Jejunal sarcomatoid carcinoma: A case report and review of literature.

BACKGROUND: Sarcomatoid carcinoma (SCA) of the jejunum is a rare and aggressive neoplasm affecting the smooth muscle cells of the jejunum. This study presents a recent case of jejunal SCA, detailing its diagnosis and treatment, thereby providing a reference for clinical practice. CASE SUMMARY: A 65-year-old male presented to Yichang Central People's Hospital with a chief complaint of hemorrhoids. A computed tomography (CT) scan incidentally revealed multiple abnormal signals in the liver. Subsequent positron emission tomography/CT at Wuhan Union Hospital indicated malignant tumor progression, with a primary duodenal tumor and multiple metastases in the upper left abdomen. Intraoperatively, a large tumor was identified on the omentum. Histopathological and immunohistochemical analyses of the resected specimen confirmed the diagnosis of jejunal SCA. The patient received a combination therapy of sintilimab, nanoparticle albumin-bound paclitaxel, and anlotinib. Follow-up imaging demonstrated significant reduction of hepatic and peritoneal lesions. The patient has remained stable for over one year postoperatively. CONCLUSION: This case suggests that chemotherapy, immunotherapy, plus targeted therapy may represent an optimal treatment for intestinal SCA, meriting further investigation.

Prevalence of antenatal depression and postpartum depression among Chinese fathers: A systematic review and meta-analysis.

Background: Paternal antenatal depression and postpartum depression are associated with adverse health outcomes in mothers and infants; however, their prevalence among Chinese fathers remains controversial. This meta-analysis aimed to summarize the prevalence of antenatal depression and postpartum depression in Chinese fathers. Methods: We conducted a systematic meta-analysis on the prevalence of antenatal depression and postpartum depression among Chinese fathers by searching 11 databases. Pooled estimates and 95 % confidence intervals were calculated. The choice between a random-effects model and a fixed-effects model was based on an assessment of heterogeneity among the studies as well as assumptions regarding the similarity of the studies in terms of clinical characteristics, quality, design, and conduct. Subgroup and meta-regression analyses were conducted based on the scale used to measure antenatal depression and postpartum depression, the region where the study was completed, the time of the study, the study design, the number of children, publication language, the study site, and quality assessment. Results: This meta-analysis included 28 studies with 8795 participants. The prevalence of antenatal depression among Chinese fathers was 11 % (95 % CI: 5%-17 %, P < 0.01) using a random-effects model. Heterogeneity was I2 = 91 %. Publication language moderated the prevalence of paternal antenatal depression (the amount of heterogeneity accounted for was 92.13 %). The prevalence of postpartum depression among Chinese fathers was 16 % (95 % CI: 13%-18 %, P < 0.01), using a random-effects model. The heterogeneity was I2 = 94 %. The prevalence of paternal postpartum depression was moderated by the scale used to measure postpartum depression (39.17 % heterogeneity) and the region where the study was completed (33.15 % heterogeneity). Moreover, Egger's test (t = 4.542, P < 0.001) indicated publication bias in studies on postpartum depression among Chinese fathers. However, after applying the trimming correction, the pooled prevalence of postpartum depression had a P value of <0.05, indicating that despite the publication bias, the results remain reliable and unaffected in terms of effect size. Conclusion: The prevalence of antenatal depression and postpartum depression among Chinese fathers was similar to those reported in low- and middle-income countries. Fathers should receive regular screening, effective prevention, and appropriate treatment. However, interpreting these results requires consideration of the limitations of the study.

The unconventional resistance protein PTR recognizes the Magnaporthe oryzae effector AVR-Pita in an allele-specific manner.

