Rapid and sensitive visual detection of avian leukosis virus by reverse transcription loop-mediated isothermal amplification combined with a lateral flow immunochromatographic strip assay.

Considering that avian leukosis virus (ALV) infection has inflicted massive economic losses on the poultry breeding industry in most countries, its early diagnosis remains an important measure for timely treatment and control of the disease, for which a rapid and sensitive point-of-care test is required. We established a user-friendly, economical, and rapid visualization method for ALV amplification products based on reverse transcription loop-mediated isothermal amplification (RT-LAMP) combined with an immunochromatographic strip in a lateral flow device (LFD). Using the ALVp27 gene as the target, five RT-LAMP primers and one fluorescein-isothiocyanate-labeled probe were designed. After 60 min of RT-LAMP amplification at 64 °C, the products could be visualized directly using the LFD. The detection limit of this assay for ALV detection was 102 RNA copies/µL, and the sensitivity was 100 times that of reverse transcription polymerase chain reaction (RT-PCR), showing high specificity and sensitivity. To verify the clinical practicality of this assay for detecting ALV, the gold standard RT-PCR method was used for comparison, and consistent results were obtained with both assays. Thus, the assay described here can be used for rapid detection of ALV in resource-limited environments.

Insights into mechanism of peroxymonosufate activation by Mo single-atom catalysts: Singlet oxygen evolution and role of Mo-N coordination.

Recently, the Fenton-like reaction using peroxymonosulfate (PMS) has been acknowledged as a potential method for breaking down organic pollutants. In this study, we successfully synthesized a highly efficient and stable single atom molybdenum (Mo) catalyst dispersed on nitrogen-doped carbon (Mo-NC-0.1). This catalyst was then utilized for the first time to activate PMS and degrade bisphenol A (BPA). The Mo-NC-0.1/PMS system demonstrated the ability to completely degrade BPA within just 20 min. Scavenging tests and density functional theory (DFT) calculations have demonstrated that the primary reactive oxygen species was singlet oxygen (1O2) produced by Mo-N4 sites. The self-cycling of Mo facilitated PMS activation and the transition from a free radical activation pathway to a non-radical pathway mediated by 1O2. Simultaneously, the nearby pyridinic N served as adsorption sites to immobilize BPA and PMS molecules. The exceptionally high catalytic activity of Mo-NC-0.1 derived from its unique Mo-N coordination, which markedly reduced the distance for 1O2 to migrate to the BPA molecules. The Mo-NC-0.1/PMS system effectively reduced the acute toxicity of BPA and exhibited excellent cycling stability with minimal leaching. This study presented a new catalyst with high selectivity for 1O2 generation and provided valuable insights for the application of single atom catalysts in PMS-based AOPs.

Transcription factor ZIC2 regulates the tumorigenic phenotypes associated with both bulk and cancer stem cells in epithelial ovarian cancer.

Epithelial ovarian cancer (EOC) is the most lethal gynecologic malignancy in North America. Current therapeutic regimens are ineffective against advanced EOC. A better understanding of the molecular mechanisms that regulate the biology of EOC will be a critical step toward developing more efficacious therapies against EOC. Herein, we demonstrate that elevated expression of transcription factor ZIC2 was associated with lower survival of EOC patients. Knockout of endogenous ZIC2 in EOC cells attenuated the tumorigenic phenotypes associated with both bulk and cancer stem cells in vitro and in vivo, indicating a pro-tumorigenic role of ZIC2 in EOC. On the other hand, however, overexpression of ZIC2 in EOC cells that do not express endogenous ZIC2 promoted cell migration and sphere formation, but inhibited cell growth and colony formation in vitro and tumor growth in vivo, indicating that the role for ZIC2 in EOC is context dependent. Our transcriptomic analysis showed that ZIC2-regulated genes were involved in multiple biological processes and signaling pathways associated with tumor progression. In conclusion, our findings reveal a context-dependent role for ZIC2 in regulating tumorigenic phenotypes in EOC, providing evidence that ZIC2 can be a potential therapeutic target for EOCs that express a high level of ZIC2.

