Single-Plane Retroperitoneoscopic Adrenalectomy Guided by Indocyanine Green Dye: An Optimized Step.

Background: The objective of this study was to explore the perioperative outcomes of single-plane posterior retroperitoneoscopic adrenalectomy (SPRA) guided by indocyanine green dye (ICG) fluorescence imaging. Methods: A retrospective analysis of patients who underwent SPRA from April to September 2023 in our center was conducted. Patients were divided into the ICG group and the non-ICG group, based on whether they received intraoperative ICG fluorescence guided or not. Baseline and perioperative data were recorded and analyzed by R software (R 4.3.1). Results: A total of 23 patients were enrolled in the study, with 12 in the ICG group and 11 in the non-ICG group. The demographics including age, gender, body mass index, or American Society of Anesthesiologists classification showed no significant differences between groups. There were obvious advantages in shortening adrenal gland localization time and total operative time, as well as reducing estimated blood loss in the ICG group compared with the non-ICG group (5.58 ± 0.36 minutes vs 7.55 ± 0.62 minutes, p < 0.001; 27.50 ± 5.46 minutes vs 45.00 ± 10.99 minutes, p < 0.001; 22.91 ± 7.57 mL vs 54.54 ± 18.90 mL, p < 0.001; respectively). Furthermore, patients in the ICG group exhibited significantly lower visual analog pain scale scores at 24 hours postoperatively and at discharge (p = 0.001 and p = 0.006, respectively). The oral intake intervals, hospital stays, and perioperative complications were comparable between groups. Conclusions: ICG-guided SPRA could be a safe and effective procedure for patients with adrenal tumors. This technique improves the accuracy and efficacy of adrenal gland localization and has shown benefits in perioperative outcomes. The use of ICG fluorescence guidance represents a promising clinical application.

Bladder neck contracture following transurethral surgery of prostate: a retrospective single-center study.

PURPOSE: Bladder neck contracture (BNC) is a rare but intolerant complication after transurethral surgery of prostate. The present study aims to investigate the incidence and risk factors of BNC in patients diagnosed benign prostate hyperplasia (BPH) and following transurethral resection or enucleation of the prostate (TURP/TUEP). METHODS: This retrospective study included 1008 BPH individuals who underwent transurethral surgery of the prostate between January 2017 and January 2022. Patients' demographics, medical comorbidities, urologic characteristics, perioperative parameters, and the presence of BNC were documented. Univariate and multivariate analyses were conducted to identify the risk factors. RESULTS: A total of 2% (20/1008) BPH patients developed BNC postoperatively and the median occurring time was 5.8 months. Particularly, the incidences of BNC were 4.7% and 1.3% in patients underwent Bipolar-TURP and TUEP respectively. Preoperative urinary tract infection (UTI), elevated PSA, smaller prostate volume (PV), bladder diverticulum (BD), and B-TURP were significantly associated with BNC in the univariate analysis. Further multivariate logistic regression demonstrated preoperative UTI (OR 4.04, 95% CI 2.25 to 17.42, p < 0.001), BD (OR 7.40, 95% CI 1.83 to 31.66, p < 0.001), and B-TURP (OR 3.97, 95% CI 1.55 to 10.18, p = 0.004) as independent risk factors. All BNC patients were treated with transurethral incision of the bladder neck (TUIBN) combined with local multisite injection of betamethasone. During a median follow-up of 35.8 months, 35% (7/20) of BNC patients recurred at a median time of 1.8 months. CONCLUSION: BNC was a low-frequency complication following transurethral surgery of prostate. Preoperative UTI, BD, and B-TURP were likely independent risk factors of BNC. TUIBN combined with local multisite injection of betamethasone may be promising choice for BNC treatment.

Significant Enhancement of Thermoelectric Performance in Bi0.5 Sb1.5 Te3 Thin Film via Ferroelectric Polarization Engineering.

