Application of multidisciplinary in situ simulation training in the treatment of acute ischemic stroke: a quality improvement project

BACKGROUND:Ischemic stroke refers to a disorder in the blood supply to a local area of brain tissue for various reasons and is characterized by high morbidity,mortality,and disability.Early reperfusion of brain tissue at risk of injury is crucial for the treatment of acute ischemic stroke.The purpose of this study was to evaluate comfort levels in managing acute stroke patients with hypoxemia who required endotracheal intubation after multidisciplinary in situ simulation training and to shorten the door-to-image time.METHODS:This quality improvement project utilized a comprehensive multidisciplinary in situ simulation exercise.A total of 53 participants completed the two-day in situ simulation training.The main outcome was the self-reported comfort levels of participants in managing acute stroke patients with hypoxemia requiring endotracheal intubation before and after simulation training.A 5-point Likert scale was used to measure participant comfort.A paired-sample t-test was used to compare the mean self-reported comfort scores of participants,as well as the endotracheal intubation time and door-to-image time on the fi rst and second days of in situ simulation training.The door-to-image time before and after the training was also recorded.RESULTS:The findings indicated that in situ simulation training could enhance participant comfort when managing acute stroke patients with hypoxemia who required endotracheal intubation and shorten door-to-image time.For the emergency management of hypoxemia or tracheal intubation,the mean post-training self-reported comfort score was signifi cantly higher than the mean pre-training comfort score(hypoxemia:4.53±0.64 vs.3.62±0.69,t=-11.046,P<0.001;tracheal intubation:3.98±0.72 vs.3.43±0.72,t=-6.940,P<0.001).We also observed a decrease in the tracheal intubation and door-to-image time and a decreasing trend in the door-to-image time,which continued after the training.CONCLUSION:Our study demonstrates that the implementation of in situ simulation training in a clinical environment with a multidisciplinary approach may improve the ability and confi dence of stroke team members,optimize the fi rst-aid process,and eff ectively shorten the door-to-image time of stroke patients with emergency complications.

Simultaneous Determination of 2- and 3-MCPD Esters in Infant Formula Milk Powder and Edible Vegetable Oils by Gas Chromatography-Mass Spectrometry

Esters of 2- and 3-monochloropropane-1,2-diol (MCPD) are significative contaminants of processed edible oils used as foods or food ingredients. The aim of this study was to develop and validate a new method by GC-MS for the simultaneous quantification of 2 and 3-MCPD esters in infant milk powder and edible vegetable oils. The developed protocol included fat fraction in infant milk powder and edible vegetable oils samples was extracted and treated with sodium methylate-methanol to cleave the ester bonds of the 2- and 3-MCPD esters, moreover, standard samples of deuterium isotope-labeled 2- and 3-MCPD palmitic acid double esters and stearic acid double esters were used as the internal standards. Furthermore, this method was validated when it was applied to food products, concrete manifestation in its good accuracy (the recovery of MCPD esters ranged from 86% to 114%), high sensitivity (the LOD of 3-MCPD and 2-MCPD esters were 0.025 and 0.020 mg/kg, LOQ were 0.075, 0.060 mg/kg, respectively) and satisfactory repeatability (RSD below 6.8%) for all analytes. In the 150 commercial edible vegetable oils and infant formula milk powder samples, we obtained a preliminary profile of MCPD ester contamination.

