The Effectiveness of 23-valent Pneumococcal Polysaccharide Vaccine on Elderly Colorectal Cancer Long-Term Survivors: A population-based exact-matched cohort study.

Colorectal cancer (CRC) long-term survivor is a rapid enlarging group. However, the effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPSV23) on this group is unknown. This nationwide population-based study in Taiwan was designed to examine the effect of PPSV23 on incidence rate ratio (IRR) of pneumonia hospitalization, cumulative incidence, and overall survival rate for these long-term CRC survivors. This cohort study was based on the Taiwan Cancer Registry and Taiwan National Health Insurance Research Database from 2000-2017. After individual exact matching to covariates with 1:1 ratio, there were a total of 1,355 vaccinated and 1,355 unvaccinated survivors. After adjusted by multivariate Poisson regression model, vaccinated group had a non-significantly lower pneumonia hospitalization risk than unvaccinated, with an adjusted IRR of 0.879 (p = .391). Besides, vaccinated group had both lower cumulative incidence rate and higher overall survival time than unvaccinated.

Associations between interconnectedness, compassion, and participation in collective action for people with mental illness: A random-intercept cross-lagged panel modeling approach.

The present study aims to prospectively investigate the relationships between interconnectedness, compassion, and participation in private and public forms of collective action for people with mental illness. Public form refers to collective action at the macrolevel such as large-scale protests and demonstrations going on in the communities. Private form refers to collective action happening at the microlevel that targets promoting awareness of social inequalities and positive changes among personal social circles, such as calling out microaggressions or correcting others' stigmatizing language. Eligible responses from 501 participants were collected at baseline, with 345 and 318 participants retained at 6-month and 12-month follow-up assessments, respectively. Random-intercept cross-lagged panel models were conducted to investigate the mediating role of compassion in the relationships between interconnectedness and participation in private and public forms of collective action. Interconnectedness was consistently associated with a higher frequency of participation in private form, but not public form, of collective action at subsequent time points. Contrary to the hypothesis, results showed the nonsignificant mediating effect of compassion between interconnectedness and participation in both forms of collective action. The present study highlights the potential of interconnectedness in promoting a private form of collective action for the rights of people with mental illness. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Legacy Mercury Re-emission and Subsurface Migration at Contaminated Sites Constrained by Hg Isotopes and Chemical Speciation.

The re-emission and subsurface migration of legacy mercury (Hg) are not well understood due to limited knowledge of the driving processes. To investigate these processes at a decommissioned chlor-alkali plant, we used mercury stable isotopes and chemical speciation analysis. The isotopic composition of volatilized Hg(0) was lighter compared to the bulk total Hg (THg) pool in salt-sludge and adjacent surface soil with mean ε202HgHg(0)-THg values of -3.29 and -2.35‰, respectively. Hg(0) exhibited dichotomous directions (E199HgHg(0)-THg = 0.17 and -0.16‰) of mass-independent fractionation (MIF) depending on the substrate from which it was emitted. We suggest that the positive MIF enrichment during Hg(0) re-emission from salt-sludge was overall controlled by the photoreduction of Hg(II) primarily ligated by Cl- and/or the evaporation of liquid Hg(0). In contrast, O-bonded Hg(II) species were more important in the adjacent surface soils. The migration of Hg from salt-sludge to subsurface soil associated with selective Hg(II) partitioning and speciation transformation resulted in deep soils depleted in heavy isotopes (δ202Hg = -2.5‰) and slightly enriched in odd isotopes (Δ199Hg = 0.1‰). When tracing sources using Hg isotopes, it is important to exercise caution, particularly when dealing with mobilized Hg, as this fraction represents only a small portion of the sources.

Association of spironolactone use with risk of urinary tract cancer in the general population: A matched population-based cohort study.

