Development and Validation of a Discharge Assessment Scale for Outpatients Undergoing Sedative Anesthesia in the Ambulatory Postanesthesia Care Unit: A Comprehensive Delphi Study.

PURPOSE: The purpose of this study was to develop a discharge assessment scale tailored for outpatients undergoing sedative anesthesia treatment in the ambulatory postanesthesia care unit and validate its agreement with the Post-Anesthetic Discharge Scoring System. DESIGN: The Delphi method. METHODS: A Delphi survey was conducted with 30 experts focusing on the evaluation of outpatient discharges following treatment under ambulatory anesthesia. Subsequently, a cross-sectional observational study employing convenience sampling selected 2,579 outpatients who had undergone painless ambulatory gastrointestinal endoscopy at a tertiary hospital to analyze the level of agreement with the Post-Anesthesia Discharge Scoring System. FINDINGS: The study conducted three rounds of expert consultations to create the ambulatory discharge assessment scale. Twenty-five experts from 12 provinces and municipalities in our country were interviewed. The discharge assessment form encompassed five aspects: consciousness level, vital signs, directional stability, mobility, and adverse reactions. According to the scale, if the total score exceeded 9 points, with none of the items scoring 0 points, the ambulatory patient could be discharged from the hospital with the accompaniment of family members. Patients assessed using this newly constructed scale were able to leave the hospital earlier compared to those assessed using the comparative scale. No significant differences were observed in vital signs at the time of discharge or the occurrence of adverse events within 24 hours after the procedure. CONCLUSIONS: This assessment tool for discharging ambulatory patients after the ambulatory anesthesia from the postanesthesia outpatient care unit can be considered a valuable addition to formalize the discharge process in outpatient services.

A randomized control study: The effectiveness of multimedia education on self-care and quality of life in patients with enterostomy.

Colorectal cancer is typically treated through surgery, and self-care skills play a crucial role in disease adaptation and quality of life improvement. Therefore, this study aimed to investigate the effectiveness of a multimedia patient education intervention on enhancing the self-care and quality of life among patients with a postoperative stoma as well as on establishing an easy-to-use ostomy self-care skills assessment. The sample comprised 108 patients with new ostomies who were randomly assigned to two groups. Data were collected from June 2018 to March 2019. The conventional education service program group received individual education in the hospital environment, consisting of four 3-h sessions delivered over 4 consecutive days. The multimedia group viewed a multimedia educational program using a laptop. Data were collected at baseline and 3 months after the intervention using a demographic questionnaire, an ostomy self-care ability scale and the Stoma Quality of Life Scale. Before the intervention, there were no significant differences in self-care ability and quality of life scores between the two groups (p = 0.764 and p = 0.466, respectively). However, 3 months after the intervention, the group that received the multimedia software intervention showed significantly higher self-care ability and quality of life scores compared to the group that received conventional education services (p < 0.001). When a set threshold is reached, self-care ability and a good quality of life can be met. The threshold value of the ostomy self-care skill scale was determined to be 20 points, resulting in a sensitivity of 77.8% and a specificity of 75.5%. The results indicate that the multimedia education program enhanced home self-care ability and quality of life among patients with enterostomy.

Platinum-Based Mcl-1 Inhibitor Targeting Mitochondria Achieves Enhanced Antitumor Activity as a Single Agent or in Combination with ABT-199.

Discovery of small molecule inhibitors targeting Mcl-1 (Myeloid cell leukemia 1) confronts many challenges. Based on the fact that Mcl-1 is mainly localized in mitochondria, we propose a new strategy of targeting mitochondria to improve the binding efficiency of Mcl-1 inhibitors. We report the discovery of complex 9, the first mitochondrial targeting platinum-based inhibitor of Mcl-1, which selectively binds to Mcl-1 with high binding affinity. Complex 9 was mainly concentrated in the mitochondria of tumor cells which led to an enhanced antitumor efficacy. Complex 9 induced Bax/Bak-dependent apoptosis in LP-1 cells and synergized with ABT-199 to kill ABT-199 resistant cells in multiple cancer models. Complex 9 was effective and tolerable as a single agent or in combination with ABT-199 in mouse models. This research work demonstrated that developing mitochondria-targeting Mcl-1 inhibitors is a new potentially efficient strategy for tumor therapy.

Nudix hydrolase 14 influences plant development and grain chalkiness in rice.

