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BackgroundExisting research indicates that the personality traits of miners influence their emotional regulation strategies, and these strategies in turn affect their performance in work fatigue. However, whether there is an intermediary or moderating role among these factors remains unclear. Additionally, while some studies suggest an increased likelihood of unsafe behavior among miners following fatigue, physiological data concerning their cognition remains incomplete and requires further exploration. This study aims to explore the mediating and moderating effects of emotional regulation strategies among miners regarding their personality traits and work fatigue, and to expand understanding of the cognitive and physiological data related to miners’ risk decision-making following fatigue.MethodFifty adult miners (Mage = 25, aged 18–40, 100% male) were selected as participants. Emotional regulation tendency, significant levels of personality traits based on the Big Five Personality Traits questionnaire, and the three-dimensional levels of work fatigue were measured using emotional regulation strategy scale, Big Five Personality Traits questionnaire, and work fatigue scale, respectively. The eye–brain consistency hypothesis posits that eye movement trajectories and fixation points reflect the brain’s cognitive processes and focus. Therefore, combining eye-tracking experiments, miners’ preferences in risk decision-making were further measured.ResultsExpressive suppression strategies mediated between conscientiousness and depersonalization; expressive suppression strategies moderated between agreeableness and emotional exhaustion. In eye-tracking physiological experiments, significant differences were found in eye movement data among miners with varying levels of emotional exhaustion.ConclusionPreferences in emotional regulation strategies play mediating and moderating roles between miners’ Big Five Personality Traits and work fatigue. The levels and dimensions of work fatigue are influenced not only by personality traits but also by individual tendencies in emotional regulation strategies, which significantly affect performance in risk decision-making. The findings of this study can further enrich theories related to work fatigue among miners and provide insights for personalized safety management in mining.

BackgroundIn China’s coal mines, employees work in environments reaching depths of 650 m, with temperatures around 40°C and humidity levels as high as 90%, adversely affecting their health, safety capabilities, and cognitive functions, especially working memory. This study aims to explore different temperature and humidity conditions’ impact on neurocognitive mechanisms to enhance occupational health and safety.MethodsThis study, conducted between June and August 2023, with 100 coalmine workers from the Hongliulin Mining Group, utilized functional near infrared spectroscopy (fNIRS) and short-term visual memory tasks to evaluate the effects of high temperatures and humidity on working memory by monitoring activity in the cerebral cortex. Behavioral data, and neurophysiological data were analyzed using Tukey’s HSD for significant differences and multiple regression to explore the impact of temperature and humidity. The β-values of Oxy-Hb for different regions of interest were calculated using General liner model (GLM), and the activation maps were plotted by NIRS_KIT.ResultsHigh temperature and humidity (Condition IV) significantly depressed reaction times and working memory compared to other conditions, with temperature having a more pronounced impact than humidity on these cognitive measures (p

Abstract As the depth of coal mining increases, the temperature and humidity of the underground environment also rise, which can negatively impact the physiological health of miners, and may even pose a threat to their safety and lives. However, studies on the neurocognitive mechanisms underlying the relationship between temperature, humidity, and miners’ alertness are scant. This study investigates several research objectives: (A) the differences in reaction time and error rate in different temperature and humidity conditions, which factor has a greater impact; (B) the differences in the levels of Oxy-Hb in different conditions and which factor has a greater impact; (C) the differences of activation degree between different regions of interest; and (D) the differences in the shape of Oxy-Hb time course between different conditions between different regions of interests. The fNIRS was used to measure the activity in 100 participants’ prefrontal cortex in this study. The results showed that both temperature and humidity would lead to decreased alertness of miners, which would not only prolong the reaction time, increase the error rate, and increase the Oxy-Hb concentration, but also lead to increased activation of the prefrontal cortex and greater activation of the right side than that of the left side, the Oxy-Hb time course was different on both sides, and temperature has a greater effect on alertness than humidity.

Abstract Alhagi honey (AH) is produced in arid and hot areas of Central Asia, and its polysaccharides (AP) are widely known for their activity in the treatment of intestinal diseases such as diarrhea. However, the therapeutic potential and mechanism of AP in ulcerative colitis (UC) remain unclear. Here, AH polysaccharide‐2 (AP2), a polysaccharide with the highest content in AP, was isolated and evaluated for its effects on dextran sulfate sodium (DSS)‐induced UC in mice. AP2 was found to alleviate UC symptoms and regulate gut microbiota dysbiosis by decreasing Helicobacter levels and increasing Lactobacillus levels. Analysis of PICRUSt2 predicted that AP2 may regulate carbohydrate and amino acid metabolism, and metabolomic analysis confirmed that AP2 promotes the metabolism of tryptophan to produce kynurenic acid (kyna). Moreover, kyna acted as an aryl hydrocarbon receptor (AhR) ligand, which activated AhR to increase the expression of the tight junction proteins claudin‐1 and occludin. Interestingly, AP2 showed similar effects in protecting the intestinal barrier and alleviating colitis as the AhR agonist 6‐formylindolo[3,2‐b]carbazole, and the AhR antagonist CH223191 partially blocked the therapeutic effect of AP2 in UC mice, indicating that the anti‐UC effect of AP2 was AhR dependent. These findings demonstrate that AP2 alleviates UC by regulating the gut microbiota and promoting tryptophan metabolism to generate kyna‐activated AhR. The insights gained from this study could help in the future development of AP2 as a drug candidate or functional food for the treatment of UC.

