Hidden army within:Harnessing the microbiome to improve cancer treatment outcomes

The gut microbiome has emerged as a critical player in cancer pathogenesis and treatment response.Dysbiosis,an imbalance in the gut microbial community,impacts tumor initiation,progression,and therapy outcomes.Specific bacterial species have been associated with either promoting or inhibiting tumor growth,offering potential targets for therapeutic intervention.The gut microbiome in-fluences the efficacy and toxicity of conventional treatments and cutting-edge immunotherapies,highlighting its potential as a therapeutic target in cancer care.However,translating microbiome research into clinical practice requires addres-sing challenges such as standardizing methodologies,validating microbial bio-markers,and ensuring ethical considerations.Here,we provide a comprehensive overview of the gut microbiome's role in cancer highlighting the need for on-going research,collaboration,and innovation to harness its full potential for im-proving patient outcomes in oncology.The current editorial aims to explore these insights and emphasizes the need for standardized methodologies,validation of microbial biomarkers,and interdisciplinary collaboration to translate microbiome research into clinical applications.Furthermore,it underscores ethical consider-ations and regulatory challenges surrounding the use of microbiome-based the-rapies.Together,this article advocates for ongoing research,collaboration,and innovation to realize the full potential of microbiome-guided oncology in impro-ving patient care and outcomes.

Comparison of Oral Manifestations in Hospitalized COVID-19 Positive Patients and COVID-19 Negative Dental Outpatients. A Case Series Study and Literature Review

Background: The Coronavirus disease 2019 (COVID-19) is a respiratory infectious disease, also named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which can cause various systemic manifestations that pose a threat to human life. Oral lesions in patients with COVID-19 may appear during or after the illness and may or may not be a consequence of the viral infection. Objective: In this case series we compare the oral manifestations in hospitalized COVID-19 positive patients and COVID-19 negative dental outpatients. Methods: 60 hospitalized COVID-19 patients and 41 control patients, were examined for oral signs and symptoms. The controls were dental patients who visited the hospital for dental care without complaining of any problems related to the oral cavity itself. Results: We have observed a strong association between certain clinical findings and COVID-19, including alterations in taste (ageusia, dysgeusia, and hypogeusia), anosmia, hairy tongue, tongue imprints, red tongue, erythematous candidiasis, pseudomembranous candidiasis, and exfoliative cheilitis. A trend but not statistically significant association at the level of 5% was also noted for colored tongue, linea alba, and pale mucosa. On the contrary, fissured tongue and oral mucosa pigmentation were more frequent in the controls, statistically significant at the level of 5%. Conclusion: COVID-19 has been found to impact the oral cavity, resulting in various oral lesions that can be attributed to either the direct action of the virus or the patient’s immune response.

Is there a role of lipid-lowering therapies in the management of fatty liver disease?

Atherogenic dyslipidemia is characterized by increased triglyceride-rich lipoproteins and low high-density lipoprotein cholesterol concentrations.It is highly prevalent in non-alcoholic fatty liver disease(NAFLD)and contributes to the increased cardiovascular risk associated with this condition.Alongside insulin resistance it plays an important pathogenetic role in NAFLD/non-alcoholic steatohepatitis(NASH)development and progression.It has been shown that cholesterol-lowering reduces cardiovascular risk more in NAFLD vs non-NAFLD high-risk individuals.This evidence highlights the importance of effective lipid modulation in NAFLD.In this narrative review the effects of the most commonly used lipid-lowering therapies on liver outcomes alongside their therapeutic implications in NAFLD/NASH are critically discussed.Preclinical and clinical evidence suggests that statins reduce hepatic steatosis,inflammation and fibrosis in patients with NAFLD/NASH.Most data are derived from observational and small prospective clinical studies using changes in liver enzyme activities,steatosis/fibrosis scores,and imaging evidence of steatosis as surrogates.Also,relevant histologic benefits were noted in small biopsy studies.Atorvastatin and rosuvastatin showed greater benefits,whereas data for other statins are scarce and sometimes conflicting.Similar studies to those of statins showed efficacy of ezetimibe against hepatic steatosis.However,no significant anti-inflammatory and anti-fibrotic actions of ezetimibe have been shown.Preclinical studies showed that fibrates through peroxisome proliferator-activated receptor(PPAR)αactivation may have a role in NAFLD prevention and management.Nevertheless,no relevant benefits have been noted in human studies.Species-related differences in PPARαexpression and its activation responsiveness may help explain this discrepancy.Omega-3 fatty acids reduced hepatic steatosis in numerous heterogeneous studies,but their benefits on hepatic inflammation and fibrosis have not been established.Promising preliminary data for the highly purified eicosapentaenoic acid require further confirmation.Observational studies suggest that proprotein convertase subtilisin/kexin9 inhibitors may also have a role in the management of NAFLD,though this needs to be established by future prospective studies.

