Suspected duloxetine-induced restless legs syndrome phenotypic variant: a case report.

BACKGROUND: Restless arms syndrome (RAS) is the most common variant of restless legs syndrome (RLS), which is easy to be ignored in clinical practice due to the lack of specific diagnostic criteria. When effective therapeutic agents induced RAS and symptoms persisted after briefly observation, clinicians will face the challenge of weighing efficacy against side effects. CASE PRESENTATION: A 67-year-old woman was admitted to a geriatric psychiatric ward with depression. Upon admission, the escitalopram dose was reduced from 15 mg to 10 mg per day, and the duloxetine dose was increased from 60 mg to 80 mg per day. The next night before bedtime, she developed itching and creeping sensations deep inside bilateral shoulders and arms, with the urge to move, worsening at rest, and alleviation after hammering. The symptoms persisted when escitalopram was discontinued. A history of RLS was confirmed. Treatment with 40 mg of duloxetine and 0.125 mg of pramipexole significantly improved depression, and the paresthesia disappeared, with no recurrence occurring 6 months after discharge. DISCUSSION AND CONCLUSIONS: This case suggests that psychiatrists should pay attention to RLS variants when increasing doses of duloxetine. Long-term improvement can be achieved through dosage reduction combined with dopaminergic drugs instead of immediate discontinuation.

Novel Ag3PO4/ZnWO4-modified graphite felt electrode for photoelectrocatalytic removal of harmful algae: Performance and mechanism.

A novel Ag3PO4/ZnWO4-modified graphite felt electrode (AZW@GF) was prepared by drop coating method and applied to photoelectrocatalytic removal of harmful algae. Results showed that approximately 99.21% of chlorophyll a and 91.57% of Microcystin-LR (MCLR) were degraded by the AZW@GF-Pt photoelectrocatalytic system under the optimal operating conditions with a rate constant of 0.02617 min-1 and 0.01416 min-1, respectively. The calculated synergistic coefficient of photoelectrocatalytic algal removal and MC-LR degradation by the AZW@GF-Pt system was both larger than 1.9. In addition, the experiments of quenching experiments and electron spin resonance (ESR) revealed that the photoelectrocatalytic reaction mainly generated •OH and •O2- for algal removal and MC-LR degradation. Furthermore, the potential pathway for photoelectrocatalytic degradation of MC-LR was proposed. Finally, the photoelectrocatalytic cycle algae removal experiments were carried out on AZW@GF electrode, which was found to maintain the algae removal efficiency at about 91% after three cycles of use, indicating that the photoelectrocatalysis of AZW@GF electrode is an effective emergency algae removal technology.

Rapid self-assembly of self-healable and transferable liquid metal epidermis.

Healable electronic skins, an essential component for future soft robotics, implantable bioelectronics, and smart wearable systems, necessitate self-healable and pliable materials that exhibit functionality at intricate interfaces. Although a plethora of self-healable materials have been developed, the fabrication of highly conformal biocompatible functional materials on complex biological surfaces remains a formidable challenge. Inspired by regenerative properties of skin, we present the self-assembled transfer-printable liquid metal epidermis (SALME), which possesses autonomous self-healing capabilities at the oil-water interface. SALME comprises a layer of surfactant-grafted liquid metal nanodroplets that spontaneously assemble at the oil-water interface within a few seconds. This unique self-assembly property facilitates rapid restoration (<10 s) of SALME following mechanical damage. In addition to its self-healing ability, SALME exhibits excellent shear resistance and can be seamlessly transferred to arbitrary hydrophilic/hydrophobic curved surfaces. The transferred SALME effectively preserves submicron-scale surface textures on biological substrates, thus displaying tremendous potential for future epidermal bioelectronics.

Adulteration Detection of Pork in Mutton Using Smart Phone with the CBAM-Invert-ResNet and Multiple Parts Feature Fusion.