BackgroundProgressive glioblastoma (GBM) is a malignancy with extremely poor prognosis. Chemotherapy is one of the approved systemic treatment modalities. The aim of this study is to assess the cost-effectiveness of using bevacizumab (BEV) in combination with lomustine (LOM) regimen for the treatment of progressive glioblastoma in China.MethodsThe estimation results are derived from a multicenter randomized phase III trial, which demonstrated improved survival in GBM patients receiving BEV+LOM combination therapy. To calculate the incremental cost-effectiveness ratio (ICER) from the perspective of Chinese society, a Markov model was established. Univariate deterministic analysis and probabilistic sensitivity analysis were employed to address the uncertainties within the model.ResultsCompared to LOM monotherapy, the total treatment cost for BEV+LOM combination therapy increased from $2,646.70 to $23,650.98. The health-adjusted life years (QALYs) for BEV+LOM combination therapy increased from 0.26 QALYs to 0.51 QALYs, representing an increment of 0.25 QALYs. The incremental cost-effectiveness ratio (ICER) was $84,071.12. The cost-effectiveness curve indicates that within the willingness-to-pay (WTP) range of $35,906 per QALY, BEV+LOM combination therapy is not a cost-effective treatment option for unresectable malignant pleural mesothelioma patients.ConclusionsTaken as a whole, the findings of this study suggest that, from the perspective of payers in China, BEV+LOM combination therapy as a first-line treatment for GBM is not a cost-effective option. However, considering the survival advantages this regimen may offer for this rare disease, it may still be one of the clinical treatment options for this patient population.

Abstract Objectives The purpose of this study was to assess the impact of polypharmacy, potentially inappropriate medications, and drug-drug interactions on in-hospital mortality in older COVID-19 inpatients. Methods A cross-sectional study was conducted using electronic medical data from a tertiary hospital in Chengdu from December 2022 to January 2023. The 2019 AGS/Beers criteria was used to evaluate the potentially inappropriate mediation (PIM) status of older COVID-19 inpatients (age ≥ 65 years), the drug-drug interactions were evaluated on Medscape, and multivariate logistic regression was used to identify the risk factors associated with in-hospital mortality. Results A total of 206 older COVID-19 inpatients were included in the study. The mean number of drugs per day was 13.04. The prevalence of PIM use based on the 2019 AGS Beers Criteria was 66.99%. The prevalence of drug-drug interactions was 61.65%. Logistic regression demonstrated that age ≥ 80 (OR: 10.321, 95% CI: 1.649, 64.579, P = 0.013), renal insufficiency (OR: 4.740, 95% CI: 1.366, 16.447, P = 0.014), long-term hospitalization (OR: 6.637, 95% CI: 1.030, 42.779, P = 0.046), severe pneumonia (OR: 50.230, 95% CI: 5.180, 487.041, P = 0.001) were influencing factors associated with in-hospital mortality in older COVID-19 inpatients. Conclusions The polypharmacy, potentially inappropriate medications, and drug-drug interactions were seen in many older COVID-19 inpatients.

Abstract The purpose of this study is to evaluate the efficacy of prophylactic use amphotericin B in patients with hematologic disorders complicated by neutropenia. We searched the PubMed, EMBASE, The Cochrane Library, CBM, CNKI, VIP and WanFang Data database and the China Clinical Trials Registry ( www.chictr.org.cn ) to collect randomized controlled trials (RCTs) of amphotericin B for patients with hematologic disorders complicated by neutropenia from inception to May 2023. The Cochrane risk-of-bias tool for RCTs was used to assess the bias risk of the included studies. The meta-analysis was performed using RevMan 5.3 software. A total of 6 studies with a total of 1019 patients were included. The results of the meta-analysis showed that the treatment group was superior to the control group in terms of the fungal infection rate, and the differences were statistically significant [RR = 0.47, 95% CI (0.32, 0.69), P

AbstractIntroduction At present, there are some randomized controlled trials (RCTs) of oral small molecule drugs. The purpose of this study was to evaluate the efficacy and safety of oral small molecule drug treatment for COVID-19.Methods RCTs were identified through systematic searches of PubMed, Embase, and Cochrane Central Register of Controlled Trials through 1 April 2023. A total of nine RCTs were included, including 30,970 COVID-19 patients comparing five treatments (azvudine, molnupiravir, paxlovid, VV116, and placebo). The Cochrane risk of bias tool for randomized trials (RoB) was used to assess the bias risk of the included studies. The direct and indirect evidence were combined using a Bayesian network meta-analysis (PROSPERO Code No: CRD42023397837).Results Direct analysis showed that paxlovid was associated with a reduced risk of mortality (odds ratio [OR] 0.12, 95% confidence interval [CI] 0.06–0.25) and hospitalization (OR = 0.04, 95% CI: 0.00–0.67) compared with placebo. Network meta-analysis showed that paxlovid had the highest probability of being the best management strategy in patients with COVID-19, reducing mortality (OR = 0.11, 95% CI: 0.01–1.99; surface under the cumulative ranking curve [SUCRA]: 0.77) and hospitalization (OR = 0.06, 95% CI: 0.00–1.03; SUCRA: 0.95). For prespecified safety outcomes, SUCRA values ranked VV116 (OR = 0.09, 95% CI: 0.00–2.07: SUCRA 0.86) as the most beneficial intervention for the prevention of serious adverse events.Conclusions When compared to other antiviral medications, paxlovid can reduce the mortality and hospitalization of COVID-19 patients.

