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Background: Antimicrobial resistance (AMR) is a multifaceted global challenge, partly driven by inappropriate antibiotic prescribing. The objectives of this study were to evaluate the impact of the COVID-19 pandemic on treatment of common infections, develop risk prediction models and examine the effects of antibiotics on infection-related hospital admissions. Methods: With the approval of NHS England, we accessed electronic health records from The Phoenix Partnership (TPP) through OpenSAFELY platform. We included adult patients with primary care diagnosis of common infections, including lower respiratory tract infection (LRTI), upper respiratory tract infections (URTI), and lower urinary tract infection (UTI), from 1 January 2019 to 31 August 2022. We excluded patients with a COVID-19 record in the 90 days before to 30 days after the infection diagnosis. Risk prediction models using Cox proportional-hazard regression were developed for infection-related hospital admission in the 30 days after the common infection diagnosis. Results: We found 12,745,165 infection diagnoses from 1 January 2019 to 31 August 2022. Of them, 80,395 (2.05%) cases were admitted to the hospital during follow-up. Counts of hospital admission for infections dropped during COVID-19, for example LRTI from 3,950 in December 2019 to 520 in April 2020. Comparing those prescribed an antibiotic to those without, reduction in risk of hospital admission were largest with LRTI (adjusted hazard ratio (aHR) of 0.35; 95% confidence interval (CI), 0.35–0.36) and UTI (aHR 0.45; 95% CI, 0.44–0.46), compared to URTI (aHR 1.04; 95% CI, 1.03–1.06). Conclusions: A substantial variation in hospital admission risks between infections and patient groups was found. Antibiotics appeared more effective in preventing infection-related complications with LRTI and UTI, but not URTI. While this study has several limitations, the results indicate that a focus on risk-based antibiotic prescribing could help tackle AMR in primary care. [ABSTRACT FROM AUTHOR]

Neuronal loss is a hallmark of stroke and other neurodegenerative diseases, and as such, neuronal loss caused by microglia has been thought to be a contributing factor to disease progression. Here, we show that microglia indeed contribute significantly to neuronal loss in a mouse model of stroke, but this microglial-dependent process of neuronal clearance specifically targets stressed and degenerating neurons in the ischemic cortical region and not healthy non-ischemic neurons. Nonspecific stimulation of microglia decreased the density of neurons in the ischemic cortical region, whereas specific inhibition of MFG-E8 signaling, which is required for microglial phagocytosis of neurons, had the opposite effect. In both scenarios, the effects were microglia specific, as the same treatments had no effect in mice whose microglia were depleted prior to stroke. Finally, even though the inhibition of MFG-E8 signaling increased neuronal density in the ischemic brain region, it substantially exacerbated the development of cortical infarction. In conclusion, microglia through MFG-E8 signaling contribute to the loss of ischemic neurons and, in doing so, minimize the development of cortical infarction after stroke. [ABSTRACT FROM AUTHOR]

In response to rising interest over the years, many experiments and several models have been devised to understand emission of nitrous oxide (N2O) from agricultural soils. Notably absent from almost all of this discussion is iron, even though its role in both chemical and biochemical reactions that generate N2O was recognized well before research on N2O emission began to accelerate. We revisited iron by exploring its importance alongside other soil properties commonly believed to control N2O production in agricultural systems. A set of soils from California's main agricultural regions was used to observe N2O emission under conditions representative of typical field scenarios. Results of multivariate analysis showed that in five of the twelve different conditions studied, iron ranked higher than any other intrinsic soil property in explaining observed emissions across soils. Upcoming studies stand to gain valuable information by considering iron among the drivers of N2O emission, expanding the current framework to include coupling between biotic and abiotic reactions.