RBP7 functions as a tumor suppressor in HR + breast cancer by inhibiting the AKT/SREBP1 pathway and reducing fatty acid.

BACKGROUND: Increasing evidence proves that RBP7 plays a significant role in breast cancer (BC). The present study was aimed to investigate the mechanism of RBP7. METHODS: Western Blotting and qRT-PCR were performed for evaluating the expression levels. CCK8, colony forming, xenograft mouse model, wound healing and transwell assays were conducted to examine cell ability of proliferation, invasion and migration. Nile red staining and Oil red O staining were used for testing the lipid. RESULTS: RBP7 was related to overall survival (OS) in patients with HR + BC. RBP7 protein was significantly decreased in HR + BC tissues and cells. RBP7 suppressed HR + BC cell proliferation in vitro and in vivo, and inhibited migration and invasion. RBP7 reduced fatty acid in HR + BC cells by inhibiting the AKT/SREBP1 pathway. CONCLUSIONS: RBP7 may function as a tumor suppressor in HR + BC by inhibiting the AKT/SREBP1 pathway and reducing fatty acid.

Gastrointestinal contrast-enhanced ultrasonography for diagnosis and treatment of peptic ulcer in children.

BACKGROUND: The detection rate of peptic ulcer in children is improving, with development of diagnostic procedures. Gastroscopy is the gold standard for the diagnosis of peptic ulcer, but it is an invasive procedure. Gastrointestinal contrast-enhanced ultrasonography (CEUS) has the advantages of being painless, noninvasive, nonradioactive, easy to use, and safe. AIM: To investigate the clinical value of CEUS for diagnosis and treatment of peptic ulcer in children. METHODS: We investigated 43 children with digestive tract symptoms in our hospital from January 2021 to June 2022. All children were examined by routine ultrasound, gastrointestinal CEUS, and gastroscopy. The pathological results of gastroscopy were taken as the gold standard. Routine ultrasonography was performed before gastrointestinal CEUS. Conventional ultrasound showed the thickness of the gastroduodenal wall, gastric peristalsis, and the adjacent organs and tissues around the abdominal cavity. Gastrointestinal CEUS recorded the thickness of the gastroduodenal wall; the size, location and shape of the ulcer; gastric peristalsis; and adjacent organs and tissues around the abdominal cavity. The results of routine ultrasound and gastrointestinal ultrasound were compared with those of gastroscopy to evaluate the diagnostic results and coincidence rate of routine ultrasound and gastrointestinal CEUS. All children received informed consent from their guardians for CEUS. This study was reviewed and approved by the hospital medical ethics committee. RESULTS: Among the 43 children, 17 (15 male, 2 female) were diagnosed with peptic ulcer by gastroscopy. There were 26 children with nonpeptic ulcer. There were eight cases of peptic ulcer and 35 of nonpeptic ulcer diagnosed by conventional ultrasound. The diagnostic coincidence rate of peptic ulcer in children diagnosed by conventional ultrasound was 79.1% (34/43), which was significantly different from that of gastroscopy (P = 0.033). It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is low. Fifteen cases of peptic ulcer and 28 of nonpeptic ulcer were diagnosed by CEUS. The diagnostic coincidence rate of peptic ulcer in children was 95.3% (41/43). There was no significant difference between CEUS and gastroscopy (P = 0.655). It indicates that the coincidence rate of gastrointestinal contrast-enhanced ultrasound and gastroscope is high. CONCLUSION: Gastrointestinal CEUS has a high coincidence rate in the diagnosis of peptic ulcer in children, and can be used as a preliminary examination method.

Increased Extracellular Water in Normal-Appearing White Matter in Patients with Cerebral Small Vessel Disease.