Exercise for tendinopathy

Tendinopathies are one of the most common sports/musculoskeletal injury in modern western societies.Many physiotherapy approaches have been recommended in the literature for the management of tendinopathy.The most effective treatment in the management of tendinopathy is the eccentric training.Load,speed and frequency of contractions are the three principles of eccentric exercises,discussed in this report.However,eccentric training is not effective for all patients withtendinopathy and the effectiveness of this approach when applied as monotherapy is lower than it is applied as part of the rehabilitation process.For this reason,clinicians combine eccentric training with other physiotherapy techniques such as stretching,isometric and lumbar stability exercises,electrotherapy,manual therapy,soft tissue manipulation techniques,taping and acupuncture in the management of tendinopathies.Further research is needed to find out which treatment strategy combined with eccentric training will provide the best results in the rehabilitation of tendinopathy.

Mu-Net:Multi-Path Upsampling Convolution Network for Medical Image Segmentation

Medical image segmentation plays an important role in clinical diagnosis,quantitative analysis,and treatment process.Since 2015,U-Net-based approaches have been widely used formedical image segmentation.The purpose of the U-Net expansive path is to map low-resolution encoder feature maps to full input resolution feature maps.However,the consecutive deconvolution and convolutional operations in the expansive path lead to the loss of some high-level information.More high-level information can make the segmentationmore accurate.In this paper,we propose MU-Net,a novel,multi-path upsampling convolution network to retain more high-level information.The MU-Net mainly consists of three parts:contracting path,skip connection,and multi-expansive paths.The proposed MU-Net architecture is evaluated based on three different medical imaging datasets.Our experiments show that MU-Net improves the segmentation performance of U-Net-based methods on different datasets.At the same time,the computational efficiency is significantly improved by reducing the number of parameters by more than half.

Impact of Financial Technology on Regional Green Finance

Finance is the core of modern economy,and a strong country cannot do without the support of financial system.With the rapid development of economy and society,the traditional financial services can not support the increasingly large and complex economic system.As a brand-new format,financial technology can help the financial industry to restructure and upgrade.At the same time,as an international consensus,green development is the only way for China to achieve sustainable development.Therefore,it is of great practical significance to study the impact of finance on the regional development of green finance.Based on the essence of green finance development,fuzzy principal component analysis is used to build the green finance evaluation index system in this paper.Taking the data of three provinces and cities in the Yangtze River Delta from 2015 to 2019 as an example,QAP analysis is used to study the impact of financial tech-nology on the regional development of green finance.Research shows that expla-natory variables are highly significant,that is,financial technology has a significant role in promoting green finance.Finally,based on the research conclu-sions,this paper puts forward suggestions on how green technology can better promote the development of green finance from three aspects of top-level design,technical research and supervision.

LINX^(■) reflux management system to bridge the “treatment gap” in gastroesophageal reflux disease: A systematic review of 35 studies

BACKGROUND Gastroesophageal reflux disease(GERD) occurs when the reflux of stomach contents causes troublesome symptoms and/or complications. When medical therapy is insufficient, surgical therapy is indicated and, until now, Laparoscopic fundoplication(LF) constitutes the gold-standard method. However, magnetic sphincter augmentation(MSA) using the LINX^® Reflux Management System has recently emerged and disputes the standard therapeutic approach.AIM To investigate the device’s safety and efficacy in resolving GERD symptoms.METHODS This is a systematic review conducted in accordance to the PRISMA guidelines.We searched MEDLINE, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials CENTRAL databases from inception until September 2019.RESULTS Overall, 35 studies with a total number of 2511 MSA patients were included and analyzed. Post-operative proton-pump inhibitor(PPI) cessation rates reached 100%, with less bloating symptoms and a better ability to belch or vomit in comparison to LF. Special patient groups(e.g., bariatric or large hiatal-hernias)had promising results too. The most common postoperative complication was dysphagia ranging between 6% and 83%. Dilation due to dysphagia occurred in 8% of patients with typical inclusion criteria. Esophageal erosion may occur in up to 0.03% of patients. Furthermore, a recent trial indicated MSA as an efficient alternative to double-dose PPIs in moderate-to-severe GERD.CONCLUSION The findings of our review suggest that MSA has the potential to bridge the treatment gap between maxed-out medical treatment and LF. However, further studies with longer follow-up are needed for a better elucidation of these results.