Recognizing medical named entities is a crucial aspect of applying deep learning in the medical domain. Automated methods for identifying specific entities from medical literature or other texts can enhance the efficiency and accuracy of information processing, elevate medical service quality, and aid clinical decision-making. Nonetheless, current methods exhibit limitations in contextual awareness and insufficient consideration of contextual relevance and interactions between entities. In this study, we initially encode medical text inputs using the Chinese pre-trained RoBERTa-wwm-ext model to extract comprehensive contextual features and semantic information. Subsequently, we employ recurrent neural networks in conjunction with the multi-head attention mechanism as the primary gating structure for parallel processing and capturing inter-entity dependencies. Finally, we leverage conditional random fields in combination with the cross-entropy loss function to enhance entity recognition accuracy and ensure label sequence consistency. Extensive experiments conducted on datasets including MCSCSet and CMeEE demonstrate that the proposed model attains F1 scores of 91.90% and 64.36% on the respective datasets, outperforming other related models. These findings confirm the efficacy of our method for recognizing named entities in Chinese medical texts.

INhibitor of Growth (ING1-5) proteins are epigenetic readers that target histone acetyltransferase (HAT) or histone deacetylase (HDAC) complexes to the H3K4Me3 mark of active transcription. ING5 targets Moz/Morf and HBO1 HAT complexes that alter acetylation of H3 and H4 core histones, affecting gene expression. Previous experiments in vitro indicated that ING5 functions to maintain stem cell character in normal and in cancer stem cells. Here we find that CRISPR/Cas9 ING5 knockout (KO) mice are sub-fertile but show no decrease in lifespan or ability to heal wounds despite indications of depleted stem cell pools in several tissues. ING5 KO mouse embryo fibroblasts accumulate in G2 of the cell cycle, have high levels of abnormal nuclei and show high basal levels of the γH2AX indicator of DNA damage. KO animals also develop severe dermatitis at a 5-fold higher rate that wild-type littermates. Consistent with ING5 serving a tumor suppressive role, ING5 KO mice developed germinal centre diffuse large B-cell lymphomas at a rate 6-fold higher than control mice at 18 months of age. These data suggest that ING5 functions in vivo to maintain stem cell character in multiple organs, that reduction of stem cell populations is not limiting for murine lifespan and that like a subset of other ING family members, ING5 functions as a tumor suppressor in hematopoietic cells in vivo.

The cervical uncinate process is a unique structure of the cervical spine that undergoes significant changes in its morphological characteristics with age, and these changes may be related to osteoporosis. This study aimed to observe the distribution of cancellous bone in the cervical uncinate process and its morphological features using micro-computed tomography (Micro-CT) to gain a deeper understanding of the morphological characteristics of the uncinate microstructure. We performed Micro-CT scans on 31 sets of C3-C7 vertebrae, a total of 155 intact bone samples, and subsequently used the measurement software with the Micro-CT system to obtain parameters related to the cancellous bone of the uncinate process. We found that the cancellous bone of the uncinate process was predominantly longitudinally cross-aligned and continuous with the cancellous bone within the vertebral body. Comparisons between the left and right sides of each parameter showed significant differences only in the bone surface area, and the peaks of each parameter were primarily concentrated in C4-C6. In this study, we found that the C5 uncinate process is the site of most significant stress in the cervical vertebrae, which leads to the earliest occurrence of osteoporosis, and this study provides experimental, theoretical bases for the prevention of cervical spondylosis and osteoporosis, and the diagnosis and treatment of related diseases.

BackgroundThe spread of COVID-19 has a huge impact on the medical system, affecting the normal order of routine patients, especially obvious effect on the Shenzhen Third People's Hospital as the designated hospital for COVID-19 patients. After the epidemic was loosened in early December 2022, the normal medical order gradually restored in China. How much was the impact on the admission and treatment of emergency trauma patients during and after the epidemic? This study aims to compare the differences between trauma patients admitted to the emergency department during and after the COVID-19 pandemic.Methods and findingsThe study included all trauma patients admitted through the emergency department from January 2020 to March 2024. Clinical data were collected, and a retrospective comparative analysis was performed on the characteristics of the two groups of trauma patients during and after the pandemic, including gender, age, average length of hospital stay, proportions of admissions to various departments, proportions of severe cases, proportions of surgical patients, and mortality rates, using statistical methods for analysis. The proportion of male patients during the pandemic (69.98%) was higher than after the pandemic (67.01%). The proportion of patients under 60 years of age during the pandemic was higher than that after the pandemic. There was no significant difference in the average hospital stay between patients during and after the pandemic (P>0.05). Comparisons between the two groups in terms of admissions to departments such as otolaryngology, hepatobiliary surgery, hepatic surgery, orthopedics, urology, neurosurgery, gastroenterology surgery, thoracic surgery, ophthalmology and intensive care unit showed no significant differences (P>0.05). The proportion of surgical patients during the pandemic (75.09%) was higher than after the pandemic (69.53%). The mortality rate during the pandemic (0.13%) was lower than after the pandemic (2.45%).ConclusionThe COVID-19 pandemic has impacted trauma patients admitted through the emergency department, with increases in the proportion of male and younger patients, surgical cases, and a decrease in mortality rates during the pandemic.

