Percutaneous transluminal angioplasty and stenting for severe stenosis of the intracranial carotid artery and its branches: Comparison of the Wingspan stent versus the Credo stent.

BACKGROUND: Despite the widespread use of the Wingspan stent system for treating severe medically refractory intracranial artery stenosis (SMR-ICAS), a new Credo stent system was approved because it could integrate stent delivery within the balloon catheter. However, the therapeutic outcomes of these two systems have not been compared. This preliminary study aimed to compare the results of percutaneous angioplasty and stenting (PTAS) in SMR-ICAS patients treated with either Wingspan or Credo stents within the anterior circulation. METHODS: SMR-ICAS patients with more than 70% stenosis in the anterior circulation who underwent PTAS using either the Wingspan or Credo stent system were analyzed. We evaluated the technical success, safety, and outcomes of the two stent systems. RESULTS: A total of 29 patients were analyzed, including 17 patients treated with Wingspan stents and 12 with Credo stents. The outcomes of the Wingspan stent vs. Credo stent were as follows: technical success (16/17 [94%] vs. 11/12 [92%], p = 1.00); periprocedural intracranial hemorrhage (2/17 [12%] vs. 0/12 [0%], p = 0.50); silent embolic ischemic lesions on peri-procedural MRI (13/17 [76%] vs. 7/12 [58%], p = 0.42); and significant (more than 50%) in-stent restenosis in one year (4/17 [24%] vs. 2/12 [17%], p = 1.00). No recurrent stroke or mortality was noted within 30 days after the procedures or during the one-year follow-up period. CONCLUSION: The technical success, safety, and outcomes of the Credo stent system were comparable to those of the Wingspan stent system in the management of SMR-ICAS patients. Further large-scale studies are warranted to substantiate these findings.

Preparation of a Highly Flame-Retardant Urea-Formaldehyde Resin and Flame Retardance Mechanism.

Urea-formaldehyde (UF) resin is the most widely used adhesive resin. However, it is necessary to improve its flame-retardant performance to expand its applications. In this study, exploiting electrostatic interactions, anionic phytic acid and cationic chitosan were combined to form a bio-based intumescent flame-retardant, denoted phytic acid-chitosan polyelectrolyte (PCS). The molecular structure of the urea-formaldehyde resin was optimized by crosslinking with melamine and plasticizing with polyvinyl alcohol-124. Thus, by combining PCS with the urea-formaldehyde resin and with ammonium polyphosphate and ammonium chloride as composite curing agents, flame-retardant urea-formaldehyde resins (FRUFs) were prepared. Compared to traditional UF resin, FRUF showed excellent flame retardancy and not only reached the UL-94 V-0 level, but the limit of oxygen index was also as high as 36%. Compared to those of UF, the total heat release and peak heat release rate of FRUF decreased by 86.44% and 81.13%, respectively. The high flame retardancy of FRUF originates from the combination of oxygen and heat isolation by the dense carbon layer, quenching of phosphorus free radicals, and dilution of oxygen by a non-flammable gas. In addition, the mechanical properties of the FRUF remained good, even after modification. The findings of this study provide a reference for the flame-retardant application of FRUF for applications in multiple fields.

2023 Inaugural Healthcare Delivery Science: Innovation and Partnerships for Health Equity Research (DESCIPHER) Symposium.

Introduction: This article provides an overview of presentations and discussions from the inaugural Healthcare Delivery Science: Innovation and Partnerships for Health Equity Research (DESCIPHER) Symposium. Methods: The symposium brought together esteemed experts from various disciplines to explore models for translating evidence-based interventions into practice. Results: The symposium highlighted the importance of disruptive innovation in healthcare, the need for multi-stakeholder engagement, and the significance of family and community involvement in healthcare interventions. Conclusions: The article concluded with a call to action for advancing healthcare delivery science to achieve health equity.

A case of Abernethy malformation type I combined with hepatoblastoma.

This article encountered an extremely rare case of a 2-year-old male with Abernethy malformation Type I combined with hepatoblastoma. Furthermore, the medical history was characterized by several other abnormalities: gross facial asymmetry and cardiac defects，thus, diagnosis of Goldenhar syndrome in the setting of Abernethy type I was made. In this article, we exhibit the typical clinical presentation and Pathology imaging features of this disease.

