Sprayed PAA-CaO2 nanoparticles combined with calcium ions and reactive oxygen species for antibacterial and wound healing.

The most common socioeconomic healthcare issues in clinical are burns, surgical incisions and other skin injuries. Skin lesion healing can be achieved with nanomedicines and other drug application techniques. This study developed a nano-spray based on cross-linked amorphous calcium peroxide (CaO2) nanoparticles of polyacrylic acid (PAA) for treating skin wounds (PAA-CaO2 nanoparticles). CaO2 serves as a 'drug' precursor, steadily and continuously releasing calcium ions (Ca2+) and hydrogen peroxide (H2O2) under mildly acidic conditions, while PAA-CaO2 nanoparticles exhibited good spray behavior in aqueous form. Tests demonstrated that PAA-CaO2 nanoparticles exhibited low cytotoxicity and allowed L929 cells proliferation and migration in vitro. The effectiveness of PAA-CaO2 nanoparticles in promoting wound healing and inhibiting bacterial growth in vivo was assessed in SD rats using full-thickness skin defect and Staphylococcus aureus (S.aureus)-infected wound models based thereon. The results revealed that PAA-CaO2 nanoparticles demonstrated significant advantages in both aspects. Notably, the infected rats' skin defects healed in 12 days. The benefits are linked to the functional role of Ca2+ coalesces with H2O2 as known antibacterial and healing-promoted agents. Therefore, we developed nanoscale PAA-CaO2 sprays to prevent bacterial development and heal skin lesions.

Overcoming defensive responding in the estimation of prevalence of non-medical use of prescription stimulants.

BACKGROUND: Prevalence of Non-Medical Use of Prescription Stimulants (NMUPS) is estimated to be high among young adults enrolled in college. However, precise estimation of the prevalence of NMUPS is challenging owing to biases affecting self-report of sensitive and potentially illegal behaviors. OBJECTIVE: This study aimed to estimate the prevalence and risk factors of NMUPS using the crosswise randomized response technique (CRRT) and compare findings to the traditionally-used direct self-report (DSR) method. METHODS: This study utilized a cross-sectional, randomized experimental design to survey adult undergraduate students at a major southeastern university in the United States. Eligible respondents were randomly assigned to a DSR group or a CRRT group. Those in the DSR group were presented a direct question about NMUPS, but those in the CRRT group were asked to indicate whether their response to the NMUPS question was the 'same' or 'different' compared to a random non-sensitive question. RESULTS: Prevalence of NMUPS was found to be 18.6% (95% CI:18.5%-18.7%) in the DSR group and 32.5% (95% CI:32.1%-32.9%; p = 0.003) in the CRRT group. Logistic regression analysis predicting NMUPS in the DSR group showed that it was significantly associated with positive expectancies (OR:3.50; 95% CI:2.44-5.02), negative expectancies (OR:0.49; 95% CI:0.35-0.68), perceived norms (OR:1.71; 95% CI:1.27-2.29), and religious beliefs (OR:0.69; 95% CI:0.52-0.92). CONCLUSIONS: The setting and mechanism of the survey is likely closely related to the validity of prevalence estimation of sensitive behaviors. This study found that prevalence of sensitive behaviors such as NMUPS is significantly higher when respondents are provided increased anonymity.

Optimum Reaction Conditions for the Synthesis of Selenized Ornithogalum caudatum Ait. (Liliaceae) Polysaccharides and Measurement of Their Antioxidant Activity In Vivo.

