299645 research outputs found
Sort by
Derivation and internal validation of a clinical diagnostic score for acute Chinese medicine poisoning involving aconite
No full textIntroduction: Aconitum spp. alkaloids, used in traditional Chinese medicine, are potent cardiotoxins and neurotoxins. Timely diagnosis of aconite poisoning remains challenging due to the long laboratory turnaround time. We aimed to derive and internally validate a diagnostic score for rapid recognition of acute Chinese medicine poisoning involving aconite using clinical parameters. Methods: We conducted a retrospective cross-sectional study on consecutive patients with laboratory-confirmed Chinese medicine poisoning reported to the Hong Kong Poison Control Centre between 1 July 2008 and 30 June 2021. The reference standard was the diagnosis of acute aconite poisoning by a clinical toxicologist and laboratory detection of aconitine or related alkaloids in the patients’ urine, serum, or gastric lavage specimens. Univariate analyses, followed by multivariable logistic regression, were performed to identify independent predictors of laboratory-confirmed aconite poisoning. A scoring system was developed based on the regression coefficients of the independent predictors and internally validated using bootstrapping. Results: We identified 542 eligible episodes, of which 179 involved aconite and 363 involved other herbs. The median patient age of the included episodes was 55 years (range 4–98 years). A clinical diagnostic score was developed based on the six independent predictors: hypotension (systolic blood pressure <90 mmHg in adults or < age-appropriate ranges in children, 3 points), herbal decoction or wine formulation (2 points), facial or oral numbness (2 points), ventricular tachycardia (1 point), limb numbness (1 point), and premature atrial or ventricular contractions (1 point). The score ranges from 0 to 10, with a higher score indicating a higher likelihood of aconite poisoning. At the cutoff point of ≥3, the sensitivity and negative predictive value of the score were 0.98 and 0.99, respectively. A higher specificity (0.92) and positive predictive value (0.84) could be achieved with a cutoff point at ≥4. The area under the receiver operating characteristic curve was 0.965 (95% CI: 0.950–0.980) during derivation and 0.965 (95% bias-corrected and accelerated CI: 0.947–0.977) during internal validation. Discussion: The newly derived Clinical Aconite Poisoning Score is simple to use, but its real-time discriminatory performance in diverse populations with Chinese medicine poisoning in real-world settings and its impacts on clinical management are unknown. Conclusions: In the context of Chinese medicine poisoning, the Clinical Aconite Poisoning Score might be useful in early recognition of aconite poisoning before laboratory confirmation. Future prospective studies are warranted to externally validate its real-time discriminatory performance in real-world settings before clinical adoption
Novel use of a light-emitting nasogastric tube to enhance oesophageal dissection during laparoscopic fundoplication in children: a case report
No full textBackground: Laparoscopic Nissen fundoplication is the standard treatment for gastroesophageal reflux disease in children. The proper dissection of the oesophagus and the hiatus is essential yet may be associated with higher morbidities in scenarios where dense adhesions obscuring a clear tissue plane were anticipated, for instance, patients with previous laparotomies, redo-fundoplication, etc. We hereby report the first experience of the novel use of a light-emitting nasogastric tube to enhance oesophageal dissection during laparoscopic fundoplication in children. Case Description: In this case report, we report a four-year-old girl with known cystic fibrosis who required supplemental milk to improve nutrition and medications administered via a nasogastric tube. Since long-term tube feeding was expected, the patient’s parents were advised of the need for gastrostomy tube insertion and a pre-operative potential of hydrogen (pH) study. The 24-hour pH study revealed significant gastroesophageal reflux; therefore, laparoscopic fundoplication and gastrostomy were planned. An infrared illumination system urethral kit was put inside a feeding tube for identification of the boundary of the intra-abdominal oesophagus and aiding dissection in real time. Laparoscopic fundoplication and gastrostomy were smoothly performed. The patient resumed feeding 1 day after the procedure and was fit for discharge 3 days after the operation. Conclusions: Light-emitting nasogastric tube is safe and potentially facilitates oesophageal dissection during laparoscopic fundoplication in children.</p
The impacts of airport economic zones on local urban development in China
No full textChina's implementation of Airport Economic Zones (AEZs) seeks to capitalize on aviation infrastructure for local development. While existing studies have assessed airport-related urban development in China, the specific impacts of AEZ policies on local economies remain underexamined. To this end, our study evaluates the impacts of AEZs on local economies, utilizing a panel dataset of 62 prefecture-level cities in China spanning 2000–2019. We employ a heterogeneous timing difference-in-differences method to assess localized economic impacts of AEZs, considering three specific treatment timings. The results show that AEZs have positive but limited impacts on localized economic growth, particularly evident in increased economic activities around airports. Local economic impacts of more recently announced national airport economic demonstration zones are insignificant in the analysis. Meanwhile, the establishment of other kinds of development zones around airports fosters nearby economic activity and employment in airport-related sectors, oftentimes with higher levels of statistical significance. These findings add empirical evidence for airport region development's impact on economy and underscore the importance of institutional support for maximizing AEZs' contributions to urban development.</p
Differentiated Order Allocation to Electrify Ride-sourcing System
