Surgical management of adult hand macrodactyly in a 49-year-old patient: A case report.

BACKGROUND: Macrodactyly is a rare congenital malformation characterized by an increase in the size of all structures of a digit, accounting for less than 1% of all congenital upper extremity conditions. CASE SUMMARY: We report a case involving a 49-year-old woman who presented for the first time with untreated, radial-sided hand macrodactyly. We performed soft tissue debulking, amputation, median nerve neurotomy and coaptation, and carpal tunnel release. At the 6-year follow-up, no significant growth was observed in the bone or soft tissue of the affected area. CONCLUSION: Tissue overgrowth in patients with progressive macrodactyly can continue and progress excessively with age. Median nerve neurotomy and coaptation play a crucial role in preventing recurrence of the deformity.

Astragalusliuaiminii, a new species of Astragalus (Fabaceae) from Xinjiang, China.

A new species, Astragalusliuaiminii Z. Z. Yang & Q. R. Liu (Fabaceae), is described and illustrated from Xinjiang Province, China. The new species is close to A.wenquanensis S. B. Ho, but differs from the latter by leaves having a single leaflet (vs. 3-5 leaflets), and inflorescences with 1-2 flowers (vs. inflorescences with 5-7 flowers). It is also similar to A.monophyllus Maxim in leaf shape, but differs by its calyx expanding to become saccate and totally enveloping the pod (vs. calyx tubular, and ruptured by pod after flowering).

Paradoxical herniation associated with hyperbaric oxygen therapy after decompressive craniectomy: A case report.

BACKGROUND: Whether hyperbaric oxygen therapy (HBOT) can cause paradoxical herniation is still unclear. CASE SUMMARY: A 65-year-old patient who was comatose due to brain trauma underwent decompressive craniotomy and gradually regained consciousness after surgery. HBOT was administered 22 d after surgery due to speech impairment. Paradoxical herniation appeared on the second day after treatment, and the patient's condition worsened after receiving mannitol treatment at the rehabilitation hospital. After timely skull repair, the paradoxical herniation was resolved, and the patient regained consciousness and had a good recovery as observed at the follow-up visit. CONCLUSION: Paradoxical herniation is rare and may be caused by HBOT. However, the underlying mechanism is unknown, and the understanding of this phenomenon is insufficient. The use of mannitol may worsen this condition. Timely skull repair can treat paradoxical herniation and prevent serious complications.

Analyzing urban influence on extreme winter precipitation through observations and numerical simulation of two South China case studies.

This study investigates the impact of urbanization on extreme winter rainfall in the South China Greater Bay Area (GBA) through the analysis of hourly station observations and simulations using the Weather Research and Forecasting Model with the Single Layer Urban Canopy Model (WRF-SLUCM). Data from 2008 to 2017 reveal that urban areas in the GBA experience lower 99th percentile hourly winter rainfall intensity compared to surrounding rural regions. However, urban locations exhibit higher annual maximum hourly rainfall (Rmax) and very extreme rainfall events (99.99th percentile) in winter, suggesting a positive influence of urbanization on extreme winter precipitation. A case study further underscores the role of the Urban Heat Island (UHI) effect in enhancing extreme rainfall intensity and probability in the GBA urban areas. Additionally, two extreme cases were dynamically downscaled using WRF-SLUCM, involving four parallel experiments: replacing urban land use with cropland (Nourban), using historical urban land use data from 1999 (99LS), projecting near-future urban land use for 2030 (30LS), and considering 2030 urban land use without anthropogenic heat (AH) (30LS-AH0). Synoptic analysis demonstrates that cold air intrusion suppresses the GBA UHI in Case 2013 but not in Case 2015. Reduced evaporation and humidity induced by urban surfaces significantly decrease urban precipitation in Case 2013. In contrast, the persistent UHI in Case 2015 enhances local convection and land-ocean circulation, leading to increased moisture flux convergence and amplified urban precipitation intensity and probability in 30LS compared to Nourban. This amplification is primarily attributed to AH, while the change in 99LS remains insignificant. These findings suggest that urban influences on extreme precipitation in the GBA persist during winter, particularly when the UHI effect is maintained.

