Prospectively Recording Errors Is Valuable in Reducing Complications

Errors have traditionally been a less commonly discussed topic but are becoming increasingly examined due to a trend towards expanded awareness about the high human and financial cost of errors in medicine. Recording and reporting of errors has been a difficult issue in the health sector due to fear of litigation from patients, complaint to governing bodies, and embarrassment from colleagues. In this article we examine the advantages of prospective error recording. The studies on this subject report that the culture of prospective error recording is of high value in improving most parameters of errors and may indeed reduce complications.

Liquefaction susceptibility and deformation characteristics of saturated coral sandy soils subjected to cyclic loadings-a critical review

Coral sandy soils widely exist in coral island reefs and seashores in tropical and subtropical regions.Due to the unique marine depositional environment of coral sandy soils,the engineering characteristics and responses of these soils subjected to monotonic and cyclic loadings have been a subject of intense interest among the geotechnical and earthquake engineering communities.This paper critically reviews the progress of experimental investigations on the undrained behavior of coral sandy soils under monotonic and cyclic loadings over the last three decades.The focus of coverage includes the contractive-dilative behavior,the pattern of excess pore-water pressure(EPWP)generation and the liquefaction mechanism and liquefaction resistance,the small-strain shear modulus and strain-dependent shear modulus and damping,the cyclic softening feature,and the anisotropic characteristics of undrained responses of saturated coral sandy soils.In particular,the advances made in the past decades are reviewed from the following aspects:(1)the characterization of factors that impact the mechanism and patterns of EPWP build-up;(2)the identification of liquefaction triggering in terms of the apparent viscosity and the average flow coefficient;(3)the establishment of the invariable form of strain-based,stress-based,or energy-based EPWP ratio formulas and the unique relationship between the new proxy of liquefaction resistance and the number of cycles required to reach liquefaction;(4)the establishment of the invariable form of the predictive formulas of small strain modulus and strain-dependent shear modulus;and(5)the investigation on the effects of stress-induced anisotropy on liquefaction susceptibility and dynamic deformation characteristics.Insights gained through the critical review of these advances in the past decades offer a perspective for future research to further resolve the fundamental issues concerning the liquefaction mechanism and responses of coral sandy sites subjected to cyclic loadings associated with seismic events in marine environments.

Recent advances in the study of epitopes,allergens and immunologic cross-reactivity of edible mango

Mango(Mangifera indica L.)is a tropical fruit that is widely consumed as both fresh fruits and processed products around the world.The high incidence of mango allergy,on the other hand,has sparked widespread concern.Therefore,a summary and analysis of the current status and issues in mango allergen research can guide in-depth study on the mechanism of mango allergy and reveal effective desensitization methods.We described the incidence of fruit allergy,as well as the mechanism and clinical symptoms of mango allergy,in this review.We also looked into the structural properties of mango allergens,the effect of processing methods on mango allergens,prediction methods for mango allergen epitopes,and the current state of research on mango cross-reactive allergens and preventive measures.Finally,the research directions and ideas for the future are proposed and discussed.

Plant-based dietary patterns and risk of esophageal cancer:A prospective cohort study spanning 17 years

Objective: Plant-based diets have multiple health benefits for cancers;however, little is known about the association between plant-based dietary patterns and esophageal cancer(EC).This study presents an investigation of the prospective associations among three predefined indices of plant-based dietary patterns and the risk of EC.Methods: We performed endoscopic screening for 15,709 participants aged 40-69 years from two high-risk areas of China from January 2005 to December 2009 and followed the cohort until December 31, 2022. The overall plant-based diet index(PDI), healthful plant-based diet index(h PDI), and unhealthful plant-based diet index(u PDI), were calculated using survey responses to assess dietary patterns. We applied Cox proportional hazard regression to estimate the multivariable hazard ratios(HRs) and 95% confidence intervals(95% CIs) of EC across 3plant-based diet indices and further stratified the analysis by subgroups.Results: The final study sample included 15,184 participants in the cohort. During a follow-up of 219,365person-years, 176 patients with EC were identified. When the highest quartile was compared with the lowest quartile, the pooled multivariable-adjusted HR of EC was 0.50(95% CI, 0.32-0.77) for h PDI. In addition, the HR per 10-point increase in the h PDI score was 0.42(95% CI, 0.27-0.66) for ECs. Conversely, u PDI was positively associated with the risk of EC, and the HR was 1.80(95% CI, 1.16-2.82). The HR per 10-point increase in the u PDI score was 1.90(95% CI, 1.26-2.88) for ECs. The associations between these scores and the risk of EC were consistent in most subgroups. These results remained robust in sensitivity analyses.Conclusions: A healthy plant-based dietary pattern was associated with a reduced risk of EC. Emphasizing the healthiness and quality of plant-based diets may be important for preventing the development of EC.

