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Abstract Background With the adjustment of China’s birth policy, the repeat cesarean sections raises concerns about potential gastrointestinal mechanical injuries and disturbances in gastrointestinal neurohormonal regulation, affecting the postoperative recovery of gastrointestinal function. These affect maternal nutritional status, prolong recovery, extend hospitalization, increase medical costs, and lead to neonatal care challenges.This study is to examine the effects of different postoperative feeding protocols on the restoration of gastrointestinal function in women undergoing repeat cesarean section. Methods A total of 103 women were randomly assigned to three groups: experimental group A (n = 35), experimental group B (n = 34), and a control group (n = 34). In group A, women without choking symptoms received a clear fluid diet postoperatively, followed by a pureed diet after 6 h, and a regular soft diet after passing flatus. In group B, women chewed gum postoperatively, followed by a clear fluid diet after 2 h, a pureed diet after 6 h, and a regular soft diet after passing flatus. The control group received a clear fluid diet, a pureed diet after passing flatus, and a regular soft diet after defecation. Outcomes measured included recovery of gastrointestinal function, blood biochemical markers, comfort level, exclusive breastfeeding rate, and newborn weight loss. Results The baseline maternal data across the three groups demonstrated no significant differences (P > 0.05). Both experimental groups A and B showed earlier recovery of postoperative gastrointestinal function compared to the control group, though there was no significant difference between the two experimental groups (P > 0.05). Additionally, postoperative comfort levels were significantly higher in both experimental groups than in the control group (P

The die-casting process of ADC12 aluminum alloy right crankcase cover was simulated based on AnyCasting software, and the influence of pouring temperature, initial mold temperature and injection speed on the filling and solidification process of ADC12 right crankcase cover casting was explored by orthogonal experiment method. The optimal process parameters were obtained through optimization, and the die-casting mold was designed. The program was verified in production. The results show that the porosity and shrinkage of the right crankcase cover are mainly concentrated in the thick wall part. The sequence of process parameters that affect the residual melt modulus is pouring temperature, initial mold temperature, and injection speed; The best combination of process parameters: pouring temperature is ∼680 °C, initial mold temperature is ∼200 °C, injection speed is ∼5 m/s. By analyzing the filling process and temperature field simulation results, the casting structure, mold structure and cooling system were optimized, and the process plan was improved. The production verification was carried out according to the optimized process plan. The casting quality is good and has no obvious defects, which meets the actual production needs.

Investigating the behavior of noninteracting fermions subjected to local dephasing, we reveal that quasi-particle dephasing can induce superdiffusive transport. This superdiffusion arises from nodal points within the momentum distribution of local dephasing quasi-particles, leading to asymptotic long-lived modes. By studying the dynamics of the Wigner function, we rigorously elucidate how the dynamics of these enduring modes give rise to Lévy walk processes, a renowned mechanism underlying superdiffusion phenomena. Our research demonstrates the controllability of dynamical scaling exponents by selecting quasi-particles and extends its applicability to higher dimensions, underlining the pervasive nature of superdiffusion in dephasing models.

Objective To evaluate the methodological quality of clinical practice guidelines and expert consensus for cervical and lumbar chronic muscle and bone injury.Methods China National Knowledge Network, VIP, Wanfang, China Biomedical Literature Database, PubMed, International Guidelines Network, National Institute for Health and Clinical Excellence, International Guidelines Center Network were searched to collect clinical practice guidelines and expert consensus related to cervical and lumbar chronic muscle and bone diseases. The search period is from the establishment of the databases to July 31, 2022. The guidelines were independently screened by two researchers according to in-clusion and exclusion criteria and relevant information was extracted. The AGREE II evaluation tool was used by four reseachers to evaluate the guidelines' quality, and the intra-group correlation coefficient (ICC) was used to evaluate their consistency.Results A total of 23 clinical practice guidelines and expert consensus were included in this study, of which 21 were clinical practice guidelines and 2 were expert consensus. The median and interquartile spacing of score rates for the six fields of AGREE II were: range and purpose 84.72% (69.44%, 88.89%), participants 59.72% (38.89%, 75.00%), rigor 71.88%(45.83%, 81.77%), clarity 81.94% (73.61%, 87.50%), application 56.25% (30.21%, 65.63%), in-dependence 79.17% (30.25%, 85.42%). The overall evaluation consistency ICC was 0.769.Conclusions The existing evidence shows that the overall quality of domestic clinical guidelines related to cervical and lumbar chronic muscle and bone injury is relatively general compared with that of foreign countries, so it is necessary to further improve the construction of clinical problems, evidence retrieval and synthesis, as well as the value and willingness of patients and interest statement, and it is suggested to construct clinical guidelines for bone injury diseases based on the evidence of traditional Chinese medicine.

