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BackgroundFraud, Waste, and Abuse (FWA) detection is a significant yet challenging problem in the health insurance industry. An essential step in FWA detection is to check whether the medication is clinically reasonable with respect to the diagnosis. Currently, human experts with sufficient medical knowledge are required to perform this task. To reduce the cost, insurance inspectors tend to build an intelligent system to detect suspicious claims with inappropriate diagnoses/medications automatically. ObjectiveThe aim of this study was to develop an automated method for making use of a medical knowledge graph to identify clinically suspected claims for FWA detection. MethodsFirst, we identified the medical knowledge that is required to assess the clinical rationality of the claims. We then searched for data sources that contain information to build such knowledge. In this study, we focused on Chinese medical knowledge. Second, we constructed a medical knowledge graph using unstructured knowledge. We used a deep learning–based method to extract the entities and relationships from the knowledge sources and developed a multilevel similarity matching approach to conduct the entity linking. To guarantee the quality of the medical knowledge graph, we involved human experts to review the entity and relationships with lower confidence. These reviewed results could be used to further improve the machine-learning models. Finally, we developed the rules to identify the suspected claims by reasoning according to the medical knowledge graph. ResultsWe collected 185,796 drug labels from the China Food and Drug Administration, 3390 types of disease information from medical textbooks (eg, symptoms, diagnosis, treatment, and prognosis), and information from 5272 examinations as the knowledge sources. The final medical knowledge graph includes 1,616,549 nodes and 5,963,444 edges. We designed three knowledge graph reasoning rules to identify three kinds of inappropriate diagnosis/medications. The experimental results showed that the medical knowledge graph helps to detect 70% of the suspected claims. ConclusionsThe medical knowledge graph–based method successfully identified suspected cases of FWA (such as fraud diagnosis, excess prescription, and irrational prescription) from the claim documents, which helped to improve the efficiency of claim processing.

Intestinal stem cells are an important part of maintaining the stability of intestinal barrier function, which is closely related to intestinal homeostasis, intestinal epithelial renewal, and repair of intestinal damage. Normal physiological activities of the human body cannot be separated from energy intake and metabolism, and the differentiation fate of stem cells is affected by energy metabolism, and impaired intestinal barrier is associated with the development of many intestinal diseases. Therefore, this paper focuses on intestinal stem cells, takes energy metabolism and metabolites as the background to investigate how energy metabolism and metabolites regulate the function and activity of stem cells, thus regulating the function of intestinal barrier and providing ideas for the treatment of various intestinal diseases; in addition, with the in-depth research of modern medical science in protecting intestinal barrier, the theory of traditional Chinese medicine (TCM) that cares for spleen and stomach is gradually showing its scientific validity, with the hope of providing ideas for the subsequent research.

Intestinal stem cells are regulated by the intestinal nervous system, and both of them are closely related to intestinal inflammation. Relevant studies have shown the existence of intestinal nerve dysfunction in intestinal inflammation. By summarizing the relationship among intestinal stem cells, intestinal nervous system and intestinal inflammation, this paper discusses that intestinal nervous system injury related to intestinal inflammation may be the basis for persistent alteration of intestinal function, while enteric neurons provide feasible targets for improving intestinal nerve dysfunction in inflammatory bowel diseases, so as to apply various types of stem cells to the improvement of intestinal nerve dysfunction in intestinal inflammation.

Feature selection (FS) is a promising pre-processing step before performing most data engineering tasks. The goal of it is to select the optimal feature subset with promising quality from the original high-dimension feature space. The Salp Swarm Algorithm (SSA) has been widely used as the optimizer for FS problems. However, with the increase of dimensionality of original feature sets, the FS problems propose significant challenges for SSA. To solve these issues that SSA is easy to fall into local optimum and have poor convergence performance, we propose a multi-swarm SSA (MSSA) to solve the FS problem. In MSSA, the salp swarm was divided into three sub-swarms, the followers updated their positions according to the optimal leader of the corresponding sub-swarm. The design of multi-swarm and multi-exemplar were beneficial to maintain the swarm diversity. Moreover, the updating models of leaders and followers were modified. The salps learn from their personal historical best positions, which significantly improves the exploration ability of the swarm. In addition, an adaptive perturbation strategy (APS) was proposed to improve the exploitation ability of MSSA. When the swarm stagnates, APS will perform the opposition-based learning with the lens imaging principle and the simulated binary crossover strategy to search for promising solutions. We evaluated the performance of MSSA by comparing it with 14 representative swarm intelligence algorithms on 10 well-known UCI datasets. The experimental results showed that the MSSA can obtain higher convergence accuracy with a smaller feature subset.