Associations of Trimester-Specific Exposure to Perchlorate, Thiocyanate, and Nitrate with Childhood Neurodevelopment: A Birth Cohort Study in China.

Studies about the impacts of maternal exposure to perchlorate, thiocyanate, and nitrate on offspring neurodevelopment are scarce. Based on a birth cohort in China, 1,028 mothers provided urine samples at three trimesters for determination of the three target analytes, and their offspring neurodevelopment was evaluated at 2 years old. Associations of maternal exposure to the three chemicals with offspring neurodevelopment were estimated using three statistical methods. Trimester-specific analyses using generalized estimating equation models showed that double increment of thiocyanate and nitrate during the first trimester was associated with 1.56 (95% CI: -2.82, -0.30) and 1.22 (-2.40, -0.03) point decreases in the offspring mental development index (MDI), respectively. Weighted quantile sum (WQS) regression analyses showed that the mixture exposure at the first and second trimesters was negatively associated with the offspring MDI (ß = -2.39, 95% CI: -3.85, -0.93; ß = -1.75, 95% CI: -3.04, -0.47, respectively) and thiocyanate contributed the most to the association (65.0 and 91.6%, respectively). Bayesian kernel machine regression analyses suggested an inverted U-shape relationship of maternal urinary thiocyanate with the offspring MDI. These findings suggested that prenatal exposure to the three chemicals (at current levels), especially thiocyanate and nitrate, may impair neurodevelopment. Early pregnancy seems to be the sensitive window.

Para-toluenesulfonamide, a novel potent carbonic anhydrase inhibitor, improves hypoxia-induced metastatic breast cancer cell viability and prevents resistance to αPD-1 therapy in triple-negative breast cancer.

Overexpression of the hypoxia-induced transmembrane enzyme carbonic anhydrase IX (CA9) has been associated with poor prognosis and chemoresistance in aggressive breast cancer. This study aimed to investigate the involvement of CA9 in the anti-tumor activity of para-toluenesulfonamide (PTS) and elucidate its mechanism of action against breast cancer both in vitro and in vivo. MCF-7 and MDA-MB-231 breast cancer cells were treated with PTS or subjected to hypoxic conditions using cobalt chloride (CoCl2), with acetazolamide serving as a positive control. Additionally, 4T1 breast cancer cell allograft mice were co-treated with PTS and α-programmed cell death 1 (αPD-1) monoclonal antibody for one month. The results demonstrated that PTS effectively reduced cell viability and reversed migration ability in MCF-7 and MDA-MB-231 cells under CoCl2-induced hypoxia. Furthermore, PTS upregulated the expression of apoptosis-related proteins and downregulated CA9, hypoxia-inducible factor-1α (HIF-1α), and vascular endothelial growth factor (VEGF) proteins, possibly through modulation of p38 MAPK and ERK1/2 phosphorylated proteins. In the animal model, PTS100 inhibited tumor growth and lung metastasis in mammary tumor allograft mice, exhibiting synergistic effects when combined with αPD-1 therapy. Collectively, our findings suggest that PTS inhibits breast cancer growth and metastasis through the p38 MAPK/ERK1/2 pathway. Moreover, PTS may have the potential to prevent the development of resistance to αPD-1 therapy in breast cancer.

Flexible dispersion engineering using polymer patterning in nanophotonic waveguides.

We demonstrate the engineering of waveguide dispersion by lithographically patterning the polymer cladding on silicon nitride waveguide resonators. Both normal and anomalous dispersion, ranging from - 462 to 409 ps/nm/km, can be achieved for the same waveguide dimension within an integrated photonic chip. In the meantime, this simple process shows no impact on the waveguide loss and the quality factor of the waveguide resonators, offering flexibility in tailoring designable dispersion for a universal photonic platform. In addition, by adjusting the coverage ratio of cladding, relatively low dispersion (≈ - 130 ps/nm/km) is also demonstrated in the same waveguide resonator, yielding the potentials for zero-dispersive waveguide resonators by a proper coverage ratio of the polymer cladding.

The effect of anterior superior iliac spine preservation on donor site morbidity and function after harvesting a vascularized iliac bone flap.