Introduction: Azivudine has undergone a few randomized controlled trials (RCTs) as of late. This study aimed to assess the COVID-19 treatment with azvudine's efficacy and safety. Methods: Through January 20, 2023, systematic searches of PubMed, Embase, ClinicalTrials.gov, International Clinical Trials Registry Platform (ICTRP), Cochrane Central Register of Controlled Trials (CENTRAL), and MedRxiv were conducted to find the RCTs. The included studies' bias risk was evaluated using the Cochrane Handbook for Systematic Reviews of Interventions. Meta-analysis was performed using Revman 5.4 (PROSPERO Code: CRD42023395022). Results: A total of five RCTs with 1142 COVID-19 patients, 575 of whom received azvudine, were included. Additionally, seven RCTs are currently being conducted. In terms of clinical improvement and PT-PCR (reverse transcription polymerase chain reaction) negativity, the azvudine group had a greater patient percentage than the usual treatment or placebo group. It also took less time for the PT-PCR to become negative. In comparison to the placebo or standard treatment groups, the frequency of adverse events was reduced in the azvudine group (risk ratio [RR] = 0.89, 95% confidence interval [CI]: 0.80 to 0.99) and major adverse events (RR = 0.63, 95% CI: 0.22 to 1.79) groups. Conclusions: Without the burden of side effects, azvudine can hasten the clinical symptoms of COVID-19 patients and PT-PCR negative. It will take more extensive research to confirm these conclusions.

Abstract Miners’ unsafe behavior is the main cause of accidents in coal mines, and unsafe state have an important influence on unsafe behavior among miners. To minimize accidents from the source of accident chain, we evaluated the impact of workload on miners’ unsafe state. It is important for coal enterprises to monitor miners’ unsafe state and to prevent unsafe accidents. Workload is divided into two dimensions: work time and work demand. Meanwhile, we introduced job satisfaction as a moderating variable. Through empirical research methods, first-line employees from two coal mines in China were enrolled in the questionnaire survey. Regression analysis was used to verify the impact of workload and its various dimensions, job satisfaction, and miners’ unsafe state. We found that workload, work time and work demand have significant positive effects on miners’ unsafe state. Job satisfaction plays a moderating effect in the relationship between workload and miners’ unsafe state. To some extent, a higher job satisfaction was associated with reduced workload, reduced occurrence of miners’ unsafe state and minimal incidences of unsafe accidents. On this basis, measures were proposed to improve miners’ unsafe state in terms of workload and job satisfaction. This study informs the establishment of effective intervention measures to monitor miners’ unsafe state and is also beneficial to the improvement of coal mine safety.

Abstract Animal experiments play an essential role in advances in the research and treatment of burns. Currently, researchers often rely on personal experience or the literature to complete the construction of animal disease models, which may lead to a lack of scientific rigor and a wide range of animal disease models with reference value. The purposes of this study were to establish a third-degree burn model of rats using the Delphi method to provide a reference. Two rounds of a Delphi expert consultation survey were conducted on experts (n = 13) in this study, and then the boundary value method was used to screen, modify and supplement the indicators. Next, the indicator weight was determined by dividing the boundary value, and finally, the index system of the rat model of third-degree burns was established. The statistical analysis results show that the positive coefficients of the two rounds of expert consultation are 100% and 88.67% respectively. The expert authority coefficient values were 0.73 and 0.67, respectively, and the expert coordination coefficient test was P

Background: Older patients with dementia always need multiple drugs due to comorbidities and cognitive impairment, further complicating drug treatment and increasing the risk of potentially inappropriate medication. The objective of our study is to estimate the global prevalence of polypharmacy and potentially inappropriate medication (PIM) and explore the factors of PIM for older patients with dementia.Methods: We searched PubMed, Embase (Ovid), and Web of Science databases to identify eligible studies from inception to 16 June 2023. We conducted a meta-analysis for observational studies reporting the prevalence of potentially inappropriate medication and polypharmacy in older patients with dementia using a random-effect model. The factors associated with PIM were meta-analyzed.Results: Overall, 62 eligible studies were included, of which 53 studies reported the prevalence of PIM and 28 studies reported the prevalence of polypharmacy. The pooled estimate of PIM and polypharmacy was 43% (95% CI 38–48) and 62% (95% CI 52–71), respectively. Sixteen studies referred to factors associated with PIM use, and 15 factors were further pooled. Polypharmacy (2.83, 95% CI 1.80–4.44), diabetes (1.31, 95% CI 1.04–1.65), heart failure (1.17, 95% CI 1.00–1.37), depression (1.45, 95% CI 1.14–1.88), history of cancer (1.20, 95% CI 1.09–1.32), hypertension (1.46, 95% CI 1.05–2.03), ischemic heart disease (1.55, 95% CI 0.77–3.12), any cardiovascular disease (1.11, 95% CI 1.06–1.17), vascular dementia (1.09, 95% CI 1.03–1.16), chronic obstructive pulmonary disease (1.39, 95% CI 1.13–1.72), and psychosis (1.91, 95% CI 1.04–3.53) are positively associated with PIM use.Conclusion: PIM and polypharmacy were highly prevalent in older patients with dementia. Among different regions, the pooled estimate of PIM use and polypharmacy varied widely. Increasing PIM in older patients with dementia was closely associated with polypharmacy. For other comorbidities such as heart failure and diabetes, prescribing should be cautioned.