The Bi0.5 Sb1.5 Te3 (BST) thin film shows great promise in harvesting low-grade heat energy due to its excellent thermoelectric performance at room temperature. In order to further enhance its thermoelectric performance, specifically the power factor and output power, new approaches are highly desirable beyond the common "composition-structure-performance" paradigm. This study introduces ferroelectric polarization engineering as a novel strategy to achieve these goals. A Pb(Zr0.52 Ti0.48 )O3 /Bi0.5 Sb1.5 Te3 (PZT/BST) hybrid film is fabricated via magnetron sputtering. Density functional theory calculations demonstrate PZT polarization's influence on charge redistribution and interlayer charge transfer at the PZT/BST interface, facilitating adjustable carrier transport behavior and power factor of the BST film. As a result, a 26.7% enhancement of the power factor, from unpolarized 12.0 to 15.2 µW cm-1 K-2 , is reached by 2 kV out-of-plane downward polarization of PZT. Furthermore, a five-leg generator constructed using this PZT/BST hybrid film exhibits a maximum output power density of 13.06 W m-2 at ΔT = 39 K, which is 20.8% higher than that of the unpolarized one (10.81 W m-2 ). The research presents a new approach to enhance thermoelectric thin films' power factor and output performance by introducing ferroelectric polarization engineering.

Outcomes of retrograde ureteroscopy in Chinese infants and toddlers under 3 years old with ureteric stones from a single center.

INTRODUCTION: Pediatric urolithiasis is a less common disease with a steadily increasing incidence of 10.6 % per year. The comprehensive management of pediatric urolithiasis is more challenging than in adults, and published studies of endourological treatment in children have small sample sizes and older mean ages, which may not be representative of the overall pediatric population, especially in infants and toddlers. This study aimed to report results of retrograde ureteroscopy for treating pediatric ureteral stones in infants and toddlers (<3 years) from a single center in China. METHODS: Demographic and surgical data of infants and toddlers with ureteral stones who underwent retrograde URS were retrospectively analyzed from January 2015 to September 2022. RESULTS: The mean age of 100 infants (73 boys and 27 girls) was 19.6 ± 7.6 months and stone burden was 0.27 (0.11-0.52) cm³. 111 procedures were performed for all children due to 11 patients with bilateral ureteric stones were simultaneously treated. Among them, 70.3 % were semi-rigid URS, 12.6 % were Micro-URS and 17.1 % were flexible URS. SFR was up to 96 %, the median operation time and hospitalization days were 35.0 (25.0-50.0) minutes and 6.0 (5.0-6.0) days, respectively. 15 (15.0 %) infants had postoperative fever (Grade I), and complications above grade I were not observed. DISCUSSIONS: This research reported the largest sample size of infant and toddler ureteric stones (under 3 years old) and shared optimal management strategies for these special populations. Compared to other related studies, we had a higher SFR due to diverse management strategies and reasonable application of pre-operative ureteric stents. The most important potential reason why our complication rate was relatively higher might be the younger population under 3 years old. In additionally, the reason of long hospitalization was maybe some patients underwent staged surgeries during one hospitalization. Those results indicated the robust effectiveness of URS for infants. This study has limitations, including its retrospective single-center design, absence of long-term follow-up data, and potential variability in surgical outcomes due to differences in surgeons' experience. CONCLUSIONS: The experience of endourologic procedures for 100 infant and toddler patients with ureteric stones from a Chinese single center was reported. And URS showed its effectiveness and safety for those special populations based on its high SFR and low complication rate.

Regulation of species metabolism in synthetic community systems by environmental pH oscillations.

Constructing a synthetic community system helps scientist understand the complex interactions among species in a community and its environment. Herein, a two-species community is constructed with species A (artificial cells encapsulating pH-responsive molecules and sucrose) and species B (Saccharomyces cerevisiae), which causes the environment to exhibit pH oscillation behaviour due to the generation and dissipation of CO2. In addition, a three-species community is constructed with species A' (artificial cells containing sucrose and G6P), species B, and species C (artificial cells containing NAD+ and G6PDH). The solution pH oscillation regulates the periodical release of G6P from species A'; G6P then enters species C to promote the metabolic reaction that converts NAD+ to NADH. The location of species A' and B determines the metabolism behaviour in species C in the spatially coded three-species communities with CA'B, CBA', and A'CB patterns. The proposed synthetic community system provides a foundation to construct a more complicated microecosystem.

Lactylation of METTL16 promotes cuproptosis via m6A-modification on FDX1 mRNA in gastric cancer.