PURPOSE: The correlation between spironolactone usage and cancer risk has sparked interest. The objective of this study is to examine the association between spironolactone use and the incidence of urinary tract cancer in the general population. METHODS: We conducted a matched population-based cohort study. The study population was obtained from the Taiwan National Health Insurance Research Database (TNHIRD) during the period from 2000 to 2016. The multivariate Cox proportional hazard model was performed to examine the impact of spironolactone use on the risk of urinary tract cancer. A total of 8,608 individuals exposed to spironolactone were exact matched by 1:1 ratio with unexposed controls on factors including age, gender, comorbidities, CCI scores and socioeconomic status. The incidences of urinary tract cancer, including prostate, renal and bladder cancer, were estimated in both spironolactone exposed and non-exposed cohorts. RESULTS: After adjusting for confounding variables, the multivariate Cox regression analysis showed no significant association between spironolactone exposure and urinary tract cancer incidence, including bladder (adjusted hazard ratio [aHR] = 1.19, 95% confidence interval [CI] = 0.72-1.96, p = 0.50), renal (aHR = 1.75, 95% CI = 0.99-3.07, p = 0.053), and prostate cancer (aHR = 0.67, 95% CI = 0.43-1.04, p = 0.07). When the population was stratified into low (cumulative dose < = 29,300 mg) and high (cumulative dose >29,300 mg) dose of spironolactone, only high dose of spironolactone use was significantly associated with a reduced risk of prostate cancer (aHR = 0.45, 95% CI = 0.23-0.89, p = 0.02), while being associated with an elevated risk of renal cancer (aHR = 2.09, 95% CI = 1.07-4.08, p = 0.03). However, no clear cumulative dose-response relationship was observed in theses associations. CONCLUSIONS: High cumulative dose of spironolactone may be potentially associated with a decreased incidence of prostate cancer and an increased incidence of renal cancer, while no significant association was observed with bladder cancer incidence. However, given the lack of support from the dose-response pattern, the available evidence is inconclusive to establish a definitive association between spironolactone use and urinary tract cancer.

Foraging behavior and sea ice-dependent factors affecting the bioaccumulation of mercury in Antarctic coastal waters.

To elucidate the potential risks of the toxic pollutant mercury (Hg) in polar waters, the study of accumulated Hg in fish is compelling for understanding the cycling and fate of Hg on a regional scale in Antarctica. Herein, the Hg isotopic compositions of Antarctic cod Notothenia coriiceps were assessed in skeletal muscle, liver, and heart tissues to distinguish the differences in Hg accumulation in isolated coastal environments of the eastern (Chinese Zhongshan Station, ZSS) and the antipode western Antarctica (Chinese Great Wall Station, GWS), which are separated by over 4000 km. Differences in odd mass-independent isotope fractionation (odd-MIF) and mass-dependent fractionation (MDF) across fish tissues were reflection of the specific accumulation of methylmercury (MeHg) and inorganic Hg (iHg) with different isotopic fingerprints. Internal metabolism including hepatic detoxification and processes related to heart may also contribute to MDF. Regional heterogeneity in iHg end-members further provided evidence that bioaccumulated Hg origins can be largely influenced by polar water circumstances and foraging behavior. Sea ice was hypothesized to play critical roles in both the release of Hg with negative odd-MIF derived from photoreduction of Hg2+ on its surface and the impediment of photochemical transformation of Hg in water layers. Overall, the multitissue isotopic compositions in local fish species and prime drivers of the heterogeneous Hg cycling and bioaccumulation patterns presented here enable a comprehensive understanding of Hg biogeochemical cycling in polar coastal waters.

Molecular subtypes of breast cancer predicting clinical benefits of radiotherapy after breast-conserving surgery: a propensity-score-matched cohort study.

