Cost-Effectiveness Analysis of Remimazolam and Midazolam in Goal-Guided Sedation in ICU.

Objective: This study aimed to compare the direct medication costs and clinical effectiveness of using remimazolam versus midazolam for goal-guided sedation therapy in the ICU patients. Methods: This randomized controlled study was conducted in the ICU of People's Hospital Affiliated to Shandong First Medical University. Eighty adult patients admitted to the ICU and requiring sedation were enrolled and randomly assigned in a 1:1 ratio to receive either remimazolam-based sedation (study group, n=40) or midazolam-based sedation (control group, n=40). The inclusion criteria for patient selection were age 18-80 years, requirement for mechanical ventilation, and an expected ICU stay of at least 24 hours. Patients with significant liver or kidney dysfunction, neurological disorders, or contraindications to the study drugs were excluded. The target sedation depth for both groups was a Ramsay Sedation Scale score of 3-4, which was maintained by titrating the infusion rates of remimazolam or midazolam as needed. Vital signs, sedation scores, and respiratory parameters were closely monitored throughout the sedation period. Results: The time to onset of sedation, time to reach the target sedation depth, time to awakening, and length of ICU stay were all significantly shorter in the remimazolam group compared to the midazolam group (P < .05 for all). The remimazolam group had a mean time to onset of 5.2 ± 1.8 minutes versus 8.9 ± 2.4 minutes in the midazolam group. The mean time to reach the target Ramsay Sedation Scale score of 3-4 was 12.6 ± 3.1 minutes in the remimazolam group compared to 18.4 ± 4.2 minutes in the midazolam group. The mean time to awakening was 10.2 ± 2.7 minutes in the remimazolam group versus 16.5 ± 3.9 minutes in the midazolam group. The remimazolam group also had a significantly shorter mean ICU length of stay of 5.1 ± 1.3 days compared to 7.8 ± 2.1 days in the midazolam group (P < .01). The remimazolam group had a significantly higher metabolic clearance rate compared to the midazolam group (P < .001). The Ramsay sedation scores and Wong-Baker FACES pain scores were also significantly lower in the remimazolam group throughout the sedation period (P < .01). There were no significant differences in heart rate between the two groups at any timepoint. However, the overall incidence of adverse events was significantly lower in the remimazolam group compared to the midazolam group (P < .05). Conclusion: This study demonstrated that the use of remimazolam-based goal-directed sedation in the ICU setting resulted in significantly faster onset of action, quicker achievement of the target sedation depth, shorter time to awakening, and shorter ICU length of stay compared to midazolam-based sedation. The remimazolam group also had a higher metabolic clearance rate, lower sedation and pain scores, and a lower incidence of adverse events.These findings suggest that remimazolam may provide advantages over midazolam for ICU sedation, potentially leading to improved patient comfort, more efficient utilization of ICU resources, and potentially better clinical outcomes. The rapid onset, titratability, and favorable safety profile of remimazolam make it a promising sedative agent that could help optimize sedation practices in the critical care setting. Further research is warranted to fully evaluate the impact of remimazolam on long-term patient-centered outcomes and overall healthcare costs in the ICU.

Diagnostic value of fibrinogen in lower extremity deep vein thrombosis caused by rib fracture: A retrospective study.

Objectives: To investigate the diagnostic value of fibrinogen (FIB) in patients with rib fractures complicated by lower extremity deep venous thrombosis (DVT).Methods: Analyzing data from 493 patients at Shijiazhuang Third Hospital, FIB levels at 24, 48, and 72 h post-injury were compared between DVT and non-DVT groups.Results: DVT group had elevated FIB levels at all times (p < .001). FIB at 24 h showed highest AUC, particularly in patients with BMI <28.Conclusion: In conclusion, measuring FIB at 24 h post-injury enhances DVT detection in rib fracture patients, with potential BMI-related variations.

Sex-specific associations of urinary mixed-metal concentrations with femoral bone mineral density among older people: an NHANES (2017-2020) analysis.