Invasive fungal infections are on the rise, leading to a continuous demand for antifungal antibiotics. Rare actinomycetes have been shown to contain a variety of interesting compounds worth exploring. In this study, 15 strains of rare actinobacterium Gordonia were isolated from the gut of Periplaneta americana and screened for their anti-fungal activity against four human pathogenic fungi. Strain WA8-44 was found to exhibit significant anti-fungal activity and was selected for bioactive compound production, separation, purification, and characterization. Three anti-fungal compounds, Collismycin A, Actinomycin D, and Actinomycin X2, were isolated from the fermentation broth of Gordonia strain WA8-44. Of these, Collismycin A was isolated and purified from the secondary metabolites of Gordonia for the first time, and its anti-filamentous fungi activity was firstly identified in this study. Molecular docking was carried out to determine their hypothetical binding affinities against nine target proteins of Candida albicans. Chitin Synthase 2 was found to be the most preferred antimicrobial protein target for Collismycin A, while 1,3-Beta-Glucanase was the most preferred anti-fungal protein target for Actinomycin D and Actinomycin X2. ADMET prediction revealed that Collismycin A has favorable oral bioavailability and little toxicity, making it a potential candidate for development as an orally active medication.

IntroductionVibrio parahaemolyticus is a foodborne pathogen commonly found in seafood, and drug resistance poses significant challenges to its control. This study aimed to identify novel drug targets for antibacterial drug discovery.MethodsTo identify drug targets, we performed a pan-genome analysis on 58 strains of V. parahaemolyticus genomes to obtain core genes. Subsequently, subtractive proteomics and physiochemical checks were conducted on the core proteins to identify potential therapeutic targets. Molecular docking was then employed to screen for anti-V. parahaemolyticus compounds using a in-house compound library of Streptomyces parvus, chosen based on binding energy. The anti-V. parahaemolyticus efficacy of the identified compounds was further validated through a series of experimental tests.Results and DiscussionPangenome analysis of 58 V. parahaemolyticus genomes revealed that there were 1,392 core genes. After Subtractive proteomics and physiochemical checks, Flagellar motor switch protein FliN was selected as a therapeutic target against V. parahaemolyticus. FliN was modeled and docked with Streptomyces parvus source compounds, and Actinomycin D was identified as a potential anti-V. parahaemolyticus agent with a strong binding energy. Experimental verification confirmed its effectiveness in killing V. parahaemolyticus and significantly inhibiting biofilm formation and motility. This study is the first to use pan-genome and subtractive proteomics to identify new antimicrobial targets for V. parahaemolyticus and to identify the anti-V. parahaemolyticus effect of Actinomycin D. These findings suggest potential avenues for the development of new antibacterial drugs to control V. parahaemolyticus infections.

The mechanical reliability of the gas-insulated metal-enclosed switchgear (GIS) is critical to the safe and stable operation of a power system. The internal stress induced in GIS insulators, which typically lead to cracking, can degrade the mechanical properties and compromise the reliability of the GIS. In this work, ultrasonic nondestructive measurements of the internal stress in a GIS 126 kV epoxy composite with the transverse waves are demonstrated for the first time. Our results show that the velocities of ultrasonic transverse waves increase linearly with the compressive stress and decrease linearly with the tensile stress. The acoustoelastic coefficients are −1.18 × 10−4/MPa and −1.96 × 10−4/MPa for measurements with transverse waves polarized vertically and parallelly to stress, respectively. Based on these acoustoelastic coefficients, the internal stresses are calculated, and the maximum absolute values of relative errors are 35.4% and 26.3% for measurements with the transverse wave polarized vertically and parallelly to stress, respectively.

Objectives: In older lung cancer patients, polypharmacy and the use of potentially inappropriate medications (PIMs) are commonly reported, but no systematic review or meta-analysis has been carried out to ascertain the prevalence and risk variables in this group. This study aimed to identify the prevalence of polypharmacy, PIMs and associated risk variables in older lung cancer patients.Methods: We searched for articles from the beginning to February 2022 in PubMed, Embase, and Web of Science that related the use of PIMs and polypharmacy by older lung cancer patients (PROSPERO Code No: CRD42022311603). Meta-analysis was performed on observational studies describing the prevalence and correlation of polypharmacy or PIMs in older patients with lung cancer.Results: Of the 387 citations, 6 articles involving 16,890 patients were included in the final sample. In older lung cancer patients pooled by meta-analysis, 38% and 35% of PIMs and polypharmacy, respectively. The prevalence of PIMs was 43%, 49%, and 28%, respectively, according to the 2019 AGS Beers criteria, 2014 screening tool for older people’s prescriptions/screening tool for alerting to the proper therapy (STOPP/START criteria) criteria, and other criteria.Conclusion: This systematic review and meta-analysis demonstrated a high prevalence of polypharmacy and PIMs among older lung cancer patients. Therefore, it is essential to take rational interventions for older lung cancer patients to receive reasonable pharmacotherapy.Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42022311603].