BACKGROUND: Based on the molecular expression of cancer cells, molecular subtypes of breast cancer have been applied to classify patients for predicting clinical outcomes and prognosis. However, further evidence is needed regarding the influence of molecular subtypes on the efficacy of radiotherapy (RT) after breast-conserving surgery (BCS), particularly in a population-based context. Hence, the present study employed a propensity-score-matched cohort design to investigate the potential role of molecular subtypes in stratifying patient outcomes for post-BCS RT and to identify the specific clinical benefits that may emerge. METHODS: From 2006 to 2019, the present study included 59,502 breast cancer patients who underwent BCS from the Taiwan National Health Insurance Research Database. Propensity scores were utilized to match confounding variables between patients with and without RT within each subtype of breast cancer, namely luminal A, luminal B/HER2-negative, luminal B/HER2-positive, basal-like, and HER2-enriched ones. Several clinical outcomes were assessed, in terms of local recurrence (LR), regional recurrence (RR), distant metastasis (DM), disease-free survival (DFS), and overall survival (OS). RESULTS: After post-BCS RT, patients with luminal A and luminal B/HER2-positive breast cancers exhibited a decrease in LR (adjusted hazard ratio [aHR] = 0.18, p < 0.0001; and, 0.24, p = 0.0049, respectively). Furthermore, reduced RR and improved DFS were observed in patients with luminal A (aHR = 0.15, p = 0.0004; and 0.29, p < 0.0001), luminal B/HER2-negative (aHR = 0.06, p = 0.0093; and, 0.46, p = 0.028), and luminal B/HER2-positive (aHR = 0.14, p = 0.01; and, 0.38, p < 0.0001) breast cancers. Notably, OS benefits were found in patients with luminal A (aHR = 0.62, p = 0.002), luminal B/HER2-negative (aHR = 0.30, p < 0.0001), basal-like (aHR = 0.40, p < 0.0001), and HER2-enriched (aHR = 0.50, p = 0.03), but not luminal B/HER2-positive diseases. Remarkably, when considering DM, luminal A patients who received RT demonstrated a lower cumulative incidence of DM than those without RT (p = 0.02). CONCLUSION: In patients with luminal A breast cancer who undergo BCS, RT could decrease the likelihood of tumor metastasis. After RT, the tumor's hormone receptor status may predict tumor control regarding LR, RR, and DFS. Besides, the HER2 status of luminal breast cancer patients may serve as an additional predictor of OS after post-BCS RT. However, further prospective studies are required to validate these findings.

Long-Term Usage of Proton Pump Inhibitors Associated with Prognosis in Patients with Colorectal Cancer.

The dose-response effect of proton pump inhibitors on colorectal cancer prognosis is still under exploration. This population-based study in Taiwan was designed to examine the effect of proton pump inhibitors on overall death, colorectal cancer-specific death, and recurrence in colorectal cancer patients with different cumulative proton pump inhibitor dose levels. This cohort study was based on the Taiwan Cancer Registry and Taiwan National Health Insurance Research Database from 2005 to 2020. After frequency matching with a 1:1 ratio, a total of 20,889 users with proton pump inhibitors and 20,889 without proton pump inhibitors were analyzed. The cumulative defined daily dose level of proton pump inhibitor was stratified to explore the dose-response relationship. A proton pump inhibitor exposure cumulative defined daily dose > 60 after colorectal cancer diagnosis had higher risk of all-cause death than non-proton pump inhibitor users with adjusted hazard ratios of 1.10 (95% CIs: 1.04-1.18). For recurrence, a proton pump inhibitor exposure cumulative defined daily dose > 60 had reduced recurrence risk with an adjusted hazard ratio of 0.84 (95% CIs: 0.76-0.93). This study demonstrated that the long-term use of proton pump inhibitors in patients with colorectal cancer was associated with an increased risk of death that related to the proton pump inhibitor exposure cumulative defined daily dose > 60 and had different dose-response effect in various dose level.

The lipid digestion behavior of oil-in-water emulsions stabilized by different particle-sized insoluble dietary fiber from citrus peel.