BACKGROUND: Microcirculatory variations have been observed in the normal-appearing white matter (NAWM) of individuals affected by cerebral small vessel disease (CSVD). These variations collectively possess the potential to trigger neuroinflammation and edema, ultimately leading to an elevation in extracellular fluid (ECF). Nevertheless, the specific alterations in ECF within the NAWM of CSVD patients have remained inadequately understood. METHODS: We reviewed the clinical and imaging characteristics of a cohort comprising 129 patients diagnosed with CSVD to investigate alterations in the ECF within NAWM. The severity of CSVD was assessed by total CSVD magnetic resonance (MR) score according to the four imaging markers, namely perivascular space, lacunar infarction, white matter hyperintensities and cerebral microbleed. ECF was evaluated by the parameter free water (FW), ranging from 0 to 1 generated from diffusion tensor imaging. RESULTS: Significant differences in NAWM FW were observed in relation to the total CSVD MR score (p < 0.05). Patients with a total CSVD MR score of 0 exhibited significantly lower NAWM free water (FW) values compared to those with a score greater than 0 (p < 0.05). Similarly, patients with a total CSVD MR score of 1 also demonstrated notably lower NAWM FW values than those with a score greater than 1 (p < 0.05). After conducting multivariate regression analysis, age and total CSVD MR score was independently associated with FW in NAWM (p < 0.001). Further, the total CSVD MR score served as a partial mediator in the relationship between age and FW in the NAWM among patients with CSVD. CONCLUSIONS: ECF in NAWM is increased in CSVD patients, even during the early course of CSVD.

The ultrasound-based radiomics-clinical machine learning model to predict papillary thyroid microcarcinoma in TI-RADS 3 nodules.

Background: Conventional ultrasound (CUS) technology has proven to be successful in the identification of thyroid nodules. Moreover, the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) was developed for the purpose of evaluating the risk of thyroid nodules based on ultrasound imaging. Nevertheless, identifying papillary thyroid microcarcinoma (PTMC) from TI-RADS 3 nodules using this system can be difficult due to overlapping morphological features. The main objective of this study was to investigate the efficacy of a machine learning model that utilizes ultrasound-based radiomics features and clinical information in accurately predicting the presence of PTMC in TI-RADS 3 nodules. Methods: A total of 221 patients with TI-RADS 3 nodules were included, consisting of 91 cases of PTMC and 130 benign thyroid nodules. They were randomly divided into training and test cohort in an 8:2 ratio. Radiomics features were extracted from CUS images by manually outlining the targets, while clinical parameters were obtained from electronic medical records. The radiomics model, clinical model, and combined model were constructed and validated to distinguish between PTMC and benign thyroid nodules. Radiomics variables were extracted via the Pyradiomics package (V1.3.0). Moreover, least absolute shrinkage and selection operator (LASSO) regression was used for feature selection. Light Gradient Boosting Machine (LightGBM) was employed to build both radiomics and clinical models. Ultimately, a radiomics-clinical model, which fused radiomics features with clinical information, was developed. Results: Among a total of 1,477 radiomics features, fifteen features that were found to be associated with PTMC through univariate analysis and LASSO regression were selected for the development of the radiomics model. The combined "radiomics-clinical" model demonstrated superior diagnostic accuracy compared to the clinical model for distinguishing PTMC in both the training dataset [area under receiver operating curve (AUC): 0.975 vs. 0.845] and the validation dataset (AUC: 0.898 vs. 0.811). We constructed a radiomics-clinical nomogram, and the clinical applicability was confirmed through decision curve analysis. Conclusions: Utilizing an ultrasound-based radiomics approach has proven to be effective in predicting PTMC in patients with TI-RADS 3 nodules.

Deep vein diameters and perivascular space scores are associated with deep medullary vein hypo-visibility in patients with white matter hyperintensity.