This paper proposes the Modulated Whale Optimization Algorithm(MWOA), an innovative metaheuristic algorithm derived from the classic WOA and tailored for bionics-inspired optimization. MWOA tackles common optimization problems like local optima and premature convergence using two key methods: shrinking encircling and spiral position updates. In essence, it prevents algorithms from settling for suboptimal solutions too soon, encouraging exploration of a broader solution space before converging, by incorporating cauchy variation and a perturbation term, MWOA achieve optimization over a wide search space. After that, comparisons were conducted between MWOA and seven recently proposed metaheuristics, utilizing the CEC2005 benchmark functions to assess MWOA's optimization performance. Moreover, the Wilcoxon rank sum test is used to verify the effectiveness of the proposed algorithm. Eventually, MWOA was juxtaposed with the BiLSTM classifier and six other meta-heuristics combined with the BiLSTM classifier. The aim was to affirm that MWOA-BiLSTM outperforms its counterparts, showcasing superior performance across crucial metrics such as accuracy, precision, recall, and F1-Score. The study results unequivocally demonstrate that MWOA showcases exceptional optimization capabilities, adeptly striking a harmonious balance between exploration and exploitation.

The aim of this study is to explore the genetic characteristics of Guizhou Black goats and Meigu goats and their relationship to reproductive performance through population structure analysis, genetic diversity assessment, and selection signal analysis. Blood samples of 19 Guizhou Black goats and 11 Meigu goats were collected for whole-genome high-throughput sequencing. Using PCA and ADMIXTURE analyses, their population structure and genetic relationships were revealed. Further genetic diversity analysis showed that although there is significant population differentiation, the levels of genetic diversity are similar. Subsequently, these goats were categorized into high-yield and low-yield groups based on their litter sizes, with 15 goats in each group. Then, a selection signal analysis was performed using FST and π ratios for 33,563 SNP loci. The results identified six candidate genes, including KCNIP4, GFRA2, and DGKH, which are significantly associated with high litter performance. These findings enhanced our understanding of the genetic characteristics and population structure of Guizhou Black goats and Meigu goats. Moreover, they provide an important theoretical foundation and scientific basis for further breeding improvements.

BackgroundSocialism with Chinese characteristics has entered a new stage. The principal social contradiction is the uneven development of urban and rural areas. The rural revitalization strategy has emerged as time has required. The realization of rural revitalization not only requires development to lay the foundation of the countryside but also requires governance to lead the development of the countryside. Development and governance are two indispensable aspects of rural revitalization. However, China's rural areas have long been in a state of development without governance, and this situation must change. Therefore, systematically exploring the relationship between development and governance is the key to solving the current shortcomings in rural areas.MethodsBased on the data from the statistical yearbook, the study constructed a set of evaluation indicators for rural development governance and revitalization and verified the model's effectiveness.The entropy method and the assessment model were used to calculate the comprehensive score of rural development, governance, and revitalization. The relationship between rural development and governance was analyzed using a coupled coordination model. The regression analysis model was used to explore the relationship between the coupling results of rural development, governance, and rural revitalization.ResultsFrom the comprehensive results, both development and governance show an upward trend, but the upward trend of development is better. From the analysis of coupling coordination between development and governance, the C value is in good condition, the T value fluctuates wildly, and the D fluctuates with the fluctuation of T. Judging from the comprehensive score of rural revitalization, it also shows an upward trend year by year. Judging from the regression analysis results of coupling coordination degree and rural revitalization comprehensive score, coupling coordination degree will significantly impact the rural revitalization evaluation value.ConclusionsThe study found that current rural development and governance present a spiral coupling coordination relationship, and the degree of coupling coordination significantly correlates with rural revitalization. Based on the research conclusions, the study further proposes three paths to promote the coupling and coordination of development and governance. The first is an organizational isomorphism, which builds a coupled coordination system for rural development and governance. The second is to tilt resources and improve the supply of connected and coordinated factors for rural development and governance. The third is the operating mechanism to optimize rural development and governance's coupling and coordination path.

