Luminal pressure gradient and risk of arteriovenous fistula nonmaturation

While arteriovenous fistula (AVF) nonmaturation is a major issue of hemodialysis care, an effective treatment to improve AVF maturation remains lacking. AVF introduces pulsatile arterial blood flow into its venous limb and produces high luminal pressure gradient, which may have adverse effect on vascular remodeling. As such, the aim of the present study is to investigate effect of luminal pressure gradient on AVF nonmaturation. This single-center, prospective observational study includes patients receiving autologous AVF creation. Participants received early postoperative ultrasound 5–7 days after surgery to collect parameters including diameters, flow rates, and volume at inflow and outflow sites. Luminal pressure gradient was estimated by using modified Bernoulli equation. The outcome was spontaneous AVF maturation within 8 weeks after surgery without intervention. Thirty patients were included, of which the mean age was 66.9 years and 70% were male. At the end of study, 13 (43.3%) patients had spontaneous AVF maturation. All demographic and laboratory characteristics were similar between patients with mature and nonmature AVF. Regarding ultrasonographic parameters, nonmature AVF showed significantly higher inflow/outflow diameter ratio, inflow velocity, and luminal pressure gradient. While these 3 parameters were significantly correlated, multivariate logistic regression showed their significant association with AVF nonmaturation. Receiver operating characteristic curve exhibited their high predictive value for AVF nonmaturation. Our findings showed that higher inflow/outflow ratio, inflow velocity, and AVF luminal pressure gradient in early postoperative ultrasound predicted risk of AVF nonmaturation. Reducing inflow/outflow diameter ratio or inflow rate may be an approach to improve AVF maturation. The predictive value of this early assessment might have impact on the clinical practice of AVF care.     

The social and mental impact on healthcare workers: A comparative and cross-sectional study during two waves of the COVID-19 pandemic in Taiwan

The coronavirus disease 2019 (COVID-19) pandemic has caused a heavily burden on healthcare workers (HCWs) worldwide. The aim of this study was to compare differences in psychological and social impact between two waves of the pandemic among first- and second-line HCWs in Taiwan. The current study derived data from two cross-sectional surveys conducted in 2020 and 2021. Levels of depression, sleep disturbance, psychological distress, social impact, and demographic variables were collected through self-reported questionnaires. The independent t test was used to compare differences in scores between the first and second wave of the pandemic. Differences between first- and second-line HCWs were also analyzed. A total of 711 HCWs in the first wave and 560 HCWs in the second wave were recruited. For the first- and second-line HCWs, the social impact during the second wave was higher than during the first wave, and they expressed a higher intention to maintain social distancing and were more aware of the pandemic overseas in the second wave. The first-line HCWs had a trend of worse sleep quality during the second wave. In addition, sleep quality was worse in the first-line HCWs than in the second-line HCWs during both waves. The second-line HCWs expressed a greater desire to seek COVID-19-related information than the first-line HCWs during the first wave, and more intended to maintain social distancing during the second wave. Our results show the importance of evaluating the social and mental health burden of HCWs, and especially first-line workers.     

Supratentorial hemangioblastoma: A rare case report and literature review

Hemangioblastomas are rare and benign tumors of the central nervous system. They account for 1.5%-2.5% of all intracranial tumors and have an incidence of 3.2%. The resemblance of hemangioblastomas to other tumors renders preoperative diagnosis and management challenging. Herein, we report a case of a supratentorial hemangioblastoma accompanied by extensive reactive gliosis and diagnosed through magnetic resonance imaging. In addition, we review the relevant literature.     