Background: Deep medullary vein (DMV) hypo-visibility is correlated with white matter hyperintensity (WMH), but the underlying causes remain unclear. This study aimed to explore the relationship between deep vein diameters and perivascular space (PVS) scores, and DMV hypo-visibility in the presence of WMH. Methods: This cross-sectional study prospectively analyzed the clinical and imaging data of 190 cerebral small vessel disease patients with WMH and 40 healthy controls from the Lishui Hospital of Traditional Chinese Medicine affiliated with Zhejiang Chinese Medical University. PVS scores ranging from 0 to 4 were determined according to the PVS counts in the basal ganglia area on T2-weighted magnetic resonance images; high-grade PVS was defined as a PVS score >1. The diameters of the deep cerebral veins, including the bilateral septal veins (SVs), thalamostriate veins (TSVs), lateral ventricular veins (LVVs), and internal cerebral veins, were measured using susceptibility weighted imaging (SWI). Left and right DMV scores, ranging from 0 to 9, were calculated based on the visibility of the DMV on SWI in the ipsilateral frontal, parietal, and occipital lobes. Results: The deep cerebral vein diameters, left and right DMV scores, and high-grade PVS differed between the healthy controls and WMH patients (P<0.05). Left DMV scores were independently associated with age {ß [95% confidence interval (CI)]: 0.050 (0.018, 0.082)}, high-grade PVS [ß (95% CI): 0.998 (0.262, 1.737)], and the diameters of the ipsilateral SVs [ß (95% CI): -1.114 (-1.754, -0.475)], SVs [ß (95% CI): -0.734 (-1.191, -0.277)], and LVVs [ß (95% CI): -0.921 (-1.567, -0.275)] [all false discovery rate (FDR)-corrected P<0.05]. Right DMV scores were independently associated with age [ß (95% CI): 0.071 (0.037, 0.105)], high-grade PVS [ß (95% CI): 0.873 (0.111, 1.635)], and the diameters of the ipsilateral SVs [ß (95% CI): -0.837 (-1.386, -0.289)], TSVs [ß (95% CI): -0.875 (-1.331, -0.419)], and LVVs [ß (95% CI): -1.813 (-2.484, -1.142)] (all FDR-corrected P<0.05). Conclusions: Decreased hypo-visibility of DMVs on SWI was associated with a higher age, the presence of high-grade PVS, and smaller diameters of the ipsilateral deep cerebral veins in individuals with WMH. Our findings provide novel insights into the probable mechanisms leading to high DMV scores.

Carbon dots@noble metal nanoparticle composites: research progress report.

Carbon dots@noble metal nanoparticle composites are formed by combining carbon dots and metal nanoparticles using various strategies. Carbon dots exhibit a reducing ability and function as stabilisers; consequently, metal-ion solutions can be directly reduced by them to synthesise gold, silver, and gold-silver alloy particles. Carbon dots@gold/silver/gold-silver particle composites have demonstrated the potential for several practical applications owing to their superior properties and simple preparation process. Until now, several review articles have been published to summarise fluorescent carbon dots or noble metal nanomaterials. Compared with metal-free carbon dots, carbon dots@noble metal nanoparticles have a unique morphology and structure, resulting in new physicochemical properties, which allow for sensing, bioimaging, and bacteriostasis applications. Therefore, to promote the effective development of carbon dots@noble metal nanoparticle composites, this paper primarily reviews carbon dots@gold/silver/gold-silver alloy nanoparticle composites for the first time in terms of the following aspects. (1) The synthesis strategies of carbon dots@noble metal nanoparticle composites are outlined. The principle and function of carbon dots in the synthesis strategies are examined. The advantages and disadvantages of these methods and composites are analysed. (2) The characteristics and properties of such composites are described. (3) The applications of these composite materials are summarised. Finally, the potentials and limitations of carbon dots@noble metal nanoparticle composites are discussed, thus laying the foundation for their further development.

Factors that influence the intent to pursue a master's degree: evidence from Shandong Province, China.

