Possible germline mosaicism in a pedigree with Treacher Collins syndrome: A case report and brief review.

Treacher Collins syndrome (TCS) is a rare congenital craniofacial disorder, typically inherited as an autosomal dominant condition. Here, we report on a family in which germline mosaicism for TCS was likely present. The proband was diagnosed with TCS based on the typical clinical features and a pathogenic variant TCOF1 (c.4369_4373delAAGAA, p.K1457Efs*12). The mutation was not detected in his parents' peripheral blood DNA samples, suggesting a de novo mutation had occurred in the proband. However, a year later, the proband's mother became pregnant, and the amniotic fluid puncture revealed that the fetus carried the same mutation as the proband. Prenatal ultrasound also indicated a maxillofacial dysplasia with unilateral microtia. The mother then disclosed a previous birth history in which a baby had died of respiratory distress shortly after birth, displaying a TCS-like phenotype. Around the same time, the proband's father was diagnosed with mild bilateral conductive hearing loss. Based on array data, we concluded that the father may have had germline mosaicism for TCOF1 mutation. Our findings highlight the importance of considering germline mosaicism in sporadic de novo TCOF1 mutations when providing genetic consulting, and prenatal diagnosis is important when the proband's parents become pregnant again.

Value of deep learning reconstruction of chest low-dose CT for image quality improvement and lung parenchyma assessment on lung window.

OBJECTIVES: To explore the performance of low-dose computed tomography (LDCT) with deep learning reconstruction (DLR) for the improvement of image quality and assessment of lung parenchyma. METHODS: Sixty patients underwent chest regular-dose CT (RDCT) followed by LDCT during the same examination. RDCT images were reconstructed with hybrid iterative reconstruction (HIR) and LDCT images were reconstructed with HIR and DLR, both using lung algorithm. Radiation exposure was recorded. Image noise, signal-to-noise ratio, and subjective image quality of normal and abnormal CT features were evaluated and compared using the Kruskal-Wallis test with Bonferroni correction. RESULTS: The effective radiation dose of LDCT was significantly lower than that of RDCT (0.29 ± 0.03 vs 2.05 ± 0.65 mSv, p < 0.001). The mean image noise ± standard deviation was 33.9 ± 4.7, 39.6 ± 4.3, and 31.1 ± 3.2 HU in RDCT, LDCT HIR-Strong, and LDCT DLR-Strong, respectively (p < 0.001). The overall image quality of LDCT DLR-Strong was significantly better than that of LDCT HIR-Strong (p < 0.001) and comparable to that of RDCT (p > 0.05). LDCT DLR-Strong was comparable to RDCT in evaluating solid nodules, increased attenuation, linear opacity, and airway lesions (all p > 0.05). The visualization of subsolid nodules and decreased attenuation was better with DLR than with HIR in LDCT but inferior to RDCT (all p < 0.05). CONCLUSION: LDCT DLR can effectively reduce image noise and improve image quality. LDCT DLR provides good performance for evaluating pulmonary lesions, except for subsolid nodules and decreased lung attenuation, compared to RDCT-HIR. CLINICAL RELEVANCE STATEMENT: The study prospectively evaluated the contribution of DLR applied to chest low-dose CT for image quality improvement and lung parenchyma assessment. DLR can be used to reduce radiation dose and keep image quality for several indications. KEY POINTS: • DLR enables LDCT maintaining image quality even with very low radiation doses. • Chest LDCT with DLR can be used to evaluate lung parenchymal lesions except for subsolid nodules and decreased lung attenuation. • Diagnosis of pulmonary emphysema or subsolid nodules may require higher radiation doses.

Hearing outcomes following cochlear implantation with anatomic or default frequency mapping in postlingual deafness adults.

PURPOSE: The aim of this study was to compare the outcomes of different mapping procedures based on anatomic or default frequency distribution in postlingual deafness adults who underwent cochlear implantation (CI). METHODS: Forty-eight adults with postlingual deafness who underwent CI (MED-EL) from January 2021 to May 2022 in our hospital were prospectively recruited. The participants were randomly assigned to two groups (the anatomic group and the default group). Postoperative computerized tomography (CT) scans were evaluated with Otoplan® to determine the angular insertion depth (AID) and the specific locations of the intracochlear electrodes. Anatomic maps were imported into MAESTRO 9.0 software (MED-EL) for anatomy-based fitting for anatomic group, while default mapping program was set up for the default group. Hearing thresholds, Speech Recognition Scores (SRS), and subjects' auditory and musical abilities were evaluated 1 year after using the CI. Differences were determined in two groups using Stata statistical software, with significance defined as p < 0.05. RESULTS: SRS under noisy conditions was significantly greater for anatomic group than the default group (p = 0.02). Under quiet conditions, however, mean hearing thresholds (0.5, 1, 2, and 4 kHz) and SRS did not differ significantly between the two groups (p = 0.07). Modified questionnaires showed that auditory (p = 0.02) and musical (p = 0.01) quality were significantly better following the anatomic mapping than the default procedure. CONCLUSION: CI program based on the anatomic distribution may bring better SRS under noise conditions as well as better auditory and musical qualities than based on the default frequency distribution.