Blast disease caused by the fungus Magnaporthe oryzae is one of the most devastating rice diseases. Disease resistance genes such as Pi-ta or Pi-ta2 are critical in protecting rice production from blast. Published work reports that Pi-ta codes for a nucleotide-binding and leucine-rich repeat domain protein (NLR) that recognizes the fungal protease-like effector AVR-Pita by direct binding. However, this model was challenged by the recent discovery that Pi-ta2 resistance, which also relies on AVR-Pita detection, is conferred by the unconventional resistance gene Ptr, which codes for a membrane protein with a cytoplasmic armadillo repeat domain. Here, using NLR Pi-ta and Ptr RNAi knockdown and CRISPR/Cas9 knockout mutant rice lines, we found that AVR-Pita recognition relies solely on Ptr and that the NLR Pi-ta has no role in it, indicating that it is not the Pi-ta resistance gene. Different alleles of Ptr confer different recognition specificities. The A allele of Ptr (PtrA) detects all natural sequence variants of the effector and confers Pi-ta2 resistance, while the B allele of Ptr (PtrB) recognizes a restricted set of AVR-Pita alleles and, thereby, confers Pi-ta resistance. Analysis of the natural diversity in AVR-Pita and of mutant and transgenic strains identified one specific polymorphism in the effector sequence that controls escape from PtrB-mediated resistance. Taken together, our work establishes that the M. oryzae effector AVR-Pita is detected in an allele-specific manner by the unconventional rice resistance protein Ptr and that the NLR Pi-ta has no function in Pi-ta resistance and the recognition of AVR-Pita.

Construction of Magnesium Phosphate Chemical Conversion Coatings with Different Microstructures on Titanium to Enhance Osteogenesis and Angiogenesis.

Titanium (Ti) and its alloys are widely used as hard tissue substitutes in dentistry and orthopedics, but their low bioactivity leads to undesirable osseointegration defects in the early osteogenic phase. Surface modification is an important approach to overcome these problems. In the present study, novel magnesium phosphate (MgP) coatings with controllable structures were fabricated on the surface of Ti using the phosphate chemical conversion (PCC) method. The effects of the microstructure on the physicochemical and biological properties of the coatings on Ti were researched. The results indicated that accelerators in PCC solution were important factors affecting the microstructure and properties of the MgP coatings. In addition, the coated Ti exhibited excellent hydrophilicity, high bonding strength, and good corrosion resistance. Moreover, the biological results showed that the MgP coatings could improve the spread, proliferation, and osteogenic differentiation of mouse osteoblast cells (MC3T3-E1) and vascular differentiation of human umbilical vein endothelial cells (HUVECs), indicating that the coated Ti samples had a great effect on promoting osteogenesis and angiogenesis. Overall, this study provided a new research idea for the surface modification of conventional Ti to enhance osteogenesis and angiogenesis in different bone types for potential biomedical applications.

Genomic basis determining root system architecture in maize.

KEY MESSAGE: A total of 389 and 344 QTLs were identified by GWAS and QTL mapping explaining accumulatively 32.2-65.0% and 23.7-63.4% of phenotypic variation for 14 shoot-borne root traits using more than 1300 individuals across multiple field trails. Efficient nutrient and water acquisition from soils depends on the root system architecture (RSA). However, the genetic determinants underlying RSA in maize remain largely unexplored. In this study, we conducted a comprehensive genetic analysis for 14 shoot-borne root traits using 513 inbred lines and 800 individuals from four recombinant inbred line (RIL) populations at the mature stage across multiple field trails. Our analysis revealed substantial phenotypic variation for these 14 root traits, with a total of 389 and 344 QTLs identified through genome-wide association analysis (GWAS) and linkage analysis, respectively. These QTLs collectively explained 32.2-65.0% and 23.7-63.4% of the trait variation within each population. Several a priori candidate genes involved in auxin and cytokinin signaling pathways, such as IAA26, ARF2, LBD37 and CKX3, were found to co-localize with these loci. In addition, a total of 69 transcription factors (TFs) from 27 TF families (MYB, NAC, bZIP, bHLH and WRKY) were found for shoot-borne root traits. A total of 19 genes including PIN3, LBD15, IAA32, IAA38 and ARR12 and 19 GWAS signals were overlapped with selective sweeps. Further, significant additive effects were found for root traits, and pyramiding the favorable alleles could enhance maize root development. These findings could contribute to understand the genetic basis of root development and evolution, and provided an important genetic resource for the genetic improvement of root traits in maize.

The Formation Process and Mechanism of the 3D Porous Network on the Sulfonated PEEK Surface.