To achieve accurate detection the content of multiple parts pork adulterated in mutton under the effect of mutton flavor essence and colorant by RGB images, the improved CBAM-Invert-ResNet50 network based on the attention mechanism and the inversion residual was used to detect the content of pork from the back, front leg, and hind leg in adulterated mutton. The deep features of different parts extracted by the CBAM-Invert-ResNet50 were fused by feature, stitched, and combined with transfer learning, and the content of pork from mixed parts in adulterated mutton was detected. The results showed that the R2 of the CBAM-Invert-ResNet50 for the back, front leg, and hind leg datasets were 0.9373, 0.8876, and 0.9055, respectively, and the RMSE values were 0.0268 g·g-1, 0.0378 g·g-1, and 0.0316 g·g-1, respectively. The R2 and RMSE of the mixed dataset were 0.9264 and 0.0290 g·g-1, respectively. When the features of different parts were fused, the R2 and RMSE of the CBAM-Invert-ResNet50 for the mixed dataset were 0.9589 and 0.0220 g·g-1, respectively. Compared with the model built before feature fusion, the R2 of the mixed dataset increased by 0.0325, and the RMSE decreased by 0.0070 g·g-1. The above results indicated that the CBAM-Invert-ResNet50 model could effectively detect the content of pork from different parts in adulterated mutton as additives. Feature fusion combined with transfer learning can effectively improve the detection accuracy for the content of mixed parts of pork in adulterated mutton. The results of this study can provide technical support and a basis for maintaining the mutton market order and protecting mutton food safety supervision.

Synergetic application of thermal imaging and CCD imaging techniques to detect mutton adulteration based on data-level fusion and deep residual network.

To improve the performance of single thermal imaging and single CCD imaging in detecting unknown adulterated meat samples, these two imaging techniques combined with a deep residual network were synergistically applied to detect mutton adulteration. Considering the importance of spatial and detailed information in improving stability and accuracy, three data-level fusion methods, namely, colour image stitching, grey image stitching and grey channel stacking, were proposed for the fusion of thermal images and CCD images. Classification and prediction models were further developed based on fusion images. The results showed that the models with colour image stitching achieved the best performance. For the external validation set, the accuracy of the best classification model in discriminating five categories was 99.30%. In predicting pork proportions, the R2, RMSE, RPD and RER of the best prediction model were 0.9717, 0.0238, 7.8696 and 21.28, respectively. The best prediction model for duck proportions had a R2 of 0.9616, RMSE of 0.0277, RPD of 5.1015, and RER of 14.44. Therefore, the synergetic application of thermal imaging and CCD imaging can provide a novel and promising tool to detect mutton adulteration and the quality of other food items.

Rheology of graphene oxide stabilized Pickering emulsions.

Pickering emulgels stabilized by graphene oxide (GO) with didodecyldimethylammonium bromide (DDAB) as an auxiliary surfactant and liquid paraffin as the oil phase have proved to be an excellent 3D printable ink. This paper elucidates the structure of such emulgels by a combination of microscopy before and after intensive shear as well as broadband dielectric spectroscopy and rheology in the linear and nonlinear regime. An increase of the DDAB surfactant and GO-contents leads to a systematic increase of modulus and viscosity, a reduction of the limits of the nonlinear regime and a more complicated variation of the normal forces, with negative normal forces at high shear rate  for low GO-contents and positive normal forces at high GO-contents. The interfacial jamming behavior studied by morphology, rheology and dielectric spectroscopy is explained based on droplet deformation, jamming and recovery phenomena.

Understanding Gel-Powers: Exploring Rheological Marvels of Acrylamide/Sodium Alginate Double-Network Hydrogels.

This study investigates the rheological properties of dual-network hydrogels based on acrylamide and sodium alginate under large deformations. The concentration of calcium ions affects the nonlinear behavior, and all gel samples exhibit strain hardening, shear thickening, and shear densification. The paper focuses on systematic variation of the alginate concentration-which serves as second network building blocks-and the Ca2+-concentration-which shows how strongly they are connected. The precursor solutions show a typical viscoelastic solution behavior depending on alginate content and pH. The gels are highly elastic solids with only relatively small viscoelastic components, i.e., their creep and creep recovery behavior are indicative of the solid state after only a very short time while the linear viscoelastic phase angles are very small. The onset of the nonlinear regime decreases significantly when closing the second network (alginate) upon adding Ca2+, while at the same time the nonlinearity parameters (Q0, I3/I1, S, T, e3/e1, and v3/v1) increase significantly. Further, the tensile properties are significantly improved by closing the alginate network by Ca2+ at intermediate concentrations.

