MIMOSA: a resource consisting of improved methylome prediction models increases power to identify DNA methylation-phenotype associations.

Although DNA methylation (DNAm) has been implicated in the pathogenesis of numerous complex diseases, from cancer to cardiovascular disease to autoimmune disease, the exact methylation sites that play key roles in these processes remain elusive. One strategy to identify putative causal CpG sites and enhance disease etiology understanding is to conduct methylome-wide association studies (MWASs), in which predicted DNA methylation that is associated with complex diseases can be identified. However, current MWAS models are primarily trained using the data from single studies, thereby limiting the methylation prediction accuracy and the power of subsequent association studies. Here, we introduce a new resource, MWAS Imputing Methylome Obliging Summary-level mQTLs and Associated LD matrices (MIMOSA), a set of models that substantially improve the prediction accuracy of DNA methylation and subsequent MWAS power through the use of a large summary-level mQTL dataset provided by the Genetics of DNA Methylation Consortium (GoDMC). Through the analyses of GWAS (genome-wide association study) summary statistics for 28 complex traits and diseases, we demonstrate that MIMOSA considerably increases the accuracy of DNA methylation prediction in whole blood, crafts fruitful prediction models for low heritability CpG sites, and determines markedly more CpG site-phenotype associations than preceding methods. Finally, we use MIMOSA to conduct a case study on high cholesterol, pinpointing 146 putatively causal CpG sites.

Effect of seasonal variations in sea level on residual saltwater removal upstream of subsurface dam in coastal layered heterogeneity aquifers.

Subsurface dams have been recognized as one of the most effective measures for preventing saltwater intrusion. However, it may result in large amounts of residual saltwater being trapped upstream of the dam and take years to decades to remove, which may limit the utilization of fresh groundwater in coastal areas. In this study, field-scale numerical simulations were used to investigate the mechanisms of residual saltwater removal from a typical stratified aquifer, where an intermediate low-permeability layer (LPL) exists between two high-permeability layers, under the effect of seasonal sea level fluctuations. The study quantifies and compares the time of residual saltwater removal (Tre) for constant sea level (CSL) and seasonally varying sea level (FSL) scenarios. The modelling results indicate that, in most cases, seasonal fluctuations in sea level facilitate the dilution of residual saltwater and thus accelerate residual saltwater removal compared to a static sea level scenario. However, accounting for seasonal sea level variations may increase the required critical dam height (the minimum dam height required to achieve complete residual saltwater removal). Sensitivity analyses show that Tre decreases with increasing height of subsurface dam (Hd) under CSL or weaker sea level fluctuation scenarios; however, when the magnitude of sea level fluctuation is large, Tre changes non-monotonically with Hd. Tre decreases with increasing distance between subsurface dam and ocean for both CSL and FSL scenarios. We also found that stratification model had a significant effect on Tre. The increase in LPL thickness for both CSL and FSL scenarios leads to a decrease in Tre and critical dam height. Tre generally shows a non-monotonically decreasing trend as LPL elevation increases. These quantitative analyses provide valuable insights into the design of subsurface dams in complex situations.

Model-based estimation of individual-level social determinants of health and its applications in All of Us.

OBJECTIVES: We introduce a widely applicable model-based approach for estimating individual-level Social Determinants of Health (SDoH) and evaluate its effectiveness using the All of Us Research Program. MATERIALS AND METHODS: Our approach utilizes aggregated SDoH datasets to estimate individual-level SDoH, demonstrated with examples of no high school diploma (NOHSDP) and no health insurance (UNINSUR) variables. Models are estimated using American Community Survey data and applied to derive individual-level estimates for All of Us participants. We assess concordance between model-based SDoH estimates and self-reported SDoHs in All of Us and examine associations with undiagnosed hypertension and diabetes. RESULTS: Compared to self-reported SDoHs, the area under the curve for NOHSDP is 0.727 (95% CI, 0.724-0.730) and for UNINSUR is 0.730 (95% CI, 0.727-0.733) among the 329 074 All of Us participants, both significantly higher than aggregated SDoHs. The association between model-based NOHSDP and undiagnosed hypertension is concordant with those estimated using self-reported NOHSDP, with a correlation coefficient of 0.649. Similarly, the association between model-based NOHSDP and undiagnosed diabetes is concordant with those estimated using self-reported NOHSDP, with a correlation coefficient of 0.900. DISCUSSION AND CONCLUSION: The model-based SDoH estimation method offers a scalable and easily standardized approach for estimating individual-level SDoHs. Using the All of Us dataset, we demonstrate reasonable concordance between model-based SDoH estimates and self-reported SDoHs, along with consistent associations with health outcomes. Our findings also underscore the critical role of geographic contexts in SDoH estimation and in evaluating the association between SDoHs and health outcomes.