Objectives: Elderly lung cancer patients often have chronic diseases other than lung cancer. Therefore, this kind of population is often accompanied by polypharmacy. This situation and the resulting potentially inappropriate medication (PIM) use are an increasing global concern. In this context, the Chinese Association of Geriatric Research issued an expert consensus on the safety management of polypharmacy. However, the long- and short-term effects of the expert consensus on polypharmacy and PIM use are not clear.Methods: The study was conducted in Chengdu, a city in southwestern China, consisting of prescriptions for elderly lung cancer outpatients with multimorbidity (cancer with other diseases) from January 2016 to December 2021. The 2019 Beers criteria were used to evaluate PIM use, and interrupted time series analysis was used to evaluate the longitudinal effectiveness of expert consensus by measuring the prevalence of polypharmacy and PIM use. We used R software version 4.2.0 for data analysis.Results: A total of 7,238 elderly lung cancer outpatient prescriptions were included in the study. After the publication of the expert consensus, the level (β = -10.273, P < 0.001) of the prevalence of polypharmacy decreased, but the trend (β = 0.158, p = 0.855) of polypharmacy increased. The prevalence of PIM use decreased abruptly (β = -22.828, p < 0.001) after the intervention, but the long-term trend was still upward (β = 0.907, p = 0.916).Conclusion: The long-term effects of the publication of the expert consensus on the prevalence of polypharmacy and PIM use in hospitals in Chengdu were not optimal. Future research on interventions rationing polypharmacy and PIM use is needed.

Objective: Polypharmacy increases the prevalence of potentially inappropriate drugs potentially inappropriate medications among older persons, lowering their quality of life. PIMs use can lead to higher mortality in older patients. This study aimed to compare the prevalence of PIMs in older Chinese outpatients according to the Beers criteria and the Chinese criteria and to analyze the risk factors. Second, we describe the differences between the two criteria, focusing on the inappropriate prescription of drugs in older outpatients.Methods: In Chengdu, Southwest China, a cross-sectional study was undertaken using electronic medical data from 9 general hospitals s. Outpatients above the age of 60 who were treated in the Geriatrics Center of these medical institutions were included. The 2019 Beers criteria and the 2017 Chinese criteria were used to evaluate the PIM status of older outpatients, and binary logistic regression was used to identify potential risk factors for PIMs.Results: There were 44,458 prescriptions from 2016 to 2018. The prevalence of PIMs among older outpatients was 30.05% (according to the Beers criteria) and 35.38% (according to the Chinese criteria), with statistical difference. Estazolam, hydrochlorothiazide and alprazolam were the top three PIMs in the Beers criteria, while the top three PIMs in the Chinese criteria were clopidogrel, estazolam and insulin. The prevalence of PIMs was associated with age, the number of diseases and the number of drugs. PIMs were shown to be more common in patients aged 70 and above, with more than 2 kinds of diseases and more than 4 kinds of drugs.Conclusion: PIMs were shown to be common among older outpatients in China, according to this study. The detection rate of the Chinese criteria was higher than that of the Beers criteria.

With the rapid advancement of artificial neural network (ANN) algorithms, many researchers have applied these methods to mine gas prediction and achieved numerous research achievements. It is of great significance to study methods that can accurately predict the gas content for the prevention of gas disasters in mining areas. In order to enhance the accuracy, stability, and generalization capability of the gas content prediction model, the GASA-KELM prediction model was established using the GASA algorithm to improve the KELM initial parameter assignment method, and the prediction model based on BPNN and SVM was established under the same conditions. The experimental results show that the GASA-BPNN model failed to achieve the desired outcome within 800 iterations. On the other hand, the GASA-SVM and GASA-KELM models accomplished the goal in significantly fewer iterations, taking only 673 and 487 iterations, respectively. Moreover, the overall average relative errors of the cross-validated gas content predictions were 15.74%, 13.85%, and 9.87% for the three models, respectively. Furthermore, the total average variance of the test set was 3.99, 2.76, and 2.05 for the GASA-BPNN, GASA-SVM, and GASA-KELM models, respectively. As a result, compared with other ANN models, the GASA-KELM model demonstrates higher accuracy, stronger prediction stability, and generalization ability in the practical application. This novel model provides a basis for accurately predicting gas content and proposing effective regional gas management measures.

Objectives: Polypharmacy and potentially inappropriate medication (PIM) use are frequent in older lung cancer patients. This study aimed to examine the trends of polypharmacy and PIM use and explore risk factors for PIM use based on the 2019 Beers criteria in older Chinese lung cancer outpatients with multimorbidity.Methods: A repeated cross-sectional study was conducted using electronic medical data consisting of the prescriptions of older lung cancer outpatients in China from January 2016 to December 2018. Polypharmacy was defined as the use of five or more medications. The 2019 Beers criteria were used to evaluate the PIM use of older cancer outpatients (age ≥65 years), and multivariate logistic regression was used to identify the risk factors for PIM use.Results: A total of 3,286 older lung cancer outpatients and their prescriptions were included in the study. The prevalence of polypharmacy was 14.27% in 2016, 16.55% in 2017, and 18.04% in 2018. The prevalence of PIM use, according to the 2019 Beers criteria, was 31.94% in 2016, 35.78% in 2017, and 42.67% in 2018. The two most frequently used PIMs in older lung cancer outpatients were estazolam and tramadol. The logistic regression demonstrated that age 75 to 79, polypharmacy, irrational use of drugs, and lung cancer accompanied by sleep disorders, anxiety or depression, or pain were positively associated with PIM use in older lung cancer outpatients.Conclusion: The prevalence of polypharmacy and PIM use in older lung cancer outpatients with multimorbidity was high in China, and polypharmacy and PIM use increased over time. Further research on interventions rationing PIM use in the older lung cancer patient population is needed.