Introduction: In recent years, the pursuit of a master's degree has become a social phenomenon of wide concern. It is essential to understand why large number of students choose to pursue master's degree. This study aims to empirically analyze the factors that influence the intent to pursue a master's degree. Method: Based on the extended theory of planned behavior, this study conducts a questionnaire survey of university students in Shandong Province, which has had the highest number of people taking the postgraduate entrance examination in China for several years. A total of 440 questionnaires were finally collected, including 417 valid questionnaires. And then ordinary least squares (OLS) regression was used to analyze the factors that influence the intent to pursue a master's degree. Results: In general, the intent to pursue a master's degree is positively influenced by attitude (ß = 0.161, p < 0.01) and subjective norms (ß = 0.208, p < 0.01), and negatively influenced by risk perception (ß = -0.084, p < 0.05). Compared with male students, female students' intent is more likely to be influenced by risk perception (ß = -0.144, p < 0.05) and social factors (ß = 0.140, p < 0.05). The intent of upperclass students tends to be positively influenced by perceived behavioral control (ß = 0.125, p < 0.05), whereas the negative impact of risk perception (ß = -0.219, p < 0.05) on the intent is significant for underclass students. The intent of students in rural areas are more sensitive to risk perception (ß = -0.194, p < 0.01) than those of students in cities. In private universities, social factors (ß = 0.445, p < 0.05) significantly affect the intent to pursue a master's degree. In ordinary public universities, the intent of students is more likely to be influenced by risk perception (ß = -0.082, p < 0.05). Conclusion: The study is helpful to strengthen the understanding of the influencing factors of the intent to pursue a master's degree. In general, the intent to pursue a master's degree is mainly influenced by attitude, subjective norms and risk perception. Moreover, the influencing factors vary among different groups (e.g., female vs. male, rural areas vs. cities). Furthermore, attitude, subjective norms, perceived behavioral control, risk perception, and social factors have greater impacts on the intent of students from low-income households than those from high-income households. This study can provide policy implications for universities to take targeted educational measures to encourage students to make a choice that suits their own development after graduation.

LINC01836 Promotes Colorectal Cancer Progression and Functions as ceRNA to Target SLC17A9 by Sponging miR-1226-3p.

BACKGROUND: Increasing evidence proves that long non-coding RNAs (lncRNAs) play a key role in the occurrence and development of colorectal cancer. However, the function and molecular mechanism of LINC01836 in CRC are still unknown. METHODS: The differentially expressed lncRNAs in colorectal cancer were obtained from the RNA sequencing data. The effects of LINC01836 on colorectal cancer cells were tested in in vitro experiments. The mechanism of LINC01836 action was investigated through western blot, RNA immunoprecipitation assay and luciferase reporter assay. Moreover, the xenograft mouse model was conducted to examine the effects of LINC01836 in vivo. RESULTS: In this study, we showed that LINC01836 was significantly elevated in colorectal cancer tissues and cells. Elevated LINC01836 expression significantly correlated with larger tumor size, positive lymph node metastasis, distant metastasis, advanced tumor-node-metastasis (TNM) stage, and poor prognosis. Furthermore, decreased expression of LINC01836 repressed proliferation, migration, and invasion in vitro and vivo, and high LINC01836 expression displayed the opposite effect. Further analysis revealed that LINC01836 could regulate the expression of SLC17A9 by competing with miR---1226-3p. Furthermore, down-regulation of LINC01836 or increased expression of miR-1226-3p markedly reversed the effects of SLC17A9 overexpression on colorectal cancer cells. CONCLUSION: This study showed that LINC01836 regulated the expression of SLC17A9 through sponge miR-1226-3p by acting as a competitive endogenous RNA (ceRNA), promoted the progression of colorectal cancer, and suggested a new prognostic biomarker and potential cancer treatment target for colorectal cancer.

Regulating the Oxygen Vacancy and Electronic Structure of NiCo Layered Double Hydroxides by Molybdenum Doping for High-Power Hybrid Supercapacitors.

