in future. Two questions are posed for future research following from this. First, will planners require new skills and knowledge going forward as cities adapt and evolve and, second, how can we better comprehend the full spectrum of responses and trajectories of city planning post-pandemic.

Alcohol drinking, smoking, and cutaneous melanoma risk: Mendelian randomization analysis / Consumo de alcohol, tabaquismo y riesgo de melanoma cutáneo: análisis de aleatorización mendeliana

Objective: To investigate the causal relationship between poor lifestyle habits, such as smoking and drinking, and cutaneous malignant melanoma. Method: In the present study, alcohol consumption and smoking were used as exposure factors, and single nucleotide polymorphisms closely associated with alcohol consumption and smoking were used as instrumental variables, while cutaneous melanoma was set as an outcome variable. Two-sample Mendelian randomization analyses were run between alcohol consumption and melanoma and smoking and melanoma to investigate their causal associations, respectively. Results: We found a positive and statistically significant causal effect of alcohol intake on the risk of cutaneous malignant melanoma (OR: 2.23; 95%CI: 1.11-4.47; p = 0.02). The present study showed no significant causal relationship between cigarettes per day and cutaneous melanoma (OR: 0.85; 95%CI: 0.54-1.35; p = 0.50) or smoking initiation and cutaneous melanoma (OR: 1.02; 95%CI: 0.74-1.39; p = 0.88). Conclusions: This study provides Mendelian randomization evidence supporting alcohol consumption as a risk factor for cutaneous malignant melanoma. And the causal relationship between smoking and cutaneous malignant melanoma still needs to be further investigated.(AU)

Objetivo: Investigar la relación causal entre los malos hábitos de vida, como el tabaquismo y el consumo de alcohol, y el melanoma maligno cutáneo. Método: En el presente estudio, el consumo de alcohol y el tabaquismo se utilizaron como factores de exposición, y los polimorfismos de nucleótido único estrechamente asociados con el consumo de alcohol y el tabaquismo se utilizaron como variables instrumentales, mientras que el melanoma cutáneo se estableció como variable de resultado. Se realizaron análisis de aleatorización mendeliana de dos muestras entre el consumo de alcohol y el melanoma, y entre el tabaquismo y el melanoma, para investigar sus asociaciones causales, respectivamente. Resultados: Se encontró un efecto causal positivo y estadísticamente significativo del consumo de alcohol sobre el riesgo de melanoma maligno cutáneo (OR: 2,23; IC95%: 1,11-4,47; p = 0,02). El presente estudio no mostró una relación causal significativa entre cigarrillos por día y melanoma cutáneo (OR: 0,85; IC95%: 0,54-1,35; p = 0,50) ni entre inicio de fumar y melanoma cutáneo (OR: 1,02; IC95%: 0,74-1,39; p = 0,88). Conclusiones: Este estudio aporta pruebas de aleatorización mendeliana que apoyan el consumo de alcohol como factor de riesgo de melanoma maligno cutáneo. En cuanto a la relación causal entre el tabaquismo y el melanoma maligno cutáneo aún debe investigarse más a fondo.(AU)

Lasers and Intense Pulsed Light for the Treatment of Pathological Scars: A Network Meta-Analysis.

BACKGROUND: Laser and intense pulsed light (IPL) therapies have shown promising effects on pathological scars, but the comparative effectiveness of laser and IPL therapies has not yet been studied. OBJECTIVES: The aim of this study was to compare and rank the efficacy of laser and IPL therapies to determine the most effective treatment method for pathological scars. METHODS: Relevant studies published up to February 2022 were identified by searching PubMed, Web of Science, Cochrane Library, CNKI, and Wanfang databases. We defined Vancouver Scar Scale score as the primary outcome. Both frequentist and Bayesian approaches were used to perform a network meta-analysis. RESULTS: We included 25 trials with a total of 1688 participants. The rankings based on the surface under the cumulative ranking curve for the Vancouver Scar Scale score based on the Bayesian approach suggested IPL + CO2 (96.43%) > pulsed dye laser (PDL) + 1064-nm Nd:YAG (yttrium aluminum garnet) laser (86.21%) > PDL + CO2 (82.15%) > CO2 (58.97%) > 1064-nm Nd:YAG (57.03%) > PDL (52%) > 532-nm Nd:YAG (33.28%) > Er:YAG + IPL (28.38%) > Er:YAG (26.56%) > IPL (15.03%) > control (13.97%). The ranking results based on the frequentist approach were basically consistent with those based on the Bayesian approach. CONCLUSIONS: The results of the network meta-analysis showed that the combination of IPL and CO2 laser has the highest probability of being the most effective intervention. However, our conclusions must be interpreted with caution due to the relatively few evaluation indicators included in our study. Future well-designed randomized controlled trials with large sample sizes are required to confirm our conclusions.