A three-dimensional (3D) porous network can be prepared on the PEEK surface by sulfonation with enhanced osseointegration and antibacterial properties. However, few studies have been conducted on the formation mechanism of a 3D porous network. In this work, the surface and cross-sectional morphologies, chemical compositions, functional groups, surface wettability, and crystalline states of sulfonated PEEK were investigated at different sulfonation times and coagulant concentrations. The results show that the number of nodular structures and broken fibers on the sulfonated PEEK surface as well as the size of macrovoids in the cross sections increase with increasing sulfonation times when water is used as a coagulant. In contrast, dilute sulfuric acid as a coagulant can inhibit the formation of surface porous structures and macrovoids in the cross sections. Moreover, all of the sulfonated PEEK samples have the same chemical compositions but exhibit better hydrophilicity as the number of microsized pores decreases. It is proposed that non-solvent-induced phase separation (NIPS) occurs during the sulfonation process, and the formation mechanism of surface and cross-sectional morphologies is discussed. Furthermore, it is assumed that the air is trapped in the microsized pores, leaving the surface of the 3D porous network in the Cassie-wetting state. All of these preliminary results throw light on the nature of the sulfonation process and may guide further modification of the structures of sulfonated PEEK.

Serum HSP70 and VEGF levels are effective predictive factors of chemoradiosensitivity and prognosis of pancreatic cancer patients.

AIM: To evaluate the value of serum HSP70 and VEGF levels for predicting the chemoradiosensitivity of the pancreatic cancer patients. METHODS: A total of 255 patients with pancreatic cancer and 60 healthy subjects were enrolled in this study. Serum levels of HSP70 and VEGF were measured using enzyme-linked immunosorbent assay (ELISA) for the pre-treatment, during-treatment and post- chemoradiotherapy time-points. The results were analyzed to evaluate the potential of serum HSP70 and VEGF levels for predicting the chemoradiosensitivity of pancreatic cancer patients. RESULTS: The serum levels of both HSP70 and VEGF were found to be elevated in pancreatic cancer patients as compared to healthy subjects. After chemoradiotherapy treatment, 179 patients showed effective clinical response [complete response (CR) + partial response (PR)] while 76 patients showed ineffective clinical response [stable disease (SD) + progressive disease (PD)]. Compared with the pre-treatment levels, serum levels of HSP70 and VEGF were higher during chemoradiotherapy, and lower post-treatment in the effective group. However, serum levels of HSP70 and VEGF were higher during and after treatment in the ineffective group. At any given timepoint, serum levels of HSP70 and VEGF were higher in the ineffective group as compared to those of the effective group. The overall survival (OS) and progression free survival (PFS) trends were: HSP70 High/VEGFHigh < HSP70High/VEGFLow or HSP70Low/VEGFHigh < HSP70Low/VEGFLow. Serum levels of HSP70 and VEGF were individually effective, and their combination was even more effective in predicting the chemoradiosensitivity of pancreatic cancer patients. HSP70 and VEGF expression were independent risk factors for OS and PFS of pancreatic cancer patients. CONCLUSION: Higher levels of serum HSP70 and VEGF were associated with lower radiosensitivity and worse prognosis, while lower levels of serum HSP70 and VEGF were associated with improved radiosensitivity and better prognosis of pancreatic cancer patients.

Effectiveness and safety of azvudine in older adults with mild and moderate COVID-19: a retrospective observational study.

BACKGROUND: Azvudine has clinical benefits and acceptable safety against COVID-19, including in patients with comorbidities, but there is a lack of available data for its use in older adult patients. This study explored the effectiveness and safety of azvudine in older adults with mild or moderate COVID-19. METHODS: This retrospective cohort study included patients aged ≥80 diagnosed with COVID-19 at the Central Hospital of Shaoyang between October and November 2022. According to the therapies they received, the eligible patients were divided into the azvudine, nirmatrelvir/ritonavir, and standard-of-care (SOC) groups. The outcomes were the proportion of patients progressing to severe COVID-19, time to nucleic acid negative conversion (NANC), and the 5-, 7-, 10-, and 14-day NANC rates from admission. RESULTS: The study included 55 patients treated with azvudine (n = 14), nirmatrelvir/ritonavir (n = 18), and SOC (n = 23). The median time from symptom onset to NANC of the azvudine, nirmatrelvir/ritonavir, and SOC groups was 14 (range, 6-25), 15 (range, 11-24), and 19 (range, 18-23) days, respectively. The median time from treatment initiation to NANC of the azvudine and nirmatrelvir/ritonavir groups was 8 (range, 4-20) and 9 (range, 5-16) days, respectively. The median length of hospital stay in the three groups was 10.5 (range, 5-23), 13.5 (range, 10-21), and 17 (range, 10-23) days, respectively. No treatment-related adverse events or serious adverse events were reported. CONCLUSION: Azvudine showed satisfactory effectiveness and acceptable safety in older adults with mild or moderate COVID-19. Therefore, azvudine could be a treatment option for this special patient population.