BackgroundMedulloblastoma is the most common malignant brain tumor of childhood, accounting for 6 to 7 percent of all childhood CNS tumors. The purpose of this study was to evaluate the economic efficacy of a bevacizumab combined with temozolomide + irinotecan regimen for the treatment of recurrent pediatric medulloblastoma in China.MethodsThe data analyzed were from a randomized phase II screening trial that showed an improved survival benefit in child patients with recurrent medulloblastoma treated with a T+I+B combination regimen. A Markov model is constructed to estimate the incremental cost–effectiveness ratio (ICER) from the perspective of Chinese society. The uncertainty in the model is solved by one-way certainty and probabilistic sensitivity analysis.ResultsOur base case analysis showed that the total costs of treatment increased from $8,786.403 to $27,603.420 with the combination bevacizumab vs. the two-agent chemotherapy regimen. Treatment with T+I+B combination therapy was associated with an increase in effectiveness of 0.280 QALYs from 0.867 to 1.147 QALYs T+I regimen. The incremental cost-effectiveness ratio was $67,203.632/QALY, which exceeded our pre-specified willingness-to-pay threshold ($38,136.26/QALY). Cost changes associated with grade 3–4 AE management, tests used, or hospitalization costs had little effect on the ICER values predicted by sensitivity analysis.ConclusionsTaken together, the results of this study suggest that the combination of bevacizumab with temozolomide and irinotecan is not a cost-effective option from the perspective of Chinese payers as a first-line treatment option for children with recurrent medulloblastoma in China.

Objectives: Polypharmacy and potentially inappropriate medication (PIM) use among elderly Chinese patients have not yet been investigated by systematic review and meta-analysis. The purposes of this study were to investigate the prevalence of polypharmacy and PIM use and the risk factors associated with PIM use in elderly Chinese patients.Methods: Databases including PubMed, EMBase, and Web of Science were searched to collect studies which used Chinese criteria, Beers criteria, or STOPP criteria to evaluate the PIM status of elderly Chinese patients from inception to August 2021 (PROSPERO Code No: CRD42021262821). Observational studies reporting the prevalence of polypharmacy and PIM use in elderly Chinese patients were meta-analyzed. The pooled prevalence and risk ratio (RR) were calculated with a 95% confidence interval (CI).Results: A total of 8 articles involving 4,558,786 patients were included. The overall prevalence of polypharmacy (concomitant use of more than 5 medicines) and PIM use pooled by meta-analysis in Chinese older patients was 48% (95% CI: 0.17, 0.79, p = 0.003) (inpatients 73%, outpatients 23%) and 39% (95% CI: 0.25, 0.54, p < 0.001) (inpatients 50%, outpatients 29%), respectively. Polypharmacy (RR: 2.03, 95% CI: 1.13, 3.64) was significantly associated with PIM use.Conclusion: This meta-analysis demonstrated a high prevalence of polypharmacy and PIM use among elderly patients in China. Affected by the quantity and quality of the included studies, the aforementioned conclusions need to be confirmed by large samples and high-quality studies.

Objectives: The purpose of this study was to explore the prevalence of potentially inappropriate medication (PIM) among older outpatients (age ≥ 65 years old) with dementia in eight cities in China using the AGS Beers criteria of 2019 and to identify the potential factor increasing the number of PIMs.Methods: A cross-sectional study about PIM in older outpatients with dementia from January 2020 to December 2020 was carried out in eight cities in China, Chengdu, Beijing, Guangzhou, Shanghai, Shenyang, Tianjin, Zhengzhou, and Hangzhou, distributing five major geographical regions in China (east, west, north, south, central). The diagnosis of dementia was based on the International Classification of Diseases (ICD-10) to identify. Based on the 2019 AGS Beers criteria, the PIM prescriptions were evaluated. The identification of potential factors was completed using a binary logistic regression model.Results: Of 18,624 older outpatients with dementia, 3.52% were detected with 1 PIM, and 35.91% received at least two PIMs. The antipsychotic drugs quetiapine and olanzapine were most frequently prescribed in patients with PIM, accounting for 8.01 and 7.36%, respectively. Logistic regression analyses showed that female patients with dementia aged >80 years who took more medications were exposed easily to PIM use.Conclusion: PIM use among older outpatients with dementia in China is highly prevalent, and the associated risk factors were increasing age, female sex, and number of medications. The most frequently prescribed drugs by clinicians were anpsychotropic drugs, which were much more frequent than other drugs.