Deep Learning Reconstruction Improves the Image Quality of CT Angiography Derived From 80-kVp Cerebral CT Perfusion Data.

RATIONALE AND OBJECTIVE: To investigate the impact of the deep learning reconstruction (DLR) technique on the image quality of CT angiography (CTA) derived from 80-kVp cerebral CT perfusion (CTP) data and compare it with hybrid-iterative reconstruction (HIR). MATERIALS AND METHODS: Thirty-three patients underwent CTP at 80 kVp were prospectively enrolled. CTP data were reconstructed with HIR and DLR. Four image datasets were reconstructed: HIRpeak and DLRpeak were single arterial phase images derived from the time point showing the peak value, HIRtMIP and HIRtAve were time-resolved maximum intensity projection image and time-resolved average image derived from three time points with the greatest enhancement of HIR. The mean CT values, standard deviation, signal-to-noise ratio, and contrast-to-noise ratio of the internal carotid artery and basilar artery were compared among the four image dataset. Image quality was performed using a five-point rating scale. Arterial stenosis was evaluated. RESULTS: DLRpeak had the highest CT value and contrast-to-noise ratio in the internal carotid artery and basilar artery (all p < 0.001). DLRpeak showed the best subjective image quality and had the highest score (4.93 ± 0.4) compared to the other three HIR CTA images (all p < 0.001). The degree of vascular stenosis was consistent among the four evaluated sequences (HIRtAve, HIRpeak, and HIRtMIP DLRpeak). CONCLUSION: For CTA derived from 80-kVp cerebral CTP data, images reconstructed with deep learning showed better image quality and improved intracranial artery visualization than those processed with HIR and other currently used techniques.

Traditional management of ancient Pu'er teagardens in Jingmai Mountains in Yunnan of China, a designated Globally Important Agricultural Heritage Systems site.

BACKGROUND: Pu'er Traditional Tea Agroecosystem is one of the projects included in the United Nations' Globally Important Agricultural Heritage Systems (GIAHS) since 2012. Against the background of having rich biodiversity and a long history of tea culture, the ancient tea trees in Pu'er have experienced from wild-transition-cultivation for thousands of years, and the local people's knowledge about the management of ancient teagardens has not been rigorously recorded. For this reason, it is important to study and record the traditional management knowledge of Pu'er ancient teagardens and the influence on the formation of tea trees and communities. This study focuses on the traditional management knowledge of ancient teagardens in Jingmai Mountains, Pu'er, and monoculture teagardens (monoculture and intensively managed planting base for tea cultivation) were used as the control, through the community structure, composition and biodiversity of ancient teagardens to respond to the influence of traditional management, and this work with a view to providing a reference for further research on the stability and sustainable development of tea agroecosystem. METHODS: From 2021 to 2022, information on traditional management of ancient teagardens was obtained through semi-structured interviews with 93 local people in the Jingmai Mountains area of Pu'er. Informed consent was obtained from each participant before conducting the interview process. The communities, tea trees and biodiversity of Jingmai Mountains ancient teagardens (JMATGs) and monoculture teagardens (MTGs) were examined through field surveys, measurements and biodiversity survey methods. The Shannon-Weiner (H), Pielou (E) and Margalef (M) indices were calculated for the biodiversity of the teagardens within the unit sample, using monoculture teagardens as a control. RESULTS: The tea tree morphology, community structure and composition of Pu'er ancient teagardens are significantly different from those of monoculture teagardens, and the biodiversity is significantly higher than that of monoculture teagardens. The local people mainly manage the ancient tea trees mainly using several methods, including weeding (96.8%), pruning (48.4%) and pest control (33.3%). The pest control mainly relies on the removal of diseased branches. JMATGs annual gross output is approximately 6.5 times that of MTGs. The traditional management of ancient teagardens is through setting up forest isolation zones as protected areas, planting tea trees in the understory on the sunny side, keeping tea trees 1.5-7 m apart, as well as consciously protecting forest animals such as spiders, birds and bees, and reasonably rearing livestock in the teagardens. CONCLUSIONS: This study shows that local people have rich traditional knowledge and experience in the management of ancient teagardens in Pu'er, and that this traditional management knowledge has impacted the growth of ancient tea trees, enriched the structure and composition of tea plantation communities and actively protected the biodiversity within ancient teagardens.