Assessment of Concentration KRT6 Proteins in Tumor and Matching Surgical Margin from Patients with Head and Neck Squamous Cell Carcinoma.

Head and neck squamous cell carcinomas (HNSCCs) are one of the most frequently detected cancers in the world; not all mechanisms related to the expression of keratin in this type of cancer are known. The aim of this study was to evaluate type II cytokeratins (KRT): KRT6A, KRT6B, and KRT6C protein concentrations in 54 tumor and margin samples of head and neck squamous cell carcinoma (HNSCC). Moreover, we examined a possible association between protein concentration and the clinical and demographic variables. Protein concentrations were measured using enzyme-linked immunosorbent assay (ELISA). Significantly higher KRT6A protein concentration was found in HNSCC samples compared to surgical margins. An inverse relationship was observed for KRT6B and KRT6C proteins. We showed an association between the KRT6C protein level and clinical parameters T and N in tumor and margin samples. When analyzing the effect of smoking and drinking on KRT6A, KRT6B, and KRT6C levels, we demonstrated a statistically significant difference between regular or occasional tobacco and alcohol habits and patients who do not have any tobacco and alcohol habits in tumor and margin samples. Moreover, we found an association between KRT6B and KRT6C concentration and proliferative index Ki-67 and HPV status in tumor samples. Our results showed that concentrations of KRT6s were different in the tumor and the margin samples and varied in relation to clinical and demographic parameters. We add information to the current knowledge about the role of KRT6s isoforms in HNSCC. We speculate that variations in the studied isoforms of the KRT6 protein could be due to the presence and development of the tumor and its microenvironment. It is important to note that the analyses were performed in tumor and surgical margins and can provide more accurate information on the function in normal and cancer cells and regulation in response to various factors.

Relationship among group learning, individuals' and groups' internalization of evidence-based practice, and nurses' sustainment of the practice: a cross-sectional study.

PURPOSE: This study, by applying the feedback process of the organizational learning model, examined the relationships among group learning, individuals' and groups' internalization of institutionalized evidence-based practice (I-EBP), and nurses' sustainment of I-EBP. DESIGN/METHODOLOGY/APPROACH: Twelve hospitals were included in this cross-sectional study, with 1,741 nurses from 59 wards. Anonymous questionnaires were administered from October to December 2021. Participants self-reported their wards' group learning, internalization of I-EBP, sustainment of I-EBP, EBP beliefs, intra-hospital transfers, and nursing research experiences. The number of nurses and I-EBP introduction length and type of I-EBP were assessed. Internalization of I-EBP of nurses and groups was considered the mediating variable, while group learning and nurses' sustainment of I-EBP were the independent and dependent variables, respectively. Significant variables in bivariate analyses were used as control variables. Multi-level Mediation Analysis and a significance test of indirect effect using the bootstrap method were conducted. FINDINGS: Responses from 360 nurses in 48 wards from 12 hospitals were analyzed. Groups' internalization of I-EBP significantly mediated the relationship between group learning and nurses' sustainment of I-EBP. In contrast, no significant mediating effect of nurses' internalization of I-EBP was observed. ORIGINALITY/VALUE: In the feedback process of organizational learning, group learning and its subsequent effects on individuals and groups have not been previously examined. Regardless of the nurses' degree of internalization of I-EBP, those who belong to the ward with a high degree of internalization of I-EBP are more likely to sustain it. Conducting group learning may prevent superficial practice, resulting in its sustainability.