Background: Heavy metal exposure is an important cause of reduced bone mineral density (BMD). Epidemiological studies focusing on the effects of mixed heavy metal exposure on BMD in middle-aged and older people are scarce. In single-metal studies, men and women have shown distinct responses of BMD to environmental metal exposure. This study therefore aimed to elucidate the association between mixed heavy metal exposure and BMD and to investigate whether it is sex-specific. Methods: Data from the 2017-2020 National Health and Nutrition Examination Survey were selected for this cross-sectional study. The study used three statistical methods, i.e., linear regression, Bayesian kernel machine regression (BKMR) modeling, and weighted quartiles (WQS) regression, to explore the association between the urinary concentrations of 11 metals (barium, cadmium, cobalt, cesium, manganese, molybdenum, lead, antimony, tin, thallium, and Tungsten), either individually or as a mixture, and total femoral BMD. Results: A total of 1,031 participants were included in this study. Femoral BMD was found to be higher in men than women. A significant negative correlation between the urinary concentrations of the 10 metals and femoral BMD was found in the overall cohort. Further gender sub-stratified analyses showed that in men, urinary metal concentrations were negatively correlated with femoral BMD, with cobalt and barium playing a significant and non-linear role in this effect. In women, although urinary metal concentrations negatively modulated femoral BMD, none of the correlations was statistically significant. Antimony showed sex-specific differences in its effect. Conclusion: The urinary concentrations of 10 mixed heavy metals were negatively correlated with femoral BMD in middle-aged and older participants, and this effect showed gender differences. These findings emphasize the differing role of mixed metal exposure in the process of BMD reduction between the sexes but require further validation by prospective studies.

Clinical characteristics and risk factors in patients with SARS-CoV-2 Omicron variant infection complicated with cardiovascular diseases.

Objective: To investigate the clinical characteristics and risk factors of patients with SARS-CoV-2 Omicron variant infection complicated with cardiovascular diseases. Methods: A retrospective analysis of general clinical data was conducted on patients with SARS-CoV-2 omicron infection complicated with hypertension, coronary heart disease, and heart failure admitted to one hospital in Guangdong Province from December 1, 2022, to February 28, 2023. Clinical symptoms, laboratory tests, imaging examinations, treatment, and clinical outcomes were collected. Multivariate logistic regression analysis was used to analyze the risk factors for mortality in patients with SARS-CoV-2 Omicron variant infection complicated with cardiovascular diseases. ROC curves were drawn to evaluate the predictive value of CRP, D-dimer, and CK-MB in predicting the risk of death. Results: A total of 364 confirmed cases were included, divided into the asymptomatic group, mild to moderate group, and severe to critically ill group based on the symptoms of COVID-19. There were 216 males (59.34%) and 148 females (40.66%), with a median age of 75 years. The differences between the three groups in terms of sex and age were statistically significant (p < 0.05). The top three underlying diseases were hypertension (288 cases, 79.12%), coronary heart disease (100 cases, 27.47%), and diabetes (84 cases, 23.08%). The differences in unvaccinated and triple-vaccinated patients among the three groups were statistically significant (p < 0.05). The common respiratory symptoms were cough in 237 cases (65.11%) and sputum production in 199 cases (54.67%). In terms of laboratory tests, there were statistically significant differences in neutrophils, lymphocytes, red blood cells, C-reactive protein, D-dimer, aspartate aminotransferase, and creatinine among the three groups (p < 0.05). In imaging examinations, there were statistically significant differences among the three groups in terms of unilateral pulmonary inflammation, bilateral pulmonary inflammation, and bilateral pleural effusion (p < 0.05). There were statistically significant differences among the three groups in terms of antibiotic treatment, steroid treatment, oxygen therapy, nasal cannula oxygen inhalation therapy, non-invasive ventilation, and tracheal intubation ventilation (p < 0.05). Regarding clinical outcomes, there were statistically significant differences among the three groups in terms of mortality (p < 0.05). Multivariate logistic regression analysis showed that CRP (OR = 1.012, 95% CI = 1.004-1.019) and D-dimer (OR = 1.117, 95% CI = 1.021-1.224) were independent risk factors for patient mortality. The predictive value of CRP, D-dimer, and CK-MB for the risk of death was assessed. D-dimer had the highest sensitivity (95.8%) in predicting patient mortality risk, while CRP had the highest specificity (84.4%). Conclusion: For patients with COVID-19 and concomitant cardiovascular diseases without contraindications, early administration of COVID-19 vaccines and booster shots can effectively reduce the mortality rate of severe cases. Monitoring biomarkers such as CRP, D-dimer, and CK-MB and promptly providing appropriate care can help mitigate the risk of mortality in patients.

The Prevalence of Missing Incidents and Their Antecedents Among Older Adult MedicAlert Subscribers: Retrospective Descriptive Study.