Drug resistance of pathogens causing nosocomial infection in orthopedics from 2012 to 2017: a 6-year retrospective study.

BACKGROUND: Hospital-acquired infections (HAIs) are an emerging global problem that increases in-hospital mortality, length of stay, and cost. We performed a 6-year retrospective study to provide valuable insight into appropriate antibiotic use in HAI cases. We also aimed to understand how hospitals could reduce pathogen drug resistance in a population that overuses antibiotics. METHODS: All data (2012-2017) were obtained from the hospital information warehouse and clinical microbiology laboratory. RESULTS: We isolated 1392 pathogen strains from patients admitted to the orthopedics department during 2012-2017. Escherichia coli (14.7%, 204/1392), Enterobacter cloacae (13.9%, 193/1392), and Staphylococcus aureus (11.3%, 157/1392) were the most common pathogens causing nosocomial infections. The dominant Gram-negative bacterium was E. coli, with high resistance to ampicillin, levofloxacin, cotrimoxazole, gentamicin, and ciprofloxacin, in that order. E. coli was least resistant to amikacin, cefoperazone-sulbactam. The most dominant Gram-positive bacterium was S. aureus, highly resistant to penicillin and ampicillin, but not resistant to fluoroquinolones and cotrimoxazole. Analysis of risk factors related to multidrug-resistant bacteria showed that patients with open fractures (Gustillo III B and IIIC) were significantly more susceptible to methicillin-resistant S. aureus infections (p < 0.05). Additionally, extended-spectrum ß-lactamase-producing E. coli infections occurred significantly more often in patients with degenerative diseases (p < 0.05). Elderly patients tended to be more susceptible to multidrug-resistant bacterial infections, but this outcome was not statistically significant. CONCLUSIONS: Antimicrobial resistance is a serious problem in orthopedics. To effectively control antimicrobial resistance among pathogens, we advocate extensive and dynamic monitoring of MDR bacteria, coupled with careful use of antibiotics.

Peroral traction-assisted natural orifice trans-anal flexible endoscopic rectosigmoidectomy followed by intracorporeal colorectal anastomosis in a live porcine model.

BACKGROUND: Compared to traditional open surgery, laparoscopic surgery has become a standard approach for colorectal cancer due to its great superiorities including less postoperative pain, a shorter hospital stay, and better quality of life. In 2007, Whiteford et al reported the first natural orifice trans-anal endoscopic surgery (NOTES) sigmoidectomy using transanal endoscopic microsurgery. To date, all cases of NOTES colorectal resection have included a hybrid laparoscopic approach with the use of established rigid platforms. AIM: To introduce a novel technique of peroral external traction-assisted transanal NOTES rectosigmoidectomy followed by intracorporeal colorectal end-to-end anastomosis by using only currently available and flexible endoscopic instrumentation in a live porcine model. METHODS: Three female pigs weighing 25-30 kg underwent NOTES rectosigmoid resection. After preoperative work-up and bowel preparation, general anesthesia combined with endotracheal intubation was achieved. One dual-channel therapeutic endoscope was used. Carbon dioxide insufflation was performed during the operation. The procedure of trans-anal NOTES rectosigmoidectomy included the following eight steps: (1) The rectosigmoid colon was tattooed with India ink by submucosal injection; (2) Creation of gastrostomy by directed submucosal tunneling; (3) Peroral external traction using endoloop ligation; (4) Creation of rectostomy on the anterior rectal wall by directed 3 cm submucosal tunneling; (5) Peroral external traction-assisted dissection of the left side of the colon; (6) Trans-anal rectosigmoid specimen transection, where an anvil was inserted into the proximal segment after purse-string suturing; (7) Intracorporeal colorectal end-to-end anastomosis using a circular stapler by a single stapling technique; and (8) Closure of gastrostomy using endoscopic clips. All animals were euthanized immediately after the procedure, abdominal exploration was performed, and the air-under-water leak test was carried out. RESULTS: The procedure was completed in all three animals, with the operation time ranging from 193 min to 259 min. Neither major intraoperative complications nor hemodynamic instability occurred during the operation. The length of the resected specimen ranged from 7 cm to 13 cm. With the assistance of a trans-umbilical rigid grasper, intracorporeal colorectal, tension-free, end-to-end anastomosis was achieved in the three animals. CONCLUSION: Peroral traction-assisted transanal NOTES rectosigmoidectomy followed by intracorporeal colorectal end-to-end anastomosis is technically feasible and reproducible in an animal model and is worthy of further improvements.