Determination of the family caregivers'level of knowledge on pressure injury prevention.

OBJECTIVE: The purpose of this study is to determine family caregivers' level of knowledge on pressure injury (PI) prevention. METHODS: This study used a cross-sectional and descriptive design. Data were collected between February and May 2023. The population of the study consisted of family caregivers providing care to patients who were at risk of developing pressure injuries and who were planned to be discharged from the inpatient wards of the hospital. A total of 105 family caregivers participated in the study. RESULTS: Of all the patients, 61.9 % (n = 65) were female and their average age was 68.96 years (SD = 18.07). While 30.48 % (n = 32) of the patients were bedridden due to Cerebrovascular Accident, 28.57 % (n = 30) were bedridden due to old age, and 28.57 % (n = 30) had PI. Of all the caregivers, 71.43 % (n = 75) were female, and their average age was 47.11 years (SD = 14.85). While 97.14 % (n = 96) of the caregivers had not received any training on PI before, 90.48 % (n = 95) had not provided care to a patient with PI before. Family caregivers scored an average of 22.25 (SD = 6.96) points out of 40 on the Pressure Injury Prevention Knowledge Test (PIPKT). A significant difference was detected between the knowledge test scores and education level and income level (P = 0.006; P = 0.002). CONCLUSIONS: Family caregivers were found to need information about PI prevention. It is recommended to develop content on PI prevention in the guidelines for family caregivers.

Evaluating the Impact of Chronic Care Model on Smoking Cessation: An Interventional Study.

BACKGROUND: This study aims to assess the effectiveness of the chronic care model (CCM) in helping primary healthcare workers quit smoking. The intervention involves implementing the CCM, which includes six key elements: the healthcare system, clinical care planning, clinical management information, self-management guidance, community resources, and decision-making. MATERIAL AND METHODS: The study is based on a population of 60 primary healthcare workers who smoke. The main outcome measure is smoking cessation, determined by cotinine levels in urine at the baseline, and at 6 and 12 months after the intervention. Other potential results include alterations in smoking-related behaviors and attitudes. Data analysis involves using descriptive statistics and inferential tests to determine the intervention's effectiveness in smoking cessation among primary healthcare workers. RESULTS:  The CCM is expected to have contributed to a substantial decrease in the smoking rate among primary healthcare workers. It is also seen that there is a great reduction in urine cotinine levels during the 12-month intervention period. Moreover, a positive shift in the smoking-related behaviors and attitudes of the participants is expected. CONCLUSION:  This study provides key data about the effectiveness of the CCM in helping primary healthcare workers stop smoking. This statement emphasizes the importance of considering socioeconomic factors in the design and implementation of smoking cessation interventions. This ensures that people of different incomes and social statuses have equal access to quitting smoking and achieve similar results.

Satisfaction levels and associated influencing factors among inpatients and outpatients with breast cancer at a tertiary health facility in Ghana.

Objectives: To uncover variables linked to breast cancer patient satisfaction in order to improve policy choices and actions for breast cancer care in Ghana. Design: We employed a cross-sectional design using a quantitative approach. Setting: The Radiotherapy, Oncology and Surgery Departments of the Korle Bu Teaching Hospital, Accra. Participants: Inpatient and outpatient breast cancer patients. Main outcome measures: The level of inpatient and outpatient satisfaction was measured using descriptive and inferential statistical analyses. The Shapiro-Wilk test was employed to assess normality, while the Heckman selection model assessed significance with outcomes of interest. Results: A total of 636 participants, with a mean age of 52.64±14.07 years, were recruited. The measured inpatient and outpatient levels of satisfaction out of 100 were 74.06±7.41 and 49.99±1.00 respectively, while the self-reported satisfaction levels out of 5 were 4.22±0.63 and 4.11±0.85 respectively. The level of inpatient satisfaction was significantly influenced by age, marital status, income level, and number of previous facilities visited (p<0.05). Outpatient satisfaction level was significantly associated with place of residence and income level (p<0.05). Conclusions: The study offers insight into the satisfaction levels of breast cancer patients receiving inpatient and outpatient services at the largest tertiary referral centre and teaching hospital in Ghana, as well as the factors influencing attendance and satisfaction levels. Understanding and improving breast cancer patients' levels of satisfaction is a way that providers can safeguard their emotional well-being. Improvement in patient satisfaction at our institution among outpatients is an area for future growth. Funding: Gardner-Holt Women's Health Grant program, Centre for Global Surgery 2021.