BACKGROUND: With the population aging, the number of people living with dementia is expected to rise, which, in turn, is expected to lead to an increase in the prevalence of missing incidents due to critical wandering. However, the estimated prevalence of missing incidents due to dementia is inconclusive in some jurisdictions and overlooked in others. OBJECTIVE: The aims of the study were to examine (1) the demographic, psychopathological, and environmental antecedents to missing incidents due to critical wandering among older adult MedicAlert Foundation Canada (hereinafter MedicAlert) subscribers; and (2) the characteristics and outcomes of the missing incidents. METHODS: This study used a retrospective descriptive design. The sample included 434 older adult MedicAlert subscribers involved in 560 missing incidents between January 2015 and July 2021. RESULTS: The sample was overrepresented by White older adults (329/425, 77.4%). MedicAlert subscribers reported missing were mostly female older adults (230/431, 53.4%), living in urban areas with at least 1 family member (277/433, 63.8%). Most of the MedicAlert subscribers (345/434, 79.5%) self-reported living with dementia. MedicAlert subscribers went missing most frequently from their private homes in the community (96/143, 67.1%), traveling on foot (248/270, 91.9%) and public transport (12/270, 4.4%), during the afternoon (262/560, 46.8%) and evening (174/560, 31.1%). Most were located by first responders (232/486, 47.7%) or Good Samaritans (224/486, 46.1%). Of the 560 missing incidents, 126 (22.5%) were repeated missing incidents. The mean time between missing incidents was 11 (SD 10.8) months. Finally, the majority of MedicAlert subscribers were returned home safely (453/500, 90.6%); and reports of harm, injuries (46/500, 9.2%), and death (1/500, 0.2%) were very low. CONCLUSIONS: This study provides the prevalence of missing incidents from 1 database source. The low frequency of missing incidents may not represent populations that are not White. Despite the low number of missing incidents, the 0.2% (1/500) of cases resulting in injuries or death are devastating experiences that may be mitigated through prevention strategies.

Microinvasion in hepatocellular carcinoma: predictive factor and application for definition of clinical target volume for radiotherapy.

BACKGROUND: To investigate the correlation between microinvasion and various features of hepatocellular carcinoma (HCC), and to clarify the microinvasion distance from visible HCC lesions to subclinical lesions, so as to provide clinical basis for the expandable boundary of clinical target volume (CTV) from gross tumor volume (GTV) in the radiotherapy of HCC. METHODS: HCC patients underwent hepatectomy of liver cancer in our hospital between July 2019 and November 2021 were enrolled. Data on various features and tumor microinvasion distance were collected. The distribution characteristics of microinvasion distance were analyzed to investigate its potential correlation with various features. Tumor size compared between radiographic and pathologic samples was analyzed to clarify the application of pathologic microinvasion to identify subclinical lesions of radiographic imaging. RESULTS: The average microinvasion distance was 0.6 mm, with 95% patients exhibiting microinvasion distance less than 3.0 mm, and the maximum microinvasion distance was 4.0 mm. A significant correlation was found between microinvasion and liver cirrhosis (P = 0.036), serum albumin level (P = 0.049). Multivariate logistic regression analysis revealed that HCC patients with cirrhosis had a significantly lower risk of microinvasion (OR = 0.09, 95%CI = 0.02 ~ 0.50, P = 0.006). Tumor size was overestimated by 1.6 mm (95%CI=-12.8 ~ 16.0 mm) on radiographic size compared to pathologic size, with a mean %Δsize of 2.96% (95%CI=-0.57%~6.50%). The %Δsize ranged from - 29.03% to 34.78%. CONCLUSIONS: CTV expanding by 5.4 mm from radiographic GTV could include all pathologic microinvasive lesions in the radiotherapy of HCC. Liver cirrhosis was correlated with microinvasion and were independent predictive factor of microinvasion in HCC.

Childhood maltreatment, shame, and self-esteem: an exploratory analysis of influencing factors on criminal behavior in juvenile female offenders.