This study determined the optimum reaction conditions for synthesizing selenium-containing polysaccharides. Polysaccharide IIA (with the highest yield) from Ornithogalum caudatum Ait. (Liliaceae) (OCAPIIA) was extracted and purified. Then, three parameters were selected to optimize the synthesis of selenized OCAPIIA (Se-OCAPIIA) using the Box-Behnken design (BBD) and response surface methodology (RSM). The morphology of Se-OCAPIIA was analyzed by scanning electron microscopy (SEM). The characteristic peaks and the monosaccharide composition of Se-OCAPIIA were evaluated by Fourier-transform infrared spectroscopy and gas chromatography. A D-galactose-induced aging mouse model was established, and the in vivo antioxidant activity of Se-OCAPIIA was measured. The optimal conditions for the synthesis of Se-OCAPIIA were as follows: reaction temperature, 72.38 °C; Na2SeO3 to OCAPIIA mass ratio, 0.93 g/g; and reaction time, 8.05 h. The selenium content of Se-OCAPIIA obtained using the optimized process was 3.131 ± 0.090 mg/g, close to the maximum predicted value (3.152 mg/g). Se-OCAPIIA contained D-mannose, D-glucose, and D-galactose at a molar ratio of 1.00:0.34:0.88. SEM showed that Se-OCAPIIA was spherical and flocculated. Compared with OCAPIIA, Se-OCAPIIA exhibited two characteristic peaks at 833 and 610 cm-1 in the infrared spectrum. Se-OCAPIIA increased catalase, glutathione peroxidase, and superoxide dismutase activities and decreased MDA concentrations in the mouse liver. Moreover, Se-OCAPIIA treatment improved liver morphology, decreased the levels of IL-1ß and IL-6, and increased IL-10 concentration. In conclusion, the synthesis of Se-OCAPIIA is effective, simple, and feasible. Se-OCAPIIA demonstrated high antioxidant activity in vivo and is a promising antioxidant and therapeutic agent.

Enhanced Ca2+-Dependent SK-Channel Gating and Membrane Trafficking in Human Atrial Fibrillation.

BACKGROUND: Small-conductance Ca2+-activated K+ (SK)-channel inhibitors have antiarrhythmic effects in animal models of atrial fibrillation (AF), presenting a potential novel antiarrhythmic option. However, the regulation of SK-channels in human atrial cardiomyocytes and its modification in patients with AF are poorly understood and were the object of this study. METHODS: Apamin-sensitive SK-channel current (ISK) and action potentials were recorded in human right-atrial cardiomyocytes from sinus rhythm control (Ctl) patients or patients with (long-standing persistent) chronic AF (cAF). RESULTS: ISK was significantly higher, and apamin caused larger action potential prolongation in cAF- versus Ctl-cardiomyocytes. Sensitivity analyses in an in silico human atrial cardiomyocyte model identified IK1 and ISK as major regulators of repolarization. Increased ISK in cAF was not associated with increases in mRNA/protein levels of SK-channel subunits in either right- or left-atrial tissue homogenates or right-atrial cardiomyocytes, but the abundance of SK2 at the sarcolemma was larger in cAF versus Ctl in both tissue-slices and cardiomyocytes. Latrunculin-A and primaquine (anterograde and retrograde protein-trafficking inhibitors) eliminated the differences in SK2 membrane levels and ISK between Ctl- and cAF-cardiomyocytes. In addition, the phosphatase-inhibitor okadaic acid reduced ISK amplitude and abolished the difference between Ctl- and cAF-cardiomyocytes, indicating that reduced calmodulin-Thr80 phosphorylation due to increased protein phosphatase-2A levels in the SK-channel complex likely contribute to the greater ISK in cAF-cardiomyocytes. Finally, rapid electrical activation (5 Hz, 10 minutes) of Ctl-cardiomyocytes promoted SK2 membrane-localization, increased ISK and reduced action potential duration, effects greatly attenuated by apamin. Latrunculin-A or primaquine prevented the 5-Hz-induced ISK-upregulation. CONCLUSIONS: ISK is upregulated in patients with cAF due to enhanced channel function, mediated by phosphatase-2A-dependent calmodulin-Thr80 dephosphorylation and tachycardia-dependent enhanced trafficking and targeting of SK-channel subunits to the sarcolemma. The observed AF-associated increases in ISK, which promote reentry-stabilizing action potential duration shortening, suggest an important role for SK-channels in AF auto-promotion and provide a rationale for pursuing the antiarrhythmic effects of SK-channel inhibition in humans.

Hand-Sewn Gastrojejunostomy In Situ to Solve Acute Anastomotic Stricture Due to Submucosal Tunneling in Gastric Bypass.