PD-L1 Expression and Its Modulating Factors in Anaplastic Thyroid Carcinoma: A Multi-institutional Study.

Anti-PD immunotherapy is currently under investigation in anaplastic thyroid carcinoma (ATC). Tumor cell surface PD-L1 expression is considered predictive of therapeutic response. Although papillary thyroid carcinoma has been widely studied for PD-L1 expression, there are limited data on ATC. In this retrospective multi-institutional study involving 9 centers across Asia, 179 ATCs were assessed for PD-L1 expression using the SP263 (Ventana) clone. A tumor proportion score (TPS) ≥1% was required to consider a case PD-L1-positive. PD-L1 expression was compared with the histological patterns, the type of specimen (small or large), tumor molecular profile (BRAF V600E and TERT promoter mutation status), and patient outcome. PD-L1 expression in any co-existent differentiated thyroid carcinoma (DTC) was evaluated separately and compared with ATC. Most ATCs (73.2%) were PD-L1-positive. The median TPS among positive cases was 36% (IQR 11% to 75%; range 1% to 99%). A high expression (TPS ≥ 50%) was noted in 30.7%. PD-L1-negative cases were more likely to be small specimens (P=0.01). A negative result on small samples, hence, may not preclude expression elsewhere. ATCs having epithelioid and pleomorphic histological patterns were more likely to be PD-L1-positive with higher TPS than sarcomatoid (P<0.01). DTCs were more frequently negative and had lower TPS than ATC (P<0.01). Such PD-L1 conversion from DTC-negative to ATC-positive was documented in 71% of cases with co-existent DTC. BRAF V600E, but not TERT promoter mutations, correlated significantly with PD-L1-positivity rate (P=0.039), reinforcing the potential of combining anti-PD and anti-BRAF V600E drugs. PD-L1 expression, however, did not impact the patient outcome.

Visual Quantitation of Dopamine-Inspired Fluorescent Adhesion with Orthogonal Phenanthrenequinone Photochemistry.

Quantifying adhesion is crucial for understanding adhesion mechanisms and developing advanced dopamine-inspired materials and devices. However, achieving nondestructive and real-time quantitation of adhesion using optical spectra remains challenging. Here, we present a dopamine-inspired orthogonal phenanthrenequinone photochemistry strategy for the one-step adhesion and real-time visual quantitation of fluorescent spectra. This strategy utilizes phenanthrenequinone-mediated photochemistry to facilitate conjoined network formation in the adhesive through simultaneous photoclick cycloaddition and free-radical polymerization. The resulting hydrogel-like adhesive exhibits good mechanical performance, with a Young's modulus of 300 kPa, a toughness of 750 kJ m-3, and a fracture energy of 4500 J m-2. This adhesive, along with polycyclic aromatic phenanthrenequinones, shows strong adhesion (>100 kPa) and interfacial toughness thresholds (250 J m-2) on diverse surfaces─twice to triple as much as typical dopamine-contained adhesives. Importantly, such an adhesive demonstrates excellent fluorescent performance under UV irradiation, closely correlating with its adhesion strengths. Their fluorescence intensities remain constant after continuous stretching/releasing treatment and even in the dried state. Therefore, this dopamine-inspired orthogonal phenanthrenequinone photochemistry is readily available for real-time and nondestructive visual quantitation of adhesion performance under various conditions. Moreover, the adhesive precursor is chemically ultrastable for more than seven months and achieves adhesion on substrates within seconds upon blue light irradiation. As a proof-of-concept, we leverage the rapid and visual quantitation of adhesion and printability to create fluorescent patterns and structures, showcasing applications in information storage, adhesion prediction, and self-reporting properties. This general and straightforward strategy holds promise for rapidly preparing functional adhesive materials and designing high-performance wearable devices.

Cost-effective 3D-printed rotatable reflectors for two-dimensional beam steering.