Nudix hydrolases (NUDX) can hydrolyze a wide range of organic pyrophosphates and are widely distributed in various organisms. Previous studies have shown that NUDXs are extensively involved in biotic and abiotic stress responses in different plant species; however, the role of NUDXs in plant growth and development remains largely unknown. In the present study, we identified and characterized OsNUDX14 localized in the mitochondria in rice. Results showed that OsNUDX14 is constitutively expressed in various tissues and most strongly expressed in mature leaves. We used CRISPR/Cas9 introducing mutations that editing OsNUDX14 and its encoding product. OsNUDX14-Cas9 (nudx14) lines presented early flowering and a larger flag leaf angle during the reproductive stage. In addition, OsNUDX14 affected grain chalkiness in rice. Furthermore, transcript profile analysis indicated that OsNUDX14 is associated with lignin biosynthesis in rice. Six major haplotypes were identified by six OsNUDX14 missense mutations, including Hap_1 to Hap_6. Accessions having the Hap_5 allele were geographically located mainly in South and Southeast Asia with a low frequency in the Xian/indica subspecies. This study revealed that OsNUDX14 is associated with plant development and grain chalkiness, providing a potential opportunity to optimize plant architecture and quality for crop breeding.

Exon skipping in IspE Gene is associated with abnormal chloroplast development in rice albino leaf 4 mutant.

The formation of leaf color largely depends on the components of pigment accumulation in plastids, which are involved in chloroplast development and division. Here, we isolated and characterized the rice albino leaf 4 (al4) mutant, which exhibited an albino phenotype and eventually died at the three-leaf stage. The chloroplasts in al4 mutant were severely damaged and unable to form intact thylakoid structure. Further analysis revealed that the candidate gene encodes 4-diphosphocytidyl-2-C-methyl-D-erythritol kinase (IspE), which participates in the methylerythritol phosphate (MEP) pathway of isoprenoid biosynthesis. We further demonstrated that the mutation at the exon-intron junction site cause alternative splicing factors fail to distinguish the origin of the GT-AG intron, leading to exon skipping and producing a truncated OsIspE in the al4 mutant. Notably, disruption of OsIspE led to the reduced expression of chloroplast-associated genes, including chloroplast biosynthetic and translation related genes and photosynthetic associated nuclear genes (PhANGs). In summary, these findings reveal that OsIspE plays a crucial role in chloroplast biogenesis and provides novel insights into the function of CMK during chloroplast development in rice.

Pathogenic Variants in CEP85L Cause Sporadic and Familial Posterior Predominant Lissencephaly.

Lissencephaly (LIS), denoting a "smooth brain," is characterized by the absence of normal cerebral convolutions with abnormalities of cortical thickness. Pathogenic variants in over 20 genes are associated with LIS. The majority of posterior predominant LIS is caused by pathogenic variants in LIS1 (also known as PAFAH1B1), although a significant fraction remains without a known genetic etiology. We now implicate CEP85L as an important cause of posterior predominant LIS, identifying 13 individuals with rare, heterozygous CEP85L variants, including 2 families with autosomal dominant inheritance. We show that CEP85L is a centrosome protein localizing to the pericentriolar material, and knockdown of Cep85l causes a neuronal migration defect in mice. LIS1 also localizes to the centrosome, suggesting that this organelle is key to the mechanism of posterior predominant LIS.

Highly efficient charge transfer in CdS-covalent organic framework nanocomposites for stable photocatalytic hydrogen evolution under visible light.

A facile and effective impregnation combined with photo-deposition approach was adopted to deposit cadmium sulfide (CdS) nanoparticles on CTF-1, a covalent triazine-based frameworks (CTFs). In this system, CTF-1 not only acted as supporter but also served as photocatalyst and electron donor. The performance of the obtained CdS deposited CTF-1 (CdS-CTF-1) nanocomposite was evaluated by H2 evolution reaction under visible light irradiation. As a result, CdS-CTF-1 exhibited high H2 production from water, far surpassing the CdS/CTF-1 nanocomposite, in which CdS was deposited via solvothermal method. The high activity of CdS-CTF-1 was attributed to the confined CdS nanoparticles with small size, leading to expose more active sites. In addition, time-resolved spectroscopy indicated that the superior performance of CdS-CTF-1 also can be ascribed to the fast electron transfer rate and injection efficiency (KET = 0.18 × 109 s-1, ηinj = 39.38%) between CdS and CTF-1 layers, which are 3.83 times faster and 4.84 times higher than that of CdS/CTF-1 nanocomposite. This work represents the first example on using covalent organic frameworks (COFs) as a support and electron-donor for fabricating novel CdS-COF nanocomposite system and its potential application in solar energy transformations.

The association of metabolic syndrome and its factors with gallstone disease.