Epicardial adipose tissue deposition in patients with diabetes and renal impairment: Analysis of the literature

Diabetes mellitus(DM)is defined as a chronic disease of disordered metabolism with an ongoing increase in prevalence and incidence rates.Renal disease in patients with diabetes is associated with increased morbidity and premature mortality,particularly attributed to their very high cardiovascular risk.Since this group of patients frequently lacks specific symptomatology prior to the adverse events,a screening tool for the identification of high-risk patients is necessary.The epicardial adipose tissue(EAT)is a biologically active organ having properties similar to visceral adipose tissue and has been associated with metabolic diseases and coronary artery disease.Superior to conventional cardiovascular risk factors and anthropometric measures,including body mass index and waist circumference,the EAT can early predict the development of coronary artery disease.Assessment of EAT can be performed by twodimensional echocardiography,magnetic resonance imaging or computer tomography.However,its role and significance in patients with DM and nephropathy has not been thoroughly evaluated.The aim of the current editorial is to evaluate all available evidence regarding EAT in patients with DM and renal impairment.Systematic search of the literature revealed that patients with DM and nephropathy have increased EAT measurements,uncontrolled underlying disease,high body mass index and raised cardiovascular risk markers.Acknowledging the practical implications of this test,EAT assessment could serve as a novel and non-invasive biomarker to identify high-risk patients for cardiovascular adverse events.

Synchronous resection of esophageal cancer and other organ malignancies: A systematic review

BACKGROUND Neoplasms arising in the esophagus may coexist with other solid organ or gastrointestinal tract neoplasms in 6%to 15%of patients.Resection of both tumors synchronously or in a staged procedure provides the best chances for long-term survival.Synchronous resection of both esophageal and second primary malignancy may be feasible in a subset of patients;however,literature on this topic remains rather scarce.AIM To analyze the operative techniques employed in esophageal resections combined with gastric,pancreatic,lung,colorectal,kidney and liver resections and define postoperative outcomes in each case.METHODS We conducted a systematic review according to PRISMA guidelines.We searched the Medline database for cases of patients with esophageal tumors coexisting with a second primary tumor located in another organ that underwent synchronous resection of both neoplasms.All English language articles deemed eligible for inclusion were accessed in full text.Exclusion criteria included:(1)Hematological malignancies;(2)Head/neck/pharyngeal neoplasms;(3)Second primary neoplasms in the esophagus or the gastroesophageal junction;(4)Second primary neoplasms not surgically excised;and(5)Preclinical studies.Data regarding the operative strategy employed,perioperative outcomes and longterm outcomes were extracted and analyzed using descriptive statistics.RESULTS The systematic literature search yielded 23 eligible studies incorporating a total of 117 patients.Of these patients,71%had a second primary neoplasm in the stomach.Those who underwent total gastrectomy had a reconstruction using either a colonic(n=23)or a jejunal(n=3)conduit while for those who underwent gastric preserving resections(i.e.,non-anatomic/wedge/distal gastrectomies)a conventional gastric pull-up was employed.Likewise,in cases of patients who underwent esophagectomy combined with pancreaticoduodenectomy(15%of the cohort),the decision to preserve part of the stomach or not dictated the reconstruction method(whether by a gastric pullup or a colonic/jejunal limb).For the remaining patients with coexisting lung/colorectal/kidney/liver neoplasms(14%of the entire patient population)the types of resections and operative techniques employed were identical to those used when treating each malignancy separately.CONCLUSION Despite the poor quality of available evidence and the great interstudy heterogeneity,combined procedures may be feasible with acceptable safety and satisfactory oncologic outcomes on individual basis.

Lateral elbow tendinopathy: Evidence of physiotherapy management

Lateral elbow tendinopathy(LET) is a common musculoskeletal/sports injury. A plethora of physiotherapy techniques has been proposed in the management of LET. The exercise programme is the most common treatment in the management of LET. The optimal protocol of exercise programme is still unknown. The effectiveness of the exercise programme is low when it is applied as monotherapy. Therefore, exercise programme is combined with other physiotherapy modalities such as soft tissue techniques, external support, acupuncture, manual therapy and electrotherapy, in the treatment of LET. Future research is needed to determine which treatment strategy combined with exercise programme will provide the best results in LET rehabilitation.

Transition beyond the acute phase of the COVID-19 pandemic: Need to address the long-term health impacts of COVID-19

Despite gaps in knowledge,long-term sequelae of coronavirus disease 2019(COVID-19)infections are globally acknowledged and thus require special attention by public health organizations and services.Therefore,it is necessary to support and promote public health initiatives that address long-term disability due to COVID-19.