BackgroundDiabetic skin wound is a complex problem due to the disruption of normal repairing program and lack of effective remedy. Lucilia sericata larvae (maggot) is a folk method to treat chronic skin wound, while its therapeutic effects on that caused by diabetic remains unknown.ObjectiveThis study aims to investigate the therapeutic effects of maggot extract (M.E.) on diabetic skin wound and its molecular mechanism by establishing the skin wound model of diabetic Sprague Dawley (SD) rats.MethodsDiabetic model was established by injecting intraperitoneally streptozotocin in SD rats under specific pathogen-free (SPF) conditions. The rat fasting blood glucose values were ≧16.7 mmol/L 72 hours after intraperitoneal streptozotocin (60mg/kg body weight) injection. The rats were divided into five groups (n = 10/group): normal group: normal SD rats without any treatment, diabetic blank group: the diabetic rats without any treatment, Vaseline group: the diabetic rats dressed with Vaseline, recombinant human epidermal-growth-factor (rhEGF) group: the diabetic rats dressed with a mixture of Vaseline and 200 μg/g rhEGF, M.E. group: the diabetic rats dressed with a mixture of Vaseline and 150 μg/ml maggot extract. The round open wounds (1.0 cm in diameter) down to the muscle fascia were made on both sides of rat dorsa by removing the skin layer (epidermis and dermis) and were daily photographed for calculating their healing rates. Hematoxylin-eosin (HE) and Masson's trichrome staining were performed on skin wound sections to analyze re-epithelialization and granulation tissue formation. Immunohistochemical (IHC), immunofluorescent (IF) stainings and Western blotting were conducted to analyze the statuses of STAT3 signaling.ResultsThe average wound healing rates on the 14th day were 91.7% in the normal, 79.6% in M.E., 71% in rhEGF, 55.1% in vaseline and 43.3% in the diabetes blank group. Morphological staining showed more active granulation tissue formation, re-epithelialization and neovascularization in M.E.-group than those in the blank and the vaseline-treated groups. Decreased p-STAT3 nuclear tranlocation and down-regulated Bcl-2, CyclinD1 and vascular endothelial growth factor (VEGF) expression were evidenced in the diabetic rats, which could be improved by rhEGF and especially M.E.ConclusionMaggot extract would be an alternative and/or adjuvant candidate for the better management of diabetic skin wounds because of its activity in enhancing STAT3 activation.

Assessment of associated credit risk in the supply chain is a challenge in current credit risk management practices. This paper proposes a new approach for assessing associated credit risk in the supply chain based on graph theory and fuzzy preference theory. First, we classified the credit risk of firms in the supply chain into two types, namely firms’ “own credit risk” and “credit risk contagion”; second, we designed a system of indicators for assessing the credit risks of firms in the supply chain and used fuzzy preference relations to obtain the fuzzy comparison judgment matrix of credit risk assessment indicators, on which basis we constructed the basic model for assessing the own credit risk of firms in the supply chain; third, we established a derivative model for assessing credit risk contagion. On this basis, we carried out a comprehensive assessment of the credit risk of firms in the supply chain by combining the two assessment results, revealing the contagion effect of associated credit risk in the supply chain based on trade credit risk contagion (TCRC). The case study shows that the credit risk assessment method proposed in this paper enables banks to accurately identify the credit risk status of firms in the supply chain, which helps curb the accumulation and outbreak of systemic financial risks.