Cuproptosis, caused by excessively high copper concentrations, is urgently exploited as a potential cancer therapeutic. However, the mechanisms underlying the initiation, propagation, and ultimate execution of cuproptosis in tumors remain unknown. Here, we show that copper content is significantly elevated in gastric cancer (GC), especially in malignant tumors. Screening reveals that METTL16, an atypical methyltransferase, is a critical mediator of cuproptosis through the m6A modification on FDX1 mRNA. Furthermore, copper stress promotes METTL16 lactylation at site K229 followed by cuproptosis. The process of METTL16 lactylation is inhibited by SIRT2. Elevated METTL16 lactylation significantly improves the therapeutic efficacy of the copper ionophore- elesclomol. Combining elesclomol with AGK2, a SIRT2-specific inhibitor, induce cuproptosis in gastric tumors in vitro and in vivo. These results reveal the significance of non-histone protein METTL16 lactylation on cuproptosis in tumors. Given the high copper and lactate concentrations in GC, cuproptosis induction becomes a promising therapeutic strategy for GC.

Alteration of Meibum Lipidomics Profiling in Patients With Chronic Ocular Graft-Versus-Host Disease.

Purpose: To investigate the characteristics of the lipid profiling in meibum of patients with chronic ocular graft-versus-host disease (coGVHD) and to detect the potential influence of anti-inflammatory therapy on these differential lipids. Methods: This cross-sectional study included 25 coGVHD patients and 13 non-coGVHD after allogeneic hematopoietic stem cell transplantation. Among those with coGVHD, 14 had prior topical treatment (coGVHD(T)), and 11 did not (coGVHD(WT)). All participants completed ocular surface disease index questionnaire and received slit lamp examination, Schirmer's test without anesthesia, ocular surface interferometer, and meibography. Binocular meibum was collected and pooled for lipidomic analysis by liquid chromatography-mass spectrometry. Results: One hundred and twenty differential lipid species were found among the three groups (96 of coGVHD(WT) vs. non-coGVHD, 78 of coGVHD(WT) vs. coGVHD(T), and three of non-coGVHD vs. coGVHD(T)). Compared with non-coGVHD group, coGVHD(WT) group had a significant abnormality of meibum composition, showing a significant decrease in glycerolipids, and an increase in glycerophospholipids and sphingolipids. Similar changes were also observed when coGVHD(WT) versus coGVHD(T). CoGVHD severity was negatively associated with mono-unsaturated triglycerides (TG), (ß = -214.7; 95% CI, -363.9 to -65.5; P = 0.006) and poly-unsaturated TG (ß = -4019.9; 95% CI, -7758.1 to -281.6; P = 0.036). Intensity of immunosuppression was negatively associated with mono-unsaturated TG (ß = -162.4; 95% CI, -268.6 to -56.2; P = 0.004) and positively associated with phosphatidylcholine (ß = 332.0; 95% CI, 19.2-644.8; P = 0.038). Conclusions: Altered meibum in coGVHD is characterized by a decrease of glycerolipids and an increase of glycerophospholipids and may be significantly reversed by topical anti-inflammatory therapy.

Effect of Anti-Allergic Therapy on Sleep Quality of Children with Allergic Conjunctivitis and Their Parents.

PURPOSE: To assess the effect of anti-allergic therapy on sleep quality of children with allergic conjunctivitis (AC) and their parents. METHODS: This prospective single-arm intervention study included 54 AC child-parent dyads. Chinese versions of the Children's Sleep Habits Questionnaire (CSHQ) and Pittsburgh Sleep Quality Index (PSQI) were used to assess the sleep quality of children and their parents, respectively. RESULTS: CSHQ and PSQI total scores were significantly decreased after treatment, with fewer children and parents reporting poor sleep quality. Part impaired sleep behaviors of children and parents can recover to the normal levels. Sleep quality improved greater in children with a severe type of AC, those with worse baseline signs, and without other allergic diseases. For both children and parents, greater improvements in sleep quality were associated with longer treatment duration and with worse baseline sleep quality. CONCLUSION: Successful management of AC improves sleep quality for both children and their parents.

Inhibiting HIF-1 signaling alleviates HTRA1-induced RPE senescence in retinal degeneration.