BODY AWARENESS, STRESS AND SYMPTOMS IN AUTONOMIC DYSFUNCTION IN PATIENTS WITH CHRONIC PAIN: AN EXPLORATIVE STUDY.

Objective: To assess pain outcomes, stress levels and body awareness among patients with chronic pain and explore potential associations between these variables. Design: An explorative study. Methods: Patients with chronic pain in primary and specialist care were assessed regarding pain intensity using the Numerical Rating Scale (NRS; 0-10 point scale) and stress levels using the Stress and Crisis Inventory (SCI-93; 0-140). To assess body awareness, multidimensional assessment of interoceptive awareness (MAIA; 0-5), a widely used self-report measure of interoceptive bodily awareness was used. Results: Participants (n = 42) reported an average NRS of 4.4, elevated stress levels and low body awareness. Stress levels were moderately correlated with pain intensity (r = 0.53; p < 0.001; 95% confidence interval [CI] 0.25-0.72) and number of pain sites (r = 0.58; p < 0.001; 95% CI 0.32-0.76). The regression analysis showed that pain outcomes predicted stress level scores and explained almost 50% of variance (R 2 = 0.47, p < 0.001). Moreover, shorter pain duration predicted a higher body awareness (p = 0.04). Conclusion: In patients with chronic pain, high pain intensity and multiple painful sites seem to be associated with impaired stress regulation. The patients had low body awareness, which was negatively influenced by pain duration.

Contamination levels and ecological risk assessment of phthalate esters (PAEs) in the aquatic environment of Chaohu Lake.

Phthalate esters (PAEs), widely recognized as synthetic organic compounds with extensive production and utilization, are known to disrupt physiological processes in both animals and humans, even at low environmental concentrations. This study investigated the occurrence, distribution, and potential ecological risk of five representative PAEs (DMP, Dimethyl phthalate; DEP, Diethyl phthalate; DBP, Dibutyl phthalate; DiBP, Diisobutyl phthalate; DEHP, Bis(2-ethylhexyl) phthalate) in a typical lake (Chaohu Lake, China). It was found that PAEs were detected in both the aqueous (1.09-6.402 µg/L) and solid phases (0.827-6.602 µg/g) of Chaohu Lake. Notably, DiBP and DBP were the predominant PAEs in the water, and DiBP and DEHP were the most prevalent in the sediments. The concentrations of PAEs exhibited significant seasonal variations in the aqueous phases, with total PAEs in summer being nearly twice those in winter. Toxicity assessments revealed that DEHP, DBP, and DiBP posed high risks to the survival of three indicator organisms (algae, Daphnia, and fish) in the aqueous phase. In the solid phase, the exceeding rate of DiBP was as high as 92.9%. On the other hand, DBP and DEHP generally presenting moderate risk, although some sites were identified as high-risk. This study's analysis of PAEs concentrations in Chaohu Lake reveals a discernible increasing trend when compared with historical data. These findings underscore the urgent need for interventions to mitigate the ecological threats posed by PAEs in Chaohu Lake.

Evaluation of inpatient and emergency department healthcare resource utilization and costs pre- and post-nusinersen for the treatment of spinal muscular atrophy using United States claims.