In this study, oil-in-water emulsions stabilized by insoluble dietary fibre from citrus peel (CIDF) exhibited an obviously delayed lipid digestion property through gastrointestinal tract (GIT) model. Our results suggested that the rate and extent of lipid digestion greatly relied on particle sizes and concentrations of CIDF, and the inhibition effect of lipolysis was markedly enhanced with decreasing particle sizes and increasing CIDF levels. Furthermore, compared with Tween80-stabilized emulsion, the maximum inhibition extent of lipolysis was 38.77% for CIDF400-stabilized one at 0.4 wt% concentration. Effects of CIDFs on lipid digestion was mainly due to the formation of protective layers around oil droplets, further blocking the entry of lipase to the internal lipids, and/or attributed to the increasing viscosity of emulsions caused by CIDFs, finally limiting the transportation of some substances in the simulated small intestine digestion. Our research would provide useful references for the application of CIDF-stabilized emulsions in low-calorie food.

Dose- and time-dependent renoprotection of Angelica sinensis in patients with chronic kidney disease: A longitudinal cohort study.

Background: Based on their anti-oxidative and anti-fibrotic properties, Angelica sinensis (Oliv.) Diels roots [Apiaceae; Radix Angelicae sinensis] (Danggui [abbreviated as S in the context]), Astragalus membranaceus (Fisch.) Bunge [Fabaceae; Astragalus membranaceus] (Huangqi [A]), Rheum palmatum L. [Polygonaceae; Rheum palmatum] (Dahuang [R]), and Salvia miltiorrhiza Bunge [Lamiaceae; Salvia miltiorrhiza Bunge radix et rhizoma] (Danshen [D]) are potential renoprotective Chinese herbal medicines (CHMs). Renoprotection using ARD alone for the treatment of chronic kidney disease (CKD) has been documented in pre-clinical, clinical, and meta-analysis research; however, only pre-clinical data are available for the use of S alone. Moreover, with an increasing number of CKD patients taking prescribed CHMs, hyperkalemia risk remains unclear. Methods: This study retrospectively analyzed national health insurance claims data in 2001-2017. Propensity score matching was used to analyze renal and survival outcomes and the dose-response effects of S without ARD use in 18,348 new S users, 9,174 new ARD users, and 36,696 non-users. Cox proportional hazard regression was used to investigate adjusted hazard ratios (aHRs) for end-stage renal disease (ESRD) in the presence of competing mortality and death. The additive effect of the S herb in single form to compounds was also analyzed. Additionally, to analyze hyperkalemia risk, an exact match on each covariate was used to include 42,265 new CHM users and non-users, while Poisson regression was used to estimate adjusted incidence rate ratios (aIRRs) of hyperkalemia of prescribed CHMs. Results: S users and ARD users were associated with aHRs of 0.77 (95% confidence interval; 0.69-0.86) and 1.04 (0.91-1.19), respectively, for ESRD and 0.55 (0.53-0.57) and 0.71 (0.67-0.75), respectively, for death. The renal and survival benefits of S use were consistent in several sensitivity analyses. The dose- and time-dependent renoprotection and dose-dependent survival benefits were observed for S use. The top two additive renoprotective collocations of the S herb in compounds were Xue-Fu-Zhu-Yu-Tang and Shen-Tong-Zhu-Yu-Tang, followed by Shu-Jing-Huo-Xue-Tang and Shen-Tong-Zhu-Yu-Tang. Moreover, CHM users were associated with aIRRs of 0.34 (0.31-0.37) for hyperkalemia. Conclusion: This study suggests dose- and time-dependent renoprotection and dose-dependent survival benefits of the S herb in compounds and no increased hyperkalemia risk of the prescribed CHMs in CKD patients.

Hazard-based risk grouping effectively stratifying breast cancer patients in post-irradiation long-term heart diseases: a population-based cohort study.