High-voltage direct current (HVDC) transmission is a crucial way to solve the reverse distribution of clean energy and loads. The line commutated converter-based HVDC (LCC-HVDC) has become a vital structure for HVDC due to its high technological maturity and economic advantages. During the DC fault of LCC-HVDC, such as commutation failure, the reactive power regulation of the AC grid always lags the DC control process, causing overvoltage in the AC sending grid, which brings off-grid risk to the wind power generation based on power electronic devices. Nevertheless, considering that wind turbine generators have fast and flexible reactive power control capability, optimizing the reactive power control of wind turbines to participate in the transient overvoltage suppression of the sending grid not only improves the operational safety at the equipment level but also enhances the voltage stability of the system. This paper firstly analyses the impact of wind turbine's reactive power on AC transient overvoltage. Then, it proposes an improved voltage-reactive power control strategy, which contains a reactive power control delay compensation and a power command optimization based on the voltage time series prediction. The delay compensation is used to reduce the contribution of the untimely reactive power of wind turbines on transient overvoltage, and the power command optimization enables wind turbines to have the ability to regulate transient overvoltage, leading to the variation of AC voltage, thus suppressing the transient overvoltage. Finally, the effectiveness and feasibility of the proposed method are verified in a ±800kV/5000MW LCC-HVDC sending grid model based on MATLAB/Simulink.

Abstract Objective To compare the treatment effectiveness of digitized and 3D-printed repositioning splints with that of conventional repositioning splints in the treatment of anterior displacement of the temporomandibular joint disc. Methods This retrospective study included 96 patients with disc displacement of the anterior temporomandibular joint. They were treated with either digitally designed and 3D-printed repositioning splints or traditional splints and followed up for at least six months. Changes in signs and symptoms such as pain and mouth opening before and after treatment were recorded to evaluate treatment outcomes. Results During the first month of treatment, both the digitally designed and 3D-printed repositioning splint groups (Group B) and the traditional repositioning splint group (Group A) showed significant increases in mouth opening, with increases of 4.93 ± 3.06 mm and 4.07 ± 4.69 mm, respectively, and there was no significant difference between the two groups. Both groups had a significant reduction in visual analog scale (VAS) pain scores, with Group B showing a greater reduction of 1.946 ± 1.113 compared to 1.488 ± 0.978 in Group A (P

24-hour movement behaviors include physical activity, sedentary behavior and sleep. Domestic and foreign studies have found that the elderly generally have problems of low physical activity, sedentary behavior and insufficient sleep. Rational allocation of 24-hour movement behaviors has been demonstrated to be an important measure to improve adverse health outcomes in older adults, but the relevant research on 24-hour movement behaviors of the elderly is still in the exploratory stage. This paper reviews the concept, theoretical development and analytical methods of 24-hour movement behaviors and its relationship with adverse health outcomes in the elderly. In the future, relevant studies should be actively carried out to deeply explore and quantify the impact of 24-hour movement behaviors on health, develop a combination of 24-hour movement behaviors that can exert the maximum health benefits of the elderly, and develop accurate assessment tools, so as to promote active and healthy aging.