BackgroundImmune checkpoint inhibitor (ICI)-based combination therapy has opened a new avenue for the treatment of multiple malignancies including hepatocellular carcinoma (HCC). However, considering the unsatisfactory efficacy, biomarkers are urgently needed to identify the patients most likely to benefit from ICI-based combination therapy.MethodsA total of 194 patients undergoing ICI-based combination therapy for unresectable HCC were retrospectively enrolled and divided into a training cohort (n = 129) and a validation cohort (n = 65) randomly. A novel circulating immune index (CII) defined as the ratio of white blood cell count (×109/L) to lymphocyte proportion (%) was constructed and its prognostic value was determined and validated.ResultsPatients with CII ≤ 43.1 reported prolonged overall survival (OS) compared to those with CII > 43.1 (median OS: 24.7 vs 15.1 months; 6-, 12-, 18-month OS: 94.2%, 76.7%, 66.1% vs 86.4%, 68.2%, 22.8%, P = 0.019), and CII was identified as an independent prognostic factor for OS (hazard ratio, 2.24; 95% confidence interval, 1.17-4.31; P = 0.015). These results were subsequently verified in the validation cohort. Additionally, patients with low CII levels had improved best radiological tumor response (complete response, partial response, stable disease, progressive disease: 3%, 36%, 50%, 11% vs 0%, 27%, 46%, 27%; P = 0.037) and disease control rate (89% vs 73%; P = 0.031) in the pooled cohort and better pathologic response (pathologic complete response, major pathologic response, partial pathologic response, no pathologic response: 20%, 44%, 28%, 8% vs 0%, 0%, 40%, 60%; P = 0.005) in the neoadjuvant cohort. Detection of lymphocyte subsets revealed that an elevated proportion of CD4+ T cells was related to better OS, while the proportion of CD8+ T cells was not.ConclusionsWe constructed a novel circulating immune biomarker that was capable of predicting OS and therapeutic efficacy for HCC patients undergoing ICI and lenvatinib combination therapy.

BackgroundLenvatinib monotherapy and combination therapy with immune checkpoint inhibitors (ICI) were widely applied for unresectable hepatocellular carcinoma (uHCC). However, many patients failed to benefit from the treatments. A prognostic model was needed to predict the treatment outcomes and guide clinical decisions.Methods304 patients receiving lenvatinib monotherapy or lenvatinib plus ICI for uHCC were retrospectively included. The risk factors derived from the multivariate analysis were used to construct the predictive model. The C-index and area under the receiver-operating characteristic curve (AUC) were calculated to assess the predictive efficiency.ResultsMultivariate analysis revealed that protein induced by vitamin K absence or antagonist-II (PIVKA-II) (HR, 2.05; P=0.001) and metastasis (HR, 2.07; P600 mAU/mL) and PIMET-high group (with metastasis and PIVKA-II>600 mAU/mL). The C-index of PIMET score for the survival prediction was 0.63 and 0.67 in the training and validation cohort, respectively. In the training cohort, the AUC of 12-, 18-, and 24-month OS was 0.661, 0.682, and 0.744, respectively. The prognostic performances of the model were subsequently validated. The AUC of 12-, 18-, and 24-month OS was 0.724, 0.726, and 0.762 in the validation cohort. Subgroup analyses showed consistent predictive value for patients receiving lenvatinib monotherapy and patients receiving lenvatinib plus ICI. The PIMET score could also distinguish patients with different treatment responses. Notably, the combination of lenvatinib and ICI conferred survival benefits to patients with PIMET-int or PIMET-high, instead of patients with PIMET-low.ConclusionThe PIMET score comprising metastasis and PIVKA-II could serve as a helpful prognostic model for uHCC receiving lenvatinib monotherapy or lenvatinib plus ICI. The PIMET score could guide the treatment decision and facilitate precision medicine for uHCC patients.