Aim: Nusinersen, administered by intrathecal injection at a dose of 12 mg, is indicated across all ages for the treatment of spinal muscular atrophy (SMA). Evidence on real-world healthcare resource use (HRU) and costs among patients taking nusinersen remains limited. This study aimed to evaluate real-world HRU and costs associated with nusinersen use through US claims databases. Patients & methods: Using the Merative™ MarketScan® Research Databases, patients with SMA receiving nusinersen were identified from commercial (January 2017 to June 2020) and Medicaid claims (January 2017 to December 2019). Those likely to have complete information on the date of nusinersen initiation and continuous enrollment 12 months pre- and post-index (first record of nusinersen treatment) were retained. Number and costs (US$ 2020) of inpatient admissions and emergency department (ED) visits, unrelated to nusinersen administration, were evaluated for 12 months pre- and post-nusinersen initiation and stratified by age: pediatric (<18 years) and adult (≥18 years). Results: Overall, 103 individuals treated with nusinersen were retained: 59 were pediatric (mean age [range]: 9 [1-17] years), and 44 were adults (30 [18-63] years). Inpatient admissions decreased by 41% for pediatrics and 67% for adults in the 12 months post-treatment versus the 12 months pre-treatment. Average inpatient admission costs per patient for the pediatric cohort decreased by 63% ($22,903 vs $8466) and by 79% ($13,997 vs $2899) for the adult cohort when comparing the 12 months pre-index with the 12 months post-index period. Total ED visits and ED visit costs decreased by 8% and 35%, respectively, for the overall cohort over the 12-month period pre- and post-index. Conclusion: Using US claims databases, nusinersen treatment in pediatric and adult patients was associated with reductions in HRU and costs over a 12-month period post-treatment initiation relative to the pre-treatment period.

Unique algorithm for the evaluation of embryo photon emission and viability.

Living cells have spontaneous ultraweak photon emission derived from metabolic reactions associated with physiological conditions. The ORCA-Quest CMOS camera (Hamamatsu Photonics, Japan) is a highly sensitive and essential tool for photon detection; its use with a microscope incubator (Olympus) enables the detection of photons emitted by embryos with the exclusion of harmful visible light. With the application of the second law of thermodynamics, the low-entropy energy absorbed and used by embryos can be distinguished from the higher-entropy energy released and detectable in their environment. To evaluate higher-entropy energy data from embryos, we developed a unique algorithm for the calculation of the entropy-weighted spectral fractal dimension, which demonstrates the self-similar structure of the energy (photons) released by embryos. Analyses based on this structure enabled the distinction of living and degenerated mouse embryos, and of frozen and fresh embryos and the background. This novel detection of ultra-weak photon emission from mouse embryos can provide the basis for the development of a photon emission embryo control system. The ultraweak photon emission fingerprints of embryos may be used for the selection of viable specimens in an ideal dark environment.

Regulation of Interfacial Chemistry Enabling High-Power Dual-Ion Batteries at Low Temperatures.

Interfacial chemistry plays a crucial role in determining the electrochemical properties of low-temperature rechargeable batteries. Although existing interface engineering has significantly improved the capacity of rechargeable batteries operating at low temperatures, challenges such as sharp voltage drops and poor high-rate discharge capabilities continue to limit their applications in extreme environments. In this study, an energy-level-adaptive design strategy for electrolytes to regulate interfacial chemistry in low-temperature Li||graphite dual-ion batteries (DIBs) is proposed. This strategy enables the construction of robust interphases with superior ion-transfer kinetics. On the graphite cathode, the design endues the cathode interface with solvent/anion-coupled interfacial chemistry, which yields an nitrogen/phosphor/sulfur/fluorin (N/P/S/F)-containing organic-rich interphase to boost anion-transfer kinetics and maintains excellent interfacial stability. On the Li metal anode, the anion-derived interfacial chemistry promotes the formation of an inorganic-dominant LiF-rich interphase, which effectively suppresses Li dendrite growth and improves the Li plating/stripping kinetics at low temperatures. Consequently, the DIBs can operate within a wide temperature range, spanning from -40 to 45 °C. At -40 °C, the DIB exhibits exceptional performance, delivering 97.4% of its room-temperature capacity at 1 C and displaying an extraordinarily high-rate discharge capability with 62.3% capacity retention at 10 C. This study demonstrates a feasible strategy for the development of high-power and low-temperature rechargeable batteries.