Exogenous methylglyoxal alleviates drought-induced 'plant diabetes' and leaf senescence in maize.

Drought-induced leaf senescence is associated with high sugar levels, which bears some resemblance to the syndrome of diabetes in humans; however, the underlying mechanisms of such 'plant diabetes' on carbon imbalance and the corresponding detoxification strategy are not well understood. Here, we investigated the regulatory mechanism of exogenous methylglyoxal (MG) on 'plant diabetes' in maize plants under drought stress applied via foliar spraying during the grain-filling stage. Exogenous MG delayed leaf senescence and promoted photoassimilation, thereby reducing the yield loss induced by drought by 14%. Transcriptome and metabolite analyses revealed that drought increased sugar accumulation in leaves through inhibition of sugar transporters that facilitate phloem loading. This led to disequilibrium of glycolysis and overaccumulation of endogenous MG. Application of exogenous MG up-regulated glycolytic flux and the glyoxalase system that catabolyses endogenous MG and glycation end-products, ultimately alleviating 'plant diabetes'. In addition, the expression of genes facilitating anabolism and catabolism of trehalose-6-phosphate was promoted and suppressed by drought, respectively, and exogenous MG reversed this effect, implying that trehalose-6-phosphate signaling in the mediation of 'plant diabetes'. Furthermore, exogenous MG activated the phenylpropanoid biosynthetic pathway, promoting the production of lignin and phenolic compounds, which are associated with drought tolerance. Overall, our findings indicate that exogenous MG activates defense-related pathways to alleviate the toxicity derived from 'plant diabetes', thereby helping to maintain leaf function and yield production under drought.

Residential proximity to major roadways and hearing impairment in Chinese older adults: a population-based study.

BACKGROUND: With rapid urban sprawl, growing people are living in the vicinity of major roadways. However, little is known about the relationship between residential proximity to major roadways and hearing impairment (HI). METHODS: We derived data from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey, and included 13,775 participants aged 65 years or older. Multivariate logistic regressions were employed to examine the association between residential proximity to major roadways and HI. The effects of corresponding potentially modifiable factors were studied by three-way interaction analyses. Sensitivity analyses were performed to verify the robustness of the results. RESULTS: The prevalence of HI was 38.3%. Participants living near major roadways were more likely to have a higher socioeconomic status. An exposure-response relation between residential proximity to major roadways and HI was observed (Ptrend < 0.05). Compared with individuals living > 300 m away from major roadways, the adjusted odds ratios (OR) were 1.07 (95% CI: 0.96-1.24), 1.15 (95% CI: 1.07-1.34), and 1.12 (95% CI: 1.01-1.31) for those living 101-200 m, 50-100 m, and < 50 m away from the roadways, respectively. Particularly, the association was more pronounced among individuals exposed to carbon monoxide (CO) pollution or opening windows frequently (Pinteraction < 0.05). Three-way interaction analyses confirmed that participants exposed to CO pollution and frequently leaving windows open had the highest OR of 1.73 (95% CI: 1.58-1.89). CONCLUSIONS: This nation-wide cohort study suggested that residential proximity to major roadways was significantly associated with an increased exposure-response risk of HI in Chinese older adults. Exposure to CO pollution and opening windows frequently might strengthen the relations.

Coordination of carbon assimilation, allocation, and utilization for systemic improvement of cereal yield.

The growth of yield outputs is dwindling after the first green revolution, which cannot meet the demand for the projected population increase by the mid-century, especially with the constant threat from extreme climates. Cereal yield requires carbon (C) assimilation in the source for subsequent allocation and utilization in the sink. However, whether the source or sink limits yield improvement, a crucial question for strategic orientation in future breeding and cultivation, is still under debate. To narrow the knowledge gap and capture the progress, we focus on maize, rice, and wheat by briefly reviewing recent advances in yield improvement by modulation of i) leaf photosynthesis; ii) primary C allocation, phloem loading, and unloading; iii) C utilization and grain storage; and iv) systemic sugar signals (e.g., trehalose 6-phosphate). We highlight strategies for optimizing C allocation and utilization to coordinate the source-sink relationships and promote yields. Finally, based on the understanding of these physiological mechanisms, we envisage a future scenery of "smart crop" consisting of flexible coordination of plant C economy, with the goal of yield improvement and resilience in the field population of cereals crops.