In this paper, we have developed a 2D optical scanning module comprising cascaded 3D-printed one-axis rotating mirrors with large areas (30×30m m 2 for the X-direction scan and 60×25m m 2 for the Y-direction scan). Each mirror device contains a square or rectangular silicon substrate coated with aluminum, serving as the mirror. A 3D-printed structure, including the mirror frame (with four embedded mini permanent magnets on the backside), torsion springs, and base, is combined with the mirror; two electromagnets are situated under the mirror as the actuation mechanism. We apply DC voltage to the electromagnets to create magnetic force. The electromagnets can interact with the permanent magnets to make the mirror rotate. The X scan of the 2D scanning module can achieve a static optical scan angle of ∼11.8deg at the -X corners, and the corresponding Y-scan angle is ∼4.5deg, both with 12 VDC. Moreover, we have observed a fan-shaped distortion, a phenomenon not thoroughly studied previously for combining two single-axis scan mirrors. Therefore, we also perform a simulation to establish and demonstrate a correlation between the simulation prediction and experimental results. The 2D scanning module can be a low-cost alternative to the expensive conventional galvanometer scanners, and it can be used to upgrade a rangefinder to a simplified LiDAR.

Bacteria Contaminants Detected by Organic Inverter-Based Biosensors.

The importance of bacteria detection lies in its role in enabling early intervention, disease prevention, environmental protection, and effective treatment strategies. Advancements in technology continually enhance the speed, accuracy, and sensitivity of detection methods, aiding in addressing these critical issues. This study first reports the fabrication of an inverter constructed using crosslinked-poly(4-vinylphenol) (C-PVP) as the dielectric layer and an organic complementary metal-oxide semiconductor (O-CMOS) based on pentacene and N,N'-ditridecylperylene-3,4,9,10-tetracarboxylic diimide (PTCDI-C13) as a diagnostic biosensor to rapidly detect bacterial concentration. Bacteria including Escherichia coli O157, Staphylococcus aureus ATCC25922, and Enterococcus faecalis SH-1051210 were analysed on the inverters at an ultra-low operating voltage of 2 V. The high density of negative charge on bacteria surfaces strongly modulates the accumulated negative carriers within the inverter channel, resulting in a shift of the switching voltage. The inverter-based bacteria sensor exhibits a linear-like response to bacteria concentrations ranging from 102 to 108 CFU/mL, with a sensitivity above 60%. Compared to other bacterial detectors, the advantage of using an inverter lies in its ability to directly read the switching voltage without requiring an external computing device. This facilitates rapid and accurate bacterial concentration measurement, offering significant ease of use and potential for mass production.

Preparation of a Flame-Retardant Curing Agent Based on Phytic Acid-Melamine Ion Crosslinking and Its Application in Wood Coatings.

To broaden the applications of wood, it is necessary to prepare flame-retardant coatings that can protect wood substrates during combustion. In this study, a bio-based, intumescent, flame-retardant phytic acid-melamine polyelectrolyte (PM) was prepared using phosphorus-rich biomass phytic acid and nitrogen-rich melamine as raw materials through an ion crosslinking reaction. Subsequently, a series of bio-based, flame-retardant wood coatings were prepared by optimizing the structure of urea-formaldehyde resin with the addition of melamine, sodium lignosulfonate, and PM as a flame-retardant curing agent. Woods coated with PM-containing coatings displayed significantly improved flame-retardant performances in comparison to uncoated woods. For PM-cured woods, the measured values of total heat release and total smoke production were 91.51% and 57.80% lower, respectively, compared with those of uncoated wood. Furthermore, the fire growth index decreased by 97.32%, indicating a lower fire hazard. This increase in flame retardancy and smoke suppression performance is due to the dense expanded carbon layer formed during the combustion of the coating, which isolates oxygen and heat. In addition, the mechanical properties of the flame-retardant coatings cured with PM are similar to those cured with a commercial curing agent, NH4Cl. In addition, the prepared flame-retardant coating can also stain the wood. This study proves the excellent flame-retarding and curing effect of ammonium phytate in urea-formaldehyde resin coatings and provides a new approach for the application of bio-based flame retardants in wood coatings.

When concentrated disadvantage happens: Exploring the nexus of energy and internet insecurities among vulnerable households.