Design of a novel modal space sliding mode controller for electro-hydraulic driven multi-dimensional force loading parallel mechanism.

The electro-hydraulic driven multi-dimensional force loading parallel mechanism can meet the requirements of complex force loading. However, the force loading performance is affected by the strong dynamic coupling due to flexible load and structure characteristics of parallel mechanism, which is analyzed from the mathematical model built by the Newton-Euler method. In order to solve the coupling problem, a novel control strategy, modal space sliding mode control, is proposed. It can realize multi-dimensional force loading decoupling by a coordinating modal space controller. The modal space control framework is established based on the vibration theory, and the decoupling characteristics of modal space are analyzed. Furthermore, it is discussed that the consistency of modal space channels is required for the decoupling condition in degree of freedom space. In order to improve the tracking performance of modal space channels, a sliding mode controller is designed in the modal space by using the decoupling property of modal space. The modal space sliding mode controller not only reduces the chattering caused by coupling force, but also greatly improves the dynamic performance of modal space channels, as well as the consistency of modal space channels. The stability condition of the modal space sliding mode controller is given and proved by Lyapunov theorem. The experimental results show the effectiveness of the proposed modal space sliding mode control, which can significantly reduce coupling force and improve the dynamic tracking performance.

Differentiation of isomeric cresols by silylation in combination with gas chromatography/mass spectrometry analysis.

RATIONALE: m-Cresol is listed as a priority controlled contaminant in many countries, but it is very difficult to accurately determine isomeric cresols due to their incomplete chromatographic separation on commercially available chromatographic columns and their nearly identical mass spectra. METHODS: Silylation of isomeric cresols was carried out by treatment with N-methyl-N-(trimethylsilyl)trifluoroacetamide. The formed trimethyl(tolyloxy)silanes were analyzed by gas chromatography/mass spectrometry (GC/MS). Theoretical calculations were carried out with the Gaussian 03 program using the density functional theory (DFT) method at the B3LYP/6-311 + G(2d,p) level. RESULTS: The derivatives of three isomeric cresols and six isomeric xylenols have been completely separated on an HP-5MS capillary column within a GC run of only 10 minutes. In addition, the derivative o-cresol can be very easily differentiated from its isomers due to its characteristic base peak ion at m/z 91 in electron ionization (EI)-MS. DFT calculation results indicated that the formation of the abundant fragment ion at m/z 91 is attributed to a facile dissociation pathway involving the shift of a neighboring phenylmethyl hydrogen atom in EI-MS of trimethyl(o-tolyloxy)silane. CONCLUSIONS: Silylation provides a promising solution for simultaneous determination of isomeric cresols and isomeric xylenols.

Correlational analysis between neutrophil granulocyte levels and osteonecrosis of the femoral head.

BACKGROUND: The correlation between peripheral blood neutrophil level and osteonecrosis of the femoral head (ONFH) has not been extensively studied. Thus, we aimed to investigate the correlation between neutrophil level in the peripheral blood (neutrophil granulocyte) and ONFH. METHODS: A total of 984 cases of ONFH and femoral neck fractures (non-ONFH) diagnosed at the Department of Orthopedics at our institution between January 1, 2011 and December 31, 2016 were retrospectively reviewed. The ONFH and non-ONFH groups comprised 488 and 496 cases, respectively. Basic information and peripheral blood cell levels of the two groups were compared. RESULTS: The patients' mean age was 59.89 ± 17.06 years (range: 38-82 years). There were 457 male and 527 female patients, with a male-to-female ratio of 1:1.15. We found that neutrophil granulocyte levels and percentage of neutrophil granulocytes were significantly different between the ONFH and non-ONFH groups. Multimodal regression analysis showed that the percentage of neutrophil granulocytes was an independent protective factor against ONFH. CONCLUSIONS: The factors influencing ONFH are neutrophil granulocyte levels and percentage of neutrophil granulocytes. Percentage of neutrophil granulocytes has a significant correlation with aseptic femoral head necrosis, providing a new perspective and direction for further study of femoral head necrosis.