Considering the carbon emissions caused by the fresh-keeping of fresh agricultural products, this paper studied the rules of fresh-keeping decision-making in the two-echelon fresh agricultural product supply chain led by suppliers under the carbon cap-and-trade policy. In addition, we designed two contracts, cost-sharing contract and two-part pricing contract, to coordinate the supplier's fresh-keeping decision and the supply chain's revenue. The results show that: whether the carbon cap-and-trade policy is implemented or not, the higher the consumer's preference for freshness and the lower the price sensitivity coefficient of consumers, the more favorable it is for suppliers to improve their fresh-keeping efforts. Under the implementation of carbon cap-and-trade policy, suppliers' fresh-keeping efforts are only related to the carbon transaction price, not the carbon cap; the higher the carbon transaction price, the less the supplier's fresh-keeping efforts, but the more the supplier's income; the smaller the cost coefficient of carbon emission reduction and the larger the coefficient of carbon emission reduction, the more favorable it is for suppliers to increase their fresh-keeping efforts; both cost-sharing contract and two-part pricing contract can coordinate the supply chain of fresh agricultural products, but they have different application scope and coordination effect. These conclusions are of great significance to the operation and management of fresh agricultural products suppliers, the improvement of consumers' quality of life and the protection of ecological environment under carbon cap-and-trade.

BackgroundPeriprosthetic fractures (PPFs) is one of the major causes of failure of hip arthroplasty with cementless stem; however, studies on the incidence and risk factors of PPFs after cementless hemiarthroplasty for femoral neck fractures (FNFs) are lacking.MethodsThis retrospective study included patients who underwent cementless bipolar hemiarthroplasty for displaced intracapsular FNFs. The demographic data were reviewed, Dorr classification was used to describe morphology of the femur, radiological parameters were measured including stem-shaft angle, canal fill ratio (CFR), canal flare index (CFI), morphologic cortical index (MCI), canal calcar ratio (CCR), and vertical and horizontal femoral offset.ResultsThe sample comprised 10 men and 46 women (affected hip: left, 38; right, 18). The mean patient age was 82.82±10.61 (range, 69-93) years, and the mean hemiarthroplasty to PPFs time was 26.28±14.04 (range, 6.54-47.77) months. Seven (12.28%) patients had PPFs. A significant relationship was found between the incidence of PPF and CFR (p = 0.012), patients had a significantly smaller femoral stem CFR (0.76%±0.11%) than controls (0.85%±0.09%). The PPFs group had a significant shorter and unreestablished vertical femoral offset (p = 0.048).ConclusionsA smaller femoral stem CFR associated with a potentially unacceptably high PPFs risk in uncemented hemiarthroplasty for displaced FNFs may result from mismatched prosthesis and bone dimensions in the elderly population, especially when accompanied by a poorly reestablished vertical femoral offset. With increasing evidence of the benefits of cemented fixation, a cemented stem for the treatment of displaced intracapsular FNFs is recommended for such a elderly frail population.

To study the effects that the perennial freeze-thaw environment exerts on the dynamic mechanical properties of marble, which characterizes the Qinghai-Tibet Plateau, impact tests were conducted, and saturated marble was utilized; thus, we analyzed the effect of different loading rates on its dynamic compressive strength, fragmentation pattern, and energy-absorbing density. The results indicate the following: (1) When 42.02s-1 ≤[Formula: see text]≤ 49.20s-1, the degree of fragmentation and the fractal dimension of saturated state marble is greater than that of the dry state marble; when [Formula: see text]49.20s-1, the dry state marble exhibits greater fragmentation than the saturated marble; (2) When the saturated state marble is subjected to a specific fractal dimension, the energy-absorbing density of the marble that characterizes the saturated state is great compared with the dry state, and when the fractal dimension increases, the energy-absorbing densities that characterize the two states gradually converge. (3) The effect of water on the mechanical properties of marble has an obvious rate dependence, showing a weakening effect at low strain rates and a strengthening effect at high strain rates. In regard to the analysis pertaining to the dynamic fracture mechanism of marble under the influence of the freeze-thaw environment that characterizes the plateau, the aforementioned experimental results exhibit considerable significance.