OBJECTIVE: This study aimed to investigate the relationships between childhood maltreatment, shame, and self-esteem among juvenile female offenders and to explore the potential influencing factors on their criminal behavior. METHODS: Using a stratified cluster sampling method, 1,227 juvenile female offenders from 11 provinces in China were surveyed using the Childhood Trauma Questionnaire (CTQ), Self-Esteem Scale (SES), and a self-developed Shame Questionnaire for Juvenile Offenders. Data were analyzed using descriptive statistics, correlation analysis, chi-square tests, t-tests, and structural equation modeling with mediation analysis. RESULTS: (1) Childhood maltreatment have a significant potential influencing factors on criminal behavior; (2) Childhood maltreatment was positively correlated with self-esteem(ß = 0.351, p < 0.001); (3) shame (ß = 0.042, p < 0.001) mediate the relationship between Childhood maltreatment and self-esteem (childhood maltreatment → shame → self-esteem (95% Cl: 0.033, 0.052)). CONCLUSION: This study demonstrates that childhood maltreatment is a significant predictor of criminal behavior among juvenile female offenders. childhood maltreatment can directly influence of self-esteem, which can also affect juvenile female offenders'self-esteem indirectly through shame. The findings suggest that shame are important variables that mediate the effect of the juvenile female offenders'childhood maltreatment on their self-esteem.

The clinical and pathological features of Kimura disease in pediatric patients.

Background: Kimura disease is characterized by inflammation, with its underlying causes remaining uncertain. There is a lack of comprehensive and systematic research on the pathology of this condition in pediatric patients. Our objective is to study the clinical and pathological attributes of Kimura disease in pediatric patients and investigate the potential diagnostic significance of immunoglobulin E (IgE) in this context. Methods: Clinical and laboratory information, pathological characteristics, and follow-up data were correlated to examine the distinctive features. Immunohistochemistry, acid-fast staining, and molecular assay were used to identify the presence of IgE and pathogens. Results: We conducted an analysis of five cases of Kimura disease in pediatric patients at our hospital. The patients' ages ranged from 5 years and 7 months to 14 years and 2 months, with 4 (80%) being male. The most common site was the head and neck region, particularly the postauricular subcutaneous area. Eosinophilia was observed in four patients (80%), and two patients (40%) had elevated serum immunoglobulin E (IgE) levels. Histopathological changes included eosinophilic infiltrates, follicular hyperplasia, and the proliferation of postcapillary venules. Immunohistochemical results supported the reactive nature of the lymphoid process and IgE deposition in the follicle, while no specific pathogens were discovered by special staining. All patients underwent surgical excision, and none experienced recurrence in their original location. Conclusion: Children with Kimura disease show distinct eosinophilic and IgE alterations in both laboratory findings and pathological features. The application of immunohistochemical staining of IgE could serve as a promising marker for diagnosing Kimura disease.

A multi-parametric prognostic model based on clinicopathologic features: vessels encapsulating tumor clusters and hepatic plates predict overall survival in hepatocellular carcinoma patients.

BACKGROUND: Vessels encapsulating tumor clusters (VETC) is a newly described vascular pattern that is distinct from microvascular invasion (MVI) in patients with hepatocellular carcinoma (HCC). Despite its importance, the current pathological diagnosis report does not include information on VETC and hepatic plates (HP). We aimed to evaluate the prognostic value of integrating VETC and HP (VETC-HP model) in the assessment of HCC. METHODS: A total of 1255 HCC patients who underwent radical surgery were classified into training (879 patients) and validation (376 patients) cohorts. Additionally, 37 patients treated with lenvatinib were studied, included 31 patients in high-risk group and 6 patients in low-risk group. Least absolute shrinkage and selection operator (LASSO) regression analysis was used to establish a prognostic model for the training set. Harrell's concordance index (C-index), time-dependent receiver operating characteristics curve (tdROC), and decision curve analysis were utilized to evaluate our model's performance by comparing it to traditional tumor node metastasis (TNM) staging for individualized prognosis. RESULTS: A prognostic model, VETC-HP model, based on risk scores for overall survival (OS) was established. The VETC-HP model demonstrated robust performance, with area under the curve (AUC) values of 0.832 and 0.780 for predicting 3- and 5-year OS in the training cohort, and 0.805 and 0.750 in the validation cohort, respectively. The model showed superior prediction accuracy and discrimination power compared to TNM staging, with C-index values of 0.753 and 0.672 for OS and disease-free survival (DFS) in the training cohort, and 0.728 and 0.615 in the validation cohort, respectively, compared to 0.626 and 0.573 for TNM staging in the training cohort, and 0.629 and 0.511 in the validation cohort. Thus, VETC-HP model had higher C-index than TNM stage system(p < 0.01).Furthermore, in the high-risk group, lenvatinib alone appeared to offer less clinical benefit but better disease-free survival time. CONCLUSIONS: The VETC-HP model enhances DFS and OS prediction in HCC compared to traditional TNM staging systems. This model enables personalized temporal survival estimation, potentially improving clinical decision-making in surveillance management and treatment strategies.