Prospect Theory Based Individual Irrationality Modelling and Behavior Inducement in Pandemic Control

Understanding and modeling individuals’behaviors during epidemics is crucial for effective epidemic control.However,existing research ignores the impact of users’irrationality on decision-making in the epidemic.Meanwhile,existing disease control methods often assume users’full compliance with measures like mandatory isolation,which does not align with the actual situation.To address these issues,this paper proposes a prospect theorybased framework to model users’decision-making process in epidemics and analyzes how irrationality affects individuals’behaviors and epidemic dynamics.According to the analysis results,irrationality tends to prompt conservative behaviors when the infection risk is low but encourages risk-seeking behaviors when the risk is high.Then,this paper proposes a behavior inducement algorithm to guide individuals’behaviors and control the spread of disease.Simulations and real user tests validate our analysis,and simulation results show that the proposed behavior inducement algorithm can effectively guide individuals’behavior.

Development and validation of a circulating tumor DNA-based optimization-prediction model for short-term postoperative recurrence of endometrial cancer

BACKGROUND Endometrial cancer(EC)is a common gynecological malignancy that typically requires prompt surgical intervention;however,the advantage of surgical management is limited by the high postoperative recurrence rates and adverse outcomes.Previous studies have highlighted the prognostic potential of circulating tumor DNA(ctDNA)monitoring for minimal residual disease in patients with EC.AIM To develop and validate an optimized ctDNA-based model for predicting shortterm postoperative EC recurrence.METHODS We retrospectively analyzed 294 EC patients treated surgically from 2015-2019 to devise a short-term recurrence prediction model,which was validated on 143 EC patients operated between 2020 and 2021.Prognostic factors were identified using univariate Cox,Lasso,and multivariate Cox regressions.A nomogram was created to predict the 1,1.5,and 2-year recurrence-free survival(RFS).Model performance was assessed via receiver operating characteristic(ROC),calibration,and decision curve analyses(DCA),leading to a recurrence risk stratification system.RESULTS Based on the regression analysis and the nomogram created,patients with postoperative ctDNA-negativity,postoperative carcinoembryonic antigen 125(CA125)levels of<19 U/mL,and grade G1 tumors had improved RFS after surgery.The nomogram’s efficacy for recurrence prediction was confirmed through ROC analysis,calibration curves,and DCA methods,highlighting its high accuracy and clinical utility.Furthermore,using the nomogram,the patients were successfully classified into three risk subgroups.CONCLUSION The nomogram accurately predicted RFS after EC surgery at 1,1.5,and 2 years.This model will help clinicians personalize treatments,stratify risks,and enhance clinical outcomes for patients with EC.

Effects of strengthening prospective nursing practice on sleep quality,anxiety,and depression of awake patients in intensive care unit

BACKGROUND The intensive care unit(ICU)is a specialized hospital department.Awake patients in the ICU frequently encounter adverse psychological states,such as anxiety and fear,often accompanied by poor sleep quality.This situation has garnered significant attention within the medical community.AIM To investigate the impact of prospective nursing intervention strategies on the sleep quality and negative emotional state of conscious ICU patients.METHODS One hundred and twenty ICU awake patients admitted to our hospital were selected and randomly divided into control(n=60)and observation(n=60)groups.Patients in the control group were cared for using the conventional nursing model,while patients in the observation group were cared for using the prospective nursing model.Sleep improvement was assessed using the International Standardized Sleep Efficiency Formula and Pittsburgh Sleep Quality Index(PSQI).The PSQI,Generalized Anxiety Disorder 7-item(GAD-7)scale,Self-Depression Scale(SDS),and satisfaction before and after treatment were used to assess the negative emotional states of patients under the two care models.RESULTS Patient satisfaction in the observation group was significantly higher than in the control group.The GAD-7 and SDS scores in the observation group were significantly lower than those in the control group,and the total effective rate of sleep improvement in the observation group was significantly higher than in the control group.After treatment,the PSQI scores of the two groups significantly decreased(P<0.05).The decrease in the observation group was more significan than that in the control group,and the difference between the two groups was statistically significant.CONCLUSION Prospective nursing interventions can improve sleep quality and psychological levels and significantly affect conscious patients in the ICU,which is worthy of clinical application.