BACKGROUND: To investigate the association between metabolic syndrome, including its factors, and gallstone disease (GSD) in a Taiwanese population. METHODS: We conducted a cross-sectional study during 2011 ~ 2012. A total of 12050 subjects who completed a questionnaire and underwent physical examination, laboratory tests and abdominal ultrasonography formed the study population. RESULTS: The prevalences of metabolic syndrome and gallstone disease were 24.09% and 6.16%. In an age- and sex-adjusted logistic regression model, metabolic syndrome was associated with gallstone disease (OR = 1.61; P < 0.0001). Age, abdominal obesity, and lower high-density lipoprotein cholesterol were associated with gallstone disease after adjusting for other factors. Females had a higher odds ratio than males in waist circumference for GSD, whereas males had a lower odds ratio than females in HDL-C for GSD. CONCLUSIONS: The present study suggests that metabolic syndrome is related to gallstone disease. Waist circumference and high-density lipoprotein cholesterol are all associated with GSD. Men and women may possibly have different priorities and strategies to reduce the burden of GSD.

Novel single-crystal's voltage-dependent effect and magnetic order of Ln2ZrQ5 (Ln = La, Sm, Gd; Q = S, Se) semiconductors.

A series of rare-earth zirconium chalcogenides Ln(2)ZrQ(5) (Ln = La, Sm, Gd; Q = S, Se) synthesized by using boron as the reducing reagent show unprecedented single-crystal's intrinsic voltage-dependent effects and order antiferromagnetically.

Stabilization of noncondensed (As(III)S3)(3-) anions by coordinating to [Mn(II)(phen)](2+) complex cations: a mixed-valent thioarsenate (III, V) {[Mn(phen)]3(As(V)S4)(As(III)S3)}(n)·nH2O showing the coexistence of antiferromagnetic order, photoluminescence, and nonlinear optical properties.

A novel one-dimensional (1-D) mixed-valent thioarsenate (III, V), {[Mn(phen)](3)(As(V)S(4))(As(III)S(3))}(n)·nH(2)O (1), with a noncentrosymmetric (NCS) polar packing arrangement has been obtained under solvothermal conditions. The noncondensed (As(III)S(3))(3-) anion in 1 is stabilized by coordinating to [Mn(II)(phen)](2+) complex cations and exhibits an unprecedented µ(3)-1,2κS:2,3κS':3κS'' linkage mode. Compound 1 represents the first example of the stabilization of noncondensed (MQ(3))(3-) (M = As, Sb; Q = S, Se) species only in the coordination of TM(II) complex cations (TM = transition-metal) and the first observation of the coexistence of the (As(V)S(4))(3-) tetrahedron and the noncondensed (As(III)S(3))(3-) pyramid in a single compound. Of particular interest, compound 1 is also an antiferromagnet with T(N) = 31 K, and exhibits photoluminescence (PL) with a maximum emission at about 438 nm and a second harmonic generation (SHG) response.

catena-Poly[di-µ(1,1)-azido-(1,10-phenanthroline)cadmium(II)].

The asymmetric unit of the title Cd(II) compound, [Cd(N(3))(2)(C(12)H(8)N(2))](n), contains a Cd(II) atom, located on a twofold axis passing through the middle of the phenanthroline mol-ecule, one azide ion and half of a 1,10-phenanthroline mol-ecule. The Cd(II) atom exhibits a distorted octa-hedral coordin-ation including one chelating 1,10-phenanthroline ligand and four azide ligands. The crystal structure features chains along the c direction in which azide groups doubly bridge two adjacent Cd(II) atoms in an end-on (EO) mode. Inter-chain π-π stacking inter-actions, with centroid-centroid separations of 3.408 (2) Šbetween the central aromatic rings of 1,10-phenanthroline mol-ecules, lead to a supra-molecular sheet parallel to the bc plane.

Spontaneous chiral resolution, nonlinear optical and luminescence of eight-coordinate lanthanide(III) complexes.

The first eight-coordinated trivalent lanthanide complexes with an achiral ligand 6,7-dicyanodipyridoquinoxaline (dicnq), [DyCl(3)(dicnq)(2)](n) (1 and 1') were found to exhibit spontaneous chiral resolution, SHG active (two times that of KDP) and blue luminescence.

A novel metal-organic network with high thermal stability: nonlinear optical and photoluminescent properties.

A novel zinc(II) 4-(5H-tetrazol)benzoic coordination polymer with an in situ generated tetrazole ligand exhibits the gsi (gamma-silicon) topology and high thermal stability; this compound possesses second-order nonlinear optical and interesting heat-induced photoluminescent properties.