Research on consumers' purchase intention of cultural and creative products-Metaphor design based on traditional cultural symbols.

Chinese traditional cultural symbols possess great aesthetic and cultural value, and are widely utilized in product design. In this study, we explore the relationship between metaphor design based on traditional cultural symbols, customer experience and cultural identity, and further estimate how these three variables stimulate consumers' perceived value to generate consumers' purchase intention. Based on existing traditional cultural literature and Stimulus-organism-response theory (SOR), we proposed a theoretical research model to characterize the relationship among metaphor design based on traditional cultural symbols, customer experience, cultural identity, perceived value and consumers' purchase intention. A research survey was conducted and 262 questionnaires were collected in total with 241 valid. We used Smart PLS graph version 3.0 for data analysis. Results indicate that the cognition of metaphor design based on traditional cultural symbols and customer experience has a direct and significant impact on the emotional value thereby, eliciting consumers' purchase intention, metaphor design based on traditional cultural symbols is directly and indirectly (i.e., through customer experience or perceived value) positively associated with consumers' purchase intention, also customer experience is directly and indirectly (i.e., through perceived value) associated with consumer purchase intention, cultural identity mediates the indirect effect of customer experience and perceived value on purchase intention, the moderating role of cultural identity between customer experience and perceived value is not significant. Our findings help to expand the existing literature on consumer purchase intentions by rationally using traditional cultural symbols in the product metaphor design.

Rational Design of Nitride Phosphor-In-Glass with Robust Stability and Photoluminescence Performance.

Phosphor-in-glass represents a promising avenue for merging the luminous efficiency of high-quality phosphor and the thermal stability of a glass matrix. Undoubtedly, the glass matrix system and its preparation are pivotal factors in achieving high stability and preserving the original performance of embedded phosphor particles. In contrast to the well-established commercial Y3Al5O12:Ce3+ oxide phosphor, red nitride phosphor, which plays a critical role in high-quality lighting, exhibits greater structural instability during the high-temperature synthesis of inorganic glasses. A telluride glass with a refractive index (RI = 2.15@615 nm) akin to that of nitride phosphor (∼2.19) has been devised, demonstrating high efficiency in photon utilization. The lower glass-transition temperature plays a crucial role in safeguarding phosphor particles against erosion resulting from exposure to high-temperature melts. Phosphor-in-glass retains 93% of the quantum efficiency observed for pure phosphor. The assembled white light-emitting diodes module has precise color tuning capabilities, achieving an optimal color rendering index of 93.7, a luminous efficacy of 80.4 lm/W, and a correlated color temperature of 5850 K. These outcomes hold potential for advancing the realm of inorganic package and high-quality white light illumination.

1D-CNN-based audio tampering detection using ENF signals.

The extensive adoption of digital audio recording has revolutionized its application in digital forensics, particularly in civil litigation and criminal prosecution. Electric network frequency (ENF) has emerged as a reliable technique in the field of audio forensics. However, the absence of comprehensive ENF reference datasets limits current ENF-based methods. To address this, this study introduces ATD, a blind audio forensics framework based on a one-dimensional convolutional neural network (1D-CNN) model. ATD can identify phase mutations and waveform discontinuities within the tampered ENF signal, without relying on an ENF reference database. To enhance feature extraction, the framework incorporates characteristics of the fundamental harmonics of ENF signals. In addition, a denoising method termed ENF noise reduction (ENR) based on the variational mode decomposition (VMD) and robust filtering algorithm (RFA) is proposed to reduce the impact of external noise on embedded electric network frequency signals. This study investigates three distinct types of audio tampering-deletion, insertion, and replacement-culminating in the design of binary-class tampering detection scenarios and four-class tampering detection scenarios tailored to these tampering types. ATD achieves a tampering detection accuracy of over 93% in the four-class scenario and exceeds 96% in the binary-class scenario. The effectiveness, efficiency, adaptability, and robustness of ATD in the two and four classification scenarios have been confirmed by extensive experiments.

V-doped activated Ru/Ti2.5V0.5C2 dual-active center accelerate hydrogen production from ammonia borane.