[Quality of Images Reconstructed by Deep Learning Reconstruction Algorithm for Head and Neck CT Angiography at 100 kVp].

Objective To evaluate the impact of deep learning reconstruction algorithm on the image quality of head and neck CT angiography (CTA) at 100 kVp. Methods CT scanning was performed at 100 kVp for the 37 patients who underwent head and neck CTA in PUMC Hospital from March to April in 2021.Four sets of images were reconstructed by three-dimensional adaptive iterative dose reduction (AIDR 3D) and advanced intelligent Clear-IQ engine (AiCE) (low,medium,and high intensity algorithms),respectively.The average CT value,standard deviation (SD),signal-to-noise ratio (SNR),and contrast-to-noise ratio (CNR) of the region of interest in the transverse section image were calculated.Furthermore,the four sets of sagittal maximum intensity projection images of the anterior cerebral artery were scored (1 point:poor,5 points:excellent). Results The SNR and CNR showed differences in the images reconstructed by AiCE (low,medium,and high intensity) and AIDR 3D (all P<0.01).The quality scores of the image reconstructed by AiCE (low,medium,and high intensity) and AIDR 3D were 4.78±0.41,4.92±0.27,4.97±0.16,and 3.92±0.27,respectively,which showed statistically significant differences (all P<0.001). Conclusion AiCE outperformed AIDR 3D in reconstructing the images of head and neck CTA at 100 kVp,being capable of improving image quality and applicable in clinical examinations.

Comparison of Antibiotic Resistance Profiles of Salmonella Isolates from Retail Meats in Nanchang, China, in Two Periods.

Salmonella is one of the most important foodborne pathogens. In this article, a total of 160 Salmonella isolates recovered from retail meats in June-July 2018 (before COVID-19 outbreak) and December 2020-April 2021 (after COVID-19 outbreak) in Nanchang, China, were characterized for serotyping, antimicrobial susceptibility, and specific resistance gene screening. The prevalence of Salmonella Typhimurium increased from 5.4% in 2018 to 19.1% in 2021, and Salmonella Enteritidis increased from 3.3% in 2018 to 8.8% in 2021. Compared with those in June-July 2018, Salmonella isolates in December 2020-April 2021 demonstrated a significant increase in resistance to 13 tested antibiotics except for doxycycline and nitrofurantoin (p < 0.05). The Salmonella isolates in December 2020-April 2021 showed a higher presence of plasmid-mediated quinolone resistance genes (qnrA, qnrB, and qnrS), and mutations in the quinolone resistance-determining region (gyrA Asp87Asn, gyrA Asp87Tyr, parC Thr57Ser, and parC Ser80Ile). Whole-genome sequencing was used to analyze four polymyxin B-resistant strains. Some common mutation sites in eptC and micA were found in the four strains. Based on the data in this article, it indicated that antibiotic resistance was facilitated and more gene mutations related to quinolone resistance were developed.

Dulong People's Traditional Knowledge of Caryota obtusa (Arecaceae): a Potential Starch Plant with Emphasis on Its Starch Properties and Distribution Prediction.

The greatest global challenge is to ensure that all people have access to adequate and nutritious food. Wild edible plants, particularly those that provide substitutes for staple foods, can play a key role in enhancing food security and maintaining a balanced diet in rural communities. We used ethnobotanical methods to investigate traditional knowledge on Caryota obtusa, a substitute staple food plant of the Dulong people in Northwest Yunnan, China. The chemical composition, morphological properties, functional, and pasting properties of C. obtusa starch were evaluated. We used MaxEnt modeling to predict the potential geographical distribution of C. obtusa in Asia. Results revealed that C. obtusa is a vital starch species with cultural significance in the Dulong community. There are large areas suitable for C. obtusa in southern China, northern Myanmar, southwestern India, eastern Vietnam, and other places. As a potential starch crop, C. obtusa could substantially contribute to local food security and bring economic benefit. In the future, it is necessary to study the breeding and cultivation of C. obtusa, as well as the processing and development of starch, to solve long-term and hidden hunger in rural areas.

Investigating the molecular mechanism of iguratimod act on SLE using network pharmacology and molecular docking analysis.