Association of Albumin and Globulin with Mortality Risk in Incident Peritoneal Dialysis Patients

Background: Nutrition and inflammation have been implicated in predicting mortality in patients on peritoneal dialysis (PD). Serum albumin and globulin can be regarded for the nutritional and inflammatory status. However, there is lack of data to evaluate the synergistic effect of albumin and globulin on mortality prediction. Methods: In 554 patients initiating PD from January 2001 to July 2016, we divided them into four groups by the combination of two categories of low vs. high albumin and low vs. high globulin. The median values for albumin and globulin were chosen to classify them into low or high groups. Their associations with all-cause and cardiovascular (CV) mortality were examined in Cox regression models adjusted for confounding clinical and laboratory data. Results: Patients, 52.91 ± 15.2 years old and 47.8% men, had a median (interquartile range) value of 3.3 (2.9–3.8) g/dL for albumin and 2.8 (2.5–3.2) g/dL for globulin, respectively. Patients with low albumin and high globulin had the highest all-cause mortality and CV mortality, with adjusted hazard ratios of 3.87 (95% CI 1.83–8.20, p < 0.001) and 5.65 (95% CI 2.23–14.34, p < 0.001), respectively, compared with those with a high albumin and low globulin having the lowest mortality rate. Sensitivity analyses further confirmed this relationship. Conclusions: A patient profile of either low albumin or high globulin is linked to a higher risk for mortality, particularly for a profile of both low albumin and high globulin compared with one without either of them. Further studies are needed to explore the mechanisms underlying this phenomenon and how to improve clinical outcomes in those high-risk patients.     

异一枝蒿酮酸的结构

从新疆一枝蒿(Artemisia rupestris L.)中分得一个新成分,命名为异一枝蒿酮酸(isorupestonic acid),根据光谱(IR,UV,MS.NMR),X-ray晶体衍射及CD谱分析,确定其结构及绝对构型。并经X-ray晶体衍射及CD谱分析修正了一枝蒿酮酸的绝对构型。     

Carthamus tinctorius L. extract activates insulin‐like growth factor‐I receptor signaling to inhibit FAS‐death receptor pathway and suppress lipopolysaccharides‐induced H9c2 cardiomyoblast cell apoptosis

Carthamus tinctorius L. (Compositae) is used in Chinese medicine to treat heart disease and inflammation. In our previous study, we found that C. tinctorius L. inhibited lipopolysaccharides (LPS)‐induced tumor necrosis factor‐alpha (TNF‐α) activation, JNK expression, and apoptosis in H9c2 cardiomyoblast cells. The present study was performed to investigate the protective effect of C. tinctorius extract (CTF) on LPS‐challenged H9c2 myocardioblast cell and to explore the possible underlying mechanism. Cell viability assay showed that LPS treatment decreased the cell viability of H9c2 cell, whereas CTF treatment reversed LPS cytotoxicity in a dose‐dependent manner, especially in the LPS + CTF 25 (μg/mL) group. LPS treatment‐induced apoptosis was determined by transferase‐mediated dUTP nick end labeling assay, and by Western blot. LPS‐induced apoptotic bodies were decreased following CTF treatment. Expression of TNF‐α, FAS‐L, FAS, FADD, caspase‐8, BID, and t‐BID was significantly increased in LPS‐treated H9c2 cells. In contrast, it was significantly suppressed by the administration of CTF extract. In addition, CTF treatment activates antiapoptotic proteins, Bcl‐2 and p‐Bad, and downregulates Bax, cytochrome‐c, caspase‐9, caspase‐3, and apoptosis‐inducing factor expression. Furthermore, CTF exerted cytoprotective effects by activating insulin‐like growth factor‐I (IGF‐I) signaling pathway leading to downregulation of the apoptotic proteins involved in FAS death receptor pathway. In addition, AG1024 and IGF‐I receptor (IGF‐IR) inhibitor and siRNA silencing reverses the effect of CTF implying that CTF functions through the IGF‐IR pathway to inhibit LPS‐induced H9c2 apoptosis. These results suggest that treatment with CTF extract prevented the LPS‐induced apoptotic response through IGF‐I pathway.     