Abstract Proton pump inhibitor (PPI) was widely used around the world. Studies suggested conflicting results between PPI treatment and dementia event. This study examined the association between six PPI agents and dementia event by mining the US FDA Adverse Event Reporting System (FAERS) database from 2004 to 2020. We employed proportional reporting ratio (PRR) and information element (IC) methods to detect the signals of dementia relevant to PPI. We also analyzed characteristics of PPI and positive control reports, compared dementia event between long- and short-duration of PPI treatment. Finally, we identified 2396 dementia cases with PPI treatment. We did not detect significant signal between PPI and dementia event: PRR = 0.98, 95%CI 0.94 to 1.02, IC = −0.03, 95%CI − 0.17 to 0.10, even in gastroesophageal reflux disease cases: PRR = 0.65, 95%CI 0.59 to 0.72, IC = −0.62, 95%CI − 0.97 to − 0.27. No significant differences of dementia event were detected between long- and short- duration groups, the OR (95%CI) of the 3 years, 5 years and 10 years comparison were 0.70 (0.48 to 1.02), 0.72 (0.45 to 1.15) and 1.65 (0.75 to 3.63), respectively. Based on the current FAERS data mining, we discovered no association between PPI use and dementia event, even in long-term PPI therapy case.

It is hard for traditional current protection to solve problems of distribution networks with highly penetrative DGs. The fault information required by the most protection methods cannot be provided by the poor infrastructure of distribution networks. In this paper, a sufficient criterion based on the maximal current differences between adjacent transmission lines is proposed to promote selective configuration of protection scheme. The principle of the criterion and its advantages on current protection application are analyzed. The suppress influence of DG on the current of downstream transmission line current can be processed without high demand for communication in distribution network with DGs. Through the simulation in Matlab/Simulink, the effectiveness of the proposed criterion is validated.

Objectives: Age-related multimorbidity is a general problem in older patients, which increases the prevalence of potentially inappropriate medication (PIM) use. This study aimed to examine the prevalence and predictors of PIM use in older Chinese cancer outpatients with multimorbidity based on the 2017 Chinese criteria, 2019 AGS/Beers criteria, and 2014 STOPP criteria.Methods: A cross-sectional study was conducted using electronic medical data from nine tertiary hospitals in Chengdu from January 2018 to December 2018. The 2017 Chinese criteria, 2019 AGS/Beers criteria, and 2014 STOPP criteria were used to evaluate the PIM status of older cancer outpatients (age ≥65 years), the concordance among the three PIM criteria was calculated using kappa tests, and multivariate logistic regression was used to identify the risk factors associated with PIM use.Results: A total of 6,160 cancer outpatient prescriptions were included in the study. The prevalence of PIM use was 34.37, 32.65, and 15.96%, according to the 2017 Chinese criteria, 2019 AGS/Beers criteria, and 2014 STOPP criteria, respectively. Furthermore, 62.43% of PIMs met table 2, 0.27% of PIMs met table 3, 34.68% of PIMs met table 4, 2.62% of PIMs met table 5 of 2019 AGS/Beers criteria, respectively. According to the three criteria, 84.93%, 82.25%, and 94.61% of older cancer outpatients had one PIM. The most frequently used PIM in cancer outpatients was estazolam. The Chinese criteria and the STOPP criteria indicated poor concordance, whereas the 2019 AGS/Beers criteria showed moderate concordance with the other two criteria. Logistic regression demonstrated that age ≥ 80, more diseases, polypharmacy, irrational use of drugs, and lung cancer were positively associated with PIM use in older cancer outpatients.Conclusion: The prevalence of PIM use in Chinese older cancer outpatients with multimorbidity is high in China, and poor-to-moderate concordance among the three criteria was observed. Research on building PIM criteria for the older cancer population is necessary in the future.

The residue of estrogenic-disrupting compounds (EDCs) that are secreted by cows, added as drugs, and present in the feed may exist in dairy products. A gold nanoparticles (AuNPs)-estrogen receptor (ER) cocktail colorimetric assay equipped with ER cocktail solid phase extraction (SPE) was established to screen EDCs. Nine EDCs with high, moderate, and low estrogenic activity were selected to be the representative targets. The recognition range of the colorimetric assay combined with the ER cocktail SPE was wider than that of a single ERα or ERβ. The lowest detection limit of the established assay was about 10−9 mg·mL−1. The detection limits of estrone, bisphenol A, and bisphenol B were about one order of magnitude lower than the method based on a single ER. The recoveries of the spiked nine EDCs were between 80.0% and 110.0%, and daidzein was identified in the dairy product. The developed method has potential application prospects in food safety and environmental monitoring.