Impact of Doctoral Student Training Process Fit on Doctoral Students’ Mental Health

Background:Doctoral students have much higher risk of anxiety or depression than general population.Doctoral students worldwide are facing varying degrees of mental health risks.Method:Based on the survey data of 6,812 doctoral students worldwide in Nature in 2019,Probit and Logit models are used to explore the correlation between thefit of doctoral education and training process and the mental health of doctoral students.Results:(1)The training environmentfit of doctoral students has a significant positive impact on their mental health.(2)The academic professionfit of doctoral students has a significant positive impact on their mental health.(3)The orga-nizational culturefit of doctoral students has a significant positive impact on their mental health.(4)Thefinancial supportfit of doctoral students has a significant positive impact on their mental health.Conclusion:The higher the degree of doctoral students’training environmentfit,academic professionfit,organizational culturefit,andfinancial supportfit,the lower the possibility of anxiety or depression among doctoral students.The current research results can help reveal extensive factors that affect the mental health of doctoral students,facilitate the planning and development of effective intervention measures by universities,improve thefit of the doctoral education and training process,improve the mental health of doctoral students,and boost academic excellence.

Can extracorporeal shock-wave therapy be used for the management of lateral elbow tendinopathy?

Lateral elbow tendinopathy(LET) is one of the two most common tendinopathies of the upper limb. The most effective treatment in the management of LET is the exercise program. Clinicians combine exercise program with other physiotherapy, electrotherapeutic and no, techniques. Extracorporeal shock wave therapy(ESWT) is one of the most common recommended electrotherapeutic modalities for the management of LET. Further research is needed to find out the optimal treatment protocol of ESWT in the management of

Signs of Mortality in David Bowie＇s ＂Black Star＂ Video Clip

＂Black Star＂ music video was released two days before Bowie＇s death （January 8, 2016）. It bears various implications of dying and the notion of mortality is both literal and metaphorical. It is highly autobiographical and serves as a theatrical stage for Bowie to act both as a music performer and as a self-conscious human being. In this paper, we discuss the signs of mortality in Bowie＇s ＂Black Star＂ music video-clip. We focus on video＇s cinematic techniques and codes （editing, mise-en-sc6ne）, on its motivic elements and on its narrative in relation with music, lyrics, characters, and gestures. We also discuss the video＇s intertextual references and the broader signification of the black star figure. We adopt a quasi-semiotic approach considering ＂Black Star＂ music video-clip as a text which can be investigated through its signs, codes, and conventions of the musical, visual, and cinematic languages as well. Our interdisciplinary tools derive from visual semiotics and audiovisual analysis models （Barthes 1977; Goodwin 1992; Vernallis 2001, 2004）, without leaving outside Bowie＇s musical-artistic and personal history. As it turns out, Bowie created a video clip that is philosophical in nature and poetic in structure, preserving the role of protagonist. With the visuals creating a psychedelic atmosphere, the lyrics often are heard as a personal confession. They both generate cognitive and emotional responses that influence the way the viewers-listeners may experience, decompose, and interpret Bowie＇s artistic endeavor bridging life and death.

In vitro study on the transmission of multidrug-resistant bacteria from textiles to pig skin

BACKGROUND The survival of microorganisms on textiles and specifically on healthcare profes-sionals’(HCP)attire has been demonstrated in several studies.The ability of microorganisms to adhere and remain on textiles for up to hours or days raises questions as to their possible role in transmission from textile to skin via HCP to patients.AIM To evaluate the presence,survival and transmission of different multidrug-resistant bacteria(MDRB)from HCP attire onto skin.METHODS Three MDRB[methicillin-resistant Staphylococcus aureus(MRSA);vancomycin-resistant Enterococcus faecium(VRE);carbapenem-resistant Klebsiella pneumoniae,(CRKP)]were inoculated on textiles from scrubs(60%cotton-40%polyester)and white coat(100%cotton)at concentrations of 108 colony-forming units(CFU),105 CFU,and 103 CFU per mL.The inoculation of swatches was divided in time intervals of 1 min,5 min,15 min,30 min,1 h,2 h,3 h,4 h,5 h,and 6 h.At the end of each period,textiles were imprinted onto pig skins and each skin square was inverted onto three different selective chromogenic media.Growth from the pig skin squares was recorded for the 3 MDRB at the three above concentrations,for the whole length of the 6-h experiment.RESULTS MRSA was recovered from pig skins at all concentrations for the whole duration of the 6-h study.VRE was recovered from the concentration of 108 CFU/mL for 6 h and from 105 CFU/mL for up to 3 h,while showing no growth at 103 CFU/mL.CRKP was recovered from 108 CFU/mL for 6 h,up to 30 min from 105 CFU/mL and for 1 min from the concentration of 103 CFU/mL.CONCLUSION Evidence from the current study shows that MRSA can persist on textiles and transmit to skin for 6 h even at low concentrations.The fact that all MDRB can be sustained and transferred to skin even at lower concentrations,supports that textiles are implicated as vectors of bacterial spread.