Aptamer-based Upconversion Fluorescence Sensor for Doxorubicin Detection.

Doxorubicin is a common chemotherapeutic drug used to treat a variety of cancers. Monitoring the concentration of doxorubicin in human biological fluids is vital for treatment. In this work, we report an aptamer-functionalized, 808 nm-excited core-shell upconversion fluorescence sensor for specific detection of doxorubicin (DOX). Upconversion nanoparticles and DOX are used as energy donors and energy acceptors respectively. Aptamers immobilized on the surface of upconversion nanoparticles act as the molecular recognition element for DOX. The binding of DOX to the immobilized aptamers results in the fluorescence quenching of the upconversion nanoparticles via a fluorescence resonance energy transfer process. The relative fluorescence intensity exhibits a good linear response to DOX concentration in the range of 0.5 µM to 55 µM with a detection limit of 0.5 µM. The aptasensor displays high specificity and anti-interference against other antibiotics, common ions, and biomolecules owing to strong and specific interactions of aptamers towards DOX. The sensor is further applied for the detection of DOX in urine with spike recoveries of nearly 100%.

Influence of Cellulose Nanofibers on the Behavior of Pickering Emulsions. Part 1. Microscopy and Startup Flow Test.

The dispersibility of flexible polymer chains present at the emulsion's interface between the dispersed and continuous phase has obvious effects on rheology and dielectric properties of the whole emulsion. Cellulose nanofiber (CNF)-based Pickering emulsions are good systems to research these properties with respect to their microscopic phase structure, dielectric, and rheological properties by using CNF as a water-dispersible Pickering emulsifier, liquid paraffin as an oil phase, and didodecyldimethylammonium bromide (DDAB) as a cationic auxiliary surfactant. The CNF and DDAB contents were systematically varied while the water-to-paraffin oil ratio was kept constant to discern the influence of the Pickering emulsifiers. Polarized optical microscopic images reveal that the droplets tend to shrink at higher CNF content but grow bigger when increasing the DDAB content, which is proved by fluorescence analysis of the CNF dispersibility with varying DDAB content. The dielectric damping exhibits a minimum, whose value decreases with increasing DDAB and CNF content. Increasing the DDAB content promotes the solubilization of CNF in the aqueous phase, which will increase the overall viscosity and yield points. Similarly, a higher CNF content leads to a higher viscosity and yield point, but at high DDAB contents, the viscosity function exhibits an S-shape at intermediate CNF contents. To evaluate the results further, they were compared with CNF dispersions (without oil phase), which showed a surfactant effect slightly on maximum stress but strongly on yield stress τy, indicating that DDAB can promote the formation of a CNF network rather than the viscosity of the whole system. This paper provides information on how a systematical variation of the composition influences morphology and physico-chemical interactions as detected by broadband dielectric spectroscopy and rheological behavior.

Evaluation of Mutton Adulteration under the Effect of Mutton Flavour Essence Using Hyperspectral Imaging Combined with Machine Learning and Sparrow Search Algorithm.

The evaluation of mutton adulteration faces new challenges because of mutton flavour essence, which achieves a similar flavour between the adulterant and mutton. Hence, methods for classifying and quantifying the adulterated mutton under the effect of mutton flavour essence, based on near-infrared hyperspectral imaging (NIR-HSI, 1000-2500 nm) combined with machine learning (ML) and sparrow search algorithm (SSA), were proposed in this study. After spectral preprocessing via first derivative combined with multiple scattering correction (1D + MSC), classification and quantification models were established using back propagation neural network (BP), extreme learning machine (ELM) and support vector machine/regression (SVM/SVR). SSA was further used to explore the global optimal parameters of these models. Results showed that the performance of models improves after optimisation via the SSA. SSA-SVM achieved the optimal discrimination result, with an accuracy of 99.79% in the prediction set; SSA-SVR achieved the optimal prediction result, with an RP2 of 0.9304 and an RMSEP of 0.0458 g·g-1. Hence, NIR-HSI combined with ML and SSA is feasible for classification and quantification of mutton adulteration under the effect of mutton flavour essence. This study can provide a theoretical and practical reference for the evaluation and supervision of food quality under complex conditions.