Background: Even though advanced radiotherapy techniques provide a better protective effect on surrounding normal tissues, the late sequelae from radiation exposure to the heart are still considerable in breast cancer patients. The present population-based study explored the role of cox-regression-based hazard risk grouping and intended to stratify patients with post-irradiation long-term heart diseases. Materials and methods: The present study investigated the Taiwan National Health Insurance (TNHI) database. From 2000 to 2017, we identified 158,798 breast cancer patients. Using a propensity score match of 1:1, we included 21,123 patients in each left and right breast irradiation cohort. Heart diseases, including heart failure (HF), ischemic heart disease (IHD), and other heart diseases (OHD), and anticancer agents, including epirubicin, doxorubicin, and trastuzumab, were included for analysis. Results: Patients received left breast irradiation demonstrated increased risks on IHD (aHR, 1.16; 95% CI, 1.06-1.26; p < 0.01) and OHD (aHR, 1.08; 95% CI, 1.01-1.15; p < 0.05), but not HF (aHR, 1.11; 95% CI, 0.96-1.28; p = 0.14), when compared with patients received right breast irradiation. In patients who received left breast irradiation dose of >6,040 cGy, subsequent epirubicin might have a trend to increase the risk of heart failure (aHR, 1.53; 95% CI, 0.98-2.39; p = 0.058), while doxorubicin (aHR, 0.59; 95% CI, 0.26-1.32; p = 0.19) and trastuzumab (aHR, 0.93; 95% CI, 0.33-2.62; p = 0.89) did not. Older age was the highest independent risk factor for post-irradiation long-term heart diseases. Conclusion: Generally, systemic anticancer agents are safe in conjunction with radiotherapy for managing post-operative breast cancer patients. Hazard-based risk grouping may help stratify breast cancer patients associated with post-irradiation long-term heart diseases. Notably, radiotherapy should be performed cautiously for elderly left breast cancer patients who received epirubicin. Limited irradiation dose to the heart should be critically considered. Regular monitoring of potential signs of heart failure may be conducted.

Going beyond Mindfulness: How Concentration and Tranquility Commonly Co-Arising with Mindfulness Account for Mental Health.

Concentration and tranquility usually co-arise with mindfulness during mindfulness practice and in daily life and may potentially contribute to mental health; however, they have rarely been studied in empirical research. The present study aimed to examine the relationship of concentration and tranquility with mindfulness and indicators of mental health. With no existing self-report measure assessing concentration and tranquility, the Concentration Scale and Tranquility Scale were first developed and validated. Items were developed based on the extant literature, rated by a group of experts, and selected according to their ratings. Exploratory factor analyses (EFA; n = 384) and confirmatory factor analyses (CFA; n = 384) were employed in separate samples of university students and community adults to establish the factor structure of both scales. Their construct validity was established in another similar sample (n = 333) by examining their correlations with variables including (a) concentration-related concepts, (b) tranquility-related concepts, (c) mindfulness-related concepts, and (d) perceived stress and psychological distress. The relationships between concentration, tranquility, mindfulness, perceived stress and psychological distress were then examined by hierarchical multiple regressions, both cross-sectionally and longitudinally. A single-factor structure was found by the EFA and confirmed by the CFA for both scales. Concentration and tranquility were significantly and positively associated with (a) attentional control and (b) mindfulness and nonattachment; and negatively associated with (c) irritability and (d) perceived stress and psychological distress. Concentration and tranquility were found to have a significant incremental value over the effect of mindfulness on indicators of mental health. Concentration and tranquility can incrementally explain mental health above and beyond the effect of mindfulness.

Association between Otosclerosis and Rubella in Taiwan: A Nationwide Case-Control Study.