Background: The benefit of alpha-Ketoanalogues (KA) supplementation for chronic kidney disease (CKD) patients that followed low-protein diet (LPD) remains undetermined. Methods: We extracted longitudinal data for all CKD patients in the Taiwan National Health Insurance from January 1, 2000 through December 31, 2010. A total of 1483 patients with anemic advanced CKD treated with LPD, who started KA supplementation, were enrolled in this study. We analyzed the risks of end stage renal disease and all-cause mortality using Cox proportional hazard models with influential drugs as time-dependent variables. Results: A total of 1113 events of initiating long-term dialysis and 1228 events of the composite outcome of long-term dialysis or death occurred in patients with advanced CKD after a mean follow-up of 1.57 years. Data analysis suggests KA supplementation is associated with a lower risk for long-term dialysis and the composite outcome when daily dosage is more than 5.5 tablets. The beneficial effect was consistent in subgroup analysis, independent of age, sex, and comorbidities. Conclusions: Among advanced CKD patients that followed LPD, KA supplementation at an appropriate dosage may substantially reduce the risk of initiating long-term dialysis or of developing the composite outcome. KA supplementation represents an additional therapeutic strategy to slow the progression of CKD. [ABSTRACT FROM AUTHOR]

The intrusion of magmatic rocks into coal seams affects the coal quality and leads to unforeseen hazards in safety of the coal mines' production. This paper summarizes the mechanism of magmatic rocks intruding into coal seams, depicts the electromagnetic characteristics of the coal seams intruded by magmatic rocks, briefly describes the characteristics of transient electromagnetic method (TEM), and introduces the method of detection by TEM and the data processing steps. Then, the effectiveness of TEM in detecting the ranges of the coal seams intruded by magmatic rocks is theoretically analysed. It is observed that after the intrusion of magmatic rocks in the coal seams, the electromagnetic characteristics (secondary field potential and resistivity) will be dramatically affected, namely high secondary field potential and low resistivity. For experimental verification purposes, this study selects the test project of the Tongxin Minefield in the Datong Coalfield in Shanxi, China as an example, and the accuracy for the detection of the ranges of the coal seams intruded by magmatic rock using TEM is successfully verified.

The disease-information coupling propagation dynamics model is a widely used model for studying the spread of infectious diseases in society, but the parameter settings and sensitivity are often overlooked, which leads to enlarged errors in the results. Exploring the influencing factors of the disease-information coupling propagation dynamics model and identifying the key parameters of the model will help us better understand its coupling mechanism and make accurate recommendations for controlling the spread of disease. In this paper, Sobol global sensitivity analysis algorithm is adopted to conduct global sensitivity analysis on 6 input parameters (different cross regional jump probabilities, information dissemination rate, information recovery rate, epidemic transmission rate, epidemic recovery rate, and the probability of taking preventive actions) of the disease-information coupling model with the same interaction radius and heterogeneous interaction radius. The results show that: (1) In the coupling model with the same interaction radius, the parameters that have the most obvious influence on the peak density of nodes in state AI and the information dissemination scale of the information are the information dissemination rate βI and the information recovery rate μI. In the coupling model of heterogeneous interaction radius, the parameters that have the most obvious impact on the peak density of nodes in the AI state of the information layer are: information spread rate βI, disease recovery rate μE, and the parameter that has a significant impact on the scale of information spread is the information spread rate βI and information recovery rate μI. (2) Under the same interaction radius and heterogeneous interaction radius, the parameters that have the most obvious influence on peak density of nodes in state SE and the disease transmission scale of the disease layer are the disease transmission rate βE, the disease recovery rate μE, and the probability of an individual moving across regions pjump.