BACKGROUND: The purpose of this study was to investigate the effect of anterior superior iliac spine (ASIS) preservation on donor site morbidity and function after harvesting a vascularized iliac bone flap (VIBF). METHODS: Patients who underwent jaws reconstruction with VIBF were divided into a maintaining the anterior superior iliac spine (MASIS) group and a not maintaining the anterior superior iliac spine (NMASIS) group. Pain, tenderness, sensory deficit, gait disturbance, and function of the donor site were evaluated before and after the operation. RESULTS: Thirty-three patients were included in this study, of which 18 were in the MASIS group. The incidence of sensory deficit in the MASIS group was significantly lower than that in the NMASIS group (50.0% vs. 86.7%, p = 0.010). Pain, tenderness, gait disturbance, and function did not differ statistically between the two groups. CONCLUSION: Except for sensory deficit, ASIS preservation has minimal impact on donor site morbidity and function.

DownScaleBench for developing and applying a deep learning based urban climate downscaling- first results for high-resolution urban precipitation climatology over Austin, Texas.

Cities need climate information to develop resilient infrastructure and for adaptation decisions. The information desired is at the order of magnitudes finer scales relative to what is typically available from climate analysis and future projections. Urban downscaling refers to developing such climate information at the city (order of 1 - 10 km) and neighborhood (order of 0.1 - 1 km) resolutions from coarser climate products. Developing these higher resolution (finer grid spacing) data needed for assessments typically covering multiyear climatology of past data and future projections is complex and computationally expensive for traditional physics-based dynamical models. In this study, we develop and adopt a novel approach for urban downscaling by generating a general-purpose operator using deep learning. This 'DownScaleBench' tool can aid the process of downscaling to any location. The DownScaleBench has been generalized for both in situ (ground- based) and satellite or reanalysis gridded data. The algorithm employs an iterative super-resolution convolutional neural network (Iterative SRCNN) over the city. We apply this for the development of a high-resolution gridded precipitation product (300 m) from a relatively coarse (10 km) satellite-based product (JAXA GsMAP). The high-resolution gridded precipitation datasets is compared against insitu observations for past heavy rain events over Austin, Texas, and shows marked improvement relative to the coarser datasets relative to cubic interpolation as a baseline. The creation of this Downscaling Bench has implications for generating high-resolution gridded urban meteorological datasets and aiding the planning process for climate-ready cities.

The Transverse Mechanical Axis of the Pelvis for Post-Operative Evaluation of Total Hip Arthroplasty.

Currently, orthopedic surgeons mainly use the inter-teardrop line (IT-line) as the transverse mechanical axis of the pelvis (TAP) for postoperative evaluation of total hip arthroplasty (THA). However, the teardrop is often unclear in the pelvis anteroposterior (AP) radiographs, which makes postoperative evaluation of THA difficult. In this study, we attempted to identify other clear and accurate axes for postoperative evaluation of THA. We calculated the mean and standard deviation of these angles and tested the significance of these angles using t-tests. The inter-teardrops line (IT line) and the upper rim of the obturator foramen (UOF) had smaller angles with the IFH line. The bi-ischial line (BI line) was relatively inaccurate in measurements. We recommend using the IT line as the TAP when the lower boundary of the teardrops is clear and the shapes of the teardrops on both sides of the pelvis are symmetrical. When there is no deformation of the obturator foramen on pelvic AP radiographs, the UOF is also a good choice for the TAP. We do not recommend the BI line as the TAP.

Radiomic advances in the transarterial chemoembolization related therapy for hepatocellular carcinoma.

Radiomics is a hot topic in the research on customized oncology treatment, efficacy evaluation, and tumor prognosis prediction. To achieve the goal of mining the heterogeneity information within the tumor tissue, the image features concealed within the tumoral images are turned into quantifiable data features. This article primarily describes the research progress of radiomics and clinical-radiomics combined model in the prediction of efficacy, the choice of treatment modality, and survival in transarterial chemoembolization (TACE) and TACE combination therapy for hepatocellular carcinoma.

Evaluation of the Antioxidant Activities and Phenolic Profile of Shennongjia Apis cerana Honey through a Comparison with Apis mellifera Honey in China.