Auto-Segmentation on Liver with U-Net and Pixel De-Convolutional Network

Purpose: To improve the liver auto-segmentation performance of three-dimensional (3D) U-net by replacing the conventional up-sampling convolution layers with the Pixel De-convolutional Network (PDN) that considers spatial features. Methods: The U-net was originally developed to segment neuronal structure with outstanding performance but suffered serious artifacts from indirectly unrelated adjacent pixels in its up-sampling layers. The hypothesis of this study was that the segmentation quality of the liver could be improved with PDN in which the up-sampling layer was replaced by a pixel de-convolution layer (PDL). Seventy-eight plans of abdominal cancer patients were anonymized and exported. Sixty-two were chosen for training two networks: 1) 3D U-Net, and 2) 3D PDN, by minimizing the Dice loss function. The other sixteen plans were used to test the performance. The similarity Dice and Average Hausdorff Distance (AHD) were calculated and compared between these two networks. Results: The computation time for 62 training cases and 200 training epochs was about 30 minutes for both networks. The segmentation performance was evaluated using the remaining 16 cases. For the Dice score, the mean ± standard deviation were 0.857 ± 0.011 and 0.858 ± 0.015 for the PDN and U-Net, respectively. For the AHD, the mean ± standard deviation were 1.575 ± 0.373 and 1.675 ± 0.769, respectively, corresponding to an improvement of 6.0% and 51.5% of mean and standard deviation for the PDN. Conclusion: The PDN has outperformed the U-Net on liver auto-segmentation. The predicted contours of PDN are more conformal and smoother when compared with the U-Net.

Investigation of children’s habits of smartphone usage and parental awareness of myopia control in underdeveloped areas of China

AIM: To investigate the behaviors of smartphone usage and parental knowledge of vision health among primary students in the rural areas of China. METHODS: In this school-based, cross-sectional study, a total of 52 606 parents of students from 30 primary schools in the Xingguo County were investigated through an online questionnaire from July 2020 to August 2020. The self-designed questionnaire contained three parts: the demographic factors of both children and parents, parental knowledge and attitude toward myopia, and the preventive treatment of myopia.RESULTS: A total of 52 485 appropriately answered questionnaires were received, showing an effective response rate of 95.1%. The average age of the primary students was 10.1±0.98 y and the prevalence of myopia among the primary students was 40.3%. The age of myopia occurrence in elementary students was significantly correlated with the parents’ educational level(95%CI: 0.82-0.98, P=0.013), children’s gender(95%CI: 1.08-1.20, P<0.001), school location(county or countryside)(95%CI: 0.59-0.66, P<0.001), children’s smartphone ownership(95%CI: 1.09-1.26, P<0.001), and the average time spent on smartphone per day(95%CI: 0.78-0.88, P<0.001). School location in the county town, high family income, and high parents’educational level significantly affected both parents’ myopia awareness and children’s vision-threatening behaviors(P<0.01). Left-behind children showed a higher incidence of vision-threatening habits than those who lived with their parents(P<0.01).CONCLUSION: The results reveal the current situation of myopia development among rural primary school students and their parents. This survey will serve as a guidance for designing myopic prevention policies in the rural areas of China.

Polidocanol sclerotherapy for multiple gastrointestinal hemangiomas:A case report

BACKGROUND Gastrointestinal(GI)hemangioma has a low incidence among systemic hemangiomas,and some GI hemangiomas occur in the intestine,stomach,and esophagus.Polidocanol has been increasingly used in sclerotherapy.However,this paper reports that minimally invasive treatment of multiple hemangiomas with large diameters can achieve satisfactory results by multipoint injection.CASE SUMMARY A 46-year-old female patient was hospitalized in another hospital for cough.We accidentally found thickening of the lower esophagus by chest computed tomography.The patient was eventually diagnosed with multiple GI hemangiomas and underwent a series of examinations including esophagogastroduodenoscopy(EGD),endoscopic ultrasound,and magnetic resonance imaging.We calculated the dose of polidocanol according to the volumes of the hemangiomas,fixed the target vein with the help of a transparent cap,and then administered polidocanol via multipoint injection into the hemangiomas under endoscopic guidance.EGD and endoscopic ultrasound showed that the hemangiomas disappeared.The color of the esophageal mucosa returned to normal 1 mo after sclerotherapy.CONCLUSION Sclerotherapy may be a safe and effective method for treating multiple hemangiomas of the alimentary canal.

