A Novel Polyfunctional Polyurethane Acrylate Derived from Castor Oil-Based Polyols for Waterborne UV-Curable Coating Application.

Because of its unique molecular structure and renewable properties, vegetable oil has gradually become the focus of researchers. In this work, castor oil was first transformed into a castor oil-based triacrylate structure (MACOG) using two steps of chemical modification, then it was prepared into castor oil-based waterborne polyurethane acrylate emulsion, and finally, a series of coating materials were prepared under UV curing. The results showed that with the increase in MACOG content, the glass transition temperature of the sample was increased from 20.3 °C to 46.6 °C, and the water contact angle of its surface was increased from 73.85 °C to 90.57 °C. In addition, the thermal decomposition temperature, mechanical strength, and water resistance of the samples were also greatly improved. This study not only provides a new idea for the preparation of waterborne polyurethane coatings with excellent comprehensive properties but also expands the application of biomass material castor oil in the field of coating.

Triazole-modified Ru-carbene complexes: A valid olefin metathesis pre-catalyst for dynamic covalent chemistry via C=C bond formation.

The 1,2,3-triazole coordinated ruthenium carbene complexes (TA-Ru) were reported for the first time as a new class of modified Grubbs catalyst to achieve challenging olefin metathesis at higher temperatures without catalyst decomposition. Previously reported N-tethered Ru-carbene complexes all suffered from rapid cis/trans isomerization, causing significantly reduced catalyst reactivity. These new TA-Ru complexes hold the active trans-dichloro conformation even at 80 °C, allowing effective olefin metathesis for challenging substrates. With this new TA-Ru catalyst, cross-metathesis (CM), ring-closing metathesis (RCM) and dynamic covalent chemistry (DCvC) were achieved. Excitingly, the reactivity of TA-Ru prevails all previously reported N-coordinated Ru-carbene precatalysts, Grubbs II, and Hoveyda-Grubbs, making the TA-Ru a transformative catalytic system in olefin catalysis.

Cell-specific NFIA upregulation promotes epileptogenesis by TRPV4-mediated astrocyte reactivity.

BACKGROUND: The astrocytes in the central nervous system (CNS) exhibit morphological and functional diversity in brain region-specific pattern. Functional alterations of reactive astrocytes are commonly present in human temporal lobe epilepsy (TLE) cases, meanwhile the neuroinflammation mediated by reactive astrocytes may advance the development of hippocampal epilepsy in animal models. Nuclear factor I-A (NFIA) may regulate astrocyte diversity in the adult brain. However, whether NFIA endows the astrocytes with regional specificity to be involved in epileptogenesis remains elusive. METHODS: Here, we utilize an interference RNA targeting NFIA to explore the characteristics of NFIA expression and its role in astrocyte reactivity in a 4-aminopyridine (4-AP)-induced seizure model in vivo and in vitro. Combined with the employment of a HA-tagged plasmid overexpressing NFIA, we further investigate the precise mechanisms how NIFA facilitates epileptogenesis. RESULTS: 4-AP-induced NFIA upregulation in hippocampal region is astrocyte-specific, and primarily promotes detrimental actions of reactive astrocyte. In line with this phenomenon, both NFIA and vanilloid transient receptor potential 4 (TRPV4) are upregulated in hippocampal astrocytes in human samples from the TLE surgical patients and mouse samples with intraperitoneal 4-AP. NFIA directly regulates mouse astrocytic TRPV4 expression while the quantity and the functional activity of TRPV4 are required for 4-AP-induced astrocyte reactivity and release of proinflammatory cytokines in the charge of NFIA upregulation. NFIA deficiency efficiently inhibits 4-AP-induced TRPV4 upregulation, weakens astrocytic calcium activity and specific astrocyte reactivity, thereby mitigating aberrant neuronal discharges and neuronal damage, and suppressing epileptic seizure. CONCLUSIONS: Our results uncover the critical role of NFIA in astrocyte reactivity and illustrate how epileptogenic brain injury initiates cell-specific signaling pathway to dictate the astrocyte responses.