Molecular targeting of liposomal nano-particles to lymphatic system

Conventional liposomal drug delivery has been associated with obvious limitations, such as a rapid absorption by the recticulo-endothelial system in the liver and spleen, a short circulation time and a low therapeutic efficacy. Various modifications of liposomal drugs have been developed to prolong the duration of actions of the drugs at target sites, reduce its adverse effects and increase therapeutic index of drugs such as polymeric conjugation and polymeric fixation on the surface of a liposome. The lymphatic system is an important highway to spread the metastasis of most human cancers including breast, colon, and lung, ovarian and prostate. To eradicate those metastatic cancer cells from the lymphatic system, several efforts have been made to develop new and efficient lymphatic targeting drug delivery systems in order to achieve a high initial lymphatic uptake and lymph node localization. Recently, molecule targeting of liposome to lymphatic system may enhance therapeutic efficacy by improving the initial lymphatic uptake and the lymph nodal retention of liposomes such as the ligand-receptor and antibodies binding on the surface of liposome. This article aims to review the emerging liposomal drug, which is targeting the lymphatic system. The significant factors associated with targeting liposomal drugs will also be discussed in more detail in this review.     

Multidrug-resistant organisms in patients from Ukraine in the Netherlands,March to August 2022

Since March 2022, there has been an emergence of multidrug-resistant organisms (MDRO) in the Netherlands in patients originating from Ukraine (58 patients, 75 isolates). For about half of these patients, recent hospitalisation in Ukraine was reported. Genomic surveillance revealed that the majority of the MDRO represent globally spread epidemic lineages and that 60% contain New Delhi metallo-β-lactamase (NDM) genes. Professionals should be aware of an increase in such MDRO associated with migration and medical evacuation of people from Ukraine.     

Entanglement-assisted concatenated quantum codes

Entanglement-assisted concatenated quantum codes (EACQCs), constructed by concatenating two quantum codes, are proposed. These EACQCs show significant advantages over standard concatenated quantum codes (CQCs). First, we prove that, unlike standard CQCs, EACQCs can beat the nondegenerate Hamming bound for entanglement-assisted quantum error-correction codes (EAQECCs). Second, we construct families of EACQCs with parameters better than the best-known standard quantum error-correction codes (QECCs) and EAQECCs. Moreover, these EACQCs require very few Einstein–Podolsky–Rosen (EPR) pairs to begin with. Finally, it is shown that EACQCs make entanglement-assisted quantum communication possible, even if the ebits are noisy. Furthermore, EACQCs can outperform CQCs in entanglement fidelity over depolarizing channels if the ebits are less noisy than the qubits. We show that the error-probability threshold of EACQCs is larger than that of CQCs when the error rate of ebits is sufficiently lower than that of qubits. Specifically, we derive a high threshold of 47% when the error probability of the preshared entanglement is 1% to that of qubits.