Abstract Novel antimicrobial strategies are urgently needed to treat extensively drug‐resistant (XDR) bacterial infections due to the high mortality rate and lack of effective therapeutic agents. Herein, nanoengineered human umbilical cord mesenchymal stem cells (hUC‐MSCs), named PMZMU, are designed as a sonosensitizer for synergistic sonodynamic‐nano‐antimicrobial therapy against gram‐negative XDR bacteria. PMZMU is composed of a bacterial targeting peptide (UBI29‐41) modified hUC‐MSCs membrane (MSCm), a sonosensitizer meso‐tetra(4‐car‐boxyphenyl) porphine doped mesoporous organo‐silica nanoparticle and an acidity‐responsive metal–organic framework ZIF‐8. This innovative formulation enables efficient loading of polymyxin B, reduces off‐target drug release, increases circulation and targeting efficacy, and generates reactive oxygen species upon ultrasound irradiation. PMZMU exhibits remarkable in vitro inhibitory activity against four XDR bacteria: Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa (PA), and Escherichia coli. Taking advantage of the bacterial targeting ability of UBI29‐41 and the inflammatory chemotaxis of hUC‐MSC, PMZMU can be precisely delivered to lung infection sites thereby augmenting polymyxin B concentration. PMZMU‐mediated sonodynamic therapy significantly reduces bacterial burden, relieves inflammatory damage by promoting the polarization of macrophages toward M2 phenotype, and improves survival rates without introducing adverse events. Overall, this study offers promising strategies for treating deep‐tissue XDR bacterial infections, and guides the design and optimization of biomimetic nanomedicine.

Today’s increasing demand for aquaculture production is accompanied by various challenges such as diseases, broodstock improvement, domestication, development of suitable pellets and feeding methods, hatchery technology, and water quality management. Thus, probiotic usage has been reported as the ideal alternative to antibiotics, other chemotherapeutics, and additional supplements to other alternative ingredients. The main beneficial roles of probiotics include the enhancement of disease and stress resistance, immunity, promotion of growth and reproduction, improvement of digestion, provide several nutrients, and enhancement of water microbial composition. To guarantee safety, the probiotics provided must be non-invasive and non-pathogenic. The use of probiotics in aquaculture, either directly or in combination with alternative materials such as plant protein diets, vitamins, microalgae, fermented products, and so on, has been shown to improve the health and growth of aquatic animals and offer significant benefits to the sustainability of the industry. There is advocacy for a systematic approach to conducting innovative research to unearth new putative strains, which is substantial in ensuring sustainable probiotic usage and, thus, can help in the continuous development of the aquaculture industry especially in China. Some examples of the probiotics found in China are mainly photosynthetic bacteria (PSB) which are autotroph bacteria capable of photosynthesis, antagonistic bacteria (Pseudoalteromonas sp., Flavobacterium sp., Alteromonas sp., Phaeobacter sp., Bacillus sp., etc.), bacteria that contribute nutrients and enzymes during digestion (lactic acid bacteria, yeasts, etc.), bacteria that improve water quality (nitrifying bacteria, denitrifying bacteria, etc.), Bdellovibrio, and other probiotics. This review also focuses on the potential use of probiotics in aquaculture, especially in China, and probiotics’ prospective future role.

Smaller Kapitza resistance is known to be the most crucial factor responsible for the larger thermal conductivity of nanofluids. But what the underlying mechanism is remains ambiguous. Non-equilibrium molecular dynamics simulations were performed in the present work to examine the effect of ionic addition on the Kapitza resistance of Cu-water nanofluids. The temperature profile indicates that the concentration and type of the additive slightly affects the thickness of the interfacial layer, but the temperature drops significantly. For concentrations of 1 M, the interfacial thermal conductance (ITC, the reciprocal of the Kapitza resistance) of Cu-water with NaCl, NaOH and HCl increases by 48.1 %, 29.2 % and 22.6 % respectively, compared to that without additives. The greatest ITC improvement of 123.7 % can be achieved by adding 3 M NaCl. The density profiles of Cu-water nanofluids with various additives suggest that the changes in the interfacial structure are primarily due to the positions of the added cations and anions. It is important to note, however, that the ITC is closely related to the orderliness of the interfacial layer and the matching of the phonon density of states, since the addition of NaCl can increase the PDOS at lower frequencies 1–5 THz, where that for the Cu nanoparticle appears. The findings provide a practical approach to tailor the thermal conductivity of nanofluids by the addition of appropriate ions.

Thawing is an important unit operation in the processing of frozen meat. Some of the major concerns for its application are thawing duration, temperature uniformity, juice loss, cooking loss, freshness, texture characteristics and taste changes. Good thawing quality for frozen meat can be obtained by choosing appropriate thawing technologies and processing parameters. The traditional thawing technologies include air thawing and water immersion thawing, while several novel physical field thawing methods have been developed include microwave thawing, radio-frequency thawing, infrared thawing and ohmic thawing. The microwave and radio-frequency methods, which both utilize high-frequency electromagnetic wave as excitation source, have seen increasing application in the field of frozen meat processing because of short operating time and high efficiency. This article reviews dielectric thawing technology, summarizes its key influential factors, discusses the changes in meat quality during the dielectric thawing process, and puts forward some thoughts regarding the common problems and future research directions in dielectric thawing.