Designing and constructing the active center of Ru-based catalysts is the key to efficient hydrolysis of ammonia borane (NH3BH3, AB) for hydrogen production. Herein, V-doped Ru/Ti2.5V0.5C2 dual-active center catalysts were synthesized, showing excellent catalytic ability for AB hydrolysis. The corresponding turnover frequency value was 1072 min-1 at 298 K, and the hydrolysis rate rB of AB was 235 × 103 mL·min-1·gRu-1. X-ray photoelectron spectroscopy results indicated that the interaction between V-doped Ti3C2 and catalytic metal Ru transfers electrons from Ti to Ru, resulting in electron-rich Ru species. According to density functional theory calculations, the activation energy and reaction dissociation energy of the reactants AB and H2O on V-doped catalysts were lower than those of Ru/Ti3C2, thus optimizing the catalytic kinetics of AB hydrolysis. The modification strategy of V-doped Ti3C2 provides a new pathway for the development of high-performance catalysts for AB hydrolysis.

Production of Margarine Fat Containing Medium- and Long-Chain Triacylglycerols by Enzymatic Interesterification of Peony Seed Oil, Palm Stearin and Coconut Oil Blends.

This paper reports the preparation of margarine fat using Lipozyme TL IM as a catalyst and peony seed oil (PSO), palm stearin (PS) and coconut oil (CO) as raw materials. The results indicate that there were no significant changes in fatty acid composition before or after interesterification of the oil samples. However, the total amount of medium- and long-chain triglycerides (MLCTs) increased from 2.92% to 11.38% in sample E1 after interesterification, mainly including LaLaO, LaMO, LaPM, LaOO, LaPO and LaPP. Moreover, the slip melting point (SMP) of sample E1 decreased from 45.9 °C (B1) to 33.5 °C. The solid fat content (SFC) of all the samples at 20 °C was greater than 10%, indicating that they could effectively prevent oil exudation. After interesterification, the samples exhibited a ß' crystal form and could be used to prepare functional margarine.

Aging and adsorption behavior of PP-MPs for methylene blue and tetracycline in unitary and binary systems.

The omnipresence of microplastics (MPs) around the world has attracted extensive attention in the past decade with more focuses on the interactions of standard MPs without additives in regular shapes and individual pollutant, whereas the actual MPs containing various additives in irregular shapes and complex pollutants are often co-occurrence in the environments. In this paper, the adsorption performance of disposable polypropylene (PP) cups-based MPs subjected to ultraviolet irradiation was investigated in unitary and binary water matrices. The surface characteristics were analyzed and the experimental data of adsorption were fitted by various kinetic and isotherm models, and the results indicated that more cracks and oxygen-containing functional groups with decreased hydrophobicity were produced with aging, and electrostatic attraction and hydrogen bonding dominated methylene blue (MB) and tetracycline (TC) capture in the individual system. Moreover, pseudo-second order kinetic model better described the adsorption processes. In the binary system, the co-existence of TC promoted MB uptake, while the presence of MB inhibited TC capture. In addition, TC adsorption was enhanced by Ca2+, maybe due to its complexation effect, while the presence of mono- and divalent inorganic salts inhibited MB capture. This research provides useful insights for the fate of PP-MPs and organic pollutants in the complex environments.

Ginsenoside compound K plays an anti-inflammatory effect without inducing glucose metabolism disorder in adjuvant-induced arthritis rats.

Ginsenoside compound K (GCK) possesses a glucocorticoid (GC)-like structure and functions as an agonist of the glucocorticoid receptor (GR), thereby exerting anti-inflammatory effects through GR activation. However, it remains unclear whether GCK leads to hyperglycemia, which is a known adverse reaction associated with classical GCs. In this study, we have successfully demonstrated that GCK exerts its anti-inflammatory effects in a rat model of adjuvant arthritis without impacting gluconeogenesis and pentose phosphate pathways, thus avoiding any glucose metabolism disorders. By employing the GR mutant plasmid, we have identified the binding site between GCK and GR as GRM560T, which differs from the binding site shared by dexamethasone (DEX) and GR. Notably, compared to DEX, GCK induces distinct levels of phosphorylation at S211 on GR upon binding to activate steroid receptor coactivator 1 (SRC1)-a co-factor responsible for mediating anti-inflammatory effects-while not engaging peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α)-an associated coactivator involved in gluconeogenesis.