Construction and Evaluation of a High-Frequency Hearing Loss Screening Tool for Community Residents.

Early screening and detection of individuals at high risk of high-frequency hearing loss and identification of risk factors are critical to reduce the prevalence at community level. However, unlike those for individuals facing occupational auditory hazards, a limited number of hearing loss screening models have been developed for community residents. Therefore, this study used lasso regression with 10-fold cross-validation for feature selection and model construction on 38 questionnaire-based variables of 4010 subjects and applied the model to training and testing cohorts to obtain a risk score. The model achieved an area under the curve (AUC) of 0.844 in the model validation stage and individuals' risk scores were subsequently stratified into low-, medium-, and high-risk categories. A total of 92.79% (1094/1179) of subjects in the high-risk category were confirmed to have hearing loss by audiometry test, which was 3.7 times higher than that in the low-risk group (25.18%, 457/1815). Half of the key indicators were related to modifiable contexts, and they were identified as significantly associated with the incident hearing loss. These results demonstrated that the developed model would be feasible to identify residents at high risk of hearing loss via regular community-level health examinations and detecting individualized risk factors, and eventually provide precision interventions.

Relationship between cigarette smoking and hearing loss in China: A cross-sectional study in Zhejiang province.

INTRODUCTION: Hearing loss and cigarette smoking are major challenges that affect public health in China. Revealing the effect of smoking on hearing loss in the Chinese general population is critical for hearing health protection. We investigated the relationship between smoking status and hearing loss in China, especially in stratified sex and age groups. METHODS: A cross-sectional study was conducted on 4685 individuals aged 20- 80 years in Zhejiang province from 2016 to 2018, with audiometric testing for hearing loss and a structured questionnaire for collecting smoking status and covariates. Logistic regression was used to estimate the association between smoking and hearing loss. RESULTS: Cigarette smoking was not significantly associated with hearing loss in females and young males. In middle-aged males, after adjusting for covariates, current smokers and past smokers had a significantly higher prevalence of speech-frequency loss (OR=1.65; 95% CI: 1.17-2.33 and OR=1.88; 95% CI: 1.11-3.17; respectively) and high-frequency hearing loss (OR=2.01; 95% CI: 1.43-2.84 and OR=2.64; 95% CI: 1.50-4.66; respectively). In older males, only past smokers had a significantly higher prevalence of speech-frequency hearing loss than never smokers (OR=2.58; 95% CI: 1.38-4.85). Regarding middle-aged and older current smokers, a dose-dependent relationship between smoking intensity and hearing loss was found. Passive smoking was not significantly associated with an increased hearing loss risk in all the three male groups. CONCLUSIONS: The relationship between cigarette smoking and hearing loss varied according to gender and age. Therefore, the interventions for smoking need to be tailored according to age in males.

Environmental exposure to organochlorine pesticides and its association with the risk of hearing loss in the Chinese adult population: A case-control study.

Hearing loss is a common chronic sensory deficit that has become a major public health concern worldwide. Hearing loss is well documented to be induced by noise and ototoxic drugs, and the association of hearing loss with environmental pollutants has received increasing attention. Organochlorine pesticides (OCPs) are an important group of environmental pollutants that exist ubiquitously in the human body and continue to represent a significant environmental health concern. Our case-control study was performed to explore the association between serum levels of OCPs and the risk of hearing loss in China, including 87 case-control pairs. Serum concentrations of 15 OCPs were measured. Pearson's correlation analysis and principal component analysis of frequently detected (>80%) OCPs showed a different distribution pattern, indicating possible exposure sources/scenarios for the case-control adult population. A higher α-hexachlorocyclohexane (α-HCH) level was a risk factor for an increased prevalence of hearing loss. The risk of hearing loss was increased by approximately 5.25-fold in the highest tertile compared with the lowest tertile. Furthermore, a significant association of the α-HCH level with an increased hearing threshold was observed at mid/high frequencies. This study provided the first evidence indicating that exposure to α-HCH might be a potential risk factor for hearing loss.

