Baicalin Ameliorates Radiation-Induced Lung Injury by Inhibiting the CysLTs/CysLT1 Signaling Pathway.

Objective: Radiation-induced lung injury (RILI) is a common complication of radiotherapy for thoracic tumors. This study investigated the alleviating effect of baicalin (BA) on RILI and its possible mechanism. Methods: RILI model was established by chest irradiation (IR) of C57BL/6 mice for 16 weeks. Different concentrations of BA were administered, and dexamethasone (DXM) was used as a positive control. Then, the lung pathological changes were observed by HE and Masson staining. The levels of TGF-ß, TNF-α, IL-1ß, IL-6, CysLT, LTC4, and LTE4 were measured by ELISA. The CysLT1 expression was detected by qPCR, immunohistochemistry, and western blot. Type II AEC cells were pretreated with LTD-4 to establish the RILI cell model and intervened with different concentrations of BA. Then, the collagen I protein level was measured by ELISA. The CysLT1 and α-SMA expression were detected by qPCR, immunofluorescence, and western blot. Results: BA could effectively improve lung histopathological changes and pulmonary fibrosis. In vivo, BA could inhibit the levels of TGF-ß, TNF-α, IL-1ß, and IL-6 and reduce the levels of CysLT, LTC4, and LTE4. In vitro, different concentrations of LTD4 could reduce the viability of type II AEC cells, which could be reversed by the administration of different concentrations of BA. In addition, BA could reduce CysLT1 mRNA, as well as CysLT1 and α-SMA protein levels in vitro and in vivo. Conclusion: BA attenuated lung inflammation and pulmonary fibrosis by inhibiting the CysLTs/CysLT1 pathway, thereby protecting against RILI.

3,3'-Diindolylmethane attenuates inflammation and fibrosis in radiation-induced lung injury by regulating NF-κB/TGF-ß/Smad signaling pathways.

OBJECTIVE: This study aims to investigate the protective effect of 3,3'-diindolylmethane (DIM) on the radiation-induced lung injury (RILI) model and to explore its possible mechanism. Methods: A mouse model of RILI was established by thoracic irradiation, and dexamethasone was used as a positive drug to investigate the effect of DIM on RILI mice. Lung histopathology was analyzed by HE staining and Masson staining. Then the levels of inflammatory cytokines (TGF-ß, TNF-α, IL-1ß, and IL-6), inflammatory cell counts, and activity of MPO were detected. The expression of TGFß1/Smad signaling pathway-related proteins was determined by immunohistochemistry. qPCR was used to analyze the mRNA expression levels of inflammatory factors, α­SMA and COL1A1. The expression of COX-2, NF-κB, IκBα, PI3K, and Akt proteins was assessed by Western blot. Results: Histopathological staining of lung tissues showed that DIM administration alleviated the pulmonary inflammation and fibrosis caused by RILI. Moreover, the content of inflammatory factors such as IL-1ß and IL-6, the expression of NF-κB pathway-related proteins, and the counts of inflammatory cells were inhibited in lung tissue, indicating that DIM can inhibit the NF-κB pathway to reduce inflammation. In addition, DIM could down-regulate the mRNA levels of α-SMA, COL1A1, and downregulate TGFß1, Smad3, and p-Smad2/3 in lung tissues. Conclusion: Our study confirms that DIM has the potential to treat RILI in vivo by inhibiting fibrotic and inflammatory responses in lung tissue through the TGFß/Smad and NF-κB dual pathways, respectively.

Middle-age Asian male with cerebral venous thrombosis after COVID-19 AstraZeneca vaccination.

Vaccine-associated cerebral venous thrombosis has become an issue following the extensive vaccination program of the Coronavirus Disease of 2019 (COVID-19) Vaccine AstraZeneca (ChAdOx1 vaccine). The importance of early diagnosis should be emphasized due to the high mortality rate without appropriate treatment. Young female populations in western countries have been reported to be at a greater risk of this vaccine related thrombotic event, but cases in East Asia are lacking. Herein, we present the first case of cerebral venous sinus thrombosis 10 days after ChAdOx1 vaccination in a middle-age Asian male in Taiwan.