Roux-en-Y gastric bypass (RYGB) is the second most widely used bariatric surgical procedure for morbid obesity and its related comorbidities. Anastomotic stricture is one of the major complications after RYGB. Submucosal tunneling is a rare cause of anastomotic stricture or occlusion, and clinical symptoms will appear soon after surgery. We present our technical suggestions to perform a hand-sewn gastrojejunostomy in situ when the gastric pouch is too small and the tissue is not enough to be resected to solve acute anastomotic stricture due to submucosal tunneling in gastric bypass.

Could manganate be an alternative of permanganate for micropollutant abatement?

Permanganate (MnO4-), an oxidant that has been applied in water treatment, has highly varied reactivity toward pollutants. In this study, we found manganate (MnO42-) could destruct diverse functional groups, with oxidation rates being higher than that of permanganate under acidic and neutral conditions. Mechanistic study revealed manganate rapidly disproportionated to permanganate and colloidal MnO2 in solution. Under acidic conditions, the in-situ formed colloidal MnO2 possess higher reactivity than permanganate and primarily contributed to the degradation of pollutants. The reactivity of in-situ formed colloidal MnO2 is highly sensitive to pH and decreased dramatically with increasing pH. Consequently, the contribution of MnO2 to pollutant removal decreased with elevating pH, which also leads to the decreased degradation efficiency of micropollutants at high pH. Manganate is an intermediate produced during the manufacturing process of permanganate. This study indicates that manganate might be an alternative of permanganate for water purification under acidic and neutral conditions.

Clinical Application of the Roussouly Classification in the Sagittal Balance Reconstruction of 101 Adolescent Idiopathic Scoliosis Patients.

PURPOSE: Although Roussouly classification has been widely used in spinal surgery, it was mainly applied to degenerative scoliosis patients and correlational studies concerning adolescent idiopathic scoliosis (AIS) are still insufficient. This retrospective study explored the clinical application of Roussouly classification in surgeries and prognosis prediction for AIS. METHODS: This clinical research selected 101 AIS patients who received surgeries between August 2005 and November 2019. Whole spine standing radiographs were obtained for each patient preoperatively, postoperatively, and at the last follow-up (>24 months). All patients were classified into "theoretical types" and "current types." Patients were further divided into mismatch or match groups based on the consistency of their current type and theoretical type. The main parameters include: proximal junctional angle (PJA), pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), fixed thoracic kyphosis (TK), global TK, fixed lumbar lordosis (LL), global LL, thoracic tilt, proximal thoracic alignment (PTA), lumbar tilt, spino-sacral angle (SSA), and spinal tilt (ST). RESULTS: A total of 47.5% of AIS patients were subject to a preoperative mismatch of Roussouly classification. There was a significant difference in PI-LL between the preoperative mismatch and match groups (p = 0.008). There was a significant difference in the rate of PI-LL deformity between the match and mismatch groups with a preoperative mismatch (p = 0.037). A significant difference in thoracic tilt was observed between the postoperative mismatch and match groups (p = 0.019). The preoperative mismatch group has a higher risk of postoperative PI-LL malformation than match group (OR = 2.303, 95% CI: 1.026, 5.165). When mismatch occurred postoperatively, there were significant differences between groups in the rate of pelvic deformity (p = 0.002) and PI-LL deformity (p = 0.025) at the last follow-up. Compared with the postoperative match group, mismatch group had an increased risk of pelvic deformity (OR = 5.029, 95% CI: 1.618, 15.629) and PJK deformity (OR = 3.017, 95% CI: 1.709, 11.375) at the last follow-up. Short Form-36 and Scoliosis Research Society 22 score of the match group was significantly higher than that of the mismatch group at the last follow-up. CONCLUSION: The Roussouly classification mismatch before or after operation leads to increased risks of PI-LL deformity and pelvis deformity postoperatively or at the follow-up, which seriously worsens the clinical symptoms and prognosis of patients. Therefore, recovering to the theoretical type in Roussouly classification may effectively improve patients' prognosis.

The alterations of circulating mucosal-associated invariant T cells in polycystic ovary syndrome.