In vitro and in vivo models for the study of EV-D68 infection.

Enterovirus D68 (EV-D68) is one of hundreds of non-polio enteroviruses that typically cause cold-like respiratory illness. The first EV-D68 outbreak in the United States in 2014 aroused widespread concern among the public and health authorities. The infection was found to be associated with increased surveillance of acute flaccid myelitis, a neurological condition that causes limb paralysis in conjunction with spinal cord inflammation. In vitro studies utilising two-dimensional (2D) and three-dimensional (3D) culture systems have been employed to elucidate the pathogenic mechanism of EV-D68. Various animal models have also been developed to investigate viral tropism and distribution, pathogenesis, and immune responses during EV-D68 infection. EV-D68 infections have primarily been investigated in respiratory, intestinal and neural cell lines/tissues, as well as in small-size immunocompetent rodent models that were limited to a young age. Some studies have implemented strategies to overcome the barriers by using immunodeficient mice or virus adaptation. Although the existing models may not fully recapitulate both respiratory and neurological disease observed in human EV-D68 infection, they have been valuable for studying pathogenesis and evaluating potential vaccine or therapeutic candidates. In this review, we summarise the methodologies and findings from each experimental model and discuss their applications and limitations.

Predictive value of combining leucocyte and platelet counts for mortality in ST-segment elevation myocardial infarction patients after percutaneous coronary intervention treatment in Chinese population: a retrospective cohort study.

OBJECTIVE: Risk stratification is challenging in patients with acute ST segment elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PCI). We investigated the prognostic value of a novel score system combining leucocyte and platelet counts (COL-P) scores for in-hospital and long-term adverse outcomes. DESIGN: This was a retrospective cohort study of patients with STEMI. SETTING: First Affiliated Hospital of Xinjiang Medical University. PARTICIPANTS: A total of 854 STEMI patients with primary PCI were included in this study from November 2009 and December 2015. PRIMARY AND SECONDARY OUTCOME MEASURES: Major adverse cardiovascular events (MACEs). METHODOLOGY: The patients were divided into three groups according to the COL-P scores (0, 1 and 2). Cox regression analysis was used to investigate the relation between adverse outcomes and the COL-P score in patients with STEMI. RESULTS: A total of 44 patients died in hospital, and 99 within 3-year follow-up after discharge. The in-hospital and 3-year mortality and MACEs were higher in patients with higher COL-P score. Multivariable Cox regression indicated COL-P score was independently associated with long-term mortality (COL-P 1 vs COL-P 0: HR 2.07, 95% CI 1.016 to 5.567, p=0.005; COL-P 2 vs COL-P 0: HR 5.02, 95% CI 1.990 to 9.041, p<0.001). CONCLUSION: The COL-P score was a useful risk system for stratifying high-risk patients with STEMI after primary PCI.

Patients, carers and healthcare providers' perspectives on a patient-owned surveillance system for diabetic foot ulcer care: A qualitative study.

Objective: Digital health has recently gained a foothold in monitoring and improving diabetes care. We aim to explore the views of patients, carers and healthcare providers (HCPs) regarding the use of a novel patient-owned wound surveillance application as part of outpatient management of patients with diabetic foot ulcers (DFUs). Methods: Semi-structured online interviews were conducted with patients, carers and HCPs in wound care for DFUs. The participants were recruited from a primary care polyclinic network and two tertiary hospitals in Singapore, within the same healthcare cluster. Purposive maximum variation sampling was used to select participants with differing attributes to ensure heterogeneity. Common themes relating to the wound imaging app were captured. Results: A total of 20 patients, 5 carers and 20 HCPs participated in the qualitative study. None of the participants have used a wound imaging app before. Regarding a patient-owned wound surveillance app, all were open and receptive to the system and workflow for use in DFU care. Four major themes emerged from patients and carers: (1) technology, (2) application features and usability, (3) feasibility of using the wound imaging application and (4) logistics of care. Four major themes were identified from HCPs: (1) attitudes towards wound imaging app, (2) preferences regarding functionality, (3) perceived challenges for patients/carers and (4) perceived barriers for HCPs. Conclusion: Our study highlighted several barriers and facilitators from patients, carers and HCPs regarding the use of a patient-owned wound surveillance app. These findings demonstrate the potential of digital health and areas to improve and tailor a DFU wound app suitable for implementation in the local population.