No full textThis study examines the impact of differentiating electric and gasoline vehicles in order allocations to promote ride-sourcing fleet electrification and aims to provide practical guidance for ride-sourcing platforms. Specifically, this study develops an aggregate and static model of a ride-sourcing platform with electric vehicles that experience longer per-trip service times due to additional charging downtime but incur lower per-trip operation costs than gasoline vehicles. The platform uses differentiated order allocation to promote fleet electrification. Our findings suggest that, unlike monetary incentives that require direct financial investment, differentiated order allocation offers a flexible and cost-effective approach to electrifying the ride-sourcing fleet, potentially improving social welfare without adversely affecting the platform's profitability.</p
Nonlinear pulse compression of 515 nm pulses toward 20 fs and its application in all-solid-state high-harmonic generation
No full textTo capture the dynamics of light–matter interaction, intense ultrafast pulses are required. In this study, we present an all-solid-state nonlinear pulse compression setup that successfully compresses the second harmonic of 1030 nm, centered at 515 nm, from 189+- 19fs to 25+-3fs , using self-phase modulation in a few pieces of fused silica plates. The M^2 measurements show near-perfect beam quality with M^2x and M^2y being 1.16 and 1.17, respectively. We performed all-solid-state high-harmonic-generation measurements following this configuration. This work demonstrates industrial-graded all-solid-state high-harmonic generation in the extreme ultraviolet regime.</p
Lignin alkali regulated interfacial polymerization towards ultra-selective and highly permeable nanofiltration membrane
Get PDFThin-film composite polyamide (TFC PA) membranes hold promise for energy-efficient liquid separation, but achieving high permeance and precise separation membrane via a facile approach that is compatible with present manufacturing line remains a great challenge. Herein, we demonstrate the use of lignin alkali (LA) derived from waste of paper pulp as an aqueous phase additive to regulate interfacial polymerization (IP) process for achieving high performance nanofiltration (NF) membrane. Various characterizations and molecular dynamics simulations revealed that LA can promote the diffusion and partition of aqueous phase monomer piperazine (PIP) molecules into organic phase and their uniform dispersion on substrate, accelerating the IP reaction and promoting greater interfacial instabilities, thus endowing formation of TFC NF membrane with an ultrathin, highly cross-linked, and crumpled PA layer. The optimal membrane exhibited a remarkable water permeance of 26.0 L m-2 h-1 bar-1 and Cl-/SO42- selectivity of 191.0, which is superior to the state-of-the-art PA NF membranes. This study provides a cost-effective scalable strategy for fabricating ultra-selective and highly permeable NF membrane for precise ion-ion separation and small organic compounds removal.published_or_final_versio
Noninvasive Quantification of Hepatic Steatosis Using Ultrasound‐Derived Fat Fraction (CHESS2303): A Prospective Multicenter Study
No full textUltrasound-derived fat fraction (UDFF) is designed to assess the hepatic fat content quantitatively. A multicenter study that verifies the diagnostic performance of UDFF for detecting hepatic steatosis has not yet been reported. This study aimed to evaluate the performance of UDFF for diagnosing and grading hepatic steatosis. Participants referred for assessment of hepatic steatosis were prospectively recruited from eight hospitals. All participants underwent UDFF and magnetic resonance imaging proton density fat fraction (MRI-PDFF) examinations. MRI-PDFF was used as the reference for diagnosing hepatic steatosis. From January 2023 to July 2023, a total of 300 participants were included. The median body mass index was 25.4 kg/m2 (interquartile range: 22.7–28.1). UDFF values were positively correlated with MRI-PDFF (R = 0.80, p </p
Relative effects of genetically proxied glucagon-like peptide-1 receptor agonism on muscle and fat mass: A Mendelian randomization study
No full textDysregulated activation of Hippo-YAP1 signaling induces oxidative stress and aberrant development of intrahepatic biliary cells in biliary atresia
Get PDFThe canonical Hippo-YAP1 signaling pathway is crucial for liver development and regeneration, but its role in repair and regeneration of intrahepatic bile duct in biliary atresia (BA) remains largely unknown. YAP1 expression in the liver tissues of patients with BA and Rhesus rotavirus-induced experimental BA mouse models were examined using quantitative reverse transcriptase-PCR and double immunofluorescence. Mouse EpCAM-expressing cell-derived liver organoids were generated and treated with Hippo-YAP1 pathway activators (Xmu-mp-1 and TRULI) or an inhibitor (Peptide17). Morphologic, immunofluorescence, RNA-seq, and bioinformatic analyses were performed. Oxidative stress in human intrahepatic biliary epithelial cells transfected with a constitutively active YAP1 (YAPS127A) plasmid was assessed using quantitative reverse transcriptase-PCR and fluorescence-activated cell sorting analysis. PRDX1 expression in BA and experimental BA mouse model livers was examined by double immunofluorescence. The mRNA expression and nuclear localization of YAP1 in EpCAM-expressing bile duct cells were increased in the livers of BA and experimental BA mouse model. Aberrant development of intrahepatic organoids, differential expression of oxidative stress response genes Sod3 and Prdx1, enrichment of oxidative stress, and mitochondrial reactive oxidative stress-associated gene sets were observed in organoids treated with the Hippo-YAP1 activator, whereas organoid development was unaffected by the addition of the Hippo-YAP1 inhibitor. Transfection with constitutively active YAP1 led to the downregulation of PRDX1 and oxidative stress in human intrahepatic biliary epithelial cells. Additionally, reduced PRDX1 expression was also observed in the bile duct of human BA and experimental BA mouse livers. In conclusion, dysregulated activation of Hippo-YAP1 signaling induces oxidative stress and impairs the development of intrahepatic biliary organoids, which indicates therapeutic strategies targeting Hippo-YAP1 signaling may offer the potential to improve biliary repair and regeneration in patients with BA.published_or_final_versio