This study evaluates the phenolic profile as well as the antioxidant properties of Shennongjia Apis cerana honey through a comparison with Apis mellifera honey in China. The total phenolic content (TPC) ranges from 263 ± 2 to 681 ± 36 mg gallic acid/kg. The total flavonoids content (TFC) ranges from 35.9 ± 0.4 to 102.2 ± 0.8 mg epicatechin/kg. The correlations between TPC or TFC and the antioxidant results (FRAP, DPPH, and ABTS) were found to be statistically significant (p < 0.01). Furthermore, the phenolic compounds are quantified and qualified by high performance liquid chromatography-high resolution mass spectrometry (HPLC-HRMS), and a total of 83 phenolic compounds were tentatively identified in this study. A metabolomics analysis based on the 83 polyphenols was carried out and subjected to principal component analysis and orthogonal partial least squares-discriminant analysis. The results showed that it was possible to distinguish Apis cerana honey from Apis mellifera honey based on the phenolic profile.

Bepotastine Sensitizes Ovarian Cancer to PARP Inhibitors through Suppressing NF-κB-Triggered SASP in Cancer-Associated Fibroblasts.

Therapy-induced senescence (TIS) is common in tumor cells treated with PARP inhibitors (PARPis) and can serve as a promising target for improving PARPi efficacy. However, whether stromal components within the tumor microenvironment undergo TIS caused by PARPis and contribute to consequential treatment failure remain unclear. We previously revealed that PARPis triggered a senescence-like secretory phenotype in stromal fibroblasts. Here, we further explored PARPi-induced senescence in the stroma, its contribution to PARPi resistance, and opportunities to leverage stromal TIS for improved PARPi sensitivity. In this study, we demonstrated that tumor tissues from patients treated with neoadjuvant PARPis showed a significant senescence-like phenotype in the stroma. Moreover, PARPi-induced senescent cancer-associated fibroblasts (CAFs) displayed a senescence-associated secretory phenotype (SASP) profile that was sufficient to induce tumor resistance to PARPis in both homologous recombination-deficient (HRD) and -proficient ovarian cancer cells. Using the GLAD4U database, we found that bepotastine, an approved H1-antihistamine, inhibited the SASP of PARPi-primed CAFs at clinical serum concentrations. We further demonstrated that bepotastine attenuated fibroblast-facilitated tumor resistance to PARPis in three-dimensional organotypic cultures and HRD-positive patient-derived xenograft models. Mechanistically, bepotastine suppressed PARPi-triggered SASP by inhibiting NF-κB signaling independent of the histamine H1 receptor. Taken together, our results highlight the importance of stromal TIS and SASP in PARPi resistance, and targeting SASP with bepotastine may be a promising therapeutic option for improving PARPi sensitivity in ovarian cancer.

Iliac crest towards alveolar processes or mandibular inferior margin in mandibular reconstruction with a vascularized iliac bone flap: which is better?

OBJECTIVE: The study aims to compare differences among iliac bone flaps with different iliac crest orientations for the repair of mandibular defects with an aim to analyze their advantages, disadvantages, and effects. MATERIAL AND METHODS: Clinical data and computed tomography scans of all patients who underwent iliac bone flap repair of the mandible in Peking University School and Hospital of Stomatology from January 2016 to April 2021 were collected. Patients were divided into the iliac crest towards alveolar process (Group A) and the iliac crest towards mandibular inferior margin (Group B). Software was used to measure corresponding indicators. The results obtained for the groups were statistically analyzed. RESULTS: The study included 78 patients (25 and 53 in groups A and B, respectively). The symmetry of the LC-type defect was better in group A (p < 0.05). The all-bone width of the alveolar process side in group A was greater than 6 mm; in 15 cases of group B, the width was less than 6 mm (p < 0.05). The intermaxillary distance of two sites were higher in group B (p < 0.05). The bone cortical thickness was significantly thicker in group A (p < 0.05). CONCLUSION: One year after the mandibular body defect was reconstructed with a vascularized iliac bone flap, the iliac crest towards alveolar process group showed better bone symmetry, width, intermaxillary distance, and cortical thickness to meet the planting requirements. CLINICAL RELEVANCE: The use of an iliac crest towards alveolar process may be a better approach for mandible reconstruction.