Harnessing Persistent Photocurrent in a 2D Semiconductor-Polymer Hybrid Structure: Electron Trapping and Fermi Level Modulation for Optoelectronic Memory.

Recently, 2D semiconductor-based optoelectronic memory has been explored to overcome the limitations of conventional von Neumann architectures by integrating optical sensing and data storage into one device. Persistent photocurrent (PPC), essential for optoelectronic memory, originates from charge carrier trapping according to the Shockley-Read-Hall (SRH) model in 2D semiconductors. The quasi-Fermi level position influences the activation of charge-trapping sites. However, the correlation between quasi-Fermi level modulations and PPC in 2D semiconductors has not been extensively studied. In this study, we demonstrate optoelectronic memory based on a 2D semiconductor-polymer hybrid structure and confirm that the underlying mechanism is charge trapping, as the SRH model explains. Under light illumination, electrons transfer from polyvinylpyrrolidone to p-type tungsten diselenide, resulting in high-level injection and majority carrier-type transitions. The quasi-Fermi level shifts upward with increasing temperature, improving PPC and enabling optoelectronic memory at 433 K. Our findings offer valuable insights into optimizing 2D semiconductor-based optoelectronic memory.

The evaluation and optimization of the agricultural sustainable development based on a data-driven approach: A case from Northern Anhui.

The sustainable advancement of agriculture stands as the fundamental cornerstone of sustainable human progress. This study introduces a data-centric methodological framework founded upon the holistic delineation of measurement, feature assessment, and pathway enhancement for agricultural sustainability. Initially, the research articulates a comprehensive evaluative schema incorporating sub-dimensions encompassing agricultural production, agricultural economics, the agricultural resource environment, and rural society, grounded in sustainable development theory. Subsequently, it devises a methodological apparatus for assessing and enhancing sustainable development capabilities, employing entropy evaluation methods and exploratory spatial data analysis techniques. Employing North Anhui as a case study, the viability of this approach is substantiated. The empirical inquiry conducted within this article operationalizes comprehensive evaluation and explores pathways for optimizing agricultural sustainability, focusing on the period spanning 2011 to 2020 in Northern Anhui. The findings affirm the feasibility and efficacy of the data-driven approach. Recommendations derived from the empirical exploration of agricultural sustainability pathways at the local level offer valuable insights for governmental authorities and policymakers. This research endeavor could be extrapolated to other geographical locales worldwide, fostering innovative strides in the sustainable development of regional agriculture.

Shi-pi-xiao-ji formula suppresses hepatocellular carcinoma by reducing cellular stiffness through upregulation of acetyl-coA acetyltransferase 1.