Digital divide and energy insecurity are pervasive issues among underserved communities, issues that become prounoued during the COVID-19 lockdowns. These disparities underscore the critical need to address them promptly to narrow socio-economic gaps. Our study, based on an online survey of 2,588 respondents in the United Kingdom, explores how concentrated socio-economic disadvantage exacerbates insecurities relating to energy and internet access. Our findings reveal that marginalized groups including low-income households, women, renters, ethnic minorities, and individuals with lower educational attainment are disproportionately affected. Our research extends beyond financial implications to explore the broader social and psychological effects such as trust in utility and internet providers. The study also demonstrates how heightened burdens from energy and internet costs adversely affect the quality of indoor environments, underscoring the interconnected nature of these challenges. Based on these insights, we advocate for policy interventions that adopt comprehensive social justice frameworks to tackle these intersecting inequalities effectively.

Evaluating the Risk of Malignancies of the Diagnostic Categories Proposed by the World Health Organization System for Reporting Lung Cytopathology: A 2-Year Single Institutional Experience.

INTRODUCTION: The WHO System of Reporting Lung Cytopathology proposed a 5-tiered system in 2023. We report the risk of malignancies (ROMs) of bronchial washing/lavage and percutaneous fine-needle aspiration (FNA) specimens. We also evaluated the change of ROMs when image correlation is required. METHODS: Lung cytology cases in 2021 and 2022 with histologic follow-up were included. CT reports were reviewed to identify cases with a solid nodule/tumor but benign cytological findings. These were reassigned from the "benign" to "non-diagnostic" category, and the ROMs were re-estimated. RESULTS: A total of 1,031 bronchial washing/lavage and 206 FNAs were identified. The ROMs of bronchial washing/lavage were "non-diagnostic" 56.5% (13/23), "benign" 41.9% (320/764), "atypical" 71.7% (71/99), "suspicious for malignancy" 94.7% (72/76), and "malignant" 100% (70/70). The ROMs of FNAs were "non-diagnostic" 66% (33/50), "benign" 58.2% (39/67), "atypical" 70% (28/40), "suspicious for malignancy" 96.2% (25/26), and "malignant" 100% (70/70). When image finding was considered, cases initially assigned as "benign" were re-classified to "non-diagnostic" with decreases in ROMs for the "benign" category. CONCLUSIONS: Malignancy risks associated with the WHO System of Reporting Lung Cytopathology diagnostic groups were reported. Image correlation for the "benign" category led to a decrease in case number and ROM.

Establishment of a two-hit mouse model of environmental factor induced autism spectrum disorder.

Autism spectrum disorder (ASD) is a group of developmental diseases characterized by social dysfunction and repetitive stereotype behaviors. Besides genetic mutations, environmental factors play important roles in the development of ASD. Valproic acid (VPA) is widely used for modeling environmental factor induced ASD in rodents. However, traditional VPA modeling is low-in-efficiency and the phenotypes often vary among different batches of experiments. To optimize this ASD-modeling method, we tested "two-hit" hypothesis by single or double exposure of VPA and poly:IC at the critical time points of embryonic and postnatal stage. The autistic-like behaviors of mice treated with two-hit schemes (embryonic VPA plus postnatal poly:IC, embryonic poly:IC plus postnatal VPA, embryonic VPA plus poly: IC, or postnatal VPA plus poly:IC) were compared with mice treated with traditional VPA protocol. The results showed that all single-hit and two-hit schemes produced core ASD phenotypes as VPA single treatment did. Only one group, namely, mice double-hit by VPA and poly:IC simultaneously at E12.5 showed severe impairment of social preference, social interaction and ultrasonic communication, as well as significant increase of grooming activity and anxiety-like behaviors, in comparation with mice treated with the traditional VPA protocol. These data demonstrated that embryonic two-hit of VPA and poly:IC is more efficient in producing ASD phenotypes in mice than the single-hit of VPA, indicating this two-hit scheme could be utilized for modeling environmental factors induced ASD.

Growing success with sustainability: The influence of green HRM, innovation, and competitive advantage on environmental performance in the manufacturing industry.

President Xi set a long-term mitigation target of carbon neutrality by 2060 in September 2020 to cut carbon emissions and improve environmental performance. As a result, the current study aims to investigate how green human resource management and green innovation affect environmental performance in pursuit of the ultimate objective of carbon neutrality. Furthermore, the research considers the potential mediating effect of a green competitive advantage to clarify the mechanisms by which GHRM and green innovation impact environmental performance. Data from 278 employees in the manufacturing industry of Heilongjiang Province were collected through a questionnaire, for which we used a quantitative random sampling technique. The study employed the Smart PLS-4 structural equation modeling technique and revealed that all three factors significantly influenced environmental performance: green HRM, innovation, and competitive advantage. Resource-based view (RBV) theory served as the theoretical foundation for the study. The study uniquely contributes to the literature on GHRM, green innovation, competitive advantage, and environmental performance.