Knowledge and awareness of nicotine, nicotine replacement therapy, and electronic cigarettes among general practitioners with a special interest in respiratory medicine in China.

Objectives: This study aimed to assess the knowledge and awareness of nicotine, nicotine replacement therapy (NRT), and electronic cigarettes (e-cigarettes) among general practitioners with a special interest (GPwSIs) in respiratory medicine. Methods: A cross-sectional study was conducted from October 2021 to February 2022. Knowledge and awareness were compared among smokers and non-smokers, as well as different age and gender groups. Results: The study consisted of 102 GPwSIs from 21 cities in Sichuan Province, China. Most respondents would recommend NRT for long-term use. Only a few believed that e-cigarettes are an effective means of smoking cessation and 71.6% would not recommend e-cigarettes as a substitute for cigarettes to their patients. Additionally, the majority did not regularly provide extensive help to assist patients in quitting smoking and needed smoking cessation counseling training. Conclusion: GPwSIs in respiratory medicine in China could have a relatively low level of knowledge and awareness regarding nicotine, NRT, and e-cigarettes. The study highlights the need for smoking cessation training among GPwSIs to improve their knowledge and provide better assistance to patients who want to quit smoking.

Campus bullying and associated factors among college and middle school students in Tibet / 中国学校卫生

Objective@#To understand campus bullying in colleges and middle schools in Tibet, and to analyze related influencing factors, so as to provide reliable basis and reference for formulating targeted intervention measures.@*Methods@#A stratified cluster sampling method was used to investigate the status and influencing factors of being bullied by questionnaire among 3 875 college and middle school students in Ngari, Qamdo, Lhasa, Nagqu and Xigaze of Tibet, from September to November 2019. Chi-square test and Logistic regression method were used for data analysis.@*Results@#The report rate of campus bullying among college and middle school students in Tibet was 5.50%; 4.35% for girls and 6.76% for boys；8.81% for college students, 1.64% for senior high school students and 5.94% for junior high school students. The results of multivariate Logistic regression analysis showed that smoking ( OR =1.71), Internet addiction ( OR =3.82), depression ( OR =3.84), obesity ( OR =2.02), single parent family ( OR = 1.67 ) and reorganized family ( OR =3.74) were positively correlated with campus bullying ( P <0.05). Girls ( OR =0.66) and senior high school ( OR =0.28) were negatively correlated with campus bullying ( P <0.05).@*Conclusion@#Campus bullying is related to campus environment, family type, behaviors and life styles, etc. Efforts should be committed to build a caring campus culture and a good family moral education environment, in order to reduce the incidence of campus bullying and associated adverse effects.

Force and Velocity Analysis of Particles Manipulated by Toroidal Vortex on Optoelectrokinetic Microfluidic Platform.

The rapid electrokinetic patterning (REP) technique has been demonstrated to enable dynamic particle manipulation in biomedical applications. Previous studies on REP have generally considered particles with a size less than 5 µm. In this study, a REP platform was used to manipulate polystyrene particles with a size of 3~11 µm in a microfluidic channel sandwiched between two ITO conductive glass plates. The effects of the synergy force produced by the REP electrothermal vortex on the particle motion were investigated numerically for fixed values of the laser power, AC driving voltage, and AC driving frequency, respectively. The simulation results showed that the particles were subject to a competition effect between the drag force produced by the toroidal vortex, which prompted the particles to recirculate in the bulk flow adjacent to the laser illumination spot on the lower electrode, and the trapping force produced by the particle and electrode interactions, which prompted the particles to aggregate in clusters on the surface of the illuminated spot. The experimental results showed that as the laser power increased, the toroidal flow range over which the particles circulated in the bulk flow increased, while the cluster range over which the particles were trapped on the electrode surface reduced. The results additionally showed that the particle velocity increased with an increasing laser power, particularly for particles with a smaller size. The excitation frequency at which the particles were trapped on the illuminated hot-spot reduced as the particle size increased. The force and velocity of polystyrene particles by the REP toroidal vortex has implications for further investigating the motion behavior at the biological cell level.