Effectiveness of probiotic/prebiotic/synbiotic treatments on anxiety: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Anxiety can adversely affect human well-being. This meta-analysis aimed to evaluate the effects of interventions that alter the gut microbes (including probiotics, prebiotics, and synbiotics) on anxiety. METHODS: A systematic meta-analysis of the effects of probiotics, prebiotics, and synbiotics on anxiety was conducted by searching randomized controlled trials (RCTs) in 13 databases. The primary outcomes were the pre- and post-intervention anxiety scores in the intervention and placebo groups. Anxiety scores were extracted as standard mean differences (SMDs) and pooled based on a random effects model. Subgroup analyses of anxiety scales, health status, gastrointestinal symptoms, flora strains, treatment type, probiotic dose, region, and treatment duration were also performed. RESULTS: 29 RCTs (2035 participants) were included, revealing that both probiotics and synbiotics significantly reduced anxiety scores. Additionally, anxiety scores did not significantly reduce when comparing prebiotics and placebos. LIMITATIONS: Owing to the small combined effect size of probiotic/prebiotic/synbiotic treatments and the relatively few studies on prebiotics and synbiotics included in the analysis, the findings of probiotic/prebiotic/synbiotic treatments are preliminary. CONCLUSIONS: Our study indicated that probiotics and synbiotics can reduce anxiety scores; however, it might be premature to conclude their clinical efficacy in alleviating anxiety due to the small effect size. There is no consensus regarding the optimal dose, treatment duration, treatment type, or probiotic strain to improve anxiety. Moreover, the mechanisms by which probiotics and synbiotics improve anxiety remain unclear. More RCTs are needed to determine the mechanisms of action and to identify appropriate markers to clarify their effects.

Experience of postpartum depression among Chinese women: A meta-synthesis of qualitative research.

Postpartum depression (PPD) is associated with various adverse health outcomes among mothers and babies. Meta-synthesis can improve our understanding of postpartum women's experiences. However, the meta-analysis of PPD among Chinese women is limited. Therefore, a meta-analysis was conducted to evaluate the prevalence of PPD among Chinese women and if and how traditional culture may exacerbate PPD. Qualitative studies on the experiences of Chinese women with PPD were searched from database establishment until May 2022 in ten databases. The meta-ethnography reporting guidelines and framework was applied to the writing and reporting of this review. The protocol for this systematic review was registered with the International Prospective Register of Systematic Reviews (CRD42022323388). 2321 studies were retrieved, and 11 studies qualified for the meta-synthesis. The final five themes extracted and re-conceptualized from these studies were as follows: the gap between expectation and reality, conflicts with family, physical and mental frustrations, critical needs for coping with changes, and measures against PPD. Chinese women with PPD frequently feel vulnerable physically, mentally, or both after childbirth and often have conflicts with their families due to the influence of traditional Chinese culture. Family relationships and social support often are factors preventing women from seeking help.

Effects of Somatostatin and Indomethacin Mono or Combination Therapy on High-risk Hyperamylasemia and Post-pancreatitis Endoscopic Retrograde Cholangiopancreatography Patients: A Randomized Study.

BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a minimally invasive technique widely used to diagnose and treat pancreatic and biliary diseases; however, it is linked with imminent hyperamylasemia and post-ERCP pancreatitis (PEP). Somatostatin and indomethacin are the classic recommended drugs used for PEP prevention. OBJECTIVE: To elucidate the effects of somatostatin and indomethacin mono or in combination to prevent hyperamylasemia and PEP in high-risk individuals. METHODS: Altogether 1458 patients who underwent ERCP in our hospital from January 2016 to May 2022 were included in this investigation and categorized into 4 groups based on the treatment regimen: placebo, indomethacin, somatostatin, and indomethacin + somatostatin. The pre operation and post operation (at 6, 12, and 24 h) hospitalization cost, length of stay, the occurrence of hyperamylasemia and PEP, levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-8, and VAS pain score were determined in the 4 groups. In all the groups, VAS and IL-6, TNF-α, and IL-8 levels substantially increased in the pretreatment and decreased sequentially from 6 to 24 h post operation. The individuals in the indomethacin revealed substantially reduced hyperamylasemia, VAS, and levels of IL-6, TNF-α, and IL-8, 6 h post operation, whereas the hospitalization fee, length of stay, PEP incidence, VAS, levels of IL-6, TNF-α, and IL-8, 12 and 24 h post operation were not statistically important in comparison with the individuals who received placebo therapy. The somatostatin and the indomethacin + somatostatin groups indicated markedly alleviated hospitalization fee, length of stay, the occurrence of hyperamylasemia and PEP, VAS, and the levels of IL-6, TNF-α, and IL-8 at 6, 12, and 24 h post operation compared with the placebo cohort. Furthermore, compared with the indomethacin group, the above-determined factors notably reduced at 6, 12, and 24 h post operation in somatostatin and indomethacin + somatostatin groups. It was also observed that the indomethacin + somatostatin group has substantially decreased the occurrence of hyperamylasemia, VAS score, and levels of IL-6, TNF-α, and IL-8, 6 hours post operation, while at 12 and 24 h post operation, the hospitalization fee, length of stay and incidence of PEP, VAS, levels of IL-6, TNF-α, and IL-8 were not statistically important compared with the somatostatin group. It is also worth noting that the side effects of both drugs are rare and mild. RESULTS: For high-risk PEP patients, indomethacin and somatostatin can efficiently alleviate post-operative hyperamylasemia and improve their life standard within 6 hours and 24 hours, respectively. Indomethacin is suitable for individuals who underwent simple, short-duration ERCP with expected mild post-operative abdominal pain, whereas somatostatin is given to patients with complicated, long-duration ERCP and expected severe post-operative abdominal pain. Their combinational therapy produces a synergistic effect and can reduce the incidence of hyperamylasemia, thereby improving patients' quality of life within 6 h and is also effective against individuals who received a more complicated, longer-duration ERCP and were expected to have severer and longer post-operative abdominal pain.

Effect of Reaction Temperature on the Microstructure and Properties of Magnesium Phosphate Chemical Conversion Coatings on Titanium.

Magnesium phosphate (MgP) has garnered growing interest in hard tissue replacement processes due to having similar biological characteristics to calcium phosphate (CaP). In this study, an MgP coating with the newberyite (MgHPO4·3H2O) was prepared on the surface of pure titanium (Ti) using the phosphate chemical conversion (PCC) method. The influence of reaction temperature on the phase composition, microstructure, and properties of coatings was systematically researched with the use of an X-ray diffractometer (XRD), a scanning electron microscope (SEM), a laser scanning confocal microscope (LSCM), a contact angle goniometer, and a tensile testing machine. The formation mechanism of MgP coating on Ti was also explored. In addition, the corrosion resistance of the coatings on Ti was researched by assessing the electrochemical behavior in 0.9% NaCl solution using an electrochemical workstation. The results showed that temperature did not obviously affect the phase composition of the MgP coatings, but affected the growth and nucleation of newberyite crystals. In addition, an increase in reaction temperature had a great impact on properties including surface roughness, thickness, bonding strength, and corrosion resistance. Higher reaction temperatures resulted in more continuous MgP, larger grain size, higher density, and better corrosion resistance.

Needs for supporting women undergoing termination of pregnancy for fetal anomaly: A phenomenological study based on the cognitive-emotional-behavioral framework.

OBJECTIVE: To determine and describe the needs of women undergoing termination of pregnancy for fetal anomaly (TOPFA) in China. STUDY DESIGN: Qualitative study with semi-structured interviews. Consolidated Criteria for Reporting Qualitative Studies checklist was used for reporting. SETTING: Three general hospitals and one special hospital in Changsha, Hunan, China. PARTICIPANTS: 12 women who had undergone TOPFA and 12 healthcare providers who had experienced in caring for these women. METHODS: This study was based on the cognitive-emotional-behavioral framework (CEBF) of women who had to undergo TOPFA. Twenty-four participants (12 women and 12 healthcare providers) were recruited from two hospitals in China. Semi-structured face-to-face interviews were conducted based on interview guides. ATLAS.ti software was used to encode and analyze data. Qualitative content analysis was also applied. FINDINGS: Four themes emerged: information, emotional, professional psychological, and social supports. Each theme was subdivided into four phases for a detailed description of the temporal order (denial, confirmation, decision-making, and recovery phases) within the framework. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Our study analyzes the four needs of women who underwent TOPFA and the specifics of each need at different phases based on the CEBF. The importance of offering professional psychological support, detailed information, timely emotional support, and comprehensive social support for these women is illustrated. This study contributes to the understanding of women's needs, hence providing a theoretical basis for the construction of supportive programs.