Health Education Intervention on Hearing Health Risk Behaviors in College Students.

Young people, like college students, are at risk of hearing loss from prolonged and excessive exposure to loud sounds. However, behavioral interventional studies on them are inadequate. This study explored the application of a health belief model to the health education intervention on college students for improving hearing health knowledge, health belief, and hearing behaviors. From November 2017 to September 2018, a cluster randomized controlled trial was conducted, enrolling 830 college students, with 419 in the intervention group and 411 in the control group. The intervention group received a 3-month hearing health education, while the control group received no intervention. The information of hearing health knowledge, health belief, and hearing behaviors were collected using hearing health questionnaires before the intervention, after the intervention, and 3 months after the intervention cessation. The intervention significantly improved hearing health knowledge, health belief, perceived severity, and self-efficacy in female students, and effectively reduced the frequency of using headphones per day, duration of using headphones each time, and proportion of using headphones at high volume in female students, and reduced the behaviors of sleeping with headphones listening in females and males. Therefore, this study confirms the effectiveness of health belief model-based intervention for changing hearing loss-related risk behaviors.

Correlation between left behind expericences with depressive and anxiety symptoms of left behind middle school stutents / 中国学校卫生

Objective@#To explore the relationship between left behind experiences due to work migration of parents with depressive and anxiety symptoms among left behind middle school stutents, to provide a theoretical basis for the government to formulate intervention policies for mental health of left behind children.@*Methods@#The stratified random cluster sampling method was used to investigate 2 160 children in Poyang and Guangfeng Counties of Shangrao City, Jiangxi Province from April to June, 2019. Finally, 776 left behind children aged 13 to 18 were selected. The Generalized Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9) were used to evaluate the depression and anxiety symptoms. Family characteristics and lifestyle behaviors of left behind children were investigated by questionnaire.@*Results@#In terms of gender, the detection rates of both depressive symptoms and anxiety symptoms were higher in girls than in boys. In terms of age, the detection rates of depressive symptoms (43.2%) and anxiety symptoms (39.9%) in left behind children in high school (16-18 years old) were higher than those in middle school (13-15 years old)( 27.3 % and 33.0%). The detection rate of depressive among left behind children significantly differet in sexual, gender ( χ 2= 10.48 , 21.08); the detection rate of anxiety symptoms among left behind children significantly different in sexual, maternal occupation, and paternal educational background ( χ 2=8.66, 5.30, 8.35) ( P <0.05).@*Conclusion@#Parent child separation is associated with depressive symptoms in left behind middle school stutents. Mental health of children in middle school stutents is of great significance to the prevention of depression and anxiety symptoms in left behind children.

Environmental exposure to lead and cadmium and hearing loss in Chinese adults: A case-control study.

Hearing loss is the second most common nonfatal problem affecting the Chinese population. Historical studies have suggested an association between exposure to heavy metals, such as cadmium and lead, and hearing loss. Few studies have investigated this relationship in the general population in China. We conducted a case-control study with 1008 pairs of participants from a cross-sectional epidemiological survey conducted in Zhejiang Province. A self-designed questionnaire was adopted to collect information on demographics, chronic diseases, lifestyles and environmental noise. Pure-tone averages of hearing thresholds at frequencies of 0.5, 1, 2, and 4 kHz were computed. Blood lead and cadmium levels were analyzed with an atomic absorption spectrometer. After adjusting for all other potential confounding factors, compared with the lowest blood cadmium quartile (0.00-0.53 µg/L), blood cadmium quartile 2 (0.54-0.92 µg/L), quartile 3 (0.93-1.62 µg/L) and quartile 4 (1.63-57.81 µg/L) exhibited significantly elevated risks for hearing loss, with odds ratios of 1.932 (95% CI: 1.356-2.751), 2.036 (95% CI: 1.423-2.914) and 1.495 (95% CI: 1.048-2.133), respectively (P-trend<0.001). However, an association of lead with hearing loss was not found. Young age (less than 60 years), male sex and current smoking were associated with increased blood cadmium concentration. Additionally, a positive association between blood cadmium and lead concentrations was found. Therefore, we conclude that exposure to environmental cadmium may be a risk factor for hearing loss among the general population in China.