Amide naphthotubes:Biomimetic macrocycles for selective molecular recognition

Selective molecular recognition in water is routine for bioreceptors,but remains challenging for synthetic hosts.This is principally because noncovalent interactions are usually less efficient in aqueous environments.By mimicking the cavity feature of bioreceptors,Prof.Wei Jiang proposed and clarified the concept of“endo-functionalized cavity”.Through situating polar binding sites into a deep hydrophobic cavity,we designed and synthesized several macrocyclic hosts,among which amide naphthotubes are the most representative.The hosts can selectively recognize various polar molecules including organic micropollutants,drug molecules,and chiral molecules in water by employing the hydrophobic effect and shielded hydrogen bonding.In addition,these biomimetic hosts have been applied in spectroscopic analysis,adsorptive separation and self-assembly.In this review,we provide an overview of recent advances on amide naphthotubes with special emphasis on the efforts of Jiang's group.We are convinced that these biomimetic macrocycles will make further contributions to supramolecular chemistry and beyond.

Ultra-highly selective recognition of nucleosides over nucleotides by rational modification of tetralactam macrocycle and its application in enzyme assay

Artificial macrocycle with high binding selectivity in water is often challenging but urgently needed in various research and application areas.Herein,we report a new water-soluble biomimetic tetralactam macrocycle and realize the ultra-high selectivity to nucleosides over corresponding monophosphate nucleotides by rational modification.The introduction of charged groups at the periphery of endofunctionalized cavity makes the selectivity(guanosine to guanosine 5-monophosphate)increase remarkably from 100 to 1119.Based on the ultra-high selectivity of biomimetic tetralactam macrocycle,the sensitive CD73 enzyme activity assay was then achieved through product-selective fluorescence indicator displacement assay.Furthermore,the capability of the proposed method for inhibitor screening was successfully displayed.

Dynamic DNA 5-hydroxylmethylcytosine and RNA 5-methycytosine Reprogramming During Early Human Development

After implantation,complex and highly specialized molecular events render functionally distinct organ formation,whereas how the epigenome shapes organ-specific development remains to be fully elucidated.Here,nano-hmC-Seal,RNA bisulfite sequencing(RNA-BisSeq),and RNA sequencing(RNA-Seq)were performed,and the first multilayer landscapes of DNA 5-hydroxymethylcytosine(5hmC)and RNA 5-methylcytosine(m^(5)C)epigenomes were obtained in the heart,kidney,liver,and lung of the human foetuses at 13-28 weeks with 123 samples in total.We identified 70,091 and 503 organ-and stage-specific differentially hydroxymethylated regions(DhMRs)and m^(5)C-modified mRNAs,respectively.The key transcription factors(TFs),T-box transcription factor 20(TBX20),paired box 8(PAX8),krueppel-like factor 1(KLF1),transcription factor 21(TCF21),and CCAAT enhancer binding protein beta(CEBPB),specifically contribute to the formation of distinct organs at different stages.Additionally,5hmC-enriched Alu elements may participate in the regulation of expression of TF-targeted genes.Our integrated studies reveal a putative essential link between DNA modification and RNA methylation,and illustrate the epigenetic maps during human foetal organogenesis,which provide a foundation for an in-depth understanding of the epigenetic mechanisms underlying early development and birth defects.

EPL-PRM:Equipotential line sampling strategy for probabilistic roadmap planners in narrow passages

Path planning is a crucial concern in the field of mobile robotics,particularly in complex scenarios featuring narrow passages.Sampling-based planners,such as the widely utilized probabilistic roadmap(PRM),have been extensively employed in various robot applications.However,PRM’s utilization of random node sampling often results in disconnected graphs,posing a significant challenge when dealing with narrow passages.In order to tackle this issue,we present equipotential line sampling strategy for probabilistic roadmap(EPL-PRM),a novel approach derived from PRM.This paper initially proposes a sampling potential field,followed by the construction of equipotential lines that are denser in the proximity of obstacles and narrow passages.Random sampling is subsequently conducted along these lines.Consequently,the sampling strategy enhances the likelihood of sampling nodes around obstacles and narrow passages,thereby addressing the issue of sparsity encountered in traditional sampling-based planners.Furthermore,we introduce a nodal optimization method based on an artificial repulsive field,which prompts sampled nodes to move in the direction of repulsion.As a result,nodes around obstacles are distributed more uniformly,while nodes within narrow passages gravitate toward the middle of the passages.Finally,extensive simulations are conducted to evaluate the proposed method.The results demonstrate that our approach achieves path planning with superior efficiency,lower cost,and higher reliability compared with traditional algorithms.