Salivary Duct Carcinoma Originated from the Inferior Turbinate: A Rare Case Report.

Salivary duct carcinoma (SDC) is an uncommon but highly aggressive tumor with a poor prognosis. SDC mainly arises from the major salivary glands, typically the parotid gland. Here, we report a rare case of sinonasal SDC in a 54-year-old male patient that might have originated from the inferior turbinate. The patient presented with left nasal congestion and rhinorrhea. Following an endoscopic intervention, the histopathological examination revealed a diagnosis of SDC, characterized by the formation of solid cancer nests and central comedo-type necrosis. Given the highly aggressive nature and unfavorable prognosis of SDC, it is essential to consider it as a differential diagnosis for unilateral nasal tumors.

Late Split-Application with Reduced Nitrogen Fertilizer Increases Yield by Mediating Source-Sink Relations during the Grain Filling Stage in Summer Maize.

In the North China Plain, the excessive application of nitrogen (N) fertilizer for ensuring high yield and a single application at sowing for simplifying management in farmer practice lead to low N use efficiency and environmental risk in maize (Zea mays L.) production. However, it is unclear whether and how late split application with a lower level of N fertilizer influences maize yield. To address this question, a two-year field experiment was conducted with two commercial maize cultivars (Zhengdan 958 and Denghai 605) using a lower level of N input (180 kg ha-1) by setting up single application at sowing and split application at sowing and later stages (V12, R1, and R2) with four different ratios, respectively. The maize yield with split-applied 180 kg ha-1 N did not decrease compared to the average yield with 240 kg ha-1 N input in farmer practice, while it increased by 6.7% to 11.5% in the four N split-application treatments compared with that of the single-application control. Morphological and physiological analyses demonstrated that late split application of N (i) increased the net photosynthetic rate and chlorophyll content and thus promoted the photosynthetic efficiency during the reproductive stages; (ii) promoted the sink capacity via improved kernel number, endosperm cells division, and grain-filling rate; and (iii) increased the final N content and N efficiency in the plant. Therefore, we propose that late split application of N could reduce N fertilizer input and coordinately improve N efficiency and grain yield in summer maize production, which are likely achieved by optimizing the source-sink relations during the grain-filling stage.

Levels and Determinants of Antenatal Breastfeeding Attitudes among Pregnant Women: A Cross-Sectional Study.

Breastfeeding attitudes are strong predictors of breastfeeding behavior. Gaining a deeper understanding on the levels and determinants of antenatal breastfeeding attitudes is crucial. This cross-sectional study involved 124 pregnant women at a tertiary hospital in Hunan, China. A self-administered questionnaire, the Iowa Infant Feeding Attitude Scale, the Edinburgh Postnatal Depression Scale, the Pregnancy Stress Rating Scale, the Childbirth Attitude Questionnaire, the Perceived Social Support Scale, and the Breastfeeding Knowledge Questionnaire were assessed during their first-trimester, second-trimester, and third-trimester hospital visit. Multiple linear regression was conducted to identify the determinants of breastfeeding attitudes. The participants reported neutral (56.39 ± 5.69) levels of breastfeeding attitudes. The determinants of antenatal breastfeeding attitudes were other family members' support for exclusive breastfeeding: moderate (ß = 0.278, p < 0.05), depressive symptoms (ß = -0.191, p < 0.05), and breastfeeding knowledge (ß = 0.434, p < 0.001). The variables explained 33.9% (adjusted R2) of the total variation in breastfeeding attitudes scores (F = 4.507, p < 0.001). Namely, other family members' support for EBF was a negative influence on positive breastfeeding attitudes. The women whose other family members were moderate of EBF had more positive attitudes toward breastfeeding compared to those whose other family members were very supportive of EBF. The depressive symptoms were negatively associated with positive breastfeeding attitudes, and lower levels of depressive symptoms were associated with higher levels of positive breastfeeding attitudes among pregnant women. Additionally, breastfeeding knowledge was positively associated with positive breastfeeding attitudes. The more knowledgeable about breastfeeding, the more positive the attitude towards breastfeeding. Health professionals should identify these modifiable factors that may contribute to poorer breastfeeding attitudes, which is useful in targeting promotions of breastfeeding.