Identification and characterization of AnICE1 and AnCBFs involved in cold tolerance from Ammopiptanthus nanus.

The ICE-CBF-COR pathway plays a vital role in improving the cold tolerance of plants. As an evergreen small shrub, Ammopiptanthus nanus has a high tolerance to cold stress because of its special growth conditions. Regrettably, no cold-responsive genes in the ICE-CBF-COR pathway have been reported in A. nanus. In the current study, we isolated AnICE1, AnCBF1, and AnCBF2 in A. nanus and analyzed their sequence structure. Evolutionary analysis indicated that these genes are most closely related to those from Ammopiptanthus mongolicus, Glycine max, Spatholobus suberectus, and Cajanus cajan, all belonging to the Fabaceae. Expression analysis showed that the expression levels of these genes were induced under cold stress and treatment with several plant hormones. As a critical upstream regulator in the ICE-CBF-COR pathway, the function of AnICE1 was further identified. The subcellular localization indicated that AnICE1 is predominantly localized in the plasma membrane and less in the nucleus. Overexpression of AnICE1 in Arabidopsis thaliana improved seed germination and growth of transgenic seedlings during cold stress. Moreover, some physiological indices such as relative electrical conductivity, contents of proline and malondialdehyde, catalase activity, and Nitro Blue tetrazolium and 3.3'-diaminobenzidine staining were investigated by transient expression in A. nanus seedlings and stable overexpression in A. thaliana. These results indicated that AnICE1 enhanced cold tolerance in A. nanus and transgenic A. thaliana. This study is significant for understanding the cold-resistant mechanism of ICE and CBF genes in A. nanus.

Differences in end-of-life care and outcomes in palliative consultation-eligible patients with and without do-not-resuscitate orders: A propensity score-matched study.

BACKGROUND: The primary objective of palliative care, not synonymous with end-of-life (EOL) care, is to align care plans with patient goals, regardless of whether these goals include the pursuit of invasive, life-sustaining procedures, or not. This study determines the differences in EOL care, resource utilization, and outcome in palliative care consultation-eligible emergency department patients with and without do-not-resuscitate (DNR) orders. METHODS: This is a retrospective observational study. We consecutively enrolled all the acutely and critically ill emergency department patients eligible for palliative care consultation at the Taipei Veterans General Hospital, a 3000-bed tertiary hospital, from February 1 to July 31, 2018. The outcome measures included in-hospital mortality and EOL care of patients with and without DNR. RESULTS: A total of 396 patients were included: 159 with and 237 without DNR. Propensity score matching revealed that patients with DNR had significantly shorter duration of hospital stay (404.4 ± 344.4 hours vs 505.2 ± 498.1 hours; p = 0.037), higher in-hospital mortality (54.1% vs 34.6%; p < 0.001), and lower total hospital expenditure (191 239 ± 177 962 NTD vs 249 194 ± 305 629 NTD; p = 0.04). Among patients with DNR, there were fewer deaths in the intensive care unit (30.2% vs 37.0%), more deaths in the hospice ward (16.3% vs 7.4%), more critical discharge to home (9.3% vs 7.4%), more endotracheal removals (3.1% vs 0%; p = 0.024), and more narcotics use (32.7% vs 22.1%; p = 0.018). CONCLUSION: The palliative care consultation-eligible emergency department patients with DNR compared with those without DNR experienced worse outcomes, greater pain control, more endotracheal extubations, shorter duration of hospital stay, more critical discharge to home, more hospice referrals, and 23.3% reduction in total expenditure. There were fewer deaths in the ICU among them as well.

Prognostic significance of emergency department modified early warning score trend in critical ill elderly patients.

OBJECTIVE: To explore the relationship between trends in emergency department modified early warning score (EDMEWS) and the prognosis of elderly patients admitted to the intensive care unit (ICU). METHODS: Consecutive non-traumatic elderly ED patients (≥65 years old) admitted to the ICU between July 2018 and June 2019 were enrolled in this retrospective cohort study. The selected patients had at least 2 separate MEWS during their ED stay. Detailed patient information was retrieved initially from the ICU database of our hospital and then crosschecked with electronic medical recording system to confirm the completeness and correctness of the data. Patients who had do-not-resuscitate order and those with incomplete data of EDMEWS, acute physiology and chronic health evaluation (APACHE) II score, or survival information (7-day and 30-day mortality) were excluded. The trends in EDMEWS were determined using the regression line of multiple MEWS measured during ED stay, in which EDMEWS trend progression was defined as the slope of the regression line > zero. The relationship between EDMEWS trend and prognosis was assessed using univariate and multivariate analyses (multiple logistic regression analysis). RESULTS: Of the 1423 selected patients, 499 (35.1%) had worsening 24-h APACHE II score, 110 (7.7%) died within 7 days, and 233 (16.4%) died within 30 days. Factors that were significantly associated with worsening 24-h APACHE II score, 7-day mortality, and 30-day mortality in univariate analysis were selected for inclusion into multiple logistic regression analyses. After adjusting for other covariates, EDMEWS trend progression was significantly associated with 24-h APACHE II score progression, 7-day mortality, and 30-day mortality. CONCLUSIONS: EDMEWS trend progression was significantly associated with 24-h APACHE II score progression, 7-day mortality, and 30-day mortality in elderly ED patients admitted to the ICU. EDMEWS is a simple and useful tool for precisely monitoring patients' ongoing condition and predicting prognosis.

Differences in Characteristics, Hospital Care and Outcomes between Acute Critically Ill Emergency Department Patients with Early and Late Do-Not-Resuscitate Orders.

Background: A do-not-resuscitate (DNR) order is associated with an increased risk of death among emergency department (ED) patients. Little is known about patient characteristics, hospital care, and outcomes associated with the timing of the DNR order. Aim: Determine patient characteristics, hospital care, survival, and resource utilization between patients with early DNR (EDNR: signed within 24 h of ED presentation) and late DNR orders. Design: Retrospective observational study. Setting/Participants: We enrolled consecutive, acute, critically ill patients admitted to the emergency intensive care unit (EICU) at Taipei Veterans General Hospital from 1 February 2018, to 31 January 2020. Results: Of the 1064 patients admitted to the EICU, 619 (58.2%) had EDNR and 445 (41.8%) LDNR. EDNR predictors were age >85 years (adjusted odd ratios (AOR) 1.700, 1.027-2.814), living in long-term care facilities (AOR 1.880, 1.066-3.319), having advanced cardiovascular diseases (AOR 2.128, 1.039-4.358), "medical staff would not be surprised if the patient died within 12 months" (AOR 1.725, 1.193-2.496), and patients' family requesting palliative care (AOR 2.420, 1.187-4.935). EDNR patients underwent lesser endotracheal tube (ET) intubation (15.6% vs. 39.9%, p < 0.001) and had reduced epinephrine injection (19.9% vs. 30.3%, p = 0.009), ventilator support (16.7% vs. 37.9%, p < 0.001), and narcotic use (51.1% vs. 62.6%, p = 0.012). EDNR patients had significantly lower 7-day (p < 0.001), 30-day (p < 0.001), and 90-day (p = 0.023) survival. Conclusions: EDNR patients underwent decreased ET intubation and had reduced epinephrine injection, ventilator support, and narcotic use during EOL as well as decreased length of hospital stay, hospital expenditure, and survival compared to LDNR patients.

Effects of Sodium Silicate Complex against Hemorrhagic Activities Induced by Protobothrops mucrosquamatus Venom.

Protobothrops mucrosquamatus poses a serious medical threat to humans in Southern and Southeastern Asia. Hemorrhage is one of the conspicuous toxicities related to the pathology of P. mucrosquamatus envenoming. Previous in vitro and in vivo studies showed that a silica-derived reagent, sodium silicate complex (SSC), was able to neutralize hemorrhagic and proteolytic activities induced by pit viper venoms, including Crotalus atrox, Agkistrodoncontortrix contortrix and Agkistrodon piscivorus leucostoma. In this study, we validated that SSC could neutralize enzymatic and toxic effects caused by the venom of P. mucrosquamatus. We found that SSC inhibited the hemolytic and proteolytic activities induced by P. mucrosquamatus venom in vitro. In addition, we demonstrated that SSC could block intradermal hemorrhage caused by P. mucrosquamatus venom in a mouse model. Finally, SSC could neutralize lethal effects of P. mucrosquamatus venom in the mice. Therefore, SSC is a candidate for further development as a potential onsite first-aid treatment for P. mucrosquamatus envenoming.

Comprehensive geriatric assessment in the emergency department for the prediction of readmission among older patients: A 3-month follow-up study.

BACKGROUND: Older people present to the emergency department (ED) with distinct patterns and emergency care needs. This study aimed to use comprehensive geriatric assessment (CGA) surveying the patterns of ED visits among older patients and determine frailty associated with the risk of revisits/readmission. METHODS: This prospective study screened 2270 patients aged ≥75 years in the ED from August 2018 to February 2019. All patients underwent CGA. A 3-months follow-up was conducted to observe the hospital courses of admission and revisit/readmission. RESULTS: A total of 270 older patients were enrolled. The independent predictors of admission at initial ED visit were the risk of nutritional deficit and instrumental activities of daily living (IADL). In the admission group, the independent predictors of revisit/readmission were a fall in the past year and mobility difficulties. In the discharge group, the independent predictors of revisit/readmission were frailty and insomnia. Regardless if older patients were either admitted or discharged at the initial ED visit, the independent predictor of revisit/readmission for older patients was frailty. CONCLUSION: Our study showed that frailty was the only independent predictor for revisit/readmission after ED discharge during the 3-month follow up. For ED physicians, malnutrition and IADL were independent predictors in recognizing whether the older patient should be admitted to the hospital. For discharged older ED patients, frailty was the independent predictor for the integration of community services for older patients to decrease the rate of revisit/readmission in 3 months.

Online Health Information Seeking Using "#COVID-19 Patient Seeking Help" on Weibo in Wuhan, China: Descriptive Study.

BACKGROUND: First detected in Wuhan, China in December 2019, the COVID-19 pandemic stretched the medical system in Wuhan and posed a challenge to the state's risk communication efforts. Timely access to quality health care information during outbreaks of infectious diseases can be effective to curtail the spread of disease and feelings of anxiety. Although existing studies have extended our knowledge about online health information-seeking behavior, processes, and motivations, rarely have the findings been applied to an outbreak. Moreover, there is relatively little recent research on how people in China are using the internet for seeking health information during a pandemic. OBJECTIVE: The aim of this study is to explore how people in China are using the internet for seeking health information during a pandemic. Drawing on previous research of online health information seeking, this study asks the following research questions: how was the "#COVID-19 Patient Seeking Help" hashtag being used by patients in Wuhan seeking health information on Weibo at the peak of the outbreak? and what kinds of health information were patients in Wuhan seeking on Weibo at the peak of the outbreak? METHODS: Using entity identification and textual analysis on 10,908 posts on Weibo, we identified 1496 patients with COVID-19 using "#COVID-19 Patient Seeking Help" and explored their online health information-seeking behavior. RESULTS: The curve of the hashtag posting provided a dynamic picture of public attention to the COVID-19 pandemic. Many patients faced difficulties accessing offline health care services. In general, our findings confirmed that the internet is used by the Chinese public as an important source of health information. The lockdown policy was found to cut off the patients' social support network, preventing them from seeking help from family members. The ability to seek information and help online, especially for those with young children or older adult members during the pandemic. A high proportion of female users were seeking health information and help for their parents or for older adults at home. The most searched information included accessing medical treatment, managing self-quarantine, and offline to online support. CONCLUSIONS: Overall, the findings contribute to our understanding of health information-seeking behaviors during an outbreak and highlight the importance of paying attention to the information needs of vulnerable groups and the role social media may play.

Surface Architecture Design of LiNi0.8 Co0.15 Al0.05 O2 Cathode with Synergistic Organics Encapsulation to Enhance Electrochemical Stability.

Ni-rich LiNi0.8 Co0.15 Al0.05 O2 (NCA) material attracts extensive attention due to its high discharge specific capacity, but its distinct drawbacks of rapid capacity decline and poor cycle performance at elevated temperatures and high voltage during charge/discharge cycling restricts its widespread application. To solve these problems, a multifunctional coating layer composed of a lithium-ion-conductive lithium polyacrylate (LiPAA) inner layer and a cross-linked polymer outer layer from certain organic substances of silane-coupling agent (KH550) and polyacrylic acid (PAA) is successfully designed on the surface of NCA materials, which is favorable for eliminating residual lithium and improving lithium-ion conductivity, surface stability, and hydrophobicity of NCA materials. In addition, the amount of the coating material is also investigated. A series of characterization methods such as XRD, FTIR, SEM, TEM, and X-ray photoelectron spectroscopy are used to analyze the morphologies and structures for materials of pristine and modified NCA. It is revealed that the co-coating layer plays a vital part in reducing the surface residual alkalis and improving the stability of NCA particles; as a result, the modified NCA exhibits a greatly improved rate capability, cycle performance, and low polarization impedance.

Initiating palliative care consultation for acute critically ill patients in the emergency department intensive care unit.

BACKGROUND: Little is known about the characteristics of patients needing palliative care consultation in the emergency department (ED). This study aimed to investigate the impacts of initiating screening in acute critically ill patients needing palliative care on mortality, health care resources, and end-of-life (EOL) care in the intensive care unit in ED (EICU). METHODS: We conducted an analysis study in Taipei Veterans General Hospital. From February 1 to July 31, 2018, acute critically ill patients in EICU were recruited. The primary outcomes were inhospital mortality and EOL care. The secondary outcomes included clinical characteristics and health care utilization. RESULTS: A total of 796 patients were screened, with 396 eligible and 400 noneligible patients needing palliative care consultations. The mean age was 74.8 ± 17.1 years, and 62.6% of the patients were male. According to logistic regression analysis, clinical predictors, including age (adjusted odds ratio [AOR], 1.028; 95% CI, 1.015-1.042), respiratory distress and/or respiratory failure (AOR, 2.670; 95% CI, 1.829-3.897), the Acute Physiology and Chronic Health Evaluation II score (AOR, 1.036; 95% CI, 1.009-1.064), Charlson Comorbidity Index score (AOR, 1.212; 95% CI, 1.125-1.306), and Glasgow Coma Scale (AOR, 0.843; 95% CI, 0.802-0.885), were statistically more significant in eligible patients than in noneligible patients. The inhospital mortality rate was significantly higher in eligible patients than that in noneligible patients (40.7% vs 11.5%, p < 0.01). Eligible patients have a higher ratio in both vasopressor and narcotic use and withdrawal of endotracheal tube than noneligible patients (p < 0.05). CONCLUSION: Our study results demonstrated that initiating palliative consultation for acute critically ill patients in ED had an impact on the utilization of health care resources and quality of EOL care. Further assessments of the viewpoints of ED patients and their family on palliative care consultations and hospice care are required.

Purification, characterization, and bioactivity of two new polysaccharide fractions from Thelephora ganbajun mushroom.

Two new polysaccharide fractions (TZP1-1 and TZP2-1) were obtained from the fruiting bodies of Thelephora ganbajun using DEAE-52 cellulose and Superdex 200 columns chromatography. The physiochemical characterization and biological activities of TZP1-1 and TZP2-1 were investigated. The relative molecular weight of TZP1-1 and TZP2-1 were 2.07 × 106 and 4,886 Da, respectively. TZP1-1 included mannose, rhamnose, galactose, and xylose (4:1:83.9:7.5), while TZP2-1 included mannose, glucose, galactose, and xylose (5.4:1:79.0:8.1). The Congo red experiment results confirmed that TZP2-1 had triple helix conformation. Furthermore, both TZP1-1 and TZP2-1 showed a certain cytotoxicity on HeLa and SH-SY5Y cells, while they exhibited a stronger inhibitory effect on HeLa than SH-SY5Y. Besides, the cytotoxicity of TZP1-1 was better than that of TZP2-1. Moreover, both of them exhibited a moderate inhibitory effect on α-amylase and α-glucosidase. These findings could promote the application of polysaccharides from T. ganbajun. PRACTICAL APPLICATIONS: Thelephora ganbajun is an edible fungus widely distributed in Southwestern China. T. ganbajun polysaccharides as important active ingredients have not been reported. In this current study, two polysaccharides fractions (TZP1-1 and TZP2-1) were characterized, and their cytotoxicities and antidiabetic effect were also assayed. These findings could promote polysaccharides from T. ganbajun to be better application.

Relationship Between Changes in Prehospital Blood Pressure and Early Neurological Deterioration in Spontaneous Intracerebral Hemorrhage.

The aim of this study was to explore the relationship between changes in prehospital blood pressure (BP) and the incidence of early neurological deterioration (END) after spontaneous intracerebral hemorrhage (SICH) in patients who arrive at the emergency department (ED) with a normal Glasgow Coma Scale (GCS) score. Records of consecutive adults with SICH transported by ambulance and treated in our ED from January 2015 to December 2017 were retrospectively reviewed. The study cohort included all patients with SICH occurring within the previous 6 hr who had a normal GCS score on ED arrival. Detailed information was retrieved from our hospital's intracerebral hemorrhage databank and then cross-checked in the medical and nursing charts to confirm completeness and accuracy. Early neurological deterioration was defined as a decrease of 2 or more points in the GCS score within 6 hr after ED arrival. The change in prehospital BP was defined as the BP on ED arrival minus the initial on-scene BP. An association between a change in prehospital BP and the occurrence of END was assessed by univariate and multivariate analyses (multiple logistic regression analysis). Of the 168 patients evaluated, 36 (21.4%) developed END. Factors associated with END on univariate analysis were regular antiplatelet agent use, shorter elapsed time, on-scene systolic blood pressure (SBP), prehospital SBP increase of 15 mmHg or more, intraventricular extension of the hematoma, and the presence of 3 or more noncontrast computed tomographic signs of hematoma expansion. After adjusting for other covariates, an increase in prehospital SBP of 15 mmHg or more was significantly associated with a higher risk of END. In patients with SICH who arrive at the ED with a normal GCS score, an increase in the prehospital SBP of more than 15 mmHg is associated with a higher incidence of END.

Protobothrops mucrosquamatus Bites to the Head: Clinical Spectrum from Case Series.

Protobothrops mucrosquamatus (Trimeresurus mucrosquamatus) is a medically important species of pit viper with a wide geographic distribution in Southeast Asia. Bites by P. mucrosquamatus mostly involve the extremities. Little is known about the toxic effects of P. mucrosquamatus envenoming to the head because of the infrequency of such occurrence. To better delineate the clinical manifestations of envenoming to the head, we report three patients who suffered from P. mucrosquamatus bites to the head and were treated successfully. All three patients developed progressive soft tissue swelling extending from head to neck, with two patients expanding further onto the anterior chest wall. Mild thrombocytopenia was noted in two patients. One patient had transient acute renal impairment and airway obstruction, necessitating emergent intubation. All three patients received high doses of species-specific antivenom with recovery within 1 week. No adverse reactions to antivenom were observed.

Structural characterization, in vitro and in vivo antioxidant activities of a heteropolysaccharide from the fruiting bodies of Morchella esculenta.

This study aimed to investigate the structural features, in vitro and in vivo antioxidant activities of a heteropolysaccharide from the fruiting bodies of Morchella esculenta (FMP-1). FMP-1 had an average molecular weight of 4.7 × 103 Da and consisted of mannose, glucose and galactose. By methylation and NMR analysis, the backbone of FMP-1 was deduced to be made up of 1,4-linked Glcp and 1,6-linked Galp. Hydroxyl, DPPH and superoxide radicals could be efficiently scavenged by FMP-1, with IC50 values of 74.26, 119.32 and 161.49 µg/mL, respectively. Furthermore, FMP-1 could significantly protect zebrafish embryos against AAPH-induced oxidative damage. Decrease in malformations and mortalities was observed along with the reduction of ROS production, NO production and cell death. The protective effects were by decreasing MDA content and increasing SOD, CAT and GSH-Px levels. The current work provided a good suggestion of the potential utilization of FMP-1 as an attractive natural antioxidant.

Effect analysis of intradermal hyaluronic acid injection to treat enlarged facial pores.