Amelioration of nickel-cobalt layered double hydroxides (NiCo-LDH) with a high specific theoretical capacitance is of great desire for high-power supercapacitors. Herein, a molybdenum (Mo) doping strategy is proposed to improve the charge-storage performance of NiCo-LDH nanosheets growing on carbon cloth (CC) via a rapid microwave process. The regulation of the electronic structure and oxygen vacancy of the LDH is consolidated by the density functional theory (DFT) calculation, which demonstrates that Mo doping narrows the band gap, reduces the formation energy of hydroxyl vacancies, and promotes ionic and charge transfer as well as electrolyte adsorption on the electrode surface. The optimal Mo-doped NiCo-LDH electrode (MoNiCo-LDH-0.05/CC) has an amazing specific capacity of 471.1 mA h g-1 at 1 A g-1 , and excellent capacity retention of 84.8% at 32 A g-1 , far superior to NiCo-LDH/CC (258.3 mA h g-1 and 76.4%). The constructed hybrid supercapacitor delivers an energy density of 103.3 W h kg-1 at a power density of 750 W kg-1 and retains the cycle retention of 85.2% after 5000 cycles. Two assembled devices in series can drive thirty LED lamps, revealing a potential application prospect of the rationally synthesized MoNiCo-LDH/CC as an energy-storage electrode material.

Effect of thickened water swallow training in tube-feeding and dysphagia patients in the acute and early subacute phases of stroke: A quasi-experimental study.

BACKGROUND: Thickened water has been widely used in patients with dysphagia who receive oral feeding, but there is little evidence for tube-feeding patients. OBJECTIVE: To explore the effects of thickened water swallow training in tube-feeding and dysphagia patients in the acute and early subacute phases of stroke. METHODS: A quasi-experimental study. Hospitalised patients with acute and early subacute stroke who received tube feeding due to dysphagia were recruited from March to December 2021. Patients assigned to the intervention group (n = 23) received thickened water swallow training three times daily until the feeding tube was removed or they were discharged, and patients in the control group (n = 23) received usual care. The main outcomes were duration of tube feeding and rates of weaning at discharge. RESULTS: Patients in the intervention group had a shorter tube-feeding duration (p = .046) and a higher rate of weaning at discharge (p = .017) than those in the control group. Significant interaction effects between time and group were detected regarding quality of life except for the swallowing burden dimension. CONCLUSIONS: Thickened water swallow training is feasible and effective for stroke patients with tube feeding and can shorten the duration of tube feeding and improve the rates of weaning and quality of life. Healthcare providers in nonrehabilitation units should actively conduct swallowing function intervention training to maximise the potential for acute and early subacute phase rehabilitation.

In-Plane Palladium and Interplanar Copper Dual Single-Atom Catalyst in Bulk-Like Carbon Nitride for Cascade CO2 Photoreduction.

Dual single-atom catalysts (DSACs) are promising for breaking the scaling relationships and ensuring synergistic effects compared with conventional single-atom catalysts (SACs). Nevertheless, precise synthesis and optimization of DSACs with specific locations and functions remain challenging. Herein, dual single-atoms are specifically incorporated into the layer-stacked bulk-like carbon nitride, featuring in-plane three-coordinated Pd and interplanar four-coordinated Cu (Pd1 -Cu1 /b-CN) atomic sites, from both experimental results and DFT simulations. Using femtosecond time-resolved transient absorption (fs-TA) spectroscopy, it is found that the in-plane Pd features a charge decay lifetime of 95.6 ps which is much longer than that of the interplanar Cu (3.07 ps). This finding indicates that the in-plane Pd can provide electrons for the reaction as the catalytically active site in both structurally and dynamically favorable manners. Such a well-defined bi-functional cascade system ensures a 3.47-fold increase in CO yield compared to that of bulk-like CN (b-CN), while also exceeding the effects of single Pd1 /b-CN and Cu1 /b-CN sites. Furthermore, DFT calculations reveal that the inherent transformation from s-p coupling to d-p hybridization between the Pd site and CO2 molecule occurs during the initial CO2 adsorption and hydrogenation processes and stimulates the preferred CO2 -to-CO reaction pathway.

Determination of the Catalytic Activity of a Peroxidase-like Nanozyme and Differences among Layered Double Hydroxides with Different Anions and Cations.

