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OBJECTIVE: We aimed to evaluate the effectiveness of different triage strategies for high-risk human papillomavirus (hrHPV)-positive women in primary healthcare settings in China. METHODS: This study was undertaken in 11 rural and 9 urban sites. Women aged 35−64 years old were enrolled. HrHPV-positive women were randomly allocated to liquid-based cytology (LBC), visual inspection with acetic acid and Lugol’s iodine (VIA/VILI) (rural only) triage, or directly referred to colposcopy (direct COLP). At 24 months, hrHPV testing, LBC and VIA/VILI were conducted for combined screening. RESULTS: In rural sites, 1,949 hrHPV-positive women were analyzed. A total of 852, 218 and 480 women were randomly assigned to direct COLP, LBC and VIA/VILI. At baseline, colposcopy referral rates of LBC or VIA/VILI triage could be reduced by 70%−80%. LBC (n=3 and n=7) or VIA/VILI (n=8 and n=26) could significantly decrease the number of colposcopies needed to detect one cervical intraepithelial neoplasia (CIN) 2 or worse and CIN3+ compared with direct COLP (n=14 and n=23). For the 24-month cumulative detection rate of CIN2+, VIA/VILI triage was 0.50-fold compared with LBC triage and 0.46-fold with the direct COLP. When stratified by age, baseline LBC triage+ performed best (P

This study compared the severity of osteoporosis and screened differentially expressed proteins in postmenopausal osteoporotic rats with varying levels of serum follicle stimulating hormone (FSH).Thirty-six Sprague Dawley female rats were divided into four groups: sham operation (sham) group, ovariectomy (OVX) group, FSH and ovariectomy (OVX + FSH) group, and Leuprorelin (LE) and ovariectomy group (OVX + LE). Body weight, serum estradiol, FSH, tartrate-resistant acid phosphatase, alkaline phosphatase, and bone mineral density were measured. We randomly selected six rats each from the OVX and OVX + FSH groups to detect differentially expressed proteins by data-independent acquisition, and we verified the results in the remaining six rats by enzyme-linked immunosorbent assay (ELISA).Nineteen proteins were upregulated and 36 proteins were downregulated in the OVX + FSH group. The expression of heat shock protein 90 alpha (Hsp90α) and 14-3-3η protein was significantly different between the OVX and OVX + FSH groups, and both were linearly correlated with bone trabecular area. Results were verified by ELISA and were found to be consistent with the results of data-independent acquisition.In rats with high serum FSH, expression of Hsp90α protein was increased and expression of 14-3-3η protein was decreased. Both changes in protein expression were strongly correlated with bone trabecular area.

Background Birthweight is an important indicator during the fetal development process to protect the maternal and infant safety. However, birthweight is difficult to be directly measured, and is usually roughly estimated by the empirical formulas according to the experience of the doctors in clinical practice. Methods This study attempts to combine multiple electronic medical records with the B-ultrasonic examination of pregnant women to construct a hybrid birth weight predicting classifier based on long short-term memory (LSTM) networks. The clinical data were collected from 5,759 Chinese pregnant women who have given birth, with more than 57,000 obstetric electronic medical records. We evaluated the prediction by the mean relative error (MRE) and the accuracy rate of different machine learning classifiers at different predicting periods for first delivery and multiple deliveries. Additionally, we evaluated the classification accuracies of different classifiers respectively for the Small-for-Gestational-age (SGA), Large-for-Gestational-Age (LGA) and Appropriate-for-Gestational-Age (AGA) groups. Results The results show that the accuracy rate of the prediction model using Convolutional Neuron Networks (CNN), Random Forest (RF), Linear-Regression, Support Vector Regression (SVR), Back Propagation Neural Network(BPNN), and the proposed hybrid-LSTM at the 40th pregnancy week for first delivery were 0.498, 0.662, 0.670, 0.680, 0.705 and 0.793, respectively. Among the groups of less than 39th pregnancy week, the 39th pregnancy week and more than 40th week, the hybrid-LSTM model obtained the best accuracy and almost the least MRE compared with those of machine learning models. Not surprisingly, all the machine learning models performed better than the empirical formula. In the SGA, LGA and AGA group experiments, the average accuracy by the empirical formula, logistic regression (LR), BPNN, CNN, RF and Hybrid-LSTM were 0.780, 0.855, 0.890, 0.906, 0.916 and 0.933, respectively. Conclusions The results of this study are helpful for the birthweight prediction and development of guidelines for clinical delivery treatments. It is also useful for the implementation of a decision support system using the temporal machine learning prediction model, as it can assist the clinicians to make correct decisions during the obstetric examinations and remind pregnant women to manage their weight.

In this paper we provide the greatest lower bound about the number of (non-infinitesimal) limit cycles surrounding a unique singular point for a planar polynomial differential system of arbitrary degree.

Key Points Question Does integration of high-risk human papillomavirus (hrHPV) testing into China’s national screening program lead to better outcomes than current primary screening approaches? Findings In this randomized clinical trial that included 60 732 women, hrHPV testing as primary screening provided a 2.0-fold to 2.7-fold yield for cervical intraepithelial neoplasia grade 2 or worse and grade 3 or worse compared with cytology or visual inspection with acetic acid and Lugol iodine at baseline. It also resulted in a significantly lower risk of cervical intