Unsupervised EEG-Based Seizure Anomaly Detection with Denoising Diffusion Probabilistic Models.

While many seizure detection methods have demonstrated great accuracy, their training necessitates a substantial volume of labeled data. To address this issue, we propose a novel method for unsupervised seizure anomaly detection called SAnoDDPM, which uses denoising diffusion probabilistic models (DDPM). We designed a novel pipeline that uses a variable lower bound on Markov chains to identify potential values that are unlikely to occur in anomalous data. The model is first trained on normal data, then anomalous data is input to the trained model. The model resamples the anomalous data and converts it to normal data. Finally, the presence of seizures can be determined by comparing the before and after data. Moreover, the input 2D spectrograms are encoded into vector-quantized representations, which enables powerful and efficient DDPM while maintaining its quality. Experimental comparisons on the publicly available datasets, CHB-MIT and TUH, show that our method delivers better results, significantly reduces inference time, and is suitable for deployment in a clinical environments. As far as we are aware, this is the first DDPM-based method for seizure anomaly detection. This novel approach significantly contributes to the progression of seizure detection algorithms, thereby augmenting their practicality in clinical settings.

Aluminium-doped Carbon Dots for the Simultaneous Selective Detection of Five Tetracycline Antibiotics.

In this paper, the aluminium-doped carbon dots (Al-CDs) were developed for simultaneous selective detection of five tetracycline antibiotics (TCs), including minocycline (MC), tetracycline (TC), oxytetracycline (OTC), doxycycline (DOC) and chlortetracycline (CTC). With the bright blue fluorescence, Al-CDs displayed excellent stability and showed no obvious fluorescence intensity changes under different ionic strength, acidic or alkaline environment, continuous ultraviolet light illumination, and even longtime storage at room temperature. As adding different antibiotics, the fluorescence of Al-CDs was strongly quenched by five TCs and showed no distinguished changes with the addition of other kinds of antibiotics. The presence of interferential metal ions, anions and small organic molecules imposed no effect on the simultaneous selective detection of five TCs. A good linear relationship was achieved for five TCs in the range of 0-100 µM, and the limit of detection for MC, TC, OTC, DOC, and CTC were 13.91 (0-100 µM), 15.54 (0-100 µM), 14.26 (0-100 µM), 13.48 (0-100 µM) and 13.88 nM (0-100 µM), respectively. Moreover, Al-CDs was successfully used to the detection of five TCs in real samples with recovery ranging from 92.47% to 122.05%, confirming a bright future for the practical applications in the assays of foods, medicines, and environments.

SnSe2 Quantum Dots and Chlorhexidine Acetate Suppress Synergistically Non-radiative Recombination Loss for High Efficiency and Stability Perovskite Solar Cells.

Non-radiative recombination losses limit the property of perovskite solar cells (PSCs). Here, a synergistic strategy of SnSe2QDs doping into SnO2 and chlorhexidine acetate (CA) coating on the surface of perovskite is proposed. The introduction of 2D SnSe2QDs reduces the oxygen vacancy defects and increases the carrier mobility of SnO2. The optimized SnO2 as a buried interface obviously improves the crystallization quality of perovskite. The CA containing abundant active sites of ─NH2/─NH─, ─C═N, CO, ─Cl groups passivate the defects on the surface and grain boundary of perovskite. The alkyl chain of CA also improves the hydrophobicity of perovskite. Moreover, the synergism of SnSe2QDs and CA releases the residual stress and regulates the energy level arrangement at the top and bottom interface of perovskite. Benefiting from these advantages, the bulk and interface non-radiative recombination loss is greatly suppressed and thereby increases the carrier transport and extraction in devices. As a result, the best power conversion efficiency (PCE) of 23.41% for rigid PSCs and the best PCE of 21.84% for flexible PSCs are reached. The rigid PSC maintains 89% of initial efficiency after storing nitrogen for 3100 h. The flexible PSCs retain 87% of the initial PCE after 5000 bending cycles at a bending radius of 5 mm.

Force-Encoding DNA Nanomachines for Simultaneous and Direct Detection of Multiple Pathogenic Bacteria in Blood.

Pathogen detection is growing in importance in the early stages of bacterial infection and treatment due to the significant morbidity and mortality associated with bloodstream infections. Although various diagnostic approaches for pathogen detection have been proposed, most of them are time-consuming, with insufficient sensitivity and limited specificity and multiplexing capability for clinical use. Here, we report a force-encoding DNA nanomachine for simultaneous and high-throughput detection of multiple pathogens in blood through force-induced remnant magnetization spectroscopy (FIRMS). The force-encoding DNA nanomachines coupled with DNA walkers enable analytical sensitivity down to a single bacterium via a cascade signal amplification strategy. More importantly, it allows for rapid and specific profiling of various pathogens directly in blood samples, without being affected by factors such as light color and solution properties. We expect that this magnetic sensing platform holds great promise for various applications in biomedical research and clinical diagnostics.

Structural analysis of polysaccharide from Inonotus obliquus and investigate combined impact on the sex hormones, intestinal microbiota and metabolism in SPF male mice.

The dysregulation of sex hormone levels is associated with metabolic disorders such as obesity. Inonotus obliquus polysaccharide (IOP) exhibits a promising therapeutic effect on conditions like obesity and diabetes, potentially linked to its influence on intestinal microbiota and metabolism. The exact cause and mechanisms that link sex hormones, gut microbiota and metabolism are still unknown. In this research, we examined the molecular weight, monosaccharide composition, and glycosidic bond type of IOP. We found that IOP mostly consists of alpha-structured 6­carbon glucopyranose, with a predominant (1 â†’ 4) linkage to monosaccharides and a uniform distribution. Following this, we administered two different concentrations of IOP to mice through gavage. The results of the enzyme-linked immunosorbent assay (ELISA) demonstrated a significant increase in testosterone (T) levels in the IOP group as compared to the control group. Additionally, the results of tissue immunofluorescence indicated that increased IOP led to a decrease in adiponectin content and an increase in SET protein expression. The study also revealed changes in the intestinal microbiota and metabolic changes in mice through 16S rRNA data and non-targeted LC-MS data, respectively. The study also found that IOP mainly affects pathways linked to glycerophospholipid metabolism. In addition, it has been observed that there is an increase in the number of beneficial bacteria, such as the Eubacterium coprostanoligenes group and g.Lachnospiraceae NK4A136 group, while the levels of metabolites that are linked to obesity or diabetes, such as 1,5-anhydrosorbitol, are reduced. Furthermore, biomarker screening has revealed that the main microorganism responsible for the differences between the three groups is g.Erysipelatoclostridiaceae. In summary, these findings suggest that IOP exerts its therapeutic effects through a synergistic interplay between sex hormones, gut microbiome composition, and metabolic processes.

Public willingness, attitudes and related factors toward cardiopulmonary resuscitation: A grounded theory study.

OBJECTIVES: Despite receiving cardiopulmonary resuscitation (CPR) training, over 50% of bystanders were unable to actually perform CPR. Understanding public willingness and attitudes toward bystander CPR is crucial in explaining whether people initiate CPR. This study aimed to develop a theoretical understanding of factors that influence the public's willingness and attitudes to perform CPR. DESIGN: This was a qualitative study using the grounded theory method. METHODS: The data were collected from semi-structured interviews with 28 participants between August 2022 and November 2022. Purposive sampling and theoretical sampling were used to recruit participants. Interviews were recorded and transcribed. Data were analyzed using open, axial, and selective coding. RESULTS: Nine categories and 24 subcategories were summarized from four aspects: willingness, attitudes, implementation, and training. Willingness included self-willingness, self-perception, and societal factors; attitudes covered personality traits, reactions to patients and environment; implementation comprised knowledge and skills, situational coping, and risk perception; training included CPR training accessibility and barriers to CPR training. A theoretical framework of public CPR willingness, attitudes, and their influencing factors was developed. CONCLUSION: The public's CPR willingness, attitudes, training, and implementation were interrelated and influential. The findings may have significant implications for the development of legislation and policy related to CPR popularization and training.

Engineering Atomically Dispersed Cu-N1S2 Sites via Chemical Vapor Deposition to Boost Enzyme-Like Activity for Efficient Tumor Therapy.

Single-atom nanozymes (SAzymes), with well-defined and uniform atomic structures, are an emerging type of natural enzyme mimics. Currently, it is important but challenging to rationally design high-performance SAzymes and deeply reveal the interaction mechanism between SAzymes and substrate molecules. Herein, this work reports the controllable fabrication of a unique Cu-N1S2-centred SAzyme (Cu-N/S-C) via a chemical vapor deposition-based sulfur-engineering strategy. Benefiting from the optimized geometric and electronic structures of single-atom sites, Cu-N/S-C SAzyme shows boosted enzyme-like activity, especially in catalase-like activity, with a 13.8-fold increase in the affinity to hydrogen peroxide (H2O2) substrate and a 65.2-fold increase in the catalytic efficiency when compared to Cu-N-C SAzyme with Cu-N3 sites. Further theoretical studies reveal that the increased electron density around single-atom Cu is achieved through electron redistribution, and the efficient charge transfer between Cu-N/S-C and H2O2 is demonstrated to be more beneficial for the adsorption and activation of H2O2. The as-designed Cu-N/S-C SAzyme possesses an excellent antitumor effect through the synergy of catalytic therapy and oxygen-dependent phototherapy. This study provides a strategy for the rational design of SAzymes, and the proposed electron redistribution and charge transfer mechanism will help to understand the coordination environment effect of single-atom metal sites on H2O2-mediated enzyme-like catalytic processes.

Diaphragmatic breathing combined with abdominal drawing-in maneuver for walking function in post-stroke patients: a randomized controlled study protocol.

BACKGROUND: Patients with stroke frequently experience walking dysfunction. Core training can help improve balance and walking function in patients with stroke. However, core training movements in clinical practice are numerous and differently targeted. Therefore, this study will investigate the improvement of walking function in patients with combined diaphragmatic breathing maneuver (DBM) and draw-in breathing technique (ADIM) training. METHODS: This single-blind, randomized controlled preliminary will analyze the viability of DBM combined ADIM training versus routine rehabilitation therapy in patients with stroke with early to mid-stroke. Patients will be randomly assigned to either the DBM and ADIM training or the routine rehabilitation training. We will recruit 42 stroke inpatients from the Second Rehabilitation Hospital of Shanghai who meet the trial criteria and measure the balance and walking functions and improvement of that after 4 weeks of intervention. The primary outcome is the 10 m maximum walking test (10MWT). The secondary outcomes indices include the limits of stability test (LOS), Berg balance scale test (BBS), Functional Ambulation Categories test (FAC), Timed Up and Go test (TUG), trunk impairment scale test (TIS), ultrasound indicators of the diaphragm and transversus abdominis (UI), rhythmic weight shift test (RWS), walk across test (WA), Fugl-Meyer assessment of lower extremity (FMA-LE), and Barthel index of ADL test. DISCUSSION: The primary objective of this project was to investigate the effects of DBM combined with ADIM on balance capacity and walking function for patients with early to mid-stroke. The outcomes of this study will hold significant implications for future clinical applications in rehabilitation. TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR), ID: ChiCTR2100054897. Registered on 28 December 2021.

Enhancing gland segmentation in colon histology images using an instance-aware diffusion model.

In pathological image analysis, determination of gland morphology in histology images of the colon is essential to determine the grade of colon cancer. However, manual segmentation of glands is extremely challenging and there is a need to develop automatic methods for segmenting gland instances. Recently, due to the powerful noise-to-image denoising pipeline, the diffusion model has become one of the hot spots in computer vision research and has been explored in the field of image segmentation. In this paper, we propose an instance segmentation method based on the diffusion model that can perform automatic gland instance segmentation. Firstly, we model the instance segmentation process for colon histology images as a denoising process based on a diffusion model. Secondly, to recover details lost during denoising, we use Instance Aware Filters and multi-scale Mask Branch to construct global mask instead of predicting only local masks. Thirdly, to improve the distinction between the object and the background, we apply Conditional Encoding to enhance the intermediate features with the original image encoding. To objectively validate the proposed method, we compared several state-of-the-art deep learning models on the 2015 MICCAI Gland Segmentation challenge (GlaS) dataset (165 images), the Colorectal Adenocarcinoma Glands (CRAG) dataset (213 images) and the RINGS dataset (1500 images). Our proposed method obtains significantly improved results for CRAG (Object F1 0.853 ± 0.054, Object Dice 0.906 ± 0.043), GlaS Test A (Object F1 0.941 ± 0.039, Object Dice 0.939 ± 0.060), GlaS Test B (Object F1 0.893 ± 0.073, Object Dice 0.889 ± 0.069), and RINGS dataset (Precision 0.893 ± 0.096, Dice 0.904 ± 0.091). The experimental results show that our method significantly improves the segmentation accuracy, and the experiment results demonstrate the efficacy of the method.

[Characteristics and resuscitation effects of out-of-hospital sudden death: a study based on Internet data].

OBJECTIVE: To collect the Internet news about "sudden death", analyze its characteristics and resuscitation effects, so as to provide reference for formulating intervention strategies. METHODS: The Internet was used to search for "sudden death" and "cardiac arrest" on "Baidu" and "360" websites. Reports of sudden death events were collected from January 2013 to December 2022. The age, gender, characteristics of sudden death, implementation characteristics of cardiopulmonary resuscitation (CPR), and pre-hospital and final clinical outcomes of sudden death patients were recorded and analyzed. Subgroup analyses were performed for pre-hospital and final clinical outcomes. Unconditional multivariate Logistic regression analysis was used to screen the related factors affecting the pre-hospital and final clinical outcomes in patients with sudden death. RESULTS: 177 news reports were finally confirmed, involving 177 sudden death patients, including 152 males (85.9%) and 25 females (14.1%), aged (37.27±16.82) years old, and 53.1% in the 16-45 years old group. Triggering factors included strenuous exercise (29.9%), heart disease history (7.9%), overwork (6.2%), staying up late and insomnia (4.0%), activation of emotion (2.8%), and no obvious inducement (48.0%). After on-site first aid, 104 cases (58.8%) achieved restoration of spontaneous circulation (ROSC) before hospital admission, and 18 cases (10.2%) recovered consciousness. After clinical treatment, 109 cases (61.6%) achieved ROSC, 86 cases (48.6%) recovered consciousness, and 22 cases (12.4%) did not report the final outcome. Subgroup analysis showed that compared with patients who achieved pre-hospital ROSC (n = 104), sudden death in non-ROSC patients (n = 73) mainly occurred during sleep, in residence and without immediate CPR, full CPR, or automated external defibrillator (AED); and patients who ultimately did not recover consciousness clinically (n = 91) showed similar characteristics compared with patients who recovered consciousness (n = 86). Multifactorial Logistic regression analysis showed that immediate CPR [pre-hospital ROSC: odds ratio (OR) = 8.06, 95% confidence interval (95%CI) was 2.36-27.46; final recovery of consciousness: OR = 9.10, 95%CI was 2.46-33.68] and AED defibrillation (pre-hospital ROSC: OR = 36.31, 95%CI was 4.53-291.19; final recovery of consciousness: OR = 3.53, 95%CI was 1.45-8.61) facilitated pre-hospital achievement of sudden death patients ROSC and final recovery of consciousness. CONCLUSIONS: Out-of-hospital sudden death mainly occurs in young people, and vigorous exercise is one of the potential factors for out-of-hospital sudden death, with nearly half having no obvious cause. Immediate and rapid CPR and defibrillation are the simplest and most effective on-site first aid methods. Strengthening public CPR and defibrillation education and training, and advocating healthy lifestyle are effective ways to improve the survival rate of sudden death and reduce the occurrence of sudden death. Based on practical clinical rescue experience, the implementation of bystander CPR by medical personnel is also a factor that cannot be ignored in affecting the clinical outcomes of sudden death patients.

Primary hepatic paraganglioma with megacolon: A case report.

Primary hepatic paraganglioma (PGL) is a rare neuroendocrine tumor characterized by clinical manifestations including paroxysmal hypertension, palpitation, abdominal pain and constipation. In the present study, the case of a 21-year-old woman with pathologically confirmed hepatic PGL with megacolon following surgery is reported. The patient initially visited Beijing Tiantan Hospital (Beijing, China) for hypoferric anemia. A triple-phase CT scan of the whole abdomen showed a large hypodense mass with a solid periphery and strong arterial enhancement of the peripheral solid portion of the liver. The sigmoid colon and rectum were obviously distended, filled with gas and intestinal contents. The patient was preoperatively diagnosed with iron deficiency anemia, liver injury and megacolon and then underwent partial hepatectomy, total colectomy and enterostomy. Microscopically, the liver cells exhibited an irregular zellballen pattern. In addition, immunohistochemical staining revealed that liver cells were positive for CD56, chromogranin A, vimentin, S-100, melan-A and neuron-specific enolase. Therefore, the diagnosis of primary PGL of the liver was confirmed. These findings suggested that primary hepatic PGL should not be excluded when megacolon occurs and comprehensive imaging evaluation is of great importance for its diagnosis.

Effects of different drying treatments on the microstructure, free amino acids, volatile compounds and antioxidant activity of Flammulina velutipes root.

Drying treatments are an effective method of preserving the beneficial properties of postharvest mushrooms. The effects of natural-air drying (ND), hot-air drying (HD), vacuum-freeze drying (FD), heat pump drying (HPD) and microwave-vacuum drying (MVD) on the microstructure, flavor- and health-related compounds of F. velutipes root were investigated. The results showed that FD had the least impact on the microstructure of F. velutipes root and its original porous fiber structure appeared complete. It also possessed the highest content of volatile compounds. MVD gave the highest contents of umami amino acids, total phenolics and total flavonoids, and its extract exhibited high antioxidant activity. In addition, different drying treatments had significant effect on the chemical components of F. velutipes root, with FD and MVD may be the potent drying strategies for preservation of flavor and nutraceuticals respectively. Therefore, our results provided essential data support for F. velutipes root processing and functional product development.

Mental Health Needs Among Asian and Asian American Adults During the COVID-19 Pandemic.

OBJECTIVE: Disaggregated data on the mental health of Asian/Asian American people are needed to inform public health interventions related to reports of racism during the COVID-19 pandemic. We describe the prevalence of psychological distress and unmet mental health needs among Asian/Asian American adults during the COVID-19 pandemic across various sociodemographic subgroups. METHODS: We used cross-sectional, weighted data from the US-based 2021 Asian American and Native Hawaiian/Pacific Islander COVID-19 Needs Assessment Study (unweighted n = 3508) to estimate prevalence rates of psychological distress and unmet mental health needs, overall and by nativity status. We conducted population-weighted multivariable logistic regression analyses to examine sociodemographic factors associated with these mental health outcomes. RESULTS: About one-third (1419 of 3508) of Asian/Asian American adults (32.9%; 95% CI, 30.6%-35.2%) reported psychological distress; odds of psychological distress were increased among adults who were female, trans, and nonbinary; aged 18-44 years; US-born; Cambodian; multiracial; and low income. Of those reporting psychological distress (638 of 1419), 41.8% (95% CI, 37.8%-45.8%) reported unmet mental health needs; unmet mental health needs were highest among Asian/Asian American adults who were aged 18-24 years; Korean, Japanese, and Cambodian; US-born female; non-US-born young adults; and non-US-born with ≥bachelor's degree. CONCLUSIONS: The mental health of Asian/Asian American people is an important public health concern, with some groups more vulnerable and in need of services than others. Mental health resources need to be designed for vulnerable subgroups, and cultural and systemic barriers to mental health care need to be addressed.

Temporal contexts for motion tracking in ultrasound sequences with information bottleneck.

BACKGROUND: Recently, deep convolutional neural networks (CNNs) have been widely adopted for ultrasound sequence tracking and shown to perform satisfactorily. However, existing trackers ignore the rich temporal contexts that exists between consecutive frames, making it difficult for these trackers to perceive information about the motion of the target. PURPOSE: In this paper, we propose a sophisticated method to fully utilize temporal contexts for ultrasound sequences tracking with information bottleneck. This method determines the temporal contexts between consecutive frames to perform both feature extraction and similarity graph refinement, and information bottleneck is integrated into the feature refinement process. METHODS: The proposed tracker combined three models. First, online temporal adaptive convolutional neural network (TAdaCNN) is proposed to focus on feature extraction and enhance spatial features using temporal information. Second, information bottleneck (IB) is incorporated to achieve more accurate target tracking by maximally limiting the amount of information in the network and discarding irrelevant information. Finally, we propose temporal adaptive transformer (TA-Trans) that efficiently encodes temporal knowledge by decoding it for similarity graph refinement. The tracker was trained on 2015 MICCAI Challenge on Liver Ultrasound Tracking (CLUST) dataset to evaluate the performance of the proposed method by calculating the tracking error (TE) between the predicted landmarks and the ground truth landmarks for each frame. The experimental results are compared with 13 state-of-the-art methods, and ablation studies are conducted. RESULTS: On CLUST 2015 dataset, our proposed model achieves a mean TE of 0.81 ± 0.74 mm and a maximum TE of 1.93 mm for 85 point-landmarks across 39 ultrasound sequences in the 2D sequences. Tracking speed ranged from 41 to 63 frames per second (fps). CONCLUSIONS: This study demonstrates a new integrated workflow for ultrasound sequences motion tracking. The results show that the model has excellent accuracy and robustness. Reliable and accurate motion estimation is provided for applications requiring real-time motion estimation in the context of ultrasound-guided radiation therapy.

Dual-Modal Information Bottleneck Network for Seizure Detection.

In recent years, deep learning has shown very competitive performance in seizure detection. However, most of the currently used methods either convert electroencephalogram (EEG) signals into spectral images and employ 2D-CNNs, or split the one-dimensional (1D) features of EEG signals into many segments and employ 1D-CNNs. Moreover, these investigations are further constrained by the absence of consideration for temporal links between time series segments or spectrogram images. Therefore, we propose a Dual-Modal Information Bottleneck (Dual-modal IB) network for EEG seizure detection. The network extracts EEG features from both time series and spectrogram dimensions, allowing information from different modalities to pass through the Dual-modal IB, requiring the model to gather and condense the most pertinent information in each modality and only share what is necessary. Specifically, we make full use of the information shared between the two modality representations to obtain key information for seizure detection and to remove irrelevant feature between the two modalities. In addition, to explore the intrinsic temporal dependencies, we further introduce a bidirectional long-short-term memory (BiLSTM) for Dual-modal IB model, which is used to model the temporal relationships between the information after each modality is extracted by convolutional neural network (CNN). For CHB-MIT dataset, the proposed framework can achieve an average segment-based sensitivity of 97.42%, specificity of 99.32%, accuracy of 98.29%, and an average event-based sensitivity of 96.02%, false detection rate (FDR) of 0.70/h. We release our code at https://github.com/LLLL1021/Dual-modal-IB.

Continuous compression with asynchronous ventilation improves CPR prognosis? A meta-analysis from human and animal studies.

BACKGROUND: The cardiopulmonary resuscitation (CPR) compression to ventilation strategy remains controversial. We conducted a meta-analysis to compare the outcomes between continuous chest compressions CPR with asynchronous ventilation (CCC-CPR) and interrupted chest compressions CPR with synchronous ventilation (ICC-CPR) in cardiac arrest. METHODS: PubMed, Web of Science, Embase, MEDLINE (Ovid/LWW) and the Cochrane Libraries were searched up from inception to July 31, 2022. Human and animal studies comparing CCC-CPR versus ICC-CPR were included. Outcome variables were return of spontaneous circulation (ROSC), time to ROSC, survival to discharge, 1-month survival, survival at 4 h, good neurological function, mean arterial pressure (MAP) and other clinical parameters. Jadad Scale and Newcastle-Ottawa Scale were used to assess the study quality and risk of bias. RESULTS: The systematic search identified eight studies on humans and twelve studies on animal trials. There were no significant differences in ROSC (odd ratios [OR] 1.07; 95% confidence interval [CI]: 0.86-1.32; P = 0.55), survival to hospital discharge (OR 1.04; 95%CI 0.77-1.42; P = 0.79), 1-month survival (OR 1.07; 95%CI 0.84-1.36; P = 0.57), and good neurological outcome (OR 0.92; 95%CI 0.84-1.01, P = 0.09) between CCC-CPR and ICC-CPR in human studies. In animal trials, CCC-CPR had significantly higher rate of ROSC (OR = 1.81; 95% CI: 0.94-3.49; P = 0.07), survival at 4 h (OR 2.57; 95% CI: 1.16-5.72; P = 0.02) and MAP (mean difference [MD] 0.79, 95% CI: 0.04-1.53; P = 0.04), even though no significant differences in ROSC time, arterial potential of hydrogen (pH) and partial tension of carbon dioxide (PaCO2). CONCLUSION: CCC-CPR did not show superiority in human outcomes compared with ICC-CPR, but its effect value was significantly increased in animal experiments. We should take the positive outcomes from animals and apply them to human models, and more physiological mechanisms need to be confirmed in CPR patients with different compression-ventilation strategies to improve the prognosis of cardiac arrest.

Patient-Reported Outcomes Following the Use of Jiang Tang San Huang Tablets in Type 2 Diabetes Mellitus: A Retrospective Cohort Study in a Chinese Population.

Purpose: We aimed to assess the efficacy of the Jiang Tang San Huang (JTSH) tablet for the treatment of patients with type 2 diabetes mellitus (T2DM). Methods: All data for this retrospective cohort study were acquired from the outpatient clinic database of our institution, and all enrolled patients received JTSH tablet for at least two months. Overall, 147 patients were included in the analysis. The primary outcome was patient-reported outcomes on the efficacy of the JTSH tablets using a questionnaire survey. Correlation analysis evaluated the duration of JTSH tablet administration and glycemic control in patients with T2DM. The secondary outcome measures included: changes in glycated hemoglobin (HbA1c), fasting plasma glucose (FPG), 2-hour postprandial blood glucose, homeostasis model assessment of insulin resistance index (HOMA-IR) and homeostasis model assessment of ß-cell function (HOMA-ß) after 2 months of treatment with JTSH tablets. Results: Overall,120 patients (81.63%) reported a JTSH tablet treatment satisfaction score of ≥60 points, and believed that JTSH tablets had satisfactory hypoglycemic effects and could improve symptoms. The average duration of JTSH tablet treatment was 2.57±1.45 years. Overall, 111 patients achieved good blood glucose control, while 36 patients had poor glycemic control. Multivariate logistic regression model analysis showed that taking JTSH tablets for 1 year might reduce the risk of poor hypoglycemic effect by 17.00% (Risk ratio=0.830, 95% confidence interval:0.578, 1.021, P=0.066). Compared with the baseline data, the levels of HbA1c, FPG and HOMA-IR decreased significantly and HOMA-ß levels increased significantly (P<0.05). Conclusion: Good blood glucose control may be positively correlated with the duration of JTSH tablets administration. Patients with T2DM were satisfied with the anti-diabetic effects of JTSH tablets, which can significantly reduce blood glucose and insulin resistance, and improve the function of islet cells.

Gender-related differences in the effects of Inonotus obliquus polysaccharide on intestinal microorganisms in SD rats model.

Natural edible fungal polysaccharides are of research and application value for the prevention of diseases by improving the microenvironment within the intestine. Inonotus obliquus polysaccharide (IOP) extracts have strong antioxidant, anti-inflammatory, and other biological activities, and as such, it could be used as prebiotics to improve the viability of intestinal microbes, maintain intestinal homeostasis and improve intestinal immunity. The effects of sex on intestinal microbiota after IOP absorption was determined. In this study, IOP had different effects on the intestinal flora of male and female rats, with the diversity and richness showing opposite changes. At the same time, after IOP intervention, changes in the dominant intestinal flora of female rats was less compared with that of males. In addition, while Clostridia, Lactobacillus and Roseburia were the dominant intestinal microbes in female rats, males had mainly Bacteroidota from different families and genera, along with an increasing proportion of Muribaculaceae from different families and genera. IOP could further regulate the intestinal microenvironment of male and female SD rats by enhancing the vitality of their dominant microorganisms, and for both sexes, this enabled the screening of dominant microflora that were conducive to the balance of the intestinal flora. These results help to understand the effects of sex-related differences on the composition of the intestinal microbiota as well as on diseases.

Effective delivery of osteopontin small interference RNA using exosomes suppresses liver fibrosis via TGF-ß1 signaling.

Objective and aims: Osteopontin (OPN), an oxidant stress sensitive cytokine, plays a central role in liver fibrosis. While OPN expression can be reduced by small interfering RNA (siRNA), the challenge to deliver siRNA safely and effectively into liver remains unresolved. Exosomes are promising natural nanocarriers for drug delivery that are able to enter cells with different biological barriers efficiently. In this study, we used exosomes as a delivery vehicle to target OPN in liver fibrosis. Methods: Exosomes selectively home to fibrotic liver according to small animal imaging system. Electroporation technique was used to engineer exosomes to carry siRNA targeting OPN (ExosiRNA-OPN). Primary hepatic stellate cells (HSCs) were isolated and treated with ExosiRNA-OPN to assess the effect on activated HSCs (aHSCs). Immunofluorescence for α-SMA, an aHSCs marker, and sirius red staining were performed to assess ECM deposition. Finally, plasma OPN from patients with liver fibrosis was identified by ELISA assay. Results: Exosome-mediated siRNA delivery systems show high uptake and low toxicity. Besides, ExosiRNA-OPN suppressed HSCs activation and ECM deposition and more efficiently improved liver function when compared to naked siRNA-OPN. Moreover, ExosiRNA-OPN was assumed inhibiting TGF-ß1 signaling activation, along with other fibrotic-related genes based on a GEO datasheet of liver fibrosis samples for correlation analyzes. ExosiRNA-OPN inhibited TGF-ß1 signaling by decreasing high-mobility group box-1 (HMGB1). Plasma proteins from chronic HBV-induced fibrosis patients were identified that patients with high OPN expression correlates with more advanced fibrosis progression. Discussion: This study shows that exosome-mediated siRNA-OPN delivery may be an effective option for the treatment of liver fibrosis.