Nanomaterials with enzyme-like activity, namely, nanozymes, have been widely used as substitutes for natural enzymes, and they show excellent potential for application in many fields, such as biotechnology, environmental chemistry, and medicine. Layered double hydroxides (LDHs) are inorganic nanomaterials with adjustable compositions, simple preparation methods, and low costs and are some of the most promising candidate materials for the preparation of nanozymes. Here, we studied the syntheses and peroxidase-like activities of LDHs with four anions and four cations. First, LDHs prepared by the coprecipitation-hydrothermal method adopted hexagonal lamellar structures with good dispersion and uniform particle sizes. The Lambert-Beer law showed that the prepared LDHs exhibited good enzymatic activity. Later, the Km and Vmax values of the LDHs with different anionic/cationic materials intercalated into their structures were compared. Under the optimum conditions, the Vmax of Mg2Al-NO3-LDH was 7.35 × 10-2, which is 2-4 times higher than that of the LDHs containing other anions; the Vmax values of NiFe-LDH and FeAl-LDH were 0.152 and 0.284, respectively, which are 10 times higher than those of the LDHs with other cations. Importantly, according to kinetic analyses of the enzymatic reactions, the effects of Fe2+ and Fe3+ on the LDH enzyme activity were greater than those of the intercalated anions. This study showed that NiFe-LDH and FeAl-LDH with high catalytic activities are candidate materials for peroxidase simulations, which may provide new strategies for the application of LDHs in biosensors, antioxidants, biotechnology, and other nanozyme applications.

Predictive value of ELWI combined with sRAGE/esRAGE levels in the prognosis of critically ill patients with acute respiratory distress syndrome.

Acute respiratory distress syndrome (ARDS) is a life-threatening condition. Accurate judgement of the disease progression is essential for controlling the condition in ARDS patients. We investigated whether changes in the level of serum sRAGE/esRAGE could predict the 28-day mortality of ICU patients with ARDS. A total of 83 ARDS patients in the ICU of the Second Affiliated Hospital of Nantong University from January 2021 to June 2022 were consecutively enrolled in this study. Demographic data, primary diagnosis and comorbidities were obtained. Multiple scoring systems, real-time monitoring systems, and biological indicators were determined within 6 h of admission. The clinical parameters for survival status of the ARDS patients were identified by multivariate logistic regression. Receiver operating characteristic (ROC) curve analysis was employed to verify the accuracy of the prognosis of the related parameters. The admission level of sRAGE was significantly higher in the nonsurvival group than in the survival group (p < 0.05), whereas the serum esRAGE level showed the opposite trend. Multivariate logistic regression analysis showed that sRAGE (AUC 0.673, p < 0.05), esRAGE (AUC 0.704, p < 0.05), and ELWI (extravascular lung water index) (AUC 0.717, p < 0.05) were independent risk factors for the prognosis of ARDS. Model B (ELWI + esRAGE) could not be built as a valid linear regression model (ELWI, p = 0.079 > 0.05). Model C (esRAGE + sRAGE) was proven to have no significance because it had a predictive value similar to that of the serum levels of esRAGE (Z = 0.993, p = 0.351) or sRAGE (Z = 1.116, p = 0.265) alone. Subsequently, Model D (sRAGE + esRAGE + ELWI) showed the best 28-day mortality predictive value with a cut-off value of 0.426 (AUC 0.841; p < 0.001), and Model A (sRAGE + ELWI) had a cut-off value of 0.401 (AUC 0.820; p < 0.001), followed by sRAGE (AUC 0.704, p = 0.004), esRAGE (AUC 0.717, p = 0.002), and ELWI (AUC 0.637, p = 0.028). In addition, there was no statistically significant difference between Model A and Model D (Z = 0.966, p = 0.334). The admission level of sRAGE was higher in the nonsurvival group, while the serum esRAGE level showed the opposite trend. Model A and Model D could be used as reliable combined prediction models for predicting the 28-day mortality of ARDS patients.

Reconstruction of Medial Orbital Wall Using Autologous Perpendicular Plate of Ethmoid.