Otosclerosis is an early adult-onset disease that is associated with 5-9% and 18-22% of all cases of hearing and conductive hearing loss, respectively, and it is suspected to have a viral etiology. However, the role of viral infection in otosclerosis is still inconclusive. This study aimed to investigate whether rubella infection was associated with otosclerosis risk. We conducted a nationwide case-control study in Taiwan. Data were retrospectively analyzed from the Taiwan National health Insurance Research Database. Cases consisted of all patients who were aged ≥6 years and had a first-time diagnosis of otosclerosis for the period between 2001 and 2012. The controls were exact matched to cases in a 4:1 ratio by birth year, sex, and must survive in the index year of their matched cases. Adjusted odds ratio (OR) and 95% confidence interval (CI) were estimated by using conditional logistic regression. We examined 647 otosclerosis cases and 2588 controls without otosclerosis. Among the 647 patients with otosclerosis, 241 (37.2%) were male and 406 (62.8%) were female, with most aged between 40 and 59 years, with a mean age of 44.9 years. After adjusting for age and sex, conditional logistic regression revealed that exposure to rubella was not associated with a significant increase in otosclerosis risk (adjusted OR, 2.0; 95% CI, 0.18-22.06, p = 0.57). In conclusion, this study did not show that rubella infection was associated with the risk of otosclerosis in Taiwan.

Do microplastics affect sulfamethoxazole sorption in soil? Experiments on polymers, ionic strength and fulvic acid.

Microplastics (MPs) and sulfamethoxazole (SMX) are emerging contaminants that are ubiquitous in the soil environment. In this study, we investigated MPs polymer type and soil environmental factor effects on SMX adsorption behavior in the soil system. Our results showed that MPs dosage affected the soil particles' SMX adsorption rate and capacity (Qe). Adding 1 % polystyrene (PS) increased the SMX adsorption rate significantly. The value of K1, which represented the adsorption rate, increased from 0.569 h-1 to 1.019 h-1. However, the addition of MPs reduced the soil's SMX equilibrium adsorption capacity slightly. Moreover, increasing salinity strength enhanced SMX adsorption capacity by MPs significantly. However, increasing calcium ions concentration decreased SMX adsorption in the MPs amended soil due to multivalent cationic bridging and competitive adsorption mechanisms. In addition, we observed that fulvic acid addition inhibited SMX adsorption. This study suggests that the addition of MPs reduced the adsorption of SMX in the soil slightly due to dilution effect. Meanwhile, changes in environmental factors also affected the adsorption behavior of SMX in soil amended with MPs.

Effect of particle size on composition, physicochemical, functional, and structural properties of insoluble dietary fiber concentrate from citrus peel.

To investigate the composition, physicochemical, functional, and structural properties of citrus insoluble dietary fiber concentrate from citrus peel affected by different particle sizes, citrus insoluble dietary fiber concentrate was modified by coarse crush and superfine grinding treatments. The results showed that the contents of hemicellulose and lignin significantly decrease and a significant increase in cellulose and insoluble dietary fiber contents with the reduction in particle size. In addition, the markedly decreased particle size and obviously microstructural changes of citrus insoluble dietary fiber concentrate powder were observed. The color value of citrus insoluble dietary fiber concentrate was observably improved, crystallinity and thermal stability of modified fiber slightly increase with the decrease in particle size, which is due to the partial elimination of hemicellulose and lignin after the treatments. However, water holding capacity, water swelling capacity, and oil holding capacity were found to be lower with the reduction in particle size, which might be attributed to the fact that superfine grinding treatment destroyed the structure integrity, thus causing some soluble components to break away from the cellulose backbone, or due to aggregation of smaller granules. The present study suggested that decreasing the particle size could effectively change some properties of citrus insoluble dietary fiber concentrate, which will provide new perspectives for the application of citrus insoluble dietary fiber concentrate in food products.

Effects of different particle-sized insoluble dietary fibre from citrus peel on adsorption and activity inhibition of pancreatic lipase.