BACKGROUND: Previous studies have shown that the Shi-pi-xiao-ji (SPXJ) herbal decoction formula is effective in suppressing hepatocellular carcinoma (HCC), but the underlying mechanisms are not known. Therefore, this study investigated whether the antitumor effects of the SPXJ formula in treating HCC were mediated by acetyl-coA acetyltransferase 1 (ACAT1)-regulated cellular stiffness. Through a series of experiments, we concluded that SPXJ inhibits the progression of HCC by upregulating the expression level of ACAT1, lowering the level of cholesterol in the cell membrane, and altering the cellular stiffness, which provides a new idea for the research of traditional Chinese medicine against HCC. AIM: To investigate the anti-tumor effects of the SPXJ formula on the malignant progression of HCC. METHODS: HCC cells were cultured in vitro with SPXJ-containing serum prepared by injecting SPXJ formula into wild-type mice. The apoptotic rate and proliferative, invasive, and migratory abilities of control and SPXJ-treated HCC cells were compared. Atomic force microscopy was used to determine the cell surface morphology and the Young's modulus values of the control and SPXJ-treated HCC cells. Plasma membrane cholesterol levels in HCC cells were detected using the Amplex Red cholesterol detection kit. ACAT1 protein levels were estimated using western blotting. RESULTS: Compared with the vehicle group, SPXJ serum considerably reduced proliferation of HCC cells, increased stiffness and apoptosis of HCC cells, inhibited migration and invasion of HCC cells, decreased plasma membrane cholesterol levels, and upregulated ACAT1 protein levels. However, treatment of HCC cells with the water-soluble cholesterol promoted proliferation, migration, and invasion of HCC cells as well as decreased cell stiffness and plasma membrane cholesterol levels, but did not alter the apoptotic rate and ACAT1 protein expression levels compared with the vehicle control. CONCLUSION: SPXJ formula inhibited proliferation, invasion, and migration of HCC cells by decreasing plasma membrane cholesterol levels and altering cellular stiffness through upregulation of ACAT1 protein expression.

Predictive value of preoperative routine examination for the prognosis of patients with pT2N0M0 or pT3N0M0 colorectal cancer.

BACKGROUND: In recent years, the incidence of colorectal cancer (CRC) has been increasing. With the popularization of endoscopic technology, a number of early CRC has been diagnosed. However, despite current treatment methods, some patients with early CRC still experience postoperative recurrence and metastasis. AIM: To search for indicators associated with early CRC recurrence and metastasis to identify high-risk populations. METHODS: A total of 513 patients with pT2N0M0 or pT3N0M0 CRC were retrospectively enrolled in this study. Results of blood routine test, liver and kidney function tests and tumor markers were collected before surgery. Patients were followed up through disease-specific database and telephone interviews. Tumor recurrence, metastasis or death were used as the end point of study to find the risk factors and predictive value related to early CRC recurrence and metastasis. RESULTS: We comprehensively compared the predictive value of preoperative blood routine, blood biochemistry and tumor markers for disease-free survival (DFS) and overall survival (OS) of CRC. Cox multivariate analysis demonstrated that low platelet count was significantly associated with poor DFS [hazard ratio (HR) = 0.995, 95% confidence interval (CI): 0.991-0.999, P = 0.015], while serum carcinoembryonic antigen (CEA) level (HR = 1.008, 95%CI: 1.001-1.016, P = 0.027) and serum total cholesterol level (HR = 1.538, 95%CI: 1.026-2.305, P = 0.037) were independent risk factors for OS. The cutoff value of serum CEA level for predicting OS was 2.74 ng/mL. Although the OS of CRC patients with serum CEA higher than the cutoff value was worse than those with lower CEA level, the difference between the two groups was not statistically significant (P = 0.075). CONCLUSION: For patients with T2N0M0 or T3N0M0 CRC, preoperative platelet count was a protective factor for DFS, while serum CEA level was an independent risk factor for OS. Given that these measures are easier to detect and more acceptable to patients, they may have broader applications.

Thermal image dataset for okra maturity analysis.

Okra, renowned for its abundance of essential nutrients, emerges as a promising solution in addressing malnutrition, advocating for sustainable agriculture, and showcasing versatile untapped potentials. Our objective is to enhance the quality, market attractiveness, and culinary adaptability of okra harvests by classifying them into over-matured and adequately matured groups through a non-invasive approach. This dataset is centered on thermal images capturing different maturity levels of okra, categorized into two distinct groups. The thermal imaging device is employed for image capture, and the okra samples are sourced from diverse vegetable vendors and farms. This dataset proves to be a valuable asset for the non-invasive examination and categorization of okras based on their maturity levels.

Superior accuracy in knee double level osteotomy using a novel hybrid fixation technique compared to conventional double plating.