Social determinants of health that impact the time to diagnosis and treatment of infertility in Taiwan.

BACKGROUND/PURPOSE: Taiwan is one of the countries with the lowest birth rate in the world. We investigated factors associated with the time to diagnosis and treatment of infertility in Taiwan. METHODS: The study was conducted through an online questionnaire in December 2021. The questionnaire was adapted from a previously published multinational survey, and culture-specific questions were added. 91 infertile patients and 89 partners of patients in Taiwan, aged 20- to 45- year-old, were included. RESULTS: The average duration before diagnosis was 2.9 years, followed by 1.5 years before treatment. Older age at marriage (p = 0.0024), higher education level (P = 0.0001), and a higher gender equality score (p = 0.0031) were associated with earlier diagnosis. Conversely, folk therapy use was linked to later diagnosis (p < 0.0001) and treatment (p < 0.0001). Notably, in the female (p = 0.039) and patient (p = 0.0377) subgroups, a higher gender equality score was associated with a shorter duration of folk therapy. Subjectively, the most frequent factor influencing treatment decision was affordability or lack thereof. The government subsidy for in vitro fertilization led to increased treatment willingness for 46.3% of respondents, and 47.3% reported more likely to pursue earlier treatment. CONCLUSIONS: This study highlights the influence of education, gender equality, folk therapy, and government subsidy on fertility care decisions. To improve the timeliness of infertility healthcare in Taiwan, potential strategies include promoting education, fostering gender equality, providing financial support, and raising awareness on the association between folk therapy and delayed medical care.

Safety and efficacy of Yaobitong capsules for lumbar disc herniation: A multicenter, randomized, double-blinded, parallel, positive-controlled clinical trial.

BACKGROUND: Lumbar disc herniation (LDH) is one of the most common diseases and is a global medical and socioeconomic problem characterized by leg or back pain, weakness in the lower extremities and paresthesia. OBJECTIVES: A multicenter, randomized, double-blinded, parallel, positive-controlled clinical trial was conducted to evaluate the efficacy and safety of Yaobitong capsules (YBT) for LDH. MATERIAL AND METHODS: Patients (n = 479) were recruited and randomized into YBT and Jingyaokang capsule (JYK) groups (the positive control), and received YBT or JYK at a dose of 3 capsules 3 times per day after a meal for 30 days. The primary efficacy outcome was the Oswestry Disability Index (ODI), with the visual analogue scale (VAS) used as the secondary efficacy outcome. The adverse events and adverse reactions were also evaluated. RESULTS: There was no significant difference in baseline characteristics between YBT (n = 358) and JYK groups (n = 120), and no difference was observed between groups for mean ODI score at day 0 (p = 0.064) or day 7 (p = 0.196), but there were differences at days 14, 21 and 30 (p < 0.001). The YBT showed more decline from baseline, and the decreased ODI score was substantially different from JYK (p < 0.001). The differences in decreased VAS scores between YBT and JYK were also significant at each time point (days 7, 14, 21, and 30), with better scores in the YBT group than in the JYK group (p < 0.001). In terms of safety, there was no obvious disparity in adverse events or adverse reactions between the 2 groups (p > 0.05). CONCLUSIONS: Yaobitong was better than JYK for LDH treatment, with no significant difference in safety. The study suggests that YBT is a promising and effective treatment for LDH.

Measurements of peri-prostatic adipose tissue by MRI predict bone metastasis in patients with newly diagnosed prostate cancer.