Insoluble dietary fibre from citrus peels (CIDF) was found to have adsorption and inhibitory effect on the activity of pancreatic lipase (PL). CIDF-400 exhibited the greatest adsorption and activity inhibition effect on PL. The fluorescence quenching spectra indicated that CIDF could quench PL through a dynamic quenching process induced by the electrostatic interactions with only one binding site between them. The synchronous fluorescence and three-dimensional fluorescence spectra showed that CIDF might combine with PL to induce the increase in hydrophobicity and the reduction in polarity of tyrosine (Tyr) and tryptophan (Try) residues, which further led to the conformational alternations of PL. Moreover, circular dichroism (CD) showed that CIDF altered the secondary structure of PL, decreased α-helical structure content, and increased ß-sheet structure content, potentially resulting in PL structure opening and its active site exposure. This study provides new perspectives for the application of CIDFs produced from agricultural waste in regulating lipid metabolism.

Associations between public and self-stigma of help-seeking with help-seeking attitudes and intention: A meta-analytic structural equation modeling approach.

The present study examined the association between help-seeking public stigma and help-seeking self-stigma (i.e., internalization of stigma) and the relative association of both types of stigma with help-seeking attitude and intention using a full-information meta-analytic structural equation modeling approach. We also investigated the moderating effect of gender, age, collectivism, and social group in the internalization process. Results from 115 independent samples containing data from 54,793 individuals showed that public stigma of help-seeking was strongly and positively associated with self-stigma of help-seeking. Moreover, after controlling for the effect of each other, self-stigma, but not public stigma, remained significantly associated with help-seeking attitude and help-seeking intention. Gender, age, collectivism, and social group did not significantly moderate the association between public and self-stigma. The findings highlight that people who perceive more stigma of help-seeking from others tend to have higher levels of self-stigma. Compared with help-seeking public stigma, help-seeking self-stigma might have a larger impact on one's help-seeking attitude and intention. Help-seeking promotion campaigns should be devised to tackle both types of stigma to foster positive help-seeking attitude and intention. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Renal and survival benefits of seventeen prescribed Chinese herbal medicines against oxidative-inflammatory stress in systemic lupus erythematosus patients with chronic kidney disease: a real-world longitudinal study.

Background: Systemic lupus erythematosus (SLE) significantly links to LN, a type of CKD with high mortality despite modern Western treatments. About 70% of SLE patients develop LN, and 30% advance to end-stage renal disease (ESRD). Concerns about glucocorticoid side effects and LN worsening due to oxidative stress prompt alternative treatment searches. In Taiwan, over 85% of SLE patients opt for complementary methods, especially Chinese herbal medicine (CHM). We pinpointed seventeen CHMs for SLE (PRCHMSLE) with antioxidative and anti-inflammatory properties from national health insurance data (2000-2017). Our primary aim was to assess their impact on renal and survival outcomes in SLE patients progressing to CKD (SLE-CKD), with a secondary focus on the risks of hospitalization and hyperkalemia. Methods: We established a propensity-matched cohort of 1,188 patients with SLE-CKD, comprising 594 PRCHMSLE users and 594 nonusers. We employed Cox proportional hazards models and restricted mean survival time (RMST) analyses to assess the renal and survival outcomes of PRCHMSLE users. Moreover, we performed pooling and network analyses, specifically focusing on the renal effects linked to PRCHMSLE. Results: PRCHMSLE use was associated with decreased adjusted hazard ratios for ESRD (0.45; 95% confidence interval, 0.25-0.79, p = 0.006), all-cause mortality (0.56; 0.43-0.75, p < 0.0001), non-cardiovascular mortality (0.56; 0.42-0.75, p < 0.0001), and hospitalization (0.72; 0.52-0.96, p = 0.009). Hyperkalemia risk did not increase. Significant differences in RMST were observed: 0.57 years (95% confidence interval, 0.19-0.95, p = 0.004) for ESRD, 1.22 years (0.63-1.82, p < 0.0001) for all-cause mortality, and 1.21 years (0.62-1.80, p < 0.0001) for non-cardiovascular mortality, favoring PRCHMSLE use. Notably renoprotective PRCHMSLE included Gan-Lu-Ying, Anemarrhena asphodeloides Bunge [Asparagaceae; Rhizoma Anemarrhenae] (Zhi-Mu), Rehmannia glutinosa (Gaertn.) DC. [Orobanchaceae; Radix Rehmanniae] (Sheng-Di-Huang), Jia-Wei-Xiao-Yao-San, and Paeonia suffruticosa Andr. [Paeoniaceae; Cortex Moutan] (Mu-Dan-Pi). Network analysis highlighted primary treatment strategies with central components like Liu-Wei-Di-Huang-Wan, Paeonia suffruticosa Andr. [Paeoniaceae; Cortex Moutan] (Mu-Dan-Pi), Anemarrhena asphodeloides Bunge [Asparagaceae; Rhizoma Anemarrhenae] (Zhi-Mu), Rehmannia glutinosa (Gaertn.) DC. [Orobanchaceae; Radix Rehmanniae] (Sheng-Di-Huang), and Zhi-Bai-Di-Huang-Wan. Conclusion: This work underscores the pronounced renal and survival benefits associated with the seventeen PRCHMSLE in the treatment of SLE-CKD, concurrently mitigating the risks of hospitalization and hyperkalemia. This highlights their potential as alternative treatment options for individuals with this condition.