Prospects in the application of ultrasensitive chromosomal aneuploidy detection in precancerous lesions of gastric cancer

Gastric cancer(GC)is a prevalent malignant tumor within the digestive system,with over 40%of new cases and deaths related to GC globally occurring in China.Despite advancements in treatment modalities,such as surgery supplemented by adjuvant radiotherapy or chemotherapeutic agents,the prognosis for GC remains poor.New targeted therapies and immunotherapies are currently under invest-igation,but no significant breakthroughs have been achieved.Studies have indicated that GC is a heterogeneous disease,encompassing multiple subtypes with distinct biological characteristics and roles.Consequently,personalized treatment based on clinical features,pathologic typing,and molecular typing is crucial for the diagnosis and management of precancerous lesions of gastric cancer(PLGC).Current research has categorized GC into four subtypes:Epstein-Barr virus-positive,microsatellite instability,genome stability,and chromosome instability(CIN).Technologies such as multi-omics analysis and gene sequencing are being employed to identify more suitable novel testing methods in these areas.Among these,ultrasensitive chromosomal aneuploidy detection(UCAD)can detect CIN at a genome-wide level in subjects using low-depth whole genome sequencing technology,in conjunction with bioinformatics analysis,to achieve qualitative and quantitative detection of chromosomal stability.This editorial reviews recent research advancements in UCAD technology for the diagnosis and management of PLGC.

In silico prospective analysis of the medicinal plants activity on the CagA oncoprotein from Helicobacter pylori

BACKGROUND Colonization with Helicobacter pylori(H.pylori)has a strong correlation with gastric cancer,and the virulence factor CagA is implicated in carcinogenesis.Studies have been conducted using medicinal plants with the aim of eliminating the pathogen;however,the possibility of blocking H.pylori-induced cell differentiation to prevent the onset and/or progression of tumors has not been addressed.This type of study is expensive and time-consuming,requiring in vitro and/or in vivo tests,which can be solved using bioinformatics.Therefore,prospective computational analyses were conducted to assess the feasibility of interaction between phenolic compounds from medicinal plants and the CagA oncoprotein.AIM To perform a computational prospecting of the interactions between phenolic compounds from medicinal plants and the CagA oncoprotein of H.pylori.METHODS In this in silico study,the structures of the phenolic compounds(ligands)kaempferol,myricetin,quercetin,ponciretin(flavonoids),and chlorogenic acid(phenolic acid)were selected from the PubChem database.These phenolic compounds were chosen based on previous studies that suggested medicinal plants as non-drug treatments to eliminate H.pylori infection.The three-dimensional structure model of the CagA oncoprotein of H.pylori(receptor)was obtained through molecular modeling using computational tools from the I-Tasser platform,employing the threading methodology.The primary sequence of CagA was sourced from GenBank(BAK52797.1).A screening was conducted to identify binding sites in the structure of the CagA oncoprotein that could potentially interact with the ligands,utilizing the GRaSP online platform.Both the ligands and receptor were prepared for molecular docking using AutoDock Tools 4(ADT)software,and the simulations were carried out using a combination of ADT and AutoDock Vina v.1.2.0 software.Two sets of simulations were performed:One involving the central region of CagA with phenolic compounds,and another involving the carboxy-terminus region of CagA with phenolic compounds.The receptor-ligand complexes were then analyzed using PyMol and BIOVIA Discovery Studio software.RESULTS The structure model obtained for the CagA oncoprotein exhibited high quality(C-score=0.09)and was validated using parameters from the MolProbity platform.The GRaSP online platform identified 24 residues(phenylalanine and leucine)as potential binding sites on the CagA oncoprotein.Molecular docking simulations were conducted with the three-dimensional model of the CagA oncoprotein.No complexes were observed in the simulations between the carboxy-terminus region of CagA and the phenolic compounds;however,all phenolic compounds interacted with the central region of the oncoprotein.Phenolic compounds and CagA exhibited significant affinity energy(-7.9 to-9.1 kcal/mol):CagA/kaempferol formed 28 chemical bonds,CagA/myricetin formed 18 chemical bonds,CagA/quercetin formed 16 chemical bonds,CagA/ponciretin formed 13 chemical bonds,and CagA/chlorogenic acid formed 17 chemical bonds.Although none of the phenolic compounds directly bound to the amino acid residues of the K-Xn-R-X-R membrane binding motif,all of them bound to residues,mostly positively or negatively charged,located near this region.CONCLUSION In silico,the tested phenolic compounds formed stable complexes with CagA.Therefore,they could be tested in vitro and/or in vivo to validate the findings,and to assess interference in CagA/cellular target interactions and in the oncogenic differentiation of gastric cells.