Association between Leucocyte Telomere Length and Risk of Hearing Loss in the General Population: A Case-Control Study in Zhejiang Province, China.

Limited studies have assessed the relation between telomere length and risk of hearing loss; moreover, they have reported equivocal associations. In the first case-control study, the subjects were chosen from the general population of Zhejiang province in order to assess the association between leucocyte telomere length and risk of hearing loss from 2016 to 2018. A total of 817 cases (55.93 ± 8.99 years) and 817 age-, sex- and residential city-matched controls (55.91 ± 9.03 years) were included for analysis. In the multivariable models, individuals in the top quartile of relative telomere length (RTL) had an odds ratio (OR) for hearing loss of 0.53 (95% confidence intervals [CI], 0.38-0.74) compared to those in the bottom quartile, and specifically, the OR was 0.45 (95% CI, 0.28-0.73) in females. In females, the risk of hearing loss decreased by 46% as RTL doubling increased; the standard deviation of RTL was associated with a 29% decrease in hearing loss risk. Additional analysis showed significant difference between participants in the female mild hearing loss group and corresponding controls. These results suggest that telomere length is associated with hearing loss in the general population, particularly in females with mild hearing loss. Telomere length might be a potential predictive biomarker of hearing loss at early stage.

A novel CpG island methylation panel predicts survival in lung adenocarcinomas.

The lack of clinically useful biomarkers compromise the personalized management of lung adenocarcinomas (ADCs); epigenetic events and DNA methylation in particular have exhibited potential value as biomarkers. By comparing genome-wide DNA methylation data of paired lung ADCs and normal tissues from 6 public datasets, cancer-specific CpG island (CGI) methylation changes were identified with a pre-specified criterion. Correlations between DNA methylation and expression data for each gene were assessed by Pearson correlation analysis. A prognostically relevant CGI methylation signature was constructed by risk-score analysis, and was validated using a training-validation approach. Survival data were analyzed by log-rank test and Cox regression model. In total, 134 lung ADC-specific CGI CpGs were identified, among which, a panel of 9 CGI loci were selected as prognostic candidates, and were used to construct a risk-score signature. The novel CGI methylation signature was identified to classify distinct prognostic subgroups across different datasets, and was demonstrated to be a potent independent prognostic factor for overall survival time of patients with lung ADCs. In addition, it was identified that cancer-specific CGI hypomethylation of RPL39L, along with the corresponding gene expression, provided optimized prognostication of lung ADCs. In summary, cancer-specific CGI methylation aberrations are optimal candidates for novel biomarkers of lung ADCs; the 9-CpG methylation panel and hypomethylation of RPL39L exhibited particularly promising significance.

Metal-induced ordered microporous polymers for fabricating large-area gas separation membranes.

Metal-induced ordered microporous polymers (MMPs), a class of porous polymer, are synthesized from amine-bearing polymers, small organic linkers and divalent metal ions using a polymer-directed chemical synthesis process. Specifically, small organic linkers first coordinate to metal ions, with the resulting unit cells then self-assembling along the extension of polymer chains to construct three-dimensional frameworks. The MMPs demonstrate good controllability of crystal and framework size, as well as hydrolytic stability. MMP dispersions were coated on a modified polysulfone substrate to fabricate MMP/mPSf membranes with an ultrathin selective layer (below 50 nm) and surface areas of >100 cm2. The MMPs are readily fabricated into defect-free thin selective-layered membranes with high CO2 permeance (3,000 GPU) and stable CO2/N2 selectivity (78) under both humid and dry gas feed conditions, demonstrating promising CO2 membrane separation performance. This synthetic methodology could be extended to other polymers, potentially enabling facile synthesis of membrane materials.