Separation of Neodymium (III) and Lanthanum (III) via a Flat Sheet-Supported Liquid Membrane with Different Extractant-Acid Systems.

The increasing demand for neodymium (Nd) permanent magnets in electric motors has revived research interest of Nd recovery and separation from other rare earth elements (REEs). Typically, Nd/La separation is necessary for Nd recovery from primary ores and secondary resource recycling. This research used a flat sheet-supported liquid membrane (FSSLM) with different extractant-acid systems to extract Nd from a Nd/La mixture. The recovery and separation of Nd/La with 204P-H2SO4, 507P-HCl, and TBP-HNO3 were discussed. The results showed effective Nd recovery and promising Nd/La selectivity could be achieved in the 507P-HCl system, compared to 204P-H2SO4 and TBP-HNO3. The addition of citric acid to the feed solution was effective for pH buffering but did not improve the Nd transport or Nd/La selectivity. Long-term stability of the 507P-HCl extractant system was demonstrated by extending the processing time from 6 h to 6 days.

Expert consensus on indocyanine green fluorescence imaging for thoracoscopic lung resection (The Version 2022).

The use of the white-light thoracoscopy is hampered by the low contrast between oncologic margins and surrounding normal parenchyma. As a result, many patients with in situ or micro-infiltrating adenocarcinoma have to undergo lobectomy due to a lack of tactile and visual feedback in the resection of solitary pulmonary nodules. Near-infrared (NIR) guided indocyanine green (ICG) fluorescence imaging technique has been widely investigated due to its unique capability in addressing the current challenges; however, there is no special consensus on the evidence and recommendations for its preoperative and intraoperative applications. This manuscript will describe the development process of a consensus on ICG fluorescence-guided thoracoscopic resection of pulmonary lesions and make recommendations that can be applied in a greater number of centers. Specifically, an expert panel of thoracic surgeons and radiographers was formed. Based on the quality of evidence and strength of recommendations, the consensus was developed in conjunction with the Chinese Guidelines on Video-assisted Thoracoscopy, and the National Comprehensive Cancer Network (NCCN) guidelines on the management of pulmonary lesions. Each of the statements was discussed and agreed upon with a unanimous consensus amongst the panel. A total of 6 consensus statements were developed. Fluorescence-guided thoracoscopy has unique advantages in the visualization of pulmonary nodules, and recognition and resection of the anterior plane of the pulmonary segment. The expert panel agrees that fluorescence-guided thoracoscopic surgery has the potential to become a routine operation for the treatment of pulmonary lesions.