Discussion on the application prospect of the transient electromagnetic method based on the dual launcher and mine advanced detection

The dual transmitter implements the equivalent anti-magnetic flux transient electromagnetic method, which can effectively reduce the scope of the transient electromagnetic detection blind area. However, this method is rarely reported in the detection of pipelines in urban geophysical exploration and the application of coal mines. Based on this, this paper realizes the equivalent anti-magnetic flux transient electromagnetic method based on the dual launcher. The suppression effect of this method on the blind area is analyzed by physical simulation. And the detection experiment of underground pipelines is carried out outdoors. The results show that the dual launcher can significantly reduce the turn-off time, thereby effectively reducing the impact of the blind area on the detection results, and the pipeline detection results verify the device’s effectiveness. Finally, based on the ground experimental results, the application prospect of mine advanced detection is discussed. Compared with other detection fields, the formation of blind areas is mainly caused by the equipment. If the dual launcher can be used to reduce the blind area, the accuracy of advanced detection can be improved more effectively. The above research results are of great significance for improving the detection accuracy of the underground transient electromagnetic method.

Gold Mineralisation in the Intiédougou Prospect (Diébougou District) in Southwest Burkina Faso, West African Craton

The Intiédougou located in the Houndé Birimian greenstone belt has been the subject of several mining and geoscience studies that have led to the discovery of mineralized gold targets. One of these mineralized targets has prompted work that raises the issue of control factors for the gold mineralization of the prospect. The methodology used in this study combines a study of core drill hole data located in the area and laboratory studies. The Intiédougou sector is based on andesito-basaltic, andesitic interstratified volcanoclastite rocks and Tarkwaïen type detrital sedimentary rocks caught in a vice in the volcano-sedimentary unit. Lithostructural analysis of the sector shows that the subvolcanic rocks bearing gold mineralization are subjected to heterogeneous ductile to brittle deformations and affected by hydrothermalism evolving at stages marked by large fissure fillings. These hydrothermal phases evolve in the zones of expansion created by the brittle deformations that have contributed to the deposits of different types of gold-enriched sulphides. These different phases of hydrothermal destabilization generally of low degree accompany the tardi to post-eburnean brittle tectonics. This deformation system is favorable to the establishment of gold mineralization in the form of vein bodies. The overimposition of deformed and altered areas suggests a genetic relationship between deformation and hydrothermal activity. In conclusion, the mineralization of Intiédougou in vein styles, set up in a volcanic arc environment with a paragenesis of gold-pyrite deposit ± chalcopyrite would be controlled by the structural aspect and accompanied by hydrothermal alteration.

Leucocyte telomere length,brain volume and risk of dementia:a prospective cohort study