The aim of this study is to investigate the feasibility of perpendicular plate of ethmoid as material for the reconstruction of medial orbital wall. The main outcome measurement was preoperative and postoperative orbital volume. The authors performed a study including 17 patients who have isolated medial orbital wall fracture (blow-out fracture). All the patients were fixed the defect using autologous perpendicular plate of ethmoid under endonasal approach. The authors compared the preoperative and postoperative orbital volume difference (unaffected orbit, affected orbit) of all the patients, and observed the improvement of diplopia or ocular motility disorders after operation. All 17 medial orbital wall reconstruction surgeries were successful with no severe postoperative ophthalmic complications. Statistically significant differences were found between the preoperative and postoperative orbital tissue volumes for the affected orbit. There was no statistically significant difference found between the tissue volume of the contralateral unaffected orbit and the affected orbit after reconstruction. And postoperative computed tomography showed the implant is in place and there is no medial rectus incarceration. Autologous perpendicular plate of ethmoid proved to be safe and effective in the reconstruction of medial orbital wall under endonasal approach with cost-effectivence, low complication rate, high biocompatibility, and minimally invasion.

Machine learning for predicting the risk stratification of 1-5 cm gastric gastrointestinal stromal tumors based on CT.

BACKGROUD: To predict the malignancy of 1-5 cm gastric gastrointestinal stromal tumors (GISTs) by machine learning (ML) on CT images using three models - Logistic Regression (LR), Decision Tree (DT) and Gradient Boosting Decision Tree (GBDT). METHODS: 231 patients from Center 1 were randomly assigned into the training cohort (n = 161) and the internal validation cohort (n = 70) in a 7:3 ratio. The other 78 patients from Center 2 served as the external test cohort. Scikit-learn software was used to build three classifiers. The performance of the three models were evaluated by sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV) and area under the curve (AUC). Diagnostic differences between ML models and radiologists were compared in the external test cohort. Important features of LR and GBDT were analyzed and compared. RESULTS: GBDT outperformed LR and DT with the largest AUC values (0.981 and 0.815) in the training and internal validation cohorts and the greatest accuracy (0.923, 0.833 and 0.844) across all three cohorts. However, LR was found to have the largest AUC value (0.910) in the external test cohort. DT yielded the worst accuracy (0.790 and 0.727) and AUC values (0.803 and 0.700) in both the internal validation cohort and the external test cohort. GBDT and LR performed better than radiologists. Long diameter was demonstrated to be the same and most important CT feature for GBDT and LR. CONCLUSIONS: ML classifiers, especially GBDT and LR with high accuracy and strong robustness, were considered to be promising in risk classification of 1-5 cm gastric GISTs based on CT. Long diameter was found the most important feature for risk stratification.

The impact of COVID-19 on the value of coastal recreational resource from the perspective of recreational behaviour change: Evident from China.

The Corona Virus Disease 2019 (COVID-19) outbreak took a heavy toll on the global tourism industry in 2020, and affected the value realization of coastal recreational ecosystem service. From the micro perspective, this paper combines travel cost method with contingent behaviour method to obtain residents' actual behaviour and contingent behaviour data, and discusses the impact of the outbreak of COVID-19 on the value realization of coastal recreational resources from the perspective of the change in residents' recreational behaviour in Qingdao, China. Residents are observed to significantly reduce their outdoor activities in response to the COVID-19. The number of visits to the beach decreases by 25.2% when there is an outbreak, and decreases by 0.064% for every 1% increase in the number of confirmed cases, which is used to represent the severity of the epidemic. The asymmetries effects of epidemic situation on residents' recreational behaviour show that the improvements lead to larger and more significant impacts than the deteriorations. The disappearance of the pandemic crisis will provide considerable welfare for the citizens in Qingdao, which reaches to 1.9323 billion CNY/year. If the number of confirmed cases deteriorates to 900, the environmental welfare loss will be 0.3366 billion CNY/year. Additionally, we test the effects of residents' cognitive variables, and find that risk perception can strengthen the negative impacts of COVID-19 cases. Furthermore, the deteriorations in the environmental attributes are found to have stronger impacts on the number of visits than the improvements. This paper provides empirical-support results about the change of coastal recreational value through the evaluation of recreational behaviours in the post-epidemic period, which will give important implications for government's marine ecosystem restoration and coastal management work.