Do Research Incentives Promote Researchers’Mental Health?

Background:Researchers have a higher risk of anxiety and depression than the general population,so it is important to promote researchers’mental health.Method:Based on the data from 3210 global researchers surveyed by the journal Nature in 2021,confirmatory factor analysis,OLS regression and other regressions were used to explore the research incentive dimensions and their effects on researchers’mental health.Results:(1)Material incentive factors,work-family life balance factors,good organizational environment and spiritual motivation had significant positive effects on researchers’mental health.(2)The spiritual motivation could better promote researchers’mental health than the other factors.(3)Heterogeneity analysis showed that material incentive factors and spiritual motivation created more significant stimulating effects on the mental health of humanities and social sciences researchers.Work-family life balance factors were more effective in promoting the mental health of the mid-career group and the overtime group.Conclusion:Application of the four research incentives resulted in lower likelihood of anxiety or depression among researchers,and special attention should be paid to the role of the spiritual motivation.In order to promote researchers’mental health,different incentives should be applied to different researcher groups to better improve researchers’mental health.

A New Speech Encoder Based on Dynamic Framing Approach

Latent information is difficult to get from the text in speech synthesis.Studies show that features from speech can get more information to help text encoding.In the field of speech encoding,a lot of work has been conducted on two aspects.The first aspect is to encode speech frame by frame.The second aspect is to encode the whole speech to a vector.But the scale in these aspects is fixed.So,encoding speech with an adjustable scale for more latent information is worthy of investigation.But current alignment approaches only support frame-by-frame encoding and speech-to-vector encoding.It remains a challenge to propose a new alignment approach to support adjustable scale speech encoding.This paper presents the dynamic speech encoder with a new alignment approach in conjunction with frame-by-frame encoding and speech-to-vector encoding.The speech feature fromourmodel achieves three functions.First,the speech feature can reconstruct the origin speech while the length of the speech feature is equal to the text length.Second,our model can get text embedding fromspeech,and the encoded speech feature is similar to the text embedding result.Finally,it can transfer the style of synthesis speech and make it more similar to the given reference speech.

COVID-19 and the cardiovascular system-current knowledge and future perspectives

The current coronavirus disease 2019(COVID-19) pandemic has had devastating impact on populations around the world.The high mortality rates in patients with COVID-19 has been attributed to the influence of severe acute respiratory syndrome coronavirus-2(SARS-CoV-2),its causative viral agent,on several physiological systems in human body,including the respiratory,cardiovascular,and neurological systems.There is emerging evidence on propensity of this virus to attack cardiovascular system.However,various pathophysiological mechanisms by which SARS-CoV-2 interacts with cardiovascular system and leads to high morbidity and mortality,including cardiovascular complications,are poorly understood.This mini review aims to provide an update on the current knowledge and perspectives on areas of future research.

Predicting Carpark Prices Indices in Hong Kong Using AutoML

The aims of this study were threefold:1)study the research gap in carpark and price index via big data and natural language processing,2)examine the research gap of carpark indices,and 3)construct carpark price indices via repeat sales methods and predict carpark indices via the AutoML.By researching the keyword“carpark”in Google Scholar,the largest electronic academic database that coversWeb of Science and Scopus indexed articles,this study obtained 999 articles and book chapters from 1910 to 2019.It confirmed that most carpark research threw light on multi-storey carparks,management and ventilation systems,and reinforced concrete carparks.The most common research method was case studies.Regarding price index research,many previous studies focused on consumer,stock,press and futures,with many keywords being related to finance and economics.These indicated that there is no research predicting carpark price indices based on an AutoML approach.This study constructed repeat sales indices for 18 districts in Hong Kong by using 34,562 carpark transaction records from December 2009 to June 2019.Wanchai’s carpark price was about four times that of Yuen Long’s carpark price,indicating the considerable carpark price differences inHong Kong.This research evidenced the features that affected the carpark price indices models most:gold price ranked the first in all 19 models;oil price or Link stock price ranked second depending on the district,and carpark affordability ranked third.