BACKGROUND: Age-related macular degeneration (AMD), characterized by the degeneration of retinal pigment epithelium (RPE) and photoreceptors, is the leading cause of irreversible vision impairment among the elderly. RPE senescence is an important contributor to AMD and has become a potential target for AMD therapy. HTRA1 is one of the most significant susceptibility genes in AMD, however, the correlation between HTRA1 and RPE senescence hasn't been investigated in the pathogenesis of AMD. METHODS: Western blotting and immunohistochemistry were used to detect HTRA1 expression in WT and transgenic mice overexpressing human HTRA1 (hHTRA1-Tg mice). RT-qPCR was used to detect the SASP in hHTRA1-Tg mice and ARPE-19 cells infected with HTRA1. TEM, SA-ß-gal was used to detect the mitochondria and senescence in RPE. Retinal degeneration of mice was investigated by fundus photography, FFA, SD-OCT and ERG. The RNA-Seq dataset of ARPE-19 cells treated with adv-HTRA1 versus adv-NC were analyzed. Mitochondrial respiration and glycolytic capacity in ARPE-19 cells were measured using OCR and ECAR. Hypoxia of ARPE-19 cells was detected using EF5 Hypoxia Detection Kit. KC7F2 was used to reduce the HIF1α expression both in vitro and in vivo. RESULTS: In our study, we found that RPE senescence was facilitated in hHTRA1-Tg mice. And hHTRA1-Tg mice became more susceptible to NaIO3 in the development of oxidative stress-induced retinal degeneration. Similarly, overexpression of HTRA1 in ARPE-19 cells accelerated cellular senescence. Our RNA-seq revealed an overlap between HTRA1-induced differentially expressed genes associated with aging and those involved in mitochondrial function and hypoxia response in ARPE-19 cells. HTRA1 overexpression in ARPE-19 cells impaired mitochondrial function and augmented glycolytic capacity. Importantly, upregulation of HTRA1 remarkably activated HIF-1 signaling, shown as promoting HIF1α expression which mainly located in the nucleus. HIF1α translation inhibitor KC7F2 significantly prevented HTRA1-induced cellular senescence in ARPE-19 cells, as well as improved the visual function in hHTRA1-Tg mice treated with NaIO3. CONCLUSIONS: Our study showed elevated HTRA1 contributes to the pathogenesis of AMD by promoting cellular senescence in RPE through damaging mitochondrial function and activating HIF-1 signaling. It also pointed out that inhibition of HIF-1 signaling might serve as a potential therapeutic strategy for AMD. Video Abstract.

Detachment of Dodecane from Silica Surfaces with Variable Surface Chemistry Studied Using Molecular Dynamics Simulation.

The adsorption and detachment processes of n-dodecane (C12H26) molecules were studied on silica surfaces with variable surface chemistry (Q2, Q3, Q4 environments), using molecular dynamics simulations. The area density of the silanol groups varied from 9.4 to 0 per nm2. The shrinking of the oil-water-solid contact line was a key step for the oil detachment, due to water diffusion on the three-phase contact line. The simulation results showed that oil detachment was easier and faster on a perfect Q3 silica surface which had (≡Si(OH))-type silanol groups, due to the H-bond formation between the water and silanol groups. When the surfaces contained more Q2 crystalline type which had (≡Si(OH)2)-type silanol groups, less oil detached, due to the formations of H-bonds among the silanol groups. There were no silanol groups on the Si-OH 0 surface. Water cannot diffuse on the water-oil-silica contact line, and oil cannot detach from the Q4 surface. The detachment efficiency of oil from the silica surface not only depended on the area density, but also on the types of silanol groups. The density and type of silanol groups depend on the crystal cleavage plane, particle size, roughness, and humidity.

Combine EfficientNet and CNN for 3D model classification.