Objective To explore the value of ultrasound in evaluating T/N staging of differentiated thyroid carcinoma (DTC). Methods The clinical data of 1206 patients with DTC in our hospital from January 2018 to December 2020 were retrospectively analyzed. Cervical ultrasound was performed before surgery, and the standard ultrasound images of thyroid nodules and cervical lymph nodes I to VII were retained. According to the 8th TNM staging guidelines of AJCC DTC, the T/N stages were assessed by preoperative ultrasonic data. Then, the sensitivity, specificity, negative predicted value, positive predicted value (PPV), and diagnostic value of ultrasound T/N staging were assessed using postoperative pathological staging as the reference. Results Ultrasonic T-stage had good consistency to pathological T stage in T4a and T4b tumors (kappa value>0.75), and moderate consistency to pathological T stage in T1, T2 and T3a tumors (kappa value between 0.4 and 0.75). ultrasonic T-stage had a sensitivity higher than 66%, except in T3b assessment (13/44, 29.5%, 95%CI: 16.1%-43.0%). All ultrasonic T-stage had specificity higher than 93%, except in T1b assessment (734/889, 82.6%, 95%CI: 80.1%-85.1%). The PPV of ultrasonic T1a to T4b was 94.3% (494/524), 61.0% (242/397), 54.4% (87/160), 34.3% (12/35), 20.3% (13/64), 100% (22/22) and 100% (4/4), respectively. The diagnostic accuracy values were 83% in T1a, 81% in T1b, 91% in T2, 98% in T3a, 93% in T3b, 99% in T4a and 100% in T4b. Nltrasonic N-stage had poor consistency to pathological N stage in any N stages (kappa valueConclusion Ultrasound has a good consistency and high accuracy in assessing the T-stage of DTC. However, the consistency and accuracy were poor in N-staging. It has a certain reference value in reducing excessive surgical treatment of DTC.

To study the influence of the gangue content of coal gangue particles on the vibration signal of the tail beam under sliding condition, this paper combines three-dimensional(3D) laser scanning technology with the finite element method, establishes a finite element model of the real shape of coal gangue particles and the hydraulic support in top coal caving in LS-DYNA, analyzes the influence of gangue content on some characteristics of the acceleration signal on the tail beam in the time and frequency domains, and then studies the influence of the size and total mass of the rock, and the angle of the tail beam on the characteristics. The following conclusions are obtained: when the coal gangue particles slip on the tail beam, an increase in gangue content significantly improves the effective value of the acceleration signal of the tail beam in the time domain and the average power and average amplitude in the frequency domain. With different sizes, total masses, and tail beam angles, the increase in gangue content always causes an increase in acceleration signal characteristics. In terms of the influence of various factors on the same gangue content, at the same total mass, the larger the rock mass size is, the faster the characteristic value increases with the increase in gangue content. The greater the total mass, the greater the value of the acceleration signal characteristics. A smaller angle between the tail beam and the ground increases the value of each characteristic. The results of this study provide a reference for further research on coal gangue identification based on vibrations.

Eukaryotic initiation factor 4E (eIF4E) and its phosphorylated form (p-eIF4E) play a crucial role in the protein synthesis, both are under regulation of eIF4E-binding protein 1 (4EBP1) and mitogen-activated protein kinase (MAPK)-interacting kinases (MNKs). This study aims to explore the potential prognostic significance of p-4EBP1 and p-eIF4E in NSCLC patients. The expression of p-4EBP1 and p-eIF4E in NSCLC patients was detected by immunohistochemistry (IHC) staining in tissue microarrays (TMAs) containing 354 NSCLC and 53 non-cancerous lung tissues (Non-CLT). The overexpression percentage of p-4EBP1 and p-eIF4E in lung squamous cell carcinoma (SCC) and adenocarcinoma (ADC) was significantly higher than that of Non-CLT. P-4EBP1 expression in patients with advanced clinical stage was higher than that in early stage. Expression of p-4EBP1 had a positive relationship with p-eIF4E expression both in lung SCC and ADC. NSCLC patients with high expression of p-4EBP1 and p-eIF4E alone or in combination had a lower survival rate than that of other phenotypes. For NSCLC patients, p-4EBP1 is an independent poor prognostic factor as well as clinical stage, LNM and pathological grade. Overexpression of p-4EBP1 and p-eIF4E might be novel prognostic marker for NSCLC, who possesses potential application value for NSCLC targeted therapy.