Objective: Iguratimod (IGU) is a novel small disease-modifying compound widely used in Asia for the treatment of rheumatic diseases. IGU is a methane sulfonanilide. We applied network pharmacology to investigate the pharmacological mechanisms of IGU act on SLE. Methods: We used PharmMapper, UniProt, and OMIM databases to screen the potential targets of IGU, and the SLE-related disease targets were predicted. Hub target genes among the intersections of the potential targets (IGU) and related genes (SLE) were validated using the PPI network generated by the String database. GO and KEGG enrichment analyses were carried out using the David online platform. Finally, the molecular docking of hub targets and their corresponding compounds were completed through AutoDock Vina and PyMOL software for visualization. Result: A total of 292 potential targets of IGU, 6501 related disease targets of SLE, and 114 cross targets were screened from the aforementioned database. Network topology analysis identified 10 hub targets, such as CASP3, AKT1, EGFR, MMP9, and IGF1. GO enrichment analysis mainly focuses on the negative regulation of the apoptotic process and signal transduction. KEGG enrichment analysis illustrated that the PI3K-AKT signaling pathway, MAPK signaling pathway, and FoxO signaling pathway might play a significant role in the pharmacological mechanisms of IGU act on SLE. Molecular docking confirmed that the IGU ligand had strong binding activity to the hub targets. Conclusion: This study based on network pharmacology and molecular docking validation preliminarily revealed the protein targets affected by IGU acting on SLE through, and explored potential therapeutic mechanism role of IGU in SLE treatment by multi pathways.

Using time series vector features for annual cultivated land mapping: A trial in northern Henan, China.

Annual monitoring of the spatial distribution of cultivated land is important for maintaining the ecological environment, achieving a status quo of land resource management, and guaranteeing agricultural production. With the gradual development of remote sensing technology, it has become a common practice to obtain cultivated land boundary information on a large scale with the help of satellite Earth observation images. Traditional land use classification methods are affected by multiple types of land cover, which leads to a decrease in the accuracy of cultivated land mapping. In contrast, although the current advanced methods (such as deep learning) can obtain more accurate cultivated land mapping results than traditional methods, such methods often require the use of a massive amount of training samples, large computing power, and highly complex model tuning processes, increasing the cost of mapping and requiring the involvement of more professionals. This has hindered the promotion of related methods in mapping institutions. This paper proposes a method based on time series vector features (MTVF), which uses vector thinking to establish the features. The advantage of this method is that the introduction of vector features enlarges the differences between the different land cover types, which overcomes the loss of mapping accuracy caused by the influences of the spectra of different ground objects and ensures the calculation efficiency. Moreover, the MTVF uses a traditional method (random forest) as the classification core, which makes the MTVF less demanding than advanced methods in terms of the number of training samples. Sentinel-2 satellite images were used to carry out cultivated land mapping for 2020 in northern Henan Province, China. The results show that the MTVF has the potential to accurately identify cultivated land. Furthermore, the overall accuracy, producer accuracy, and user accuracy of the overall study area and four sub-study areas were all greater than 90%. In addition, the cultivated land mapping accuracy of the MTVF is significantly better than that of the maximum likelihood, support vector machine, and artificial neural network methods.

Safety and immunogenicity of inactivated COVID-19 vaccination in adult rheumatic patients in South China: a prospective study.

Patients with rheumatic diseases (RD) are considered to be a high-risk population for infection with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The effectiveness of inactivated COVID-19 vaccinations (ICVs) was described as more effective than 95%. Despite this, no data on the immunogenicity and safety of the ICV in Han race stable RD patients in China. In this study, we sought to assess the safety and immunogenicity of the ICVs in RD patients in South China. A total of 80 adult stable RD patients were recruited. Following 14-35 days of immunization, cheiluminescence immunoassays (CLIA) were utilized to detect antibodies titers. An investigation into the relative parameters on the immunogenicity response to vaccination was carried out using logistic regression analysis. Compared to the HC group, the positive response of IgG and Nab in RD patients were lower than those in healthy control (HC) (P = .040 and P < .0001, respectively) after two doses of ICV were inoculated. The use of methotrexate (P = .016) and prednisolone (P = .018), and the level of red blood cell distribution width-C (RDW-C) (P = .035) and C-reactive protein (P = .015) were independently associated with lower rises in the magnitude of COVID-19 vaccine antibodies. No vaccine-related serious adverse reactions were observed in either group. After receiving two doses of ICVs, the production of protective antibodies in stable RD patients treated with immunosuppressive agents may decrease. It was discovered that ICVs were safe and well tolerated by RD patients.

