Impact of deprescribing intervention on potentially inappropriate medications and clinical outcomes among hospitalized older adults in Malaysia: a randomized controlled trial (REVMED RCT) protocol.

Background: Polypharmacy and the use of potentially inappropriate medications (PIMs) are prevalent among older patients admitted to hospitals, posing a heightened risk of adverse drug events. This trial aims to evaluate the effectiveness of a pharmacist-led deprescribing intervention in reducing medications, PIM and improving clinical outcomes, using the locally developed Malaysian Potentially Inappropriate Prescribing Screening tool in Older Adults (MALPIP).

Methods: This is an 18-month cluster-randomized, open-label, parallel-arm controlled trial conducted at 14 public hospitals in the Perak state of Malaysia.

Late-onset cblC defect: clinical, biochemical and molecular analysis.

Background: cblC defect is the most common type of methylmalonic acidemia in China. Patients with late-onset form (>1 year) are often misdiagnosed due to heterogeneous symptoms. This study aimed to describe clinical characteristics and evaluate long-term outcomes of Chinese patients with late-onset cblC defect.

Advancing Fault Detection in HVAC Systems: Unifying Gramian Angular Field and 2D Deep Convolutional Neural Networks for Enhanced Performance.

Efficiency and comfort in buildings rely on on well-functioning HVAC systems. However, system faults can compromise performance. Modern data-driven fault detection methods, considering diverse techniques, encounter challenges in understanding intricate interactions and adapting to dynamic conditions present in HVAC systems during occupancy periods.

Change in Health-Related Quality of Life in Youth with Chronic Hepatitis B Living in North America: A 5-Year Cohort Study.

Background: Greater hepatitis-related symptomology is associated with lower health-related quality-of-life (HRQoL) among untreated youth with chronic hepatitis B (CHB). How HRQoL changes over time in this population is unknown.

Methods: Children from 7 hepatology centers in North America positive for hepatitis B surface antigen, not taking anti-viral therapy, were enrolled in the Hepatitis B Research Network.

Fluorescence-coded logarithmic-dilution digital droplet PCR for ultrawide-dynamic-range nucleic acid quantification.

Digital PCR (dPCR) is considered the next generation of nucleic acid detection for its ability of absolute quantification and high sensitivity. However, when compared to the current gold standard, quantitative PCR (qPCR), dPCR is falling behind by several orders of magnitude in dynamic range, which limits its clinical applicability. Here we present fluorescence-coded logarithmic-dilution digital droplet PCR (Flodd-PCR) that features a dynamic range across 7 orders of magnitude, over 2 orders higher than conventional dPCR (4-5 log range) and approaching that of qPCR (7-8 log range).

Differential cortical and subcortical visual processing with eyes shut.

Closing our eyes largely shuts down our ability to see. That said, our eyelids still pass some light, allowing our visual system to coarsely process information about visual scenes, such as changes in luminance. However, the specific impact of eye closure on processing within the early visual system remains largely unknown.

Inequalities in treatment among patients with colon and rectal cancer: a multistate survival model using data from England national cancer registry 2012-2016.

Background: Individual and tumour factors only explain part of observed inequalities in colorectal cancer survival in England. This study aims to investigate inequalities in treatment in patients with colorectal cancer.

Methods: All patients diagnosed with colorectal cancer in England between 2012 and 2016 were followed up from the date of diagnosis (state 1), to treatment (state 2), death (state 3) or censored at 1 year after the diagnosis.

Direct Ink Writing 3D Printing for High-Performance Electrochemical Energy Storage Devices: A Minireview.

Despite tremendous efforts that have been dedicated to high-performance electrochemical energy storage devices (EESDs), traditional electrode fabrication processes still face the daunting challenge of limited energy/power density or compromised mechanical compliance. 3D thick electrodes can maximize the utilization of z-axis space to enhance the energy density of EESDs but still suffer from limitations in terms of poor mechanical stability and sluggish electron/ion transport. Direct ink writing (DIW), an eminent branch of 3D printing technology, has gained popularity in the manufacture of 3D electrodes with intricately designed architectures and rationally regulated porosity, promoting a triple boost in areal mass loading, ion diffusion kinetics, and mechanical flexibility.

A deep learning-based approach for rectus abdominis segmentation and distance measurement in ultrasonography.

Diastasis recti abdominis (DRA) is a common condition in women. Measuring the distance between separated rectus abdominis (RA) in ultrasound images is a reliable method for the diagnosis of this disease. In clinical practice, the RA distance in multiple ultrasound images of a patient is measured by experienced sonographers, which is time-consuming, labor-intensive, and highly dependent on experience of operators.

Attention preserves the selectivity of feature-tuned normalization.

Attention and divisive normalization both contribute to making visual processing more efficient. Attention selectively increases the neural gain of relevant information in the early visual cortex, resulting in stronger perceived salience for attended regions or features. Divisive normalization improves processing efficiency by suppressing responses to homogeneous inputs and highlighting salient boundaries, facilitating sparse coding of inputs.

Kidney Function and Long-Term Risk of End-Stage Kidney Disease and Mortality in a Multiethnic Population.

Introduction: Contemporary differences between South Asian and White ethnicities in the incidence of end-stage kidney disease (ESKD) and mortality are poorly described.

Methods: Data for all South Asian patients who had an estimated glomerular filtration rate (eGFR) measure after January 1, 2006, and 1 million randomly selected participants of other ethnicities were extracted from the Clinical Practice Research Datalink (CPRD). All participants were followed-up with from index date until ESKD, all-cause mortality, or end of study.