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting reproductive age females and an important cause of infertility. Although the etiology is complex and its pathogenesis remains unclear, the pathological process of PCOS is tightly related with the immune dysfunction and gut microbial dysbiosis. Mucosal-associated invariant T (MAIT) cells are a subset of innate-like T cells which can regulate inflammation through the production of cytokines and play a role in regulating the gut microbiota. We aim to evaluate the correlation between characteristics of PCOS and MAIT cells as well as their impact on cytokine secretion. Methods: Peripheral blood samples were taken from PCOS patients (n=33) and healthy controls (n=30) during 2-5 days of the menstrual period. The frequencies of MAIT cells and T cells were measured by flow cytometry. Cytokines interleukin 17 (IL-17), interleukin 22(IL-22), interferon γ (IFN-γ) and granzyme B were determined by Enzyme-linked immunosorbent assay (ELISA). Results: The frequency of MAIT cells was significantly reduced in the blood of PCOS patients compared with the controls, and negatively correlated with Body Mass Index (BMI), Homeostatic model assessment- insulin resistance (HOMA-IR) index, and Anti Miillerian Hormone (AMH). Thus, the frequencies of MAIT cells decreased in PCOS patients with abnormal weight (BMI≥24kg/m2), higher HOMA-IR (≥1.5), and excessive AMH (≥8ng/ml). The Cytokine IL-17 was significantly higher in PCOS patients and negatively correlated with the frequency of MAIT cells. Even though the IL-22 was lower in PCOS Patients, no correlation with MAIT cells was detected. In subgroup, CD4+MAIT cells correlated with BMI, AMH, and testosterone (T) levels. Conclusion: The frequency change of MAIT cells may play a significant role in the pathogenesis of PCOS. Exploring these interactions with MAIT cells may provide a new target for PCOS treatment and prevention.

Impact of food affordability on diabetes-related preventable hospitalization.

OBJECTIVES: This study aims to estimate the burden of food affordability on diabetes-related preventable hospitalizations among Medicaid enrollees in the United States. STUDY DESIGN: This study used a retrospective observational design with Medicaid administrative claims data from 17 states from 2014. METHODS: Data were linked with county-level social determinants of health (SDOH) from the American Community Survey. The rate of diabetes-related preventable hospitalizations was measured using the Agency for Healthcare Research and Quality's Prevention Quality Diabetes Composite, which includes hospitalization for short-term complications, long-term complications, lower extremity amputations, and uncontrolled diabetes. Multivariable logistic regression was used to predict the occurrence of diabetes-related preventable hospitalization. RESULTS: Among the 16 million eligible individuals, diabetes-related preventable hospitalizations were identified at the rate of 1.91 per 1000 individuals and contributed to more than $160 million in charges. Rates were higher among men compared with women (0.25% vs 0.15%; P < .001) and among Black adults compared with White adults (0.29% vs 0.18%; P < .001). Compared with individuals residing in counties with low food affordability, those residing in counties with high (odds ratio [OR], 0.84; 95% CI, 0.78-0.91; P < .001) or medium (OR, 0.85; 95% CI, 0.81-0.90; P < .001) food affordability had lower odds of hospitalization. CONCLUSIONS: This study provides real-world evidence about the impact of SDOH on diabetes-related preventable hospitalizations. Federal and state policies that can help improve accessibility of healthy foods are needed to ameliorate the burden of diabetes on society.

The taTME learning curve for mid-low rectal cancer: a single-center experience in China.

PURPOSE: As transanal total mesorectal excision (taTME) is performed worldwide, the optimization of existing training and guidance programs to enhance new taTME learners' competence in performing this procedure is warranted. This study aimed to evaluate the taTME learning curve in patients with mid-low rectal cancer. METHODS: Patients who underwent taTME for mid-low rectal cancer between October 2015 and August 2021 at a single center were included. A cumulative sum (CUSUM) learning curve analysis was performed with the total operation time as the study outcome. The learning curve was analyzed using risk-adjusted CUSUM analysis, with postoperative complications and anastomotic leakage (AL) as outcomes. RESULTS: In total, 104 consecutive patients were included in this study. The CUSUM learning curve for total operative time started declining after 42 cases (309.1 ± 84.4 vs. 220.2 ± 46.4, P < 0.001). The risk-adjusted CUSUM (RA-CUSUM) learning curve for postoperative complications fluctuated in cases 44-75 and declined significantly after case 75. The RA-CUSUM learning curve for AL declined after 68 cases. CONCLUSIONS: taTME had learning curves of 42, 75, and 68 cases for total operative time, postoperative complications, and AL, respectively. A surgeon may require 42 and 75 cases to achieve "proficiency" and "mastery" in taTME procedures, respectively.