Electronic consultation accessibility influence on patient assessments: A case-control study with user-generated tags of physician expertise.

Objective: In online health communities (OHCs), patients often list their physicians' expertise by user-generated tags based on their consulted diseases. These expertise tags play an essential role in recommending the match of physicians to future patients. However, few studies have examined the impact of the accessibility of e-consults on patient assessments using marking of the physicians' expertise in OHCs. This study aims to investigate what are the patient assessments of the physicians' expertise if they have e-consult accessibility. Methods: Through a case-control study, this article examined the effect of e-consult accessibility on patient-generated tags of physician expertise in OHCs. With data collected from the Good Doctor website, the samples consisted of 9841 physicians from 1255 different hospitals widely distributed in China. The breadth of voted expertise (BE) is measured by the number of consulted disease-related labels marked by a physician's served patients (SP). The volume of votes (VV) is measured by the number of a physician's votes given by the SP. The degree of voted diversity (DD) is measured by the information entropy of each physician's service expertise (labeled and voted by patients). The data analysis of e-consult accessibility is conducted by estimating the average treatment effect on the DD of physicians' expertise. Results: For the BE, its mean was 7.305 for the case group of physicians with e-consults accessible (photo and text queries), while the mean was 9.465 for the control for physicians without e-consults. For the VV, its mean was 39.720 for the case group, while the mean was 84.565 for the control. For the DD, its mean on patient-generated tags was 2.103 for the case group, which is 0.413 lower than the control group. Conclusion: The availability of e-consults increases the concentration on physician expertise in the patient-generated tags. e-Consults reinforce the increment of the already-received physician expertise (reflected in tags), reducing the tag information diversity.

Asymmetric Hydrative Aldol Reaction (HAR) via Vinyl-Gold Promoted Intermolecular Ynamide Addition to Aldehydes.

Herein, we reported an intermolecular asymmetric hydrative aldol reaction through vinyl-gold intermediate under ambient conditions. This tandem alkyne hydration and sequential nucleophilic addition afforded a "base-free" approach to ß-hydroxy amides with high efficiency (up to 95 % yields, >50 examples). Vinyl gold intermediate was applied as reactive nucleophile and Fe(acac)3 was used as the critical co-catalyst to prevent undesired protodeauration, allowing this transformation to proceed under mild conditions with good functional group tolerance and excellent stereoselectivity (>20 : 1 d.r. and up to 99 % ee).

Fabrication of Poly(ε-caprolactone)-embedded Lignin-Chitosan Nanocomposite Porous Scaffolds from Pickering Emulsions.

Poly(ε-caprolactone) (PCL)-incorporated lignin-chitosan biomass-based nanocomposite porous scaffolds have been effectively prepared by templating oil-in-water Pickering high internal phase emulsions (HIPEs). PCL is dissolved in oil and chitosan and lignin nanoparticles originate in water. The continuous phase of the emulsions is gelled by cross-linking of chitosan with genipin and then freeze-dried to obtain porous scaffolds. The resulting scaffolds display interconnected and tunable pore structures. An increase in PCL content increases the mechanical strength and greatly reduces the water absorption capacity of the scaffolds. Scaffolds loaded with the anti-bacterial drug enrofloxacin show a slow drug release profile, adjustable release rate, and favorable long-term anti-bacterial activity. Moreover, Pickering emulsion templates with suitable viscosity are used as 3D printing inks to construct porous scaffolds with personalized geometry. The results imply that the simplicity and versatility of the technique of combining freeze-drying with Pickering HIPE templates is a promising approach to fabricate hydrophobic biopolymer-incorporated biomass-based nanocomposite porous scaffolds for biomedical applications.