Apela, a novel endogenous peptide ligand for the G-protein-coupled apelin receptor, was first discovered and identified in human embryonic stem cells in 2013. Apela has showed some biological functions in promoting angiogenesis and inducing vasodilatation of mammals by binding apelin receptor, but little is known about its expression characteristics and regulatory mechanism in chicken. In the present study, the coding sequences of Apela in chicken was cloned. The evolution history and potential function of Apela were analyzed. Subsequently, the spatiotemporal expression characteristics of chicken Apela were investigated. Furthermore, the regulatory mechanism of Apela mRNA responsing to estrogen was explored by in vitro and in vivo experiments. The results showed that the length of the CDs of Apela mRNA was 165 bp and encoded a protein consisting of 54 amino acids residues with a transmembrane domain in chicken. The Apela was derived from the same ancestor of Apelin, and abundantly expressed in liver, kidney and pancreas tissues. The expression levels of Apela in the liver of hens were significantly higher at the peak-laying stage than that at the pre-laying stage (p ≤ 0.05). The Apela mRNA levels were significantly up-regulated in primary hepatocytes treated with 17β-estradiol (p ≤ 0.05), and could be effectively inhibited by estrogen receptor antagonists MPP, ICI 182780 and tamoxifen. It indicated that chicken Apela expression was regulated by estrogen via estrogen receptor α (ERα). In individual levels, both the contents of TG, TC and VLDL-c in serum, and the expression of ApoVLDLII and Apela in liver markedly up-regulated by 17β-estradiol induction at 1mg/kg and 2mg/kg concentrations (p ≤ 0.05). This study lays a foundation for further research on Apela involving in hepatic lipid metabolism.

Salmonella contamination in food production and processing is a serious threat to consumer health. More and more rapid detection methods have been proposed to compensate for the inefficiency of traditional bacterial cultures to suppress the high prevalence of Salmonella more efficiently. The contamination of Salmonella in foods can be identified by recognition elements and screened using rapid detection methods with different measurable signals (optical, electrical, etc.). Therefore, the different signal transduction mechanisms and Salmonella recognition elements are the key of the sensitivity, accuracy and specificity for the rapid detection methods. In this review, the bioreceptors for Salmonella were firstly summarized and described, then the current promising Salmonella rapid detection methods in foodstuffs with different signal transduction were objectively summarized and evaluated. Moreover, the challenges faced by these methods in practical monitoring and the development prospect were also emphasized to shed light on a new perspective for the Salmonella rapid detection methods applications.

Background Tofacitinib is an oral Janus kinase (JAK) inhibitor that targets JAK1 and JAK3, and thus regulates immune response. Therefore, tofacitinib is used to treat immune-mediated inflammatory diseases such as chronic plaque psoriasis. The objective of this study was to systematically assess the efficacy and safety of tofacitinib in treating chronic plaque psoriasis. Objective To systematically review the efficacy and safety of tofacitinib in the treatment of chronic plaque psoriasis, we performed a meta-analysis to evaluate the efficacy and safety of tofacitinib in patients with chronic plaque psoriasis. Methods Databases including PubMed, Embase, and The Cochrane Library were searched for randomized controlled trials about the efficacy and safety of tofacitinib in treating chronic plaque psoriasis from inception to August 2017 (PROSPERO Code No: CRD42017076587). Results Six articles (seven randomized controlled trial studies) involving 3743 patients were included. The meta-analysis results showed that for efficacy, tofacitinib (5 mg or 10 mg) compared with placebo can significantly improve the Physician’s Global Assessment response, PASI75, and PASI90 after treatment. For safety, the incidence of adverse reactions was statistically significantly higher for tofacitinib compared with placebo. Conclusion Treatment of chronic plaque psoriasis with tofacitinib is effective, but there may be more adverse reactions.

Internal stress in basin insulators of gas-insulated metal-enclosed switchgear (GIS) can lead to cracks, which affects the safe operation of these apparatuses. In this research, we proposed a subsurface internal stress measurement method for GIS epoxy composites. This method is based on an ultrasonic longitudinal critically refracted (LCR) wave technique. In this study, some epoxy composite specimens were synthesized with similar materials and manufacturing processes to those of 252 kV GIS basin insulators. An ultrasonic stress measurement system that utilized the LCR wave technique was set-up to investigate the relationship between stress and LCR wave propagation time, as well as to measure the compressive stress of the epoxy specimen within 0–50 MPa. The results show that LCR wave propagation time linearly decreased when stress increased in the subsurface zone and the acoustoelastic coefficient was −4.95. We found the relative errors of stress measurements to be less than 13%.

Situations of internal stress in basin insulators inside gas-insulated metal-enclosed switchgear (GIS) can lead to cracks, which can influence the safety and stability of apparatus. However, there is currently no research on internal stress measurements for composites of GIS basin insulators, and only measurements for surface stress. In this paper, an internal stress measurement method for GIS epoxy composite is proposed using an ultrasonic longitudinal through-transmission technique based on the acoustoelastic effect. An internal stress measurement system is developed to investigate the relationship between the uniaxial compressive internal stress and the velocity of the ultrasonic wave vertical to the stress in epoxy composite within a range of 0−70 MPa, and to calculate the acoustoelastic coefficient of epoxy composite. The effects of system delay are eliminated in measuring the propagation time. Some epoxy composite cuboid specimens with similar materials and using a manufacturing process similar to those of 252 kV GIS basin insulators are synthesized, and the uniformity of the internal stress in cuboid specimens is verified by finite element simulation. The results reveal a linear increase of the ultrasonic longitudinal wave velocity with increasing stress. It has been shown that the average acoustoelastic coefficient of GIS epoxy composites, using the longitudinal waves vertical to the stress, is 4.556 × 10−5/MPa. Additionally, the absolute errors of the internal stress measurements are less than 12.397 MPa. This research shows that the ultrasonic method based on the acoustoelastic effect for measuring the internal stress in GIS epoxy composites is feasible.