What is the context?There are currently no accessible data on the efficacy and safety of inactivated COVID-19 vaccinations in South China RD patients who are receiving immunosuppressive medications.What is new?Inactivated COVID-19 vaccinations were immunogenic in stable RD patients in our investigation. No significant adverse reactions to the vaccination were seen in either group. No disease flares were observed in our study.What is the impact?Inactivated COVID-19 vaccinations are immunogenic and safe in stable RD patients in China, according to the findings of this study. The use of methotrexate or prednisolone, the RDW-C level, and the CRP level may all have an effect on the development of protective antibodies following vaccination.

Meizi-Consuming Culture That Fostered the Sustainable Use of Plum Resources in Dali of China: An Ethnobotanical Study.

Prunus mume has been cultivated for more than three millennia with important edible, ornamental, and medicinal value. Due to its sour taste, the Prunus mume fruit (called Meizi in Chinese and Ume in Japanese) is not very popular compared to other fruits. It is, however, a very favorite food for the Bai people living in Eryuan County, Dali of Yunnan, China. The local people are masters of making various local products with plum in different ways. In this research, we conducted field investigations in Eryuan County using ethnobotanical methods from August 2019 to July 2021, focusing on the Prunus mume (for its edible fruits). A total of 76 key informants participated in our semi-structured interviews. The survey recorded 37 species (and varieties) belonging to 11 families related to the Bai people's Meizi-consuming culture. Among them, there are 14 taxa of plum resources, including one original species and 13 varieties. These 37 species are either used as substitutes for plum due to their similar taste or as seasonings to improve the sour taste of plum. The higher Cultural Food Significance Index value implies that Prunus mume, Chaenomeles speciosa, Phyllanthus emblica, Prunus salicina, and Chaenomeles cathayensis have high acceptance and use value in the Bai communities. Among the various local products traditionally made by the Bai people, carved plums, preserved plums, perilla-wrapped plums, and stewed plums are the most famous and popular categories in the traditional markets. Currently, the plum business based on the traditional Meizi-consuming culture of the Bai people is already one of Eryuan's economic pillars. This study showed that plums play an important role in expressing the local cultural diversity, and they also help the local people by improving their livelihood through their edible value. In turn, for the sustainable use of plum resources, the Bai people positively manage local forests through a series of measures to protect the diversity of plum resources and related plant communities.

Can deep learning improve image quality of low-dose CT: a prospective study in interstitial lung disease.

OBJECTIVES: To investigate whether deep learning reconstruction (DLR) could keep image quality and reduce radiation dose in interstitial lung disease (ILD) patients compared with HRCT reconstructed with hybrid iterative reconstruction (hybrid-IR). METHODS: Seventy ILD patients were prospectively enrolled and underwent HRCT (120 kVp, automatic tube current) and LDCT (120 kVp, 30 mAs) scans. HRCT images were reconstructed with hybrid-IR (Adaptive Iterative Dose Reduction 3-Dimensional [AIDR3D], standard-setting); LDCT images were reconstructed with DLR (Advanced Intelligence Clear-IQ Engine [AiCE], lung/bone, mild/standard/strong setting). Image noise, streak artifact, overall image quality, and visualization of normal and abnormal features of ILD were evaluated. RESULTS: The mean radiation dose of LDCT was 38% of HRCT. Objective image noise of reconstructed LDCT images was 33.6 to 111.3% of HRCT, and signal-to-noise ratio (SNR) was 0.9 to 3.1 times of the latter (p < 0.001). LDCT-AiCE was not significantly different from or even better than HRCT in overall image quality and visualization of normal lung structures. LDCT-AiCE (lung, mild/standard/strong) showed progressively better recognition of ground glass opacity than HRCT-AIDR3D (p < 0.05, p < 0.01, p < 0.001), and LDCT-AiCE (lung, mild/standard/strong; bone, mild) was superior to HRCT-AIDR3D in visualization of architectural distortion (p < 0.01, p < 0.01, p < 0.01; p < 0.05). LDCT-AiCE (bone, strong) was better than HRCT-AIDR3D in the assessment of bronchiectasis and/or bronchiolectasis (p < 0.05). LDCT-AiCE (bone, mild/standard/strong) was significantly better at the visualization of honeycombing than HRCT-AIDR3D (p < 0.05, p < 0.05, p < 0.01). CONCLUSION: Deep learning reconstruction could effectively reduce radiation dose and keep image quality in ILD patients compared to HRCT with hybrid-IR. KEY POINTS: • Deep learning reconstruction was a novel image reconstruction algorithm based on deep convolutional neural networks. It was applied in chest CT studies and received auspicious results. • HRCT plays an essential role in the whole process of diagnosis, treatment efficacy evaluation, and follow-ups for interstitial lung disease patients. However, cumulative radiation exposure could increase the risks of cancer. • Deep learning reconstruction method could effectively reduce the radiation dose and keep the image quality compared with HRCT reconstructed with hybrid iterative reconstruction in patients with interstitial lung disease.