ObjectiveTo systematically assess the effect of discontinued vs continued oxytocin after active stage of labour is established.MethodsPubmed, Embase, and the Cochrane Library were systematically searched to 18 April 2021. The risk ratio or mean difference with corresponding 95% confidence interval were computed to investigate the effect of intervention or control on maternal and fetus outcomes. This review was registered in the International Prospective Register of Systematic Reviews: CRD42021249635.ResultsDiscontinuing oxytocin when the active labour was established might decrease the risk of cesarean delivery [RR (95% CI): 0.84 (0.72-0.98), P = 0.02]. However, when we restricted our analysis to women who performed cesarean section after the active phase was reached, the difference was no longer significant [RR (95% CI): 0.82 (0.60-1.10), P = 0.19]. The incidence of uterine tachysystole [RR (95% CI): 0.36 (0.27-0.49)], postpartum hemorrhage [RR (95% CI): 0.78 (0.65-0.93)], and non-reassuring fetal heart rate [RR (95% CI): 0.66 (0.58-0.76)] were significantly lower in the oxytocin discontinuation group. We also found a possible decrease in the risk of chorioamnionitis in discontinued oxytocin group [RR (95% CI): 2.77 (1.02-5.08)]. An increased duration of active [MD (95% CI): 2.28 (2.86-41.71)] and second [MD (95% CI): 5.36 (3.18-7.54)] phase of labour was observed in discontinued oxytocin group, while the total delivery time was not significantly different [MD (95% CI): 20.17 (-24.92-65.26)].ConclusionAfter the active labor is reached, discontinuation of oxytocin could be considered a new recommendation for the improved maternal and fetal outcomes without delaying labour.

The transient electromagnetic method (TEM) is widely applied in coal hydrogeological exploration owing to its sensitivity to low-resistivity bodies. However, when a coal seam is buried deep, particularly if there are multiple electrical layers in the vertical direction of the overlying stratum, the results of the calculation using the late-channel empirical formula of the TEM may no longer reflect the actual situation. In this study, we evaluated the principle of the one-dimensional (1D) Occam algorithm and the steps for performing an inversion. We proposed various two-, three-, and four-layer electrical models for inversion using the 1D Occam algorithm. Our results are consistent with the electrical distribution of the models, thus indicating the effectiveness of the algorithm. A test project of large-depth transient electromagnetic exploration in the Datong Coalfield in Shanxi, China, was selected for experimental verification. The 1D Occam inversion was used to successfully identify various electrical strata overlying the coal seam.

Background Venetoclax (VEN) is the first selective small molecule Bcl-2 inhibitor approved by FDA and used in adult chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL) and some acute myeloid leukemia (AML). However, the long-term safety of VEN in large sample population was unknown. This study evaluated the adverse events (AEs) of VEN from FDA Adverse Event Reporting System (FAERS) since its approval in 2016 by data mining. Methods The disproportionality analyses, including four algorithms of reporting odd ratio (ROR), proportional reporting ratio (PRR), bayesian configuration promotion neural network (BCPNN), and multi item gamma poisson shrinker (MGPS), were employed to quantify the signals of VEN-associated AEs. Results From the FAERS database, a total of 8,379,682 reports were collected during the study period. After removing the duplication, the number of reports with VEN as the primary suspect (PS) was 19,107. The 19,107 cases of AEs involved 27 organ systems, 256 significant PTs which conforming to the four algorithms. Unexpected serious AEs, such as pleural effusion, splenic infarction, atrial fibrillation, skin squamous cell carcinoma, etc., have signals. The median time of occurrence of AEs related to VEN was 31 days (inter quartile range [IQR] 7–131 days), and half of the reported AEs occurred within 1 month after administration. Conclusion Our research has found new significant AEs signals of VEN, which improved its safety information in real-world after marketing approval, and contributed to its risk control of use in clinic.