BackgroundTumor recurrence after hepatectomy is high for hepatocellular carcinoma (HCC), and minimal residual disease (MRD) could be the underlying mechanism. A predictive model for recurrence and presence of MRD is needed.MethodsCommon inflammation-immune factors were reviewed and selected to construct novel models. The model consisting of preoperative aspartate aminotransferase, C-reactive protein, and lymphocyte count, named ACLR, was selected and evaluated for clinical significance.ResultsAmong the nine novel inflammation-immune models, ACLR showed the highest accuracy for overall survival (OS) and time to recurrence (TTR). At the optimal cutoff value of 80, patients with high ACLR (> 80) had larger tumor size, higher Edmondson’s grade, more vascular invasion, advanced tumor stage, and poorer survival than those with low ACLR (≤ 80) in the training cohort (5-year OS: 43.3% vs. 80.1%, P < 0.0001; 5-year TTR: 74.9% vs. 45.3%, P < 0.0001). Multivariate Cox analysis identified ACLR as an independent risk factor for OS [hazard ratio (HR) = 2.22, P < 0.001] and TTR (HR = 2.36, P < 0.001). Such clinical significance and prognostic value were verified in validation cohort. ACLR outperformed extant models, showing the highest area under receiver operating characteristics curve for 1-, 3-, and 5-year OS (0.737, 0.719, and 0.708) and 1-, 3-, and 5-year TTR (0.696, 0.650, and 0.629). High ACLR correlated with early recurrence (P < 0.001) and extremely early recurrence (P < 0.001). In patients with high ACLR, wide resection margin might confer survival benefit by decreasing recurrence (median TTR, 25.5 vs. 11.4 months; P = 0.037).ConclusionsThe novel inflammation-immune model, ACLR, could effectively predict prognosis, and the presence of MRD before hepatectomy and might guide the decision on resection margin for patients with HCC.

In this paper, the triggering process for single-event burnout (SEB) in conventional 4H-SiC trench insulated gate bipolar transistors (C-TIGBTs) is described. Furthermore, SEB is studied for both a conventional structure and a new structure. The new structure has a Schottky contact at the collector side (S-TIGBT) and is investigated using a 2D numerical-simulation. The simulation results indicate that the Schottky-junction improves the SEB threshold voltage from 4000 V, in the C-TIGBT, to 4600 V, in the S-TIGBT, while the SEB-induced breakdown voltage for 75 MeV/(mg⋅cm−2) is improved by about 15.0%.

Xanthine dehydrogenase (XDH) is a crucial enzyme involved in purine metabolism. To evaluate the effect of XDH deficiency on rice growth during dark treatment, wild type (WT) Nipponbare (Oryza sativa L.) and two independent transgenic lines with severe RNAi suppression (xdh3 and xdh4) were used in the present experiment. Under normal growth conditions, chlorophyll levels and biomass were indistinguishable between WT and the two RNAi transgenic lines, but XDH enzyme activity and ureide levels were suppressed in XDH RNAi transgenic lines. When XDH RNAi transgenic lines were subjected to dark treatment, chlorophyll content and biomass were significantly decreased, while O2–· production rate and malonaldehyde (MDA) were significantly increased compared to WT. The spraying test of exogenous allantoin raised chlorophyll content and biomass and reduced O2–· production rate and MDA in WT and both transgenic lines, and it also simultaneously reduced differences between RNAi and WT plants caused by XDH deficiency in growth potential and anti-oxidative capacity under dark treatment. These results suggested that fully functional purine metabolism plays an important role in reducing the sensitivity of rice seedlings to dark stress.

Abstracts: Dwarf mutants are the crucial resources for molecular biology research and rice breeding. Here, a rice mutant, dwarf and deformed flower3 (ddf3), was identified in tissue culture of Oryza sativa cv. Dongjin. Compared with wild type, the ddf3 mutant exhibited severe dwarfism, a greater number of tillers and significantly decreased fertility. In addition, leaf length, panicle length, and grain length, were significantly shorter. All internodes of ddf3 were shorter than those of wild type, and histological analysis revealed that internode cell elongation was significantly inhibited in ddf3. In the ddf3 mutant, pollen activity was significantly decreased, and the development of most stigmas was abnormal. Genetic analysis indicated that the ddf3 mutant phenotypes are controlled by a single or tightly linked nuclear genes. Using an F2 mapping population generated from a cross between ddf3 and Yangdao 6 (9311), the DDF3 gene was mapped to a 45.21-kb region between insertion-deletion (InDel) markers M15 and M16 on the long arm of chromosome 7. Sequencing revealed a 13.98-kb-deletion in this region in the ddf3 mutant genome that resulted in the complete or partial deletion of ZF (DHHC type zinc finger protein), EP (expressed protein), and FH2 (actin-binding FH2 domain-containing protein) genes. Quantitative RT-PCR analyses revealed that in wild type, the transcript levels of FH2 were almost the same in all organs, while ZF was mainly expressed in the panicle, and no expression of EP was detected in any organ. Based on these results, ZF and FH2 could be potential DDF3 candidate genes involved in the regulation of rice morphology and flower organ development. Our work has laid the foundation for future functional analysis of these candidate genes and has provided a profitable gene resource for rice breeding for increased fertility in the future.

The asymmetric unit of the title compound, C14H9ClN2O, contains two molecules with dihedral angles of 33.52 (11) and 34.58 (11)° between their benzene rings and imidazole ring systems. In the crystal, C—H...N and C—H...O interactions are observed. The crystal examined was found to be a racemic twin.