With the development of multimedia technology, the number of 3D models on the web or in databases is becoming increasingly larger and larger. It becomes more and more important to classify and retrieve 3D models. 3D model classification plays important roles in the mechanical design field, education field, medicine field and so on. Due to the 3D model's complexity and irregularity, it is difficult to classify 3D model correctly. Many methods of 3D model classification pay attention to local features from 2D views and neglect the 3D model's contour information, which cannot express it better. So, accuracy the of 3D model classification is poor. In order to improve the accuracy of 3D model classification, this paper proposes a method based on EfficientNet and Convolutional Neural Network (CNN) to classify 3D models, in which view feature and shape feature are used. The 3D model is projected into 2D views from different angles. EfficientNet is used to extract view feature from 2D views. Shape descriptors D1, D2, D3, Zernike moment and Fourier descriptors of 2D views are adopted to describe the 3D model and CNN is applied to extract shape feature. The view feature and shape feature are combined as discriminative features. Then, the softmax function is used to determine the 3D model's category. Experiments are conducted on ModelNet 10 dataset. Experimental results show that the proposed method achieves better than other methods.

Learnable Distribution Calibration for Few-Shot Class-Incremental Learning.

Few-shot class-incremental learning (FSCIL) faces the challenges of memorizing old class distributions and estimating new class distributions given few training samples. In this study, we propose a learnable distribution calibration (LDC) approach, to systematically solve these two challenges using a unified framework. LDC is built upon a parameterized calibration unit (PCU), which initializes biased distributions for all classes based on classifier vectors (memory-free) and a single covariance matrix. The covariance matrix is shared by all classes, so that the memory costs are fixed. During base training, PCU is endowed with the ability to calibrate biased distributions by recurrently updating sampled features under supervision of real distributions. During incremental learning, PCU recovers distributions for old classes to avoid 'forgetting', as well as estimating distributions and augmenting samples for new classes to alleviate 'over-fitting' caused by the biased distributions of few-shot samples. LDC is theoretically plausible by formatting a variational inference procedure. It improves FSCIL's flexibility as the training procedure requires no class similarity priori. Experiments on CUB200, CIFAR100, and mini-ImageNet datasets show that LDC respectively outperforms the state-of-the-arts by 4.64%, 1.98%, and 3.97%. LDC's effectiveness is also validated on few-shot learning scenarios.

Transcriptomics and Phenotypic Analysis of gpr56 Knockout in Zebrafish.

The adhesion G-protein-coupled receptor is a seven-transmembrane receptor protein with a complex structure. Impaired GPR56 has been found to cause developmental damage to the human brain, resulting in intellectual disability and motor dysfunction. To date, studies on gpr56 deficiency in zebrafish have been limited to the nervous system, and there have been no reports of its systemic effects on juvenile fish at developmental stages. In order to explore the function of gpr56 in zebrafish, the CRISPR/Cas9 gene-editing system was used to construct a gpr56-knockout zebrafish. Subsequently, the differentially expressed genes (DEGs) at the transcriptional level between the 3 days post fertilization (dpf) homozygotes of the gpr56 mutation and the wildtype zebrafish were analyzed via RNA-seq. The results of the clustering analysis, quantitative PCR (qPCR), and in situ hybridization demonstrated that the expression of innate immunity-related genes in the mutant was disordered, and multiple genes encoding digestive enzymes of the pancreatic exocrine glands were significantly downregulated in the mutant. Motor ability tests demonstrated that the gpr56-/- zebrafish were more active, and this change was more pronounced in the presence of cold and additional stimuli. In conclusion, our results revealed the effect of gpr56 deletion on the gene expression of juvenile zebrafish and found that the gpr56 mutant was extremely active, providing an important clue for studying the mechanism of gpr56 in the development of juvenile zebrafish.

Alteration of pro-carcinogenic gut microbiota is associated with clear cell renal cell carcinoma tumorigenesis.

Objective: Increasing evidence suggests that gut microbiota is involved in the occurrence and progression of urinary system diseases such as clear cell renal cell carcinoma (ccRCC). However, the mechanism of how alteration of gut metagenome promotes ccRCC remains unclear. Here we aim to elucidate the association of specific gut bacteria and their metabolites with ccRCC. Methods: In a pilot case-control study among 30 ccRCC patients (RCC group) and 30 healthy controls (Control group), 16S ribosomal RNA (rRNA) gene sequencing were analyzed from fecal samples collected prior to surgery or hospitalization. Alpha diversity and beta diversity analysis of the gut microbiota were performed, and differential taxa were identified by multivariate statistics. Meanwhile, serum metabolism was measured by UHPLC-MS, and differential genes were identified based on the TCGA database. Results: Alpha diversity found there were no significant microbial diversity differences of gut microbiota between the RCC group and the Control group. However, beta diversity analysis showed that the overall structures of the two groups were significantly separated (p = 0.008). Random Forests revealed the relative abundances of 20 species differed significantly between the RCC group and the Control group, among which nine species were enriched in the RCC group such as Desulfovibrionaceae, and 11 species were less abundant such as four kinds of Lactobacillus. Concomitantly, serum level of taurine, which was considered to be consumed by Desulfovibrionaceae and released by Lactobacillus, has decreased in the RCC group. In addition, macrophage-related genes such as Gabbr1 was upregulated in ccRCC patients. Conclusion: Reduction of protective bacteria, proliferation of sulfide-degrading bacteria Desulfovibrionaceae, reduction of taurine, and enrichment of macrophage related genes might be the risk predictors of ccRCC.