Purpose: This study aimed to compare two different double-level knee osteotomy (DLO) fixation techniques. The primary outcome reported the radiological coronal plane correction and its accuracy. The secondary outcomes reported the correction outliers, the clinical outcomes, the 5-year postoperative satisfaction and the complications. Methods: A retrospective review of a single surgeon osteotomy database identified 52 cases of DLO between 2011 and 2019, of which 24 cases met the inclusion criteria. Patients were categorised into two groups: the nail-plate (NP) group fixed with a magnetic extendable intramedullary tibial nail and femoral conventional plate, and the double-plate (DP) group fixed with conventional plates (tibia and femur). Radiographic parameters were recorded, including the mechanical femorotibial angle (mFTA), medial proximal tibial angle (MPTA), mechanical lateral distal femoral angle (mLDFA), joint line convergence angle (JLCA) and weight-bearing line ratio (Mikulicz %). Surgical accuracy was calculated as the difference between the achieved and the planned correction. Outliers were defined as those with a greater than 10% difference from the planned correction. Simple knee value scores and visual analogue scale for pain were recorded preoperatively and postoperatively at 2 and 5 years. Five-year patient satisfaction was recorded. Results: A total of 24 patients were included: the NP group (n = 12) and the DP group (n = 12). Significant coronal plane corrections were achieved in the NP group for the mean mFTA (preoperative 167.9° ± 3.4° to postoperative 182.1° ± 1.4°), the mean MPTA (preoperative 83.5° ± 2.9° to postoperative 91.3° ± 2.8°) and the mean mLDFA (preoperative 89.8° ± 3.4° to postoperative 85.9° ± 4.4°). Similarly, significant coronal plane corrections were achieved in the DP group for the mean mFTA (preoperative 168.6° ± 4.4° to postoperative 182.2° ± 2°), the mean MPTA (preoperative 84.2° ± 2° to postoperative 88.3° ± 4.1°) and the mean mLDFA (preoperative 90.7° ± 2.9° to postoperative 83.9° ± 1.7°) (all p < 0.05). The mean correction accuracy was higher for the NP versus DP group at 3.4 ± 3.4% versus 7.1 ± 3.9% (intergroup p < 0.05). There were no outliers in the NP group versus two outliers (overcorrected) (16.7%) in the DP group. Significant clinical improvement was reported in both groups at 2 and 5 years postoperatively (all p < 0.05). Conclusion: Superior correction accuracy and no outliers were achieved in hybrid fixation double-level knee osteotomy compared to the conventional double-plating technique. The magnetic extendable nail offers the advantage of fine-tuning the correction postoperatively and could be a potential research template for future designs of postoperative correction implants. Level of Evidence: Level III, retrospective cohort study.

Quality of Popular Online Resources About Vestibular Migraine.

Objective: To evaluate the readability, understandability, actionability, and accuracy of online resources covering vestibular migraine (VM). Study Design: Cross-sectional descriptive study design. Setting: Digital collection of websites appearing on Google search. Methods: Google searches were conducted to identify common online resources for VM. We examined readability using the Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level scores, understandability and actionability using the Patient Education Materials Assessment Tool (PEMAT), and accuracy by comparing the website contents to the consensus definition of "probable vestibular migraine." Results: Eleven of the most popular websites were analyzed. Flesch-Kincaid Grade Level averaged at a 13th-grade level (range: 9th-18th). FRE scores averaged 35.5 (range: 9.1-54.4). No website had a readability grade level at the US Agency for Healthcare Research and Quality recommended 5th-grade level or an equivalent FRE score of 90 or greater. Understandability scores varied ranging from 49% to 88% (mean 70%). Actionability scores varied more, ranging from 12% to 87% (mean 44%). There was substantial inter-rater agreement for both PEMAT understandability scoring (mean κ = 0.76, SD = 0.08) and actionability scoring (mean κ = 0.65, SD = 0.08). Three sites included all 3 "probable vestibular migraine" diagnostic criteria as worded in the consensus statement. Conclusion: The quality of online resources for VM is poor overall in terms of readability, actionability, and agreement with diagnostic criteria.