Background The evidence regarding the association between leucocyte telomere length(LTL)and brain health is sparse and inconclusive.Aims To investigate the associations of LTL with brain structure and the risk of dementia based on a large-scale prospective study.Methods LTL in the peripheral blood was measured by the quantitative polymerase chain reaction(qPCR)assay from 439961 individuals in the UK Biobank recruited between 2006 and 2010 and followed up until 2020.Electronic health records were used to record the incidence of dementia,including Alzheimer’s disease(AD)and vascular dementia(VD).The brain structure,including total and regional brain volume,of 38740 participants was then assessed by magnetic resonance imaging(MRI).Results During a median follow-up of 11.6 years,a total of 5820(1.3%)dementia cases were documented.The restricted cubic spline model showed significant overall associations between LTL and the risk of dementia and AD(p for overall<0.05).The multivariable adjusted hazard ratios(HRs)for the lowest LTL tertile compared with the highest LTL tertile were 1.14(95%confidence interval(CI):1.06 to 1.21)for dementia,1.28(95%CI:1.12 to 1.46)for AD and 1.18(95%CI:0.98 to 1.42)for VD.Furthermore,we found that shorter LTL was associated with smaller total brain volume(β=−0.0128,p=0.003),white matter volume(β=−0.0224,p<0.001),hippocampus volume(β=−0.0172,p<0.001),thalamus volume(β=−0.0239,p<0.001)and accumbens(β=−0.0155,p=0.001).Conclusions Shorter LTL is associated with total and regional brain structure and a higher risk of incident dementia and AD,implying the potential of telomere length as a predictive biomarker of brain health.

Is hamstrings-to-quadriceps torque ratio useful for predicting anterior cruciate ligament and hamstring injuries?A systematic and critical review

Background:For the past 30 years,the hamstring(H)-to-quadriceps(Q)(H:Q)torque ratio has been considered an important index of muscle strength imbalance around the knee joint.The purpose of this systematic review was to examine the value of H:Q torque ratio as an independent risk factor for hamstring and anterior cruciate ligament(ACL)injuries.Methods:Database searches were performed to identify all relevant articles in PubMed,MEDLINE,Cochrane Library,and Scopus.Prospective studies evaluating the conventional(concentric H:Q),functional(eccentric H:concentric Q),and mixed(eccentric H at 300/s:concentric Q at2400/s)H:Q ratios as risk factors for occurrence of hamstring muscle strain or ACL injury were considered.Risk of bias was assessed using the Quality In Prognosis Studies tool.Results:Eighteen included studies reported 585 hamstrings injuries in 2945 participants,and 5 studies documented 128 ACL injuries in 2772participants.Best evidence synthesis analysis indicated that there is very limited evidence that H:Q strength ratio is an independent risk factor for hamstring and ACL injury,and this was not different between various ratio types.Methodological limitations and limited evidence for ACL injuries and some ratio types might have influenced these results.Conclusion:The H:Q ratio has limited value for the prediction of ACL and hamstring injuries.Monitoring strength imbalances along with other modifiable factors during the entire competitive season may provide a better understanding of the association between H:Q ratio and injury.

Lithium-bearing Pegmatite Exploration in Western Altun,Xinjiang,using Remote-Sensing Technology

Western Altun in Xinjiang is an important area,where lithium(Li)-bearing pegmatites have been found in recent years.However,the complex terrain and harsh environment of western Altun exacerbates in prospecting for Li-bearing pegmatites.Therefore,remote-sensing techniques can be an effective means for prospecting Li-bearing pegmatites.In this study,the fault information and lithologyical information in the region were obtained using the median-resolution remotesensing image Landsat-8,the radar image Sentinel-1 and hyperspectral data GF-5.Using Landsat-8 data,the hydroxyl alteration information closely related to pegmatite in the region was extracted by principal component analysis,pseudoanomaly processing and other methods.The high spatial resolution remote-sensing data WorldView-2 and WorldView-3 short-wave infrared images were used and analyzed by principal component analysis(PCA),the band ratio method and multi-class machine learning(ML),combined with conventional thresholds specified the algorithms used to automatically extract Li-bearing pegmatite information.Finally,the Li-bearing pegmatite exploration area was determined,based on a comprehensive analysis of the faults,hydroxyl alteration lithology and Li-bearing pegmatite information.Field investigations have verified that the distribution of pegmatites in the central part of the study area is consistent with that of Li-bearing pegmatites extracted in this study.This study provides a new technique for prospecting Li-bearing pegmatites,which shows that remote-sensing technology possesses great potential for identifying lithium-bearing pegmatites,especially in areas that are not readily accessible.

Elimination of lymphatic filariasis:Where do we stand so far?