Quantum error-correction codes (QECCs) are necessary to realize quantum communications and to make fault-tolerant quantum computers (1, 2). The stabilizer formalism provides a useful way to construct QECCs from classical codes, but certain orthogonality constraints are required (3). The entanglement-assisted (EA) QECC (EAQECC) (4–6) generalizes the stabilizer code. By presharing some entangled states between the sender (Alice) and the receiver (Bob), EAQECCs can be constructed from any classical linear codes without the orthogonality constraints. Therefore, the construction could be greatly simplified. As an important physical resource, entanglement can boost the classical information capacity of quantum channels (7–12). Recently, it has been shown that EAQECCs can violate the nondegenerate quantum Hamming bound (13) or the quantum Singleton bound (14).Compared to standard QECCs, EAQECCs must establish some amount of entanglement before transmission. This preshared entanglement is the price to be paid for enhanced communication capability. In a sense, we need to consider the net transmission of EAQECCs—i.e., the number of qubits transmitted minus that of ebits preshared. Further, it is difficult to preserve too many noiseless ebits in EAQECCs at present. Thus, we have to use as few ebits as possible to conduct the communication—e.g., one or two ebits are preferable (15–18). In addition, EAQECCs with positive net transmission and little entanglement can lead to catalytic quantum codes (4, 6), which are applicable to fault-tolerant quantum computation (FTQC). In ref. 4, a table of best-known EAQECCs of length up to 10 was established through computer search or algebraic methods. Several EAQECCs in ref. 4 have larger minimum distances than the best-known standard QECCs of the same length and net transmission. However, for larger code lengths, the efficient construction of EAQECCs with better parameters than standard QECCs is still unknown.In classical coding theory, concatenated codes (CCs), originally proposed by Forney in the 1960s (19), provide a useful way of constructing long codes from short ones. CCs can achieve very large coding gains with reasonable encoding and decoding complexity (20). Moreover, CCs can have large minimum distances since the distances of the component codes are multiplied. As a result, CCs have been widely used in many digital communication systems—e.g., the NASA standard for the Voyager program (21) and the compact disc (20). Similarly, in QECCs, the concatenated quantum codes (CQCs), introduced by Knill and Laflamme in 1996 (22), are also effective for constructing good quantum codes. In particular, it has been shown that CQCs are of great importance in realizing FTQC (23–25).Moreover, there exists a specific phenomenon in QECCs, called “error degeneracy,” which distinguishes quantum codes from classical ones in essence. It is widely believed that degenerate codes can correct more quantum errors than nondegenerate ones. Indeed, there are some open problems concerning whether degenerate codes can violate the nondegenerate quantum Hamming bound (26) or can improve the quantum-channel capacity (27, 28). Many CQCs have been shown to be degenerate, even if the component codes are nondegenerate—e.g., Shor’s [[9,1,3]] code and the [[25,1,9]] CQC (23, 29). If we introduce extra entanglement to CQCs, it is possible to improve the error-degeneracy performance of CQCs.In this article, we generalize the idea of concatenation to EAQECCs and propose EACQCs. We show that EACQCs can beat the nondegenerate quantum Hamming bound, while standard CQCs cannot. Several families of degenerate EACQCs that can surpass the nondegenerate Hamming bound for EAQECCs are constructed. The same conclusion could be reached for asymmetric error models, in which the phase-flip errors (Z errors) happen more frequently than the bit-flip errors (X errors) (30, 31). Furthermore, we derive a number of EACQCs with better parameters than the best-known QECCs and EAQECCs. In particular, we see that many EACQCs have positive net transmission, and each of them consumes only one or two ebits. Thus, they give rise to catalytic EACQCs with little entanglement and better parameters than the best-known QECCs. Further, we show that the EACQC scheme makes EA quantum communication possible, even if the ebits are noisy. We compute the entanglement fidelity (EF) of the [[15,1,9;10]] EACQC by using Bowen’s [[3,1,3;2]] EAQECC (32) or the [[3,1,3;2]] EA repetition code (4, 6) as the inner code. The outer code is the standard [[5,1,3]] stabilizer code. We show that the [[15,1,9;10]] EACQC performs much better than the [[25,1,9]] CQC over depolarizing channels if the ebits suffer a lower error rate than the qubits. Moreover, we compute the error-probability threshold of EACQCs, and we show that EACQCs have much higher thresholds than CQCs when the error rate of ebits is sufficiently lower than that of qubits.     

Wettability and Surface Roughness of Parylene C on Three-Dimensional-Printed Photopolymers

The use of poly-(para-chloro-xylylene) (Parylene C) in microelectromechanical systems and medical devices has increased rapidly. However, little research has been conducted on the wettability and surface roughness of Parylene C after being soaked in solutions. In this study, the contact angle and surface roughness (arithmetic average of roughness) of Parylene C on three-dimensional (3D)-printed photopolymer in 10% sodium hydroxide, 10% ammonium hydroxide, and 100% phosphate-buffered saline (PBS) solutions were investigated using a commercial contact angle measurement system and laser confocal microscope, respectively. The collected data indicated that 10% ammonium hydroxide had no major effect on the contact angle of Parylene C on a substrate, with a Shore A hardness of 50. However, 10% sodium hydroxide, 10% ammonium hydroxide, and 100% PBS considerably affected the contact angle of Parylene C on a substrate with a Shore A hardness of 85. Substrates with Parylene C coating exhibited lower surface roughness than uncoated substrates. The substrates coated with Parylene C that were soaked in 10% ammonium hydroxide exhibited high surface roughness. The aforementioned results indicate that 3D-printed photopolymers coated with Parylene C can offer potential benefits when used in biocompatible devices.