Gender Disparities in Osteoporosis Screening and Management Among Older Adults.

INTRODUCTION: One in two women and one in four men experience an osteoporosis-related fracture in their lifetime. Related morbidity and mortality rates are higher in men versus women. Current guidelines are inconsistent in the screening recommendations for osteoporosis in men. Examination of gender disparities in the management of osteoporosis-related fractures among Medicare enrollees is currently lacking. METHODS: In this retrospective cohort study using 5% National Medicare claims data from January 1, 2012 through December 31, 2016, eligible patients who were at least 65 years of age on the date of a new fracture episode were classified into two mutually exclusive cohorts on the basis of whether they received testing and/or treatment for osteoporosis in the 6-month period after the new fracture episode. The cohorts were defined on the basis of the National Committee for Quality Assurance (NCQA) quality measure "osteoporosis management in women who had a fracture." Patients were followed to identify the occurrence of subsequent fracture, all-cause mortality, and a composite outcome-defined as the first occurrence of either subsequent fracture or mortality. Logistic regression models were carried out to identify predictors of testing and/or treatment and time-varying survival analysis to identify the relationship between the presence of testing and/or treatment and patient outcomes. RESULTS: Of the 35,774 eligible patients, only 10.2% (12.1% women and 5.7% men) received osteoporosis testing and/or treatment within 6 months after a fracture. The interaction between gender and fragility fracture was significant (P < 0.0001). Fragility fracture had greater adjusted odds of testing and/or treatment among men (adjusted odds ratio [AOR] 3.47; 95% CI 2.94-4.10) than women (AOR 1.65; 95% CI 1.53-1.79). Of patients who were eligible for the outcome assessment, 27.5% experienced a subsequent fracture, 23.2% died, and 44.3% experienced a composite outcome during follow-up. Patients who received testing and/or treatment had a significantly lower hazard of all-cause mortality (hazard ratio [HR] 0.57; 95% CI 0.50-0.65; P < 0.0001) and the composite outcome (HR 0.42; 95% CI 0.39-0.45; P < 0.0001), but no difference in the risk of subsequent fracture (HR 1.02; 95% CI 0.94-1.11; P = 0.6083). Men were found to have a significantly lower hazard of subsequent fracture (HR 0.69; 95% CI 0.64-0.73; P < 0.0001), all-cause mortality (HR 0.67; 95% CI 0.61-0.72; P < 0.0001), and the composite outcome (HR 0.69; 95% CI 0.65-0.73; P < 0.0001). CONCLUSION: Testing and/or treatment for osteoporosis among older adults with a fracture is poor in the Medicare fee-for-service population overall and worse for men compared to women. Receiving appropriate testing and/or treatment was associated with reduced mortality and the risk of composite outcome. Improving osteoporosis testing and/or treatment and reducing health disparities are essential for managing the clinical and economic burden of osteoporosis in the USA.

A Self-Powered Portable Flexible Sensor of Monitoring Speed Skating Techniques.

With the development of 5G technology, contemporary technologies such as Internet of Things (IoT) and Big Data analyses have been widely applied to the sport industry. This paper focuses on the design of a portable, self-powered, flexible sensor, which does not require an external power supply. The sensor is capable of monitoring speed skating techniques, thereby helping professional athletes to enhance their performance. This sensor mainly consists of Polyvinylidene Fluoride (PVDF) with polarization after a silvering electrode and a flexible polyester substrate. Flexible sensors are attached to the push-off joint part of speed skaters and the ice skate blade. During motion, it produces different piezoelectricity signals depending on the states of motion. The monitoring and analyzing of the real-time sensor signals will adjust the athlete's skating angle, frequency, and push-off techniques, thus improving user training and enhancing performance. Moreover, the production of piezoelectric signals can charge the capacitor, provide power for small electronic equipment (e.g., wireless device), and extend the applications of wearable flexible sensors to the Big Data and IoT technologies in the sport industry.