Epitranscriptomic profiling of m6A RNA methylation in renal epithelial tubular cells stimulated with calcium oxalate crystals through microarray analysis.

The aim of this study was to investigate the relationship of m6A RNA methylation to CaOX-induced renal tubular injury. Microarray analysis was performed to detect the difference in mRNA expression and m6A methylation between the injurious groups and controls. We established injurious renal tubular epithelial cell model induced by calcium oxalate crystals (CaOX), and we validated that CaOX could increase the overall m6A methylation levels. By microarray analysis, we identified 5967 differentially expressed mRNAs (2444 were up-regulated and 3523 were down-regulated in the injurious groups) and 6853 differentially methylated mRNAs (4055 were in hypermethylation and 3688 were in hypomethylation in the injurious groups). Four clusters (hyper-up, hyper-down, hypo-up and hypo-down) were further identified via conjoint analysis. Functional analysis revealed that m6A methylation played a crucial role in the development of CaOX through participating multiple processes covering inflammation, oxidative stress, apoptosis, crystal-cell adhesion. We delineated the first transcriptome-wide m6A landscape of injurious renal tubular cells in high-CaOX environment. We identified a series of mRNAs of renal tubular epithelial cells with differential expression and m6A methylation between the CaOX-treated groups and controls.

Application and improvement methods of sludge alkaline fermentation liquid as a carbon source for biological nutrient removal: A review.

Alkaline fermentation can reduce the amount of waste activated sludge and prepare sludge alkaline fermentation liquid (SAFL) rich in short-chain fatty acids (SCFAs), which can be used as a high-quality carbon source for the biological nutrient removal (BNR) process. This review compiles the production method of SAFL and the progress of its application as a BNR carbon source. Compared with traditional carbon sources, SAFL has the advantages of higher efficiency and economy, and different operating conditions can influence the yield and structure of SCFAs in SAFL. SAFL can significantly improve the nutrient removal efficiency of the BNR process. Taking SAFL as the internal carbon source of BNR can simultaneously solve the problem of carbon source shortage and sludge treatment difficulties in wastewater treatment plants, and further reduce the operating cost. However, the alkaline fermentation process results in many refractory organics, ammonia and phosphate in SAFL, which reduces the availability of SAFL as a carbon source. Purifying SCFAs by removing nitrogen and phosphorus, directly extracting SCFAs, or increasing the amount of SCFAs in SAFL by co-fermentation or combining with other pretreatment methods, etc., are effective measures to improve the availability of SAFL.

Light-Harvesting Artificial Cells Containing Cyanobacteria for CO2 Fixation and Further Metabolism Mimicking.

The bottom-up constructed artificial cells help to understand the cell working mechanism and provide the evolution clues for organisms. The energy supply and metabolism mimicry are the key issues in the field of artificial cells. Herein, an artificial cell containing cyanobacteria capable of light harvesting and carbon dioxide fixation is demonstrated to produce glucose molecules by converting light energy into chemical energy. Two downstream "metabolic" pathways starting from glucose molecules are investigated. One involves enzyme cascade reaction to produce H2 O2 (assisted by glucose oxidase) first, followed by converting Amplex red to resorufin (assisted by horseradish peroxidase). The other pathway is more biologically relevant. Glucose molecules are dehydrogenated to transfer hydrogens to nicotinamide adenine dinucleotide (NAD+ ) for the production of nicotinamide adenine dinucleotide hydride (NADH) molecules in the presence of glucose dehydrogenase. Further, NADH molecules are oxidized into NAD+ by pyruvate catalyzed by lactate dehydrogenase, meanwhile, lactate is obtained. Therefore, the cascade cycling of NADH/NAD+ is built. The artificial cells built here pave the way for investigating more complicated energy-supplied metabolism inside artificial cells.