OBJECTIVE: To investigate the clinical application and efficacy of intradermal injection of low molecular weight hyaluronic acid (LMW-HA) for treating enlarged facial pores. METHODS: From January 2015 to May 2016, 42 subjects who sought aesthetic treatment underwent intradermal injection of LMW-HA to improve enlarged facial pores. For each treatment, 2.5 mL (25 mg) of LMW-HA was injected into the skin of the full face. The treatment was repeated 2-5 times with an interval of 1 to 1.5 months between consecutive treatments. The postoperative follow-up period was 1 to 6 months. Statistical analysis was used to compare the degree of enlargement of facial pores before and after injection. The clinical efficacy and adverse effects were recorded. RESULTS: The enlarged facial pores before and after treatment were categorized and subjected to the Wilcoxon matched-pairs signed-rank test. The difference was statistically significant (P<.01). The improvement rate was 40.03±18.41%. No infection, nodules, or pigmentation was reported at the injection sites in the subjects who sought aesthetic treatment. The overall satisfaction rate was 92.8%. CONCLUSION: Intradermal injection of LMW-HA can significantly improve skin texture, reduce pore size, and enhance skin radiance. The injection technique was simple, safe, and effective and could easily be extended to clinical practice.

Clinical predictors of outcomes in patients undergoing emergency air medical transport from Kinmen to Taiwan.

Emergency air medical transport (EAMT) is indispensable for acutely or critically ill patients in remote areas. We determined patient-level and transport-specific factors associated with all-cause mortality after EAMT.We conducted a population-based, retrospective cohort study using a prospective registry consisting of clinical/medical records. Study inclusion criteria consisted of all adults undergoing EAMT from Kinmen hospital to the ED of Taipei Veterans General Hospital (TVGH) between January 1, 2006 and December 31, 2012. The primary outcome assessments were 7-day and 30-day mortality.A total of 370 patients transported to TVGH were enrolled in the study with a mean age of 54.5 ±â€Š21.5 (SD) years and with a male predominance (71.6%). The average in-transit time was 1.4 ±â€Š0.4 hours. The 7-day, 30-day, and in-hospital mortality rates were 10.3%, 14.1%, and 14.9%. Among them 33.5% (124/370) were categorized under neurological etiologies, whereas 24.9% (90/370) cardiovascular, followed by 16.2% (60/370) trauma patients. Independent predictors associated with 7-day all-cause mortality were age (odds ratio [OR] 1.043, 95% confidence interval [CI] 1.016-1.070), Glasgow Coma Scale (GCS) (OR 0.730, 95% CI 0.650-0.821), and hematocrit level (OR 0.930, 95% CI 0.878-0.985). Independent predictors associated with 30-day all-cause mortality were age (OR 1.028, 95% CI 1.007-1.049), GCS (OR 0.686, 95% CI 0.600-0.785), hematocrit (OR 0.940, 95% CI 0.895-0.988), hemodynamic instability (OR 5.088 95% CI 1.769-14.635), and endotracheal intubation (OR 0.131 95% CI 0.030-0.569). The 7-day and 30-day mortality were not significantly related to transport-specific factors, such as length of flight, type of paramedic crew on board, or day and season of transport. Clinical patient-level factors, as opposed to transport-level factors, were associated with 7- and 30-day all-cause mortality in patients undergoing interfacility EAMT from Kinmen to Taiwan.

Controlled spatial separation of spins and coherent dynamics in spin-orbit-coupled nanostructures.

The spatial separation of electron spins followed by the control of their individual spin dynamics has recently emerged as an essential ingredient in many proposals for spin-based technologies because it would enable both of the two spin species to be simultaneously utilized, distinct from most of the current spintronic studies and technologies wherein only one spin species could be handled at a time. Here we demonstrate that the spatial spin splitting of a coherent beam of electrons can be achieved and controlled using the interplay between an external magnetic field and Rashba spin-orbit interaction in semiconductor nanostructures. The technique of transverse magnetic focusing is used to detect this spin separation. More notably, our ability to engineer the spin-orbit interactions enables us to simultaneously manipulate and probe the coherent spin dynamics of both spin species and hence their correlation, which could open a route towards spintronics and spin-based quantum information processing.