Clinical Effects of Simultaneous Implant Placement in Hydraulic Maxillary Sinus Lift Without Bone Grafting.

Context: Tooth absence is a pervasive oral condition and mostly occurs as maxillary tooth absence. The only way to treat tooth absence in adults is prosthesis implantation, and implant therapy usually requires repair of the maxillary sinus to its original state using a maxillary sinus lift (MSL). MSL has usually included bone augmentation with bone grafting simultaneously with the placement of the dental implant. Objective: The study intended to examine the clinical effects of placement of dental implants using the hydraulic maxillary sinus lift (MSL), without bone grafting, to offer new guidance, to make suggestions for future clinical treatment of tooth absence, and also to lay a reliable foundation for subsequent research on MSL without bone grafting. Design: The research team designed a randomized controlled trial. Setting: The study occurred at Suzhou Kowloon Hospital at the Shanghai Jiaotong University School of Medicine in Suzhou, China. Participants: Participants were 68 patients at the hospital with tooth defects between February 2019 and December 2019. Intervention: Participants were randomly assigned to the intervention group or the control group. Both groups received dental-implant placement in the hydraulic MSL, but the intervention group's surgery didn't include bone grafting, while the control group's included simultaneous bone grafting. Outcome Measures: Participants' surgical experience were evaluated using a visual analog scale (VAS) and the General Comfort Questionnaire (GCQ), and inflammatory factors were quantified using an enzyme-linked immunosorbent assay (ELISA). Participants' periodontal conditions after surgery were assessed, using tests for bone mineral density (BMD), periodontal probing depth (PPD), clinical attachment level (CAL), plaque index (PLI), and bleeding index (BI) as well as measurements of the implant retention rate, new bone acquisition around implants, and vertical bone loss. Participants' surgical costs were also evaluated. At a one-year follow-up, a masticatory function score and the Medical Outcomes Study (MOS) 36-Item Short-Form Health Survey (SF-36) were used for an evaluation of participants' prognoses. Results: The intervention group had a significantly lower incidence of postoperative adverse reactions, lower intraoperative blood loss, and shorter operation time than did the control group (all P < .05). After surgery at week1, the intervention group showed significantly lower levels of inflammatory factors than the control group did (all P < .05). Postoperatively at month 6, the intervention group had a significantly higher implant retention rate than did the control group (P < .05). Conclusions: Simultaneous implant placement in a hydraulic MSL without bone grafting can deliver favorable therapeutic effects, with a high safety profile, which can effectively optimize the surgical process, improve patients' postoperative feelings, and reduce surgical expenses, making it easy to popularize clinically.

Medicinal Plants and Fungi Traditionally Used by Dulong People in Northwest Yunnan, China.

The Dulong, an ethnic group living in the isolated Northwest Yunnan of Southwest China, have directly used a wide of plants to serve their needs and have accumulated rich traditional knowledge about medicinal plants over years. Unfortunately, little has been reported about the medicinal plants used by the Dulong people. Ethnobotanical data were collected through semi-structured interviews, guided field trips, and quantitative analysis. Prior informed consent was obtained before each interview. The surveys allowed for the collection of sociodemographic data and traditional knowledge about medicinal plants and their uses. This study used relative frequency of citation (RFC) to identify the most culturally significant medicinal plants and used informant consensus factor (FIC) to evaluate agreement among informants. A total of 105 medicinal plant species belonging to 69 families were recorded. Amongst these 69 families, Asteraceae (8 species), Polygonaceae, Ranunculaceae, and Rosaceae (4 species each) were the dominant families. The whole plants were the most frequently used part in the preparation of medicines. The most common preparation method was decoction and the most frequent application route was oral administration. Coptis teeta (0.15), Acorus calamus (0.12), Ophiocordyceps sinensis (0.11), Tanacetum tatsienense var. tanacetopsis (0.11), and Paris polyphylla var. yunnanensis (0.08) were shown to be the most useful plants as indicated by their relatively high RFC values. Among the usage types of medicinal plants, the highest FIC values were recorded for the circulatory system (FIC = 0.91), the immune system (FIC = 0.89), and the nervous system (FIC = 0.85). Furthermore, sixty-two medicinal plants utilized by the Dulong for medicinal purposes also have dietary use. Traditional knowledge associated with medicinal plants has been seriously threatened in recent decades. In the future, modern approaches should be used to demystify traditional medicine. However, significant measures need to be taken to protect from loss the important traditional knowledge gained by the Dulong through their experience and inheritance. A collective effort should be made to promote and conserve the important traditional medicinal knowledge and outline a plan for sustainable use of medicinal plants and improve local economic development under the premise of protection.