Objectives: To investigate the role of MRI measurements of peri-prostatic adipose tissue (PPAT) in predicting bone metastasis (BM) in patients with newly diagnosed prostate cancer (PCa). Methods: We performed a retrospective study on 156 patients newly diagnosed with PCa by prostate biopsy between October 2010 and November 2022. Clinicopathologic characteristics were collected. Measurements including PPAT volume and prostate volume were calculated by MRI, and the normalized PPAT (PPAT volume/prostate volume) was computed. Independent predictors of BM were determined by univariate and multivariate logistic regression analysis, and a new nomogram was developed based on the predictors. Receiver operating characteristic (ROC) curves were used to estimate predictive performance. Results: PPAT and normalized PPAT were associated with BM (P<0.001). Normalized PPAT positively correlated with clinical T stage(cT), clinical N stage(cN), and Grading Groups(P<0.05). The results of ROC curves indicated that PPAT and normalized PPAT had promising predictive value for BM with the AUC of 0.684 and 0.775 respectively. Univariate and multivariate analysis revealed that high normalized PPAT, cN, and alkaline phosphatase(ALP) were independently predictors of BM. The nomogram was developed and the concordance index(C-index) was 0.856. Conclusions: Normalized PPAT is an independent predictor for BM among with cN, and ALP. Normalized PPAT may help predict BM in patients with newly diagnosed prostate cancer, thus providing adjunctive information for BM risk stratification and bone scan selection.

Involvement and regulation of the left anterior cingulate cortex in the ultrasonic communication deficits of autistic mice.

Introduction: Autism spectrum disorder (ASD) is a group of diseases often characterized by poor sociability and challenges in social communication. The anterior cingulate cortex (ACC) is a core brain region for social function. Whether it contributes to the defects of social communication in ASD and whether it could be physiologically modulated to improve social communication have been poorly investigated. This study is aimed at addressing these questions. Methods: Fragile X mental retardation 1 (FMR1) mutant and valproic acid (VPA)-induced ASD mice were used. Male-female social interaction was adopted to elicit ultrasonic vocalization (USV). Immunohistochemistry was used to evaluate USV-activated neurons. Optogenetic and precise target transcranial magnetic stimulation (TMS) were utilized to modulate anterior cingulate cortex (ACC) neuronal activity. Results: In wild-type (WT) mice, USV elicited rapid expression of c-Fos in the excitatory neurons of the left but not the right ACC. Optogenetic inhibition of the left ACC neurons in WT mice effectively suppressed social-induced USV. In FMR1-/-- and VPA-induced ASD mice, significantly fewer c-Fos/CaMKII-positive neurons were observed in the left ACC following USV compared to the control. Optogenetic activation of the left ACC neurons in FMR1-/- or VPA-pretreated mice significantly increased social activity elicited by USV. Furthermore, precisely stimulating neuronal activity in the left ACC, but not the right ACC, by repeated TMS effectively rescued the USV emission in these ASD mice. Discussion: The excitatory neurons in the left ACC are responsive to socially elicited USV. Their silence mediates the deficiency of social communication in FMR1-/- and VPA-induced ASD mice. Precisely modulating the left ACC neuronal activity by repeated TMS can promote the social communication in FMR1-/- and VPA-pretreated mice.

The effect of low-level laser therapy on the oxidative stress level and quality of life in patients with Hashimoto's thyroiditis.

This study aimed to examine the effects of low-level laser therapy (LLLT) combined with levothyroxine replacement therapy on thyroid function, oxidative stress (OS), and quality of life in patients with Hashimoto's thyroiditis (HT). Forty-six patients diagnosed with HT were randomized to receive active LLLT (n = 23) and sham LLLT (n = 23) twice a week for three weeks. Clinical and laboratory evaluations of the participants were performed before treatment and three months after treatment. Biochemical parameters were taken from the patient file requested by the physician as a routine examination. Malondialdehyde and nitricoxide indicating oxidant stress and superoxide dismutase, catalase, and glutathione, which indicate antioxidant capacity, were used in OS evaluation. The Oxidative Stress Index was calculated by measuring the Total Antioxidant Status and the Total Oxidant Status. At the end of our study, a significant improvement in oxidant and antioxidant biomarker levels showing OS and quality of life was observed in the treatment groups (p < 0.05). There was no change in thyroid function and autoimmunity at the end of the treatment between the two groups (p > 0.05). Improvements in glutathione levels and quality of life were significantly higher in the active treatment group than in the sham-controlled group. LLLT was found to be more effective on OS and quality of life in patients with HT than in patients in the sham-controlled group. It was concluded that LLLT is a safe and effective method that can be used in the treatment of patients with HT.