人工合成纳米颗粒在水生食物链中的分布、传递及其影响因素

纳米技术作为一种最具有市场应用潜力的新兴科学技术,近十年来在基础理论和应用研究等方面迅猛发展,使其在化工、医疗、电子、能源、环境保护等行业得到了广泛的应用.人工合成纳米颗粒(engineered nanoparticles,ENPs)在纳米产品的整个生命周期中将不可避免地进入水环境,与水生生物直接或间接(营养传递)的接触,从而沿水生食物链进行传递和转移,并影响生物的一系列生命活动.本文以不同水生生物为对象,总结了ENPs在不同类群的生物中的分布特点,着重探讨了ENPs在淡水和海洋食物链中的传递规律,并分析了ENPs性质和水环境因素对传递过程的影响.本文最后对ENPs在水生食物链中的研究现状、前景和面临的挑战进行了分析和展望.

碳纳米材料与共存污染物的联合毒性

碳纳米材料(carbon nanomaterials,CNMs)具有广泛的应用,其产量飞速增长,并在纳米产品的消费过程中不可避免地被释放到环境中.环境中的CNMs能够与共存污染物(如有机污染物、重金属和其他纳米颗粒)相互作用,影响彼此的归趋及毒性效应.因此在评价CNMs的环境风险时,CNMs与环境中共存污染物的联合毒性不容忽视.本文首先归纳了CNMs对生物体的直接及间接致毒机制,随后着重探讨了CNMs与有机污染物、重金属等环境污染物的联合毒性,从CNMs与其他污染物的作用方式入手,探究了联合毒性与单一毒性发生差异(增强或抑制)的机制,最后对目前CNMs与共存污染物联合毒性的评价方法、研究水平以及面临的挑战进行了分析和展望,为准确评估并深入理解CNMs的环境风险提供一定的理论基础.

Iron oxidation-reduction bioavailability in and its impacts on cadmium paddy soils： a review

Redox conditions in paddy soils may vary as they are submerged and drained during rice growth. This change may bring about reductive dissolution of iron （Fe） oxides and subsequent formation of secondary Fe-bearing minerals in rice paddies. The mobility and bioavailability of metal contaminants such as cadmium （Cd） in paddy soils are closely related to the chemical behaviors of Fe. Therefore, in this paper, advances in the study of paddy Fe redox transformations and their effects on Cd availability to rice are briefly reviewed. Current concepts presented in this review include the forms of Fe in paddy soils, the reactions involved in Fe oxidation-reduction, chemical factors affecting Fe redox processes, Cd availability to rice and the impacts of Fe transformation on Cd uptake and translocation in rice. Prospects for future research in this area are also discussed.

Molecular recognition and fluorescent sensing of urethane in water

Molecular recognition and fluorescent sensing of Group 2A carcinogen-urethane was achieved in aqueous solution. The molecular sensors are the endo-functionalized molecular tubes with amide protons in the hydrophobic cavity.~1H NMR, fluorescence, and ITC titrations and single crystal X-ray crystallography reveal the binding stoichiometry, the binding affinities, and the driving forces. The binding is mainly driven by the hydrophobic effect through releasing the "high-energy" cavity water with minor contribution from hydrogen bonding. In addition, the syn-configured molecular tube was found to be a good fluorescent sensor for urethane in water(concentration range: 6.2–60 mmol/L) and in beer(concentration range: 22.9–60 mmol/L).