Characterization of a Multidrug-Resistant Salmonella Enteritidis Clinical Strain Carrying a Novel Hybrid Plasmid.

A Salmonella Enteritidis clinical strain SAL045 isolated from an infant patient in China was subjected to whole genome sequencing. Strain SAL045 is resistant to 12 antibiotics tested including ampicillin and polymyxin E. A novel hybrid plasmid pS045A harboring 22 antibiotic resistance genes and 10 virulence genes was characterized. There were no sequences in the NCBI nucleotide database that completely covered the pS045A sequence. Sequence analysis indicated that pS045A was formed by IS26-mediated recombination of two plasmids. Plasmid pS045A was transferred to E. coli EC600 recipient strain at a frequency of 1.76 × 10-6 per donor cell. Plasmid pS045A is a novel conjugative plasmid and might cause dissemination of drug-resistance and virulence genes within enterobacterial species.

Ethnobotanical study on wild edible plants used by Dulong people in northwestern Yunnan, China.

BACKGROUND: Dulong (Drung people) are one of the ethnic minorities of China, consisting of a small population living in remote and mountainous regions with limited facilities. Over the years, the Dulong have maintained their livelihood by collecting wild medicinal and edible plants. Therefore, through their experience and understanding, they had accumulated sufficient traditional knowledge about local plant resources. Since ancient times, wild edible plants have been essential to the food security of the Dulong people. However, there is almost no comprehensive report available on WEPs consumed by the Dulong people. The objectives of this study were to: (1) make a systematic study of WEPs used by Dulong people, (2) record traditional knowledge related to WEPs, (3) analyze multiple uses of WEPs, and (4) evaluate species with significant cultural significance to Dulong people. METHODS: Ethnobotanical survey including free listing, semi-structured interviews, key informant interviews and participatory observations was conducted in Dulongjiang Township, Gongshan County, Yunnan Province, Southwest China. A total of 127 informants were selected using the snowball method and information about WEPs, including vernacular name, food categories, parts used, mode of consumption, collection season, and other local uses were collected. The RFC and CFSI were calculated to identify the most culturally significant WEPs. One-way analysis of variance was performed to evaluate whether the four reference variables (gender, age, occupation, and education) significantly influenced the number of plant species mentioned by the respondents. RESULTS AND DISCUSSION: A total of 148 species of WEPs consumed by the Dulong people belonging to 58 families were collected, including wild vegetables (71), wild fruits (52), staple food substitutes (15), spices (7), nuts (4), tea substitute (2), liquor making materials (3) oils and fats (3), and culinary coagulants (1). WEPs are used in a number of different ways, including as fuelwood, feed, and medicine. Food substitute plants accounted for the majority of the top 27 wild food plants identified by RFC and CFSI. It was observed that farmers have more knowledge of WEPs, and moderate education level informants reported less WEPs used. CONCLUSION: The WEPs used by the Dulong people are diverse and abundant in the Dulongjiang region. In the future, WEPs such as Maianthemum atropurpureum, Caryota obtusa, Cardiocrinum giganteum, and Angiopteris esculenta with economic potential can be developed to provide a source of income for the residents. More studies of the nutritional value, chemical composition, and biological activities of WEPs are needed. The demands and development of local communities can be realized under the premise of protecting WEPs and the associated traditional knowledge. More attention should be paid to the value of WEP and underutilized plants during future rural development.

Factors related with COVID-19 vaccination willingness among outpatients in China.

BACKGROUND: COVID-19 vaccination has been accepted widely. However, there are only a few reports on patients' willingness to be vaccinated. This study investigated the willingness of Chinese outpatients to accept COVID-19 vaccination as well as influencing factors. METHODS: A cross-sectional survey was conducted in Jiangsu province, China in December 2020. Self-administered questionnaires, which were distributed to 625 outpatients among secondary hospitals, addressed demographic characteristics, sociological characteristics, and subjective reasons. There were 522 (83.5%) participants who gave completely valid responses. Logistic regression analysis was performed to explore the risk factors for willingness of COVID-19 vaccination. RESULTS: 71.5% of participants were willing to receive the COVID-19 vaccine. "worried about contracting COVID-19" (49.6%) and "vaccines have just been introduced and need time to consider" (38.9%) were the main reasons for being willing and unwilling to receive COVID-19 vaccine, respectively. The logistic regression analysis showed that "vaccines are an effective way to prevent diseases" (OR = 5.07, 95%CI: 3.32-7.75), "the price you are willing to pay for non-free vaccines (yuan) (101-500 vs ≤100)″ (OR = 1.87, 95%CI: 1.16-3.02), "per capital monthly income(yuan) (>6000 vs ≤3000)"(OR = 2.13, 95%CI: 1.03-4.41), and "self- assessed health status (Good vs Bad)″ (OR = 1.71, 95%CI: 1.01-2.90) were the main risk factors for outpatients to be willing to receive the COVID-19 vaccine. CONCLUSIONS: The willingness of Chinese outpatients to receive COVID-19 vaccine was not high. The government should do more to increase publicity of knowledge about COVID-19 vaccine thus increasing willingness to vaccinate, and provide free vaccine to eliminate the cost impact.