A functional crosstalk between the H3K9 methylation writers and their reader HP1 in safeguarding embryonic stem cell identity.

Histone H3 lysine 9 (H3K9) methylation, as a hallmark of heterochromatin, has a central role in cell lineage and fate determination. Although evidence of a cooperation between H3K9 methylation writers and their readers has started to emerge, their actual interplay remains elusive. Here, we show that loss of H3K9 methylation readers, the Hp1 family, causes reduced expression of H3K9 methyltransferases, and that this subsequently leads to the exit of embryonic stem cells (ESCs) from pluripotency and a reciprocal gain of lineage-specific characteristics.

Tendon Repair and Regeneration Using Bioinspired Fibrillation Engineering That Mimicked the Structure and Mechanics of Natural Tissue.

Replicating the controlled nanofibrillar architecture of collagenous tissue represents a promising approach in the design of tendon replacements that have tissue-mimicking biomechanics─outstanding mechanical strength and toughness, defect tolerance, and fatigue and fracture resistance. Guided by this principle, a fibrous artificial tendon (FAT) was constructed in the present study using an engineering strategy inspired by the fibrillation of a naturally spun silk protein. This bioinspired FAT featured a highly ordered molecular and nanofibrillar architecture similar to that of soft collagenous tissue, which exhibited the mechanical and fracture characteristics of tendons.

Buyang Huanwu Decoction alleviates blood stasis, platelet activation, and inflammation and regulates the HMGB1/NF-κB pathway in rats with pulmonary fibrosis.

Ethnopharmacological Relevance: Qi deficiency and blood stasis are identified to be pathological factors of pulmonary fibrosis (PF) in traditional Chinese medicine (TCM) theory. Buyang Huanwu Decoction (BYHWD) is a traditional Chinese prescription ameliorating Qi deficiency and blood stasis.

Aim Of The Study: The objective of this study was to investigate the anti-fibrosis effect of BYHWD and the potential molecular mechanism in rats.

Duration of Type 2 Diabetes and Incidence of Cancer: An Observational Study in England.

Objective: To investigate the association between duration of type 2 diabetes and cancer incidence.

Research Design And Methods: In the Clinical Practice Research Datalink database, we identified 130,764 individuals with type 2 diabetes aged ≥35 years at diagnosis who were linked to hospital and mortality records. We used sex-stratified Royston-Parmar models with two timescales to estimate incidence rates of all cancers, the four commonest cancers in the U.

Hot and cold tumors: Immunological features and the therapeutic strategies.

The "hotness" or "coldness" of the tumors are determined by the information of the cancer cells themselves, tumor immune characteristics, tumor microenvironment, and signaling mechanisms, which are key factors affecting cancer patients' clinical efficacy. The switch mechanism of "hotness" and "coldness" and its corresponding pathological characteristics and treatment strategies are the frontier and hot spot of tumor treatment. How to distinguish the "hotness" or "coldness" effectively and clarify the causes, microenvironment state, and characteristics are very important for the tumor response and efficacy treatments.

How Brand Knowledge Affects Purchase Intentions in Fresh Food E-Commerce Platforms: The Serial Mediation Effect of Perceived Value and Brand Trust.

The intense competition among fresh food e-commerce platforms in China has reduced the market share of the leading firms. This study aims to establish a model framework based on brand knowledge, perceived value, brand trust, and purchase intention to improve the market competitiveness of fresh food e-commerce platforms. Based on the analysis of 475 questionnaires using SmartPLS software, the results indicate that the established model framework provides an excellent explanation and forecasting (R = 45.

How Social Identity Affects Green Food Purchase Intention: The Serial Mediation Effect of Green Perceived Value and Psychological Distance.

As the global population continues to grow, the impact of environmental damage and resource depletion has been severely increased. In this context, green food gains tremendous potential as a sustainable solution. This study establishes a model framework around social identity, psychological distance, green perceived value, and purchase intention from the perspective of social identity to explore the impact the social group has on individual green food purchase intention.

Population sepsis incidence, mortality, and trends in Hong Kong between 2009-2018 using clinical and administrative data.

Background: Sepsis surveillance using electronic health record (EHR)-based data may provide more accurate epidemiologic estimates than administrative data, but experience with this approach to estimate population-level sepsis burden is lacking.

Methods: This was a retrospective cohort study including all adults admitted to publicly-funded hospitals in Hong Kong between 2009-2018. Sepsis was defined as clinical evidence of presumed infection (clinical cultures and treatment with antibiotics) and concurrent acute organ dysfunction (≥2 point increase in baseline SOFA score).

Biomimetic Silk Architectures Outperform Animal Horns in Strength and Toughness.

Structural biomimicry is an intelligent approach for developing lightweight, strong, and tough materials (LSTMs). Current fabrication technologies, such as 3D printing and two-photon lithography often face challenges in constructing complex interlaced structures, such as the sinusoidal crossed herringbone structure that contributes to the ultrahigh strength and fracture toughness of the dactyl club of peacock mantis shrimps. Herein, bioinspired LSTMs with laminated or herringbone structures is reported, by combining textile processing and silk fiber "welding" techniques.

Recurrent respiratory papillomatosis (RRP) of tracheobronchial tree presenting as lung collapse with malignant transformation after a decade.

Recurrent respiratory papillomatosis is a rare disease caused by HPV infection. We hereby report a patient with recurrent respiratory papillomatosis of the tracheobronchial tree with no laryngeal involvement who remained clinically stable for more than 10 years but then developed malignant transformation with metastases. A 61-year-old lady with good past health presented to our department in 2010 because of chronic cough for years.