Lymphatic filariasis(LF),an asymptomatic,acute,and chronic condition in human beings,is the second most common vector-borne disease after malaria.According to the World Health Organization,there are 120 million LF cases detected in 81 tropical and subtropical countries,and one billion people are at risk.Therefore,the Global Program to Eliminate Lymphatic Filariasis was launched in 2000,with the primary objective of stopping LF transmission among all at-risk groups using mass drug administration(MDA),managing morbidities,and preventing LF-related impairments using a minimum treatment package.Additionally,other programs such as epidemiological assessment including National Filaria Control Program and World Health Organization recommended routine and pre-MDA microfilaremia surveys also implemented to stop the LF transmission.The routine filaria surveys were also carried out in around 2000-4000 individuals/month throughout the year whereas pre-MDA surveys were also conducted every year in approximately 4000 individuals in four fixed and four random sites.Furthermore,the Transmission Assessment Survey was also conducted to check the risk of LF among primary school children.Moreover,potential diagnostic methods,systematic surveillance regimes,the Direct Network Report system,and regular trainings and awareness may be also effective in preventing the recurrence of LF.Hence,this review emphasizes the potential advocacy tools and various strategies as well as procedures for monitoring,which could be impactful in eliminating LF.

Evaluation of metoprolol standard dosing pathway in Chinese patients with acute coronary syndrome:a prospective multicenter single-arm interventional study

OBJECTIVE To evaluate the feasibility and tolerability of metoprolol standard dosing pathway(MSDP)in Chinese patients with acute coronary syndrome(ACS).METHODS In this multicenter,prospective,open label,single-arm and interventional study that was conducted from February 2018 to April 2019 in fifteen Chinese hospitals.A total of 998 hospitalized patients aged≥18 years and diagnosed with ACS were included.The MSDP was applied to all eligible ACS patients based on the standard treatment recommended by international guidelines.The primary endpoint was the percentage of patients achieving the target dose at discharge(V2).The secondary endpoints included the heart rate and blood pressure at V2 and four weeks after discharge(V4),and percentage of patients experiencing bradycardia(heart rate<50 beats/min),hypotension(blood pressure<90/60 mmHg)and transient cardiac dysfunction at V2 and V4.RESULTS Of the 998 patients,29.46%of patients achieved the target dose(≥95 mg/d)at V2.The total population was divided into two groups:target group(patients achieving the target dose at V2)and non-target group(patients not achieving the target dose at V2).There was significant difference in the reduction of heart rate from baseline to discharge in the two groups(-4.97±11.90beats/min vs.-2.70±9.47 beats/min,P=0.034).There was no significant difference in the proportion of bradycardia that occurred in the two groups at V2(0 vs.0,P=1.000)and V4(0.81%vs.0.33%,P=0.715).There was no significant difference in the proportion of hypotension between the two groups at V2(0.004%vs.0.004%,P=1.000)and V4(0 vs.0.005%,P=0.560).No transient cardiac dysfunction occurred in two groups during the study.A total of five adverse events(1.70%)and one serious adverse event(0.34%)were related to the pathway in target group.CONCLUSIONS In Chinese ACS patients,the feasibility and tolerability of the MSDP have been proved to be acceptable.

Three-Way Behavioral Decision Making With Hesitant Fuzzy Information Systems:Survey and Challenges

Three-way decision(T-WD)theory is about thinking,problem solving,and computing in threes.Behavioral decision making(BDM)focuses on effective,cognitive,and social processes employed by humans for choosing the optimal object,of which prospect theory and regret theory are two widely used tools.The hesitant fuzzy set(HFS)captures a series of uncertainties when it is difficult to specify precise fuzzy membership grades.Guided by the principles of three-way decisions as thinking in threes and integrating these three topics together,this paper reviews and examines advances in three-way behavioral decision making(TW-BDM)with hesitant fuzzy information systems(HFIS)from the perspective of the past,present,and future.First,we provide a brief historical account of the three topics and present basic formulations.Second,we summarize the latest development trends and examine a number of basic issues,such as one-sidedness of reference points and subjective randomness for result values,and then report the results of a comparative analysis of existing methods.Finally,we point out key challenges and future research directions.