Chinese Expert Consensus on the Use of Biologics in Patients with Chronic Rhinosinusitis (2022, Zhuhai).

BACKGROUND: Chronic rhinosinusitis (CRS) is a common inflammatory disease in otolaryngology, mainly manifested as nasal congestion, nasal discharge, facial pain/pressure, and smell disorder. CRS with nasal polyps (CRSwNP), an important phenotype of CRS, has a high recurrence rate even after receiving corticosteroids and/or functional endoscopic sinus surgery. In recent years, clinicians have focused on the application of biological agents in CRSwNP. However, it has not reached a consensus on the timing and selection of biologics for the treatment of CRS so far. SUMMARY: We reviewed the previous studies of biologics in CRS and summarized the indications, contraindications, efficacy assessment, prognosis, and adverse effects of biologics. Also, we evaluated the treatment response and adverse reactions of dupilumab, omalizumab, and mepolizumab in the management of CRS and made recommendations. KEY MESSAGES: Dupilumab, omalizumab, and mepolizumab have been approved for the treatment of CRSwNP by the US Food and Drug Administration. Type 2 and eosinophilic inflammation, need for systemic steroids or contraindication to systemic steroids, significantly impaired quality of life, anosmia, and comorbid asthma are required for the use of biologics. Based on current evidence, dupilumab has the prominent advantage in improving quality of life and reducing the risk of comorbid asthma in CRSwNP among the approved monoclonal antibodies. Most patients tolerate biological agents well in general with few major or severe adverse effects. Biologics have provided more options for severe uncontrolled CRSwNP patients or patients who refuse to have surgery. In the future, more novel biologics will be assessed in high-quality clinical trials and applied clinically.

Transcriptomic Establishment of Pig Macrophage Polarization Signatures.

Macrophages are the foremost controllers of innate and acquired immunity, playing important roles in tissue homeostasis, vasculogenesis, and congenital metabolism. In vitro macrophages are crucial models for understanding the regulatory mechanism of immune responses and the diagnosis or treatment of a variety of diseases. Pigs are the most important agricultural animals and valuable animal models for preclinical studies, but there is no unified method for porcine macrophage isolation and differentiation at present; no systematic study has compared porcine macrophages obtained by different methods. In the current study, we obtained two M1 macrophages (M1_IFNγ + LPS, and M1_GM-CSF) and two M2 macrophages (M2_IL4 + IL10, and M2_M-CSF), and compared the transcriptomic profiles between and within macrophage phenotypes. We observed the transcriptional differences either between or within phenotypes. Porcine M1 and M2 macrophages have consistent gene signatures with human and mouse macrophage phenotypes, respectively. Moreover, we performed GSEA analysis to attribute the prognostic value of our macrophage signatures in discriminating various pathogen infections. Our study provided a framework to guide the interrogation of macrophage phenotypes in the context of health and disease. The approach described here could be used to propose new biomarkers for diagnosis in diverse clinical settings including porcine reproductive and respiratory syndrome virus (PRRSV), African swine fever virus (ASFV), Toxoplasma gondii (T. gondii), porcine circovirus type 2 (PCV2), Haemophilus parasuis serovar 4 (HPS4), Mycoplasma hyopneumoniae (Mhp), Streptococcus suis serotype 2 (SS2), and LPS from Salmonella enterica serotype minnesota Re 595.