Several anti‑Aβ monoclonal antibody drugs have been approved for clinical use at home and abroad recently. In order to facilitate its safe and effective treatment of anti‑Aβ monoclonal antibody drugs for Alzheimer's disease (AD) in China, we present recommendations for the clinical use of anti‑Aβ monoclonal antibody drugs based on existing clinical trials and the clinical practice of AD treatment with Aducanumab at Ruijin Hospital Hainan Branch, Shanghai Jiaotong University School of Medicine. The recommendations include clinical indications, pre ‑ medication assessment and preparation, medication instructions and precautions, as well as post ‑ medication clinical monitoring, which is aimed to furnish clinicians with comprehensive medication guidance.

Abstract There is strong evidence that obesity is a risk factor for poor semen quality. However, the effects of multigenerational paternal obesity on the susceptibility to cadmium (a reproductive toxicant)-induced spermatogenesis disorders in offspring remain unknown. Here, we show that, in mice, spermatogenesis and retinoic acid levels become progressively lower as the number of generations exposed to a high-fat diet increase. Furthermore, exposing several generations of mice to a high fat diet results in a decrease in the expression of Wt1, a transcription factor upstream of the enzymes that synthesize retinoic acid. These effects can be rescued by injecting adeno-associated virus 9-Wt1 into the mouse testes of the offspring. Additionally, multigenerational paternal high-fat diet progressively increases METTL3 and Wt1 N6-methyladenosine levels in the testes of offspring mice. Mechanistically, treating the fathers with STM2457, a METTL3 inhibitor, restores obesity-reduced sperm count, and decreases Wt1 N6-methyladenosine level in the mouse testes of the offspring. A case-controlled study shows that human donors who are overweight or obese exhibit elevated N6-methyladenosine levels in sperm and decreased sperm concentration. Collectively, these results indicate that multigenerational paternal obesity enhances the susceptibility of the offspring to spermatogenesis disorders by increasing METTL3-mediated Wt1 N6-methyladenosine modification.

IntroductionAlmonertinib is an important third-generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) exhibiting high selectivity to EGFR-sensitizing and T790M-resistant mutations. Almonertinib resistance is a major obstacle in clinical use. Baicalein possesses antitumor properties, but its mechanism of antitumor action against almonertinib-resistant non-small cell lung cancer (NSCLC) remains unelucidated.MethodsCCK-8 assay was used to examine the survival rate of H1975/AR and HCC827/AR cells following treatment for 24 h with different concentrations of baicalein, almonertinib or their combination. The changes in colony formation ability, apoptosis, and intracellular reactive oxygen species (ROS) levels of the treated cells were analyzed using colony formation assay and flow cytometry. Western blotting was performed to detect the changes in protein expressions in the cells. The effects of pre-treatment with NAC on proliferation, apoptosis, and PI3K/Akt signaling pathway were observed in baicalein- and/or almonertinib-treated cells. A nude mouse model bearing subcutaneous HCC827/AR cell xenograft were treated with baicalein (20 mg/kg) or almonertinib (15 mg/kg), and the tumor volume and body mass changes was measured.ResultsBoth baicalein and almonertinib represses the viability of HCC827/AR and H1975/AR cells in a concentration-dependent manner. Compared with baicalein or almonertinib alone, the combined application of the two drugs dramatically attenuates cell proliferation; triggers apoptosis; causes cleavage of Caspase-3, PARP, and Caspase-9; downregulates the protein expressions of p-PI3K and p-Akt; and significantly inhibits tumor growth in nude mice. Furthermore, baicalein combined with almonertinib results in massive accumulation of reactive oxygen species (ROS) and preincubation with N-acetyl-L-cysteine (ROS remover) prevents proliferation as well as inhibits apoptosis induction, with partial recovery of the decline of p-PI3K and p-Akt.DiscussionThe combination of baicalein and almonertinib can improve the antitumor activity in almonertinib-resistant NSCLC through the ROS-mediated PI3K/Akt pathway.