Selective recognition of aromatic hydrocarbons by endo-functionalized molecular tubes via C/N-H…π interactions

Molecular recognition of aromatic hydrocarbons by four endo-functionalized molecular tubes has been studied by 1H NMR spectroscopy, computational methods, and single crystal X-ray crystallography. The binding selectivity is rationalized by invoking shape complementarity and dipole alignment. The non- covalent interactions are proved to predominantly be C/N-H...π interactions.

Biomimetic Recognition of Organic Drug Molecules in Water by Amide Naphthotubes

Molecular recognition in water is the basis of numerous biological functions.The key for efficient and selective recognition of an organic drug molecule is to bind both its polar and nonpolar groups.This is achieved by bioreceptors for which specific noncovalent interactions are efficiently used in a hydrophobic pocket.In contrast,most synthetic receptors cannot efficiently bind the neutral,polar groups of drug molecules and,thus,often exhibit poor binding selectivity and affinity.In this research,we report a systematic study on the binding behaviors of three types of macrocyclic hosts(amide naphthotubes,cucurbit[7]uril,andβ-cyclodextrin)to 18 model compounds and 13 drug molecules.Our results show that the high desolvation penalty of polar groups of guests is the reason for the relatively low binding affinity of cucurbit[7]uril andβ-cyclodextrin.However,amide naphthotubes with a biomimetic cavity bind efficiently and selectively to organic guests through hydrophobic effects and hydrogen bonding.Drug molecules with multiple polar groups can be better accommodated by these naphthotubes.The anti-configured naphthotube show good biocompatibility according to preliminary cell experiments and is capable of enhancing the water solubility of two poorly soluble drug molecules.Therefore,they may have practical applications in pharmaceutical sciences.

A phase-selective,bis-urea organogelator with a curved bis-naphthalene core

A phase-selective,bis-urea organogelator with a curved bis-naphthalene core was synthesized and characterized.This gelator is capable of gelating a variety of hydrocarbons and oils.The resulting gels have been characterized by rheology,SEM,and molecular modelling.The gelator can be applied in the powder form for the recovery of a thin layer of petrol oil spill in water.

Selective recognition of methyl viologen by an endo-functionalized naphthobox

Highly selective binding of structurally similar substrates is common for biomolecular recognition,but is often challenging to realize in synthetic hosts.Herein,we report highly selective binding of methyl viologen over other analogues by an endo-functionalized naphthobox.X-ray single crystal structure and Density Functional Theory(DFT)calculations revealed that the endo-functionalized groups in the cavity of the naphthobox is important for the high binding selectivity through the formation of multiple C-H…N,C-H…π,andπ…πinteractions with methyl viologen.

Selective Recognition of Quaternary Ammonium Ions by Structurally Flexible Cages

The binding behaviors of three structurally similar and flexible cages to a series of quaternary ammonium ions have been systematically studied.The cage with phenyl sidewalls is new;moreover,its structure and conformational states have been characterized by NMR;2D NMR,and X-ray crystallography.The results reveal that the three cages show quite high binding affinities and selectivities to different guests.Enthalpy-entropy compensation was invoked to explain the different binding performance.Moreover,a six-component,high-fidelity self-sorting system was successfully constructed by using these cages and three guests.This suggests that conformationally flexible hosts may also achieve high binding affinities and selectivities,which is in contrast to the traditional point of view-only preorganized and rigid hosts are able to do so.This research advocates that conformational flexibility should also be seriously considered in host design.

四内酰胺大环的分子识别与应用研究进展

分子识别在自然界中广泛存在,是许多生物过程以及超分子化学的核心.水的极性环境会显著削弱特定的非共价相互作用(如氢键),因此利用人工大环主体在水相中进行分子识别具有挑战性.四内酰胺大环是一类疏水空腔内部具有极性结合位点的人工大环主体,通过模仿生物受体的识别特性实现了水中亲水分子的识别,在疏水效应以及氢键的协同作用下可以实现药物分子、糖类、染料、有机污染物及疾病标志物等物质的选择性识别.总结了近三十年来四内酰胺大环在分子识别与应用方面的研究进展,尤其是在水相中的分子识别与应用研究,希望为今后四内酰胺大环的发展提供参考.