Effect of peripheral cannulation for cardiopulmonary bypass in patients with congenital heart disease undergoing reoperation: A retrospective cohort study / 中国胸心血管外科临床杂志

@#Objective    To evaluate the safety and efficacy of peripheral cannulation for cardiopulmonary bypass (CPB) in patients with reoperation of congenital heart disease. Methods    The perioperative data of patients with congenital heart disease who underwent reoperation in Fuwai Hospital from 2019 to 2020 were retrospectively collected. They were divided into two groups according to the cannulation methods: a central group and a peripheral group. The prognosis of the patients was analyzed. Results     A total of 80 patients were collected, including 43 patients in the central group, and 37 pateints in the peripheral group. In the central group, the median age was 18 (14, 32) years, and 21 patients were male. The median age of the peripheral group was 16 (10, 27 ) years, and 18 patients were male. The CPB time in the peripheral group was 201 (164, 230) min, which was longer than that in the central group [143 (97, 188 ) min, P<0.001]. The lactate after CPB in the peripheral group was statistically higher than that in the central group [2 (1, 2 ) mmol/L vs. 1 (1, 1) mmol/L, P=0.002]. The dosage of albumin use during CPB in the peripheral group was statistically higher than that in the central group [10 (0, 20) g vs. 0 (0, 0) g, P=0.004]. There was no statistical difference in the postoperative dosage of red blood cells use [0 (0, 2) U vs. 0 (0, 0) U, P=0.117], mechanical ventilation time [14 (11, 19) h vs. 13 (10, 15) h, P=0.296], ICU stay time [43 (23, 80) h vs. 40 (20, 67) h, P=0.237] or postoperative hospital stay time [10 (7, 12) d vs. 8 (7, 10) d, P=778] between the two groups. Conclusion    It’s safe and efficient to establish CPB through peripheral cannulation in patients with complex congenital heart disease undergoing reoperation.

Can online health information sources really improve patient satisfaction?

Internet information has become the main way for individuals to obtain health information. The purpose of this paper is to explore the role online information sources play in health decision-making. Specifically, we investigated the relationship between online information sources and patient satisfaction, as well as their moderating effects as compared to those of other information sources. Using logistical regression analysis, we conducted the longitudinal data on 54,027 doctors and 952,877 online doctor reviews from 3,525 hospitals in 31 provinces to test a proposed research model. The results showed that patient satisfaction was generally lower for individuals who found a doctor through online information sources. Therefore, we suggest that patients consider the doctor quality, the doctor popularity, and patient involvement. In addition, we found that the doctor popularity had a negative moderating effect between online information sources and patient satisfaction, while patient involvement had a positive moderating effect between online information sources and patient satisfaction. The study provides strategic guidance and practical implications for policies, online healthcare community managers, and patients.

Shank Circumference Reduction by Sleep Compression Stockings in University Students and Convenience Store Cashiers.

Compression stockings (CSs) are a relatively simple and effective tool for alleviating varicose veins and are often used as a preventive measure among workers whose jobs require prolonged standing. Nevertheless, the efficacy of CSs that are advertised as sleepwear remains unverified. This study recruited 10 female university students and 10 cashiers as participants to test the effects of sleep CSs. During the experiment, the changes in shank circumference (SC) and the subjective discomfort rating upon getting up and going to bed were collected. Data were recorded immediately after getting up and SC measurement was repeated 10 min later. The results demonstrated that both CS condition and measurement time significantly affected SC reduction, whereas cashier or student status did not. The reported discomfort and tightness of the legs attributed to CSs were relatively high, and the benefit toward SC reduction was minimal. Cashiers exhibited slightly larger SC values and higher perceived discomfort levels, which may be attributed to their occupational characteristic of prolonged standing, and the cumulative effect of prolonged standing on muscle properties warrants further study. The study findings suggest that wearing CSs for sleep may not be effective for reducing OE.

Impacts of physician promotion on the online healthcare community: Using a difference-in-difference approach.

In this study, we use a difference-in-difference approach to explore how physician promotion, the advancement of a physician's offline reputation, affects patient behavior toward physicians in online healthcare communities; this allows us to explore how patients interpret the signals created by physician promotion. The study sample was collected from over 140,000 physician online profiles after 25 months of continuous observation, with 280 physicians who were promoted at month 13 as the treatment group and a control group obtained by propensity score matching. Our results show that a physician's promotion causes more patients to choose that physician, makes patients willing to give more psychological rewards, and makes them tend to give that physician a higher online rating. This implies that patient behavior is susceptible to the signal of physician promotion because the quality of the physician is unlikely to have changed significantly in the short term. These findings extend prior research on reputation in online communities and have crucial implications for theory and practice.