Reducing substances-enhanced degradation of pollutants by permanganate: The role of in situ formed colloidal MnO2.

Permanganate is one of common oxidants used for organic pollutant abatement in water treatment. This study showed that the degradation rate of bisphenol A (BPA) by permanganate at pH 5.0 in the presence of aniline is much higher than that in the absence of aniline. 2, 5, and 10 µM of aniline enhanced BPA degradation rate by 104%, 326% and 601%, respectively. Colloidal MnO2 was formed through the reduction of permanganate by aniline and contributed to BPA oxidation considerably. The reactivity of MnO2 is sensitive to pH and is high under acidic conditions, resulting in the observed enhancement of aniline on BPA removal by permanganate at pH < 7.0. The role of MnO2 was further confirmed by the relationship of MnO2 formation and BPA/aniline removal, the inhibitory effect of Ca2+ on the oxidation of BPA in the presence of aniline. Besides the aniline/BPA system, the pollutants which react with permanganate rapidly are likely to enhance the degradation of coexisting pollutants which show high reactivity towards MnO2. Due to the reduction of permanganate and stabilization of the in situ formed colloidal MnO2 by water matrix, the oxidation rate of pollutant in real water is higher than that in pure water.

Opioid Use for Treatment of Acute Pain Among Children and Adolescents Enrolled in the Mississippi Medicaid Program.

BACKGROUND: Abuse of opioids among children and adolescents has become a major public concern in the United States. Understanding the epidemiology of opioid use in this vulnerable population is critical to address opioid abuse. OBJECTIVE: The aim of this study is to characterize opioid use for the treatment of acute pain among children and adolescents enrolled in Mississippi Medicaid and to determine the effects of related clinical factors (ie, mental health disorders and obstructive sleep apnea [OSA] on patterns of opioid use. METHODS: A retrospective cohort study was conducted using the Mississippi Medicaid administrative claims data from October 2015 through December 2017. We examined the proportion of children and adolescents less than 21 years of age using opioids within 7 days following any qualifying acute pain episode, as well as the difference in opioid use patterns between individuals with various demographic and clinical characteristics. RESULTS: Over 5% of the eligible population received opioids within 7 days of a qualifying pain episode. The majority received schedule II or schedule III to IV short-acting opioids. There was no significant difference in opioid use for acute pain between individuals with and without a mental health disorder. Opioid use for acute pain was significantly more likely among those with a history of OSA than those without OSA. CONCLUSION: This study characterizes the nature and patterns of opioid use among children and adolescents with acute pain. Further research is needed to understand the role of clinical and other demographic factors in the prescribing of opioids for acute pain in this population.

[Construction of T vectors based on Xcm I recognition site and optimization of PCR fragments for ligation].

OBJECTIVE: To construct T vectors based on Xcm I recognition site and optimize the PCR fragments for its ligation. METHODS: We firstly cloned the human histone H4 cDNA containing one Xcm I recognition site at both its 5' and 3' end into pCDNA 3.0 vector and then generated T vector with pCDNA 3.0 backbone by cutting the recombinant plasmid with Xcm I. To increase the ligation efficiency, the primers were firstly phosphorylated before DNA fragments amplification and then the PCR products were treated with Taq DNA polymerase and dATP after PCR amplification. Two DNA fragments with the length of 312 bp and 1 329 bp were ligated to it and the ligation mixture was transformed into E. coli DH5α competent cells and the positive rates of the transformants were evaluated by PCR and DNA agarose gel electrophoresis. RESULTS: Our results showed that the T vector produced by our method could ligate to the target DNA fragments with high efficiency. Besides, the phosphorylation state of the primers used for PCR amplification is also an important factor determining the cloning efficiency. What's more, as for longer DNA fragments, retreatment with Taq DNA polymerase and dATP after PCR amplification and purification could improve the ligation efficiency significantly. CONCLUSION: Our protocol may overcome the dependence on blue/white screening to get positive clones and provide a potent way to generate T vectors and ligate them to the target PCR fragment.