Effect of Anti-allergic Therapy on Quality of Life in Children with Allergic Conjunctivitis and Their Parents.

PURPOSE: To evaluate the effect of anti-allergic therapy on quality of life (QoL) in children with allergic conjunctivitis (AC) and their parents. METHODS: Prospective single-arm intervention study including 55 AC child-parent pairs. The endpoint was that AC was successfully controlled after anti-allergic therapies. The primary outcome was the change in QoL of children from baseline to endpoint as measured by the total Pediatric Quality of Life Inventory (PesdQL) score. RESULTS: The total PedsQL scores of children and parents were improved after treatment (P < .001). QoL improved greater in children with vernal keratoconjunctivitis/atopic keratoconjunctivitis, those without other allergy outside the eye, and those with lower baseline total PedsQL score. Greater improvement of parents' QoL was associated with longer treating duration, greater improvement of children's QoL, lower baseline parents' total PedsQL score, and more severe baseline children's signs. CONCLUSION: Both pediatric AC patients' and their parents 'reduced QoL were improved after anti-allergic therapy. CLINICAL TRIAL REGISTRATION: Chinese Clinical Trial Registry Identifier: ChiCTR2000037866.

Short-term effects of levosimendan use for venoarterial extracorporeal membrane oxygenation: A systematic review and meta-analysis.

OBJECTIVE: Levosimendan has been demonstrated to reduce the incidence of cardiogenic shock and facilitate weaning from cardiopulmonary bypass. However, the beneficial effects of levosimendan treatment on hospital outcomes in patients receiving venoarterial extracorporeal membrane oxygenation (VA-ECMO) are uncertain. We performed a systematic review and meta-analysis to evaluate the short-term effects of levosimendan use for patients undergoing VA-ECMO. METHODS: We searched PubMed, Embase, and the Cochrane Library for English articles published from inception to July 15, 2021. Observational studies comparing levosimendan versus non- levosimendan for VA-ECMO were considered eligible for the current study. RESULTS: Nine observational studies with 1058 patients were included. In-hospital mortality was 46.3% in the levosimendan group as compared with 50.7% in the control group. Levosimendan significantly reduced in-hospital mortality in patients undergoing VA-ECMO compared with the control group (RR, 0.80; 95% CI, 0.67-0.95; p = 0.013). The incidence of weaning from VA-ECMO was 79.3% in the levosimendan group as compared with 63.4% in the control group. Levosimendan significantly increase the incidence of weaning from VA-ECMO in patients as compared with the control group (RR, 1.20; 95% CI, 1.07-1.34; p = 0.002). In the one-way sensitivity analysis for estimating the effect of each study on mortality or weaning from VA-ECMO, omission of each study did not make a significant difference. CONCLUSIONS: Our study indicates that levosimendan use significantly reduced in-hospital mortality and increase the incidence of weaning in patients undergoing VA-ECMO.

Dynamic Support Network for Few-Shot Class Incremental Learning.

Few-shot class-incremental learning (FSCIL) is challenged by catastrophically forgetting old classes and over-fitting new classes. Revealed by our analyses, the problems are caused by feature distribution crumbling, which leads to class confusion when continuously embedding few samples to a fixed feature space. In this study, we propose a Dynamic Support Network (DSN), which refers to an adaptively updating network with compressive node expansion to "support" the feature space. In each training session, DSN tentatively expands network nodes to enlarge feature representation capacity for incremental classes. It then dynamically compresses the expanded network by node self-activation to pursue compact feature representation, which alleviates over-fitting. Simultaneously, DSN selectively recalls old class distributions during incremental learning to support feature distributions and avoid confusion between classes. DSN with compressive node expansion and class distribution recalling provides a systematic solution for the problems of catastrophic forgetting and overfitting. Experiments on CUB, CIFAR-100, and miniImage datasets show that DSN significantly improves upon the baseline approach, achieving new state-of-the-arts.