Design and synthesis of stable four-coordinated benzotriazole-borane with tunable fluorescence emission.

A new class of stable four-coordinated benzotriazole-borane compounds was developed via gold-catalyzed alkyne hydroboration. The application of polymeric (BH2CN) n reagent gave the formation of cyano-amine-boranes (CAB) complexes with less basic N-heterocyclic amines and anilines. Various new CABs were investigated in catalytic hydroboration to synthesize N-B cycles. The 1,2,3-benzotriazoles were identified as the only feasible N-source, giving the four coordinated borane N-B cycles (BTAB) in excellent yields (up to 90%) with good functional group tolerability. This new class of polycyclic N-B compounds showed excellent stability toward acid, base, high temperature, and photo-irradiation. The facile synthesis, excellent stability, strong and tunable fluorescence emission make BTAB interesting new fluorescent probes for future chemical and biological applications.

Understanding the Inequality of Web Traffic and Engagement in Online Healthcare Communities.

The online healthcare community (OHC) is a kind of doctor-patient communication platform, in which doctors can share medical knowledge and provide various kinds of counsel for patients. However, if the OHC's web traffic is concentrated on a small number of doctors, or if only a few doctors are actively involved in the OHC's activities, this will not be conducive to the optimal development of the OHC. This study explores this issue of inequality and makes three main innovations. First, based on data on web traffic and engagement extracted from 139,037 doctors' web pages in one popular OHC, we point out how serious the inequality phenomenon is. Second, we confirm that the Matthew effect indeed exists in this context and leads to greater inequality. Third, we demonstrate that the inequality of psychological or material rewards causes the inequality of web traffic or engagement to become worse; hence, an appropriate reward mechanism should be designed to mitigate the Matthew effect rather than enhance it. Finally, we discuss the managerial implications of these results, as well as avenues for future studies.

Extracting Additional Influences From Physician Profiles With Topic Modeling: Impact on Ratings and Page Views in Online Healthcare Communities.

How physicians can get better ratings and more page views in online healthcare communities is an important issue. Based on 38,457 physicians' profiles from a popular online healthcare community in China, we used Latent Dirichlet Allocation model, which is a common topic model, to analyze the non-English text to obtain more doctor's latent characteristics. We found five of the most frequently mentioned topics. In addition to the first topic (doctor's academic rank and practice name), "research ability," "foreign experience," "committee position," and "clinical experience" were included as unstructured descriptions in the doctor's profile. Inferences about physician ratings and page views could be improved if these themes were set as characteristics of physicians. Specifically, in our findings, Physicians' mentions of their "research ability" and "foreign experience" had a significant positive impact on physician ratings. Surprisingly, physicians mentioning more "clinical experience" had a significant negative impact on physician ratings. Moreover, while descriptions about "foreign experience" and "committee position" had a significant positive impact on page views, physician mentions of "research ability" had a significant negative impact on page views. These results provide new insights into the ways in which online healthcare community managers or physicians create their personal online profiles.

Distinct mechanisms underlying therapeutic potentials of CD20 in neurological and neuromuscular disease.

Cluster of differentiation 20 (CD20) is an integral membrane protein expressed mainly on different developmental stages of B lymphocytes and rarely on T lymphocytes, and it functions as a link to B cell antigen receptor (BCR) and immune microenvironment via regulating calcium ion influx, cell cycle progression and interaction between isotypic BCRs and their co-receptors. Diverse therapeutic monoclonal antibodies (mAbs) targeting CD20 are generated and grouped into two types based on the ability to redistribute CD20 into lipid rafts, which results in huge differences in response. Currently, multiple anti-CD20 mAbs have been approved as drugs for neurological and neuromuscular diseases with promising clinical efficacy. This review aims to summarize the potential mechanisms, development and current evidence for anti-CD20 therapy in neurological and neuromuscular diseases.