Differentiation of isomeric methylanilines by imidization and gas chromatography/mass spectrometry analysis.

RATIONALE: Carcinogenic o-methylaniline is one of the banned aromatic amines in azo dyes, but it is very difficult to distinguish it from its noncarcinogenic isomers due to their identical retention time on chromatography and similar mass spectra. METHODS: Imidization of the isomeric methylanilines was carried out by treatment with benzaldehyde under mild conditions. The formed derivatives were analyzed by gas chromatography/mass spectrometry (GC/MS). Theoretical calculations were carried out on the Gaussian 03 program by using the density functional theory method at the B3LYP/6-311+G(d,p) level. RESULTS: Imidization of methylanilines occurred easily and gave rise to the corresponding N-methylbenzylidene benzenamines. The isomeric derivatives were completely separated by GC, and thus the three isomeric methylanilines could be determined simultaneously. Due to the ortho effect, the derivative from o-methylaniline has a characteristic fragment ion at m/z 118 with a stable bicyclic structure, and it could be easily differentiated from the meta- and para-isomers in electron ionization mass spectrometry. CONCLUSIONS: These results provided a promising solution for simultaneous determination of isomeric methylanilines.

Simultaneous determination of isomeric substituted anilines by imidization with benzaldehyde and gas chromatography-mass spectrometry.

The chromatographic separation of several isomeric anilines is a challenging issue. Herein, a simple method for the simultaneous determination of four groups of isomeric primary aromatic amines, including chloroanilines, methylanilines, methoxylanilines, and dimethylanilines, was presented. In this method, all of the 15 primary aromatic amines were easily transformed into the corresponding imine derivative by treatment with benzaldehyde under mild conditions. The formed isomeric imine derivatives were completely separated on a commercial capillary gas chromatography column. The effects of several derivatization parameters were investigated and optimized. Linearity in the optimized method ranged from 0.050 to 50 µg/mL with the squared correlation coefficients (R2 ) between 0.9981 and 0.9999. Reasonable reproducibility was obtained, with the intraday relative standard deviation (N = 5) ranging from 0.89 to 4.57% and interday relative standard deviation ranging from 2.26 to 7.69% at the concentration of 5.0 µg/mL. The developed method has been successfully applied to determine these isomeric aromatic amines in real samples.

A novel first aid stretcher for immobilization and transportation of spine injured patients.

Effective immobilization and transportation are vital to the life-saving acute medical care needed when treating critically injured people. However, the most common types of stretchers used today are wrought with problems that can lead to further medical complications, difficulty in employment and rescue, and ineffective transitions to hospital treatment. Here we report a novel first aid stretcher called the "emergency carpet", which solves these problems with a unique design for spine injured patients. Polyurethane composite material, obtained by a novel process of manually mixing isocyanate and additives, can be poured into a specially designed fabric bag and allowed to harden to form a rigid human-shaped stretcher. The effectiveness of the emergency carpet was examined in the pre-hospital management of victims with spinal fractures. Additionally, it was tested on flat ground and complex terrain as well as in the sea and air. We demonstrated that the emergency carpet can be assembled and solidified on the scene in 5 minutes, providing effective immobilization to the entire injured body. With the protection of the emergency carpet, none of the 20 patients, who were finally confirmed to have spinal column fracture or dislocation, had any neurological deterioration during transportation. Furthermore, the carpet can be handled and transported by multiple means under differing conditions, without compromising immobilization. Finally, the emergency carpet allows the critically injured patient to receive multiple examinations such as X-ray, CT, and MRI without being removed from the carpet. Our results demonstrate that the emergency carpet has ideal capabilities for immobilization, extrication, and transportation of the spine injured patients. Compared with other stretchers, it allows for better mobility, effective immobilization, remarkable conformity to the body, and various means for transportation. The emergency carpet is promising for its intrinsic advantages in the pre-hospital management of accident victims.