MOF-Derived ZrO2-Supported Bimetallic Pd-Ni Catalyst for Selective Hydrogenation of 1,3-Butadiene.

A series of MOF-derived ZrO2-supported Pd-Ni bimetallic catalysts (PdNi/UiO-67-CTAB(n)-A500) were prepared by co-impregnation and pyrolysis at 500 °C under air atmosphere using UiO-67-CTAB(n) (CTAB: cetyltrimethylammonium bromide; n: the concentration of CTAB; n = 0, 3, 8, 13, 18) as a sacrificial template. The catalytic activity of PdNi/UiO-66-CTAB(n)-A500 in 1,3-butadiene hydrogenation was found to be dependent on the crystal morphology of the UiO-67 template. The highest activity was observed over the PdNi/UiO-67-CTAB(3)-A500 catalyst which was synthesized using UiO-67-CTAB(3) with uniform octahedral morphology as the template for the 1,3-butadiene selective hydrogenation. The 1,3-butadiene conversion and total butene selectivity were 98.4% and 44.8% at 40 °C within 1 h for the PdNi/UiO-67-CTAB(3)-A500 catalyst, respectively. The catalyst of PdNi/UiO-67-CTAB(3)-A500 can be regenerated in flowing N2 at 200 °C. Carbon deposited on the surface of the catalyst was the main reason for its deactivation. This work is valuable for the high-efficiency bimetallic catalyst's development on the selective hydrogenation of 1,3-butadiene.

Natural polysaccharides regulate intestinal microbiota for inhibiting colorectal cancer.

The gastrointestinal tract is an important part of the human immune system. The gut microbiome, which constitutes a major component of the gastrointestinal tract, plays a crucial role in maintaining normal physiological functions and influences the development, diagnosis, and immunotherapy of colorectal cancer (CRC). Natural polysaccharides can be extracted from animals, plants, and traditional Chinese medicines. They serve as an essential energy source for the gut microbiome, promoting probiotic proliferation and regulating the intestinal microecological balance. Moreover, polysaccharides exhibit anti-tumor effects due to their immune regulatory functions and low toxicity. This review focuses on discussing these anti-tumor effects in CRC, along with improving gut microbiome dysbiosis and regulating the tumor immune microenvironment, providing evidence for effective therapeutic strategies against CRC.

The relationship between social withdrawal and problematic social media use in Chinese college students: a chain mediation of alexithymia and negative body image.

This study explores the relationship between social withdrawal and problematic social media use among college students, with a focus on the mediating roles of alexithymia and negative body image. Using the University Student Social Withdrawal Questionnaire, Social Media Addiction Scale, Toronto Alexithymia Scale, and Negative Body Image Scale, 2582 college students (33.46% male, average age = 19.46 years, SD = 2.23) were surveyed. Social withdrawal, alexithymia, negative body image, and problematic social media use were significantly correlated with each other. Social withdrawal positively predicted problematic social media use, and both alexithymia and negative body image played a chain mediating role between social withdrawal and problematic social media use. The findings indicate that individual social withdrawal is associated with college students' problematic use of social media. The results suggest that alexithymia and negative body image may mediate this association, highlighting a potential pathway through which social withdrawal influences social media use patterns.

A multicenter proof-of-concept study on deep learning-based intraoperative discrimination of primary central nervous system lymphoma.

Accurate intraoperative differentiation of primary central nervous system lymphoma (PCNSL) remains pivotal in guiding neurosurgical decisions. However, distinguishing PCNSL from other lesions, notably glioma, through frozen sections challenges pathologists. Here we sought to develop and validate a deep learning model capable of precisely distinguishing PCNSL from non-PCNSL lesions, especially glioma, using hematoxylin and eosin (H&E)-stained frozen whole-slide images. Also, we compared its performance against pathologists of varying expertise. Additionally, a human-machine fusion approach integrated both model and pathologic diagnostics. In external cohorts, LGNet achieved AUROCs of 0.965 and 0.972 in distinguishing PCNSL from glioma and AUROCs of 0.981 and 0.993 in differentiating PCNSL from non-PCNSL lesions. Outperforming several pathologists, LGNet significantly improved diagnostic performance, further augmented to some extent by fusion approach. LGNet's proficiency in frozen section analysis and its synergy with pathologists indicate its valuable role in intraoperative diagnosis, particularly in discriminating PCNSL from glioma, alongside other lesions.