Prediction of hepatic inflammation in chronic hepatitis B patients with a random forest-backward feature elimination algorithm.

BACKGROUND: Persistent liver inflammatory damage is the main risk factor for developing liver fibrosis, cirrhosis, and even hepatocellular carcinoma in chronic hepatitis B (CHB) patients. Thus, accurate prediction of the degree of liver inflammation is a high priority and a growing medical need. AIM: To build an effective and robust non-invasive model for predicting hepatitis B-related hepatic inflammation. METHODS: A total of 650 treatment-naïve CHB (402 HBeAg-positive and 248 HBeAg-negative) patients who underwent liver biopsy were enrolled in this study. Histological inflammation grading was assessed by the Ishak scoring system. Serum quantitative hepatitis B core antibody (qAnti-HBc) levels and 21 immune-related inflammatory factors were measured quantitatively using a chemiluminescent microparticle immunoassay. A backward feature elimination (BFE) algorithm utilizing random forest (RF) was used to select optional features and construct a combined model. The diagnostic abilities of the model or variables were evaluated based on the estimated area under the receiver operating characteristics curve (AUROC) and compared using the DeLong test. RESULTS: Four features were selected to predict moderate-to-severe inflammation in CHB patients using the RF-BFE method. These predictive features included qAnti-HBc, ALT, AST, and CXCL11. Spearman's correlation analysis indicated that serum qAnti-HBc, ALT, AST, and CXCL11 levels were positively correlated with the histology activity index (HAI) score. These selected features were incorporated into the model to establish a novel model named I-3A index. The AUROC [0.822; 95% confidence interval (CI): 0.790-0.851] of the I-3A index was significantly increased compared with qAnti-HBc alone (0.760, 95%CI: 0.724-0.792, P < 0.0001) in all CHB patients. The use of an I-3A index cutoff value of 0.41 produced a sensitivity of 69.17%, specificity of 81.44%, and accuracy of 73.8%. Additionally, the I-3A index showed significantly improved diagnostic performance for predicting moderate-to-severe inflammation in HBeAg-positive and HBeAg-negative CHB patients (0.829, 95%CI: 0.789-0.865 and 0.810, 95%CI: 0.755-0.857, respectively). CONCLUSION: The selected features of the I-3A index constructed using the RF-BFE algorithm can effectively predict moderate-to-severe liver inflammation in CHB patients.

Radiomics-based comparison of MRI and CT for differentiating pleomorphic adenomas and Warthin tumors of the parotid gland: a retrospective study.

OBJECTIVE: The objective of this study was to compare the diagnostic performance of magnetic resonance imaging (MRI) and computed tomography (CT) in differentiating pleomorphic adenomas from Warthin tumors using radiomics. STUDY DESIGN: We retrospectively reviewed 626 patients who underwent preoperative MRI or CT for parotid tumor diagnosis. Patient groups were balanced by propensity score matching (PSM) and 123 radiomic features were extracted from tumor images. Radiomic signatures (rad-scores) were generated using a least absolute shrinkage and selection operator logistic regression model. The Canny edge detector was used to define tumor borders (border index). The diagnostic performance of rad-score and border index before and after PSM was evaluated with area under the receiver operating characteristic curve analysis. RESULTS: For differentiation of pleomorphic adenomas and Warthin tumors, rad-score and border index areas under the curve for MRI after PSM were 0.911 (95% confidence interval [CI], 0.871-0.951) and 0.716 (95% CI, 0.646-0.787), respectively; those for CT were 0.876 (95% CI, 0.829-0.923) and 0.608 (95% CI, 0.527-0.690), respectively. Tumor border index on MRI, but not CT, had superior diagnostic performance (P < .05); MRI- and CT-based rad-scores showed similar performance (P >.05). CONCLUSIONS: MRI is superior to CT for tumor margin examination; however, the radiomics features of both modalities showed no difference.