Microneedles for Enhanced Topical Treatment of Skin Disorders:Applications,Challenges,and Prospects

Microneedles(MNs)can be used for the topical treatment of skin disorders as they directly deliver therapeutics to the site of skin lesions,resulting in increased therapeutic efficacy while having minimum side effects.MNs are used to deliver different kinds of therapeutics(e.g.,small molecules,macromolecules,nanomedicines,living cells,bacteria,and exosomes)for treating various skin disorders,including superficial tumors,wounds,skin infections,inflammatory skin diseases,and abnormal skin appearance.The therapeutic efficacy of MNs can be improved by integrating the advantages of multiple therapeutics to perform combination therapy.Through careful designing,MNs can be further modified with biomimetic structures for the responsive drug release from internal and external stimuli and to enhance the transdermal delivery efficiency for robust therapeutic outcomes.Some studies have proposed the use of drug-free MNs as a promising mechanotherapeutic strategy to promote wound healing,scar removal,and hair regeneration via a mechanical communication pathway.Although MNs have several advantages,the practical application of MNs suffers from problems related to industrial manufacture and clinical evaluation,making it difficult for clinical translation.In this study,we summarized the various applications,emerging challenges,and developmental prospects of MNs in skin disorders to provide information on ways to advance clinical translation.

Associations between aerobic and muscle-strengthening physical activity,sleep duration,and risk of all-cause mortality:A prospective cohort study of 282,473 U.S.adults

Purpose:To examine the joint associations between meeting guidelines for physical activity(PA)and sleep duration and all-cause mortality risk among adults.Methods:Participants were adults(n=282,473)aged 18-84 years who participated in the 2004-2014 U.S.National Health Interview Survey.Mortality status was ascertained using the National Death Index through December 2015.Self-reported PA(Active:meeting both aerobic(AER)and muscle-strengthening(MSA)guidelines,AER only(AER),MSA only(MSA),or not meeting either AER or MSA(Inactive))and sleep duration(Short,recommended(Rec),or Long)were classified according to guidelines,and 12 PA-sleep categories were derived.Adjusted hazard ratios and 95%confidence intervals(95%CIs)for all-cause mortality risk were estimated using Cox proportional hazards regression models.Results:A total of 282,473 participants(55%females)were included;18,793 deaths(6.7%)occurred over an average follow-up of 5.4 years.Relative to the Active-Rec group,all other PA-sleep groups were associated with increased mortality risk except for the Active-Short group(hazard ratio=1.08;95%CI:0.92-1.26).The combination of long sleep with either MSA or Inactive appeared to be synergistic.For a given sleep duration,mortality risk progressively increased among participants classified as AER,MSA,and Inactive.Within each activity level,the mortality risk was greatest among adults with long sleep.Conclusion:Relative to adults meeting guidelines for both PA and sleep duration,adults who failed to meet guidelines for both AER and muscle strengthening PA and who also failed to meet sleep duration guidelines had elevated all-cause mortality risks.These results support interventions targeting both PA and sleep duration to reduce mortality risk.

Prognostic value of hematological parameters in older adult patients with acute coronary syndrome undergoing coronary intervention:a single centre prospective study

BACKGROUND Cardiovascular disease is a significant contributor to the disease burden in geriatric patients.Underlying systemic inflammation is thought to be the cause of age-related changes in the bone marrow and a major risk factor for atherosclerosis.The purpose of the study was to assess the accuracy of these hematological biomarkers in predicting 30-day mortality in older patients with acute coronary syndrome(ACS).METHODS This was a prospective observational study of 601 older adult patients(age>60 years)with ACS who underwent percutaneous coronary intervention over two years(2017-2019).The relationship between baseline hematological parameters and mortality was assessed during the 30-day follow-up.Logistic regression analysis and receiver operating characteristic curve analysis were done to evaluate for diagnostic accuracy of various hematological parameters.RESULTS The mean age of presentation was 77±17 years.The mean neutrophil-lymphocyte ratio(NLR)value was 5.07±4.90 and the mean platelet-lymphocyte ratio(PLR)value was 108.65±85.82.On univariate analysis,total leucocyte count[odds ratio(OR)=0.85,P=0.021],hematocrit(OR=0.91,P=0.018),NLR(OR=1.10,P=0.001)and PLR(OR=1.05,P=0.001)were associated with mortality.On receiver operating characteristic curve analysis,NLR predicted mortality with 68.1%and PLR with 65.7%accuracy.On multivariate analysis,NLR(OR=1.096,95%CI:1.006-1.15,P=0.035)was an independent predictor of 30-day mortality.CONCLUSIONS For the risk classification of all elderly ACS patients,we highly advise using NLR rather than the total white blood cell count.