Stability analysis of mode-coupling-assisted microcombs in normal dispersion.

We theoretically study the stability of mode-coupling-assisted frequency comb generation in normal-dispersion microresonators. With the aid of mode coupling, quantitative analysis of the modulational instability is explored in the parameter space of pump power and detuning. By exploring the coupled mode number, dispersion, and coupling strength in the normalized Lugiato-Lefever model, the modulational stability gain exists and yields extended spatial structures within the regime of eigenvalue bifurcations. Moreover, the dynamics and efficiency of microcombs are discussed, providing the accessibility of high-efficient, stable, and controllable combs. This work offers universal guidelines for operating mode-coupling-assisted combs in a normal-dispersion system.

Identification of predictive factors for post-transarterial chemoembolization liver failure in hepatocellular carcinoma patients: A retrospective study.

BACKGROUND: Post-transarterial chemoembolization (TACE) liver failure occurs frequently in hepatocellular carcinoma (HCC) patients. The identification of predictors for post-TACE liver failure is of great importance for clinical decision-making in this population. AIM: To investigate the occurrence rate and predictive factors of post-TACE liver failure in this retrospective study to provide clues for decision-making regarding TACE procedures in HCC patients. METHODS: The clinical records of HCC patients treated with TACE therapy were reviewed. Baseline clinical characteristics and laboratory parameters of these patients were extracted. Logistic models were used to identify candidates to predict post-TACE liver failure. RESULTS: A total of 199 HCC patients were enrolled in this study, and 70 patients (35.2%) developed post-TACE liver failure. Univariate and multivariate logistic models indicated that microspheres plus gelatin embolization and main tumor size > 5 cm were risk predictors for post-TACE liver failure [odds ratio (OR): 4.4, 95% confidence interval (CI): 1.2-16.3, P = 0.027; OR: 2.3, 95%CI: 1.05-5.3, P = 0.039, respectively]. Conversely, HCC patients who underwent tumor resection surgery before the TACE procedure had a lower risk for post-TACE liver failure (OR: 0.4, 95%CI: 0.2-0.95, P = 0.039). CONCLUSION: Microspheres plus gelatin embolization and main tumor size might be risk factors for post-TACE liver failure in HCC patients, while prior tumor resection could be a favorable factor reducing the risk of post-TACE liver failure.

Electro-Acupuncture Regulates Metabolic Disorders of the Liver and Kidney in Premature Ovarian Failure Mice.

As per the theory of traditional Chinese medicine (TCM), the liver and kidney dysfunction are important pathogenies for premature ovarian failure (POF). POF is a common gynecological disease that reduced the pregnancy rate. Electro-acupuncture (EA) is a useful non-pharmaceutical therapy that supposedly regulates the function of the liver and kidney in the treatment of POF with TCM. However, the underlying mechanism of EA in the treatment of POF has not been adequately studied through metabonomics with reference to the theory of TCM. Accordingly, we investigated the effect of EA on the liver and kidney metabolites in POF mice through metabolomics. POF mice were established via intraperitoneal injection of cisplatin. Both Sanyinjiao (SP6) and Guanyuan (CV4) were stimulated by EA for 3 weeks. The biological samples (including the serum and the ovary, liver, and kidney tissues) were evaluated by histopathology, molecular biology, and hydrogen-1 nuclear magnetic resonance (1HNMR)-based metabolomics to assess the efficacy of EA. 1HNMR data were analyzed by the orthogonal partial least squares discriminant analysis (OPLS-DA). The results revealed that EA was beneficial to ovarian function and the menstrual cycle of POF. Both the energy metabolism and neurotransmitter metabolism in the liver and kidney were regulated by EA. Notably, EA played an important role in regulating energy-related metabolism in the kidney, and the better effect of neurotransmitter-related metabolism in the liver was regulated by EA. These findings indicated that the ovarian functions could be improved and the metabolic disorder of the liver and kidney caused by POF could be regulated by EA. Our study results thus suggested that the EA therapy, based on the results for the liver and kidney, were related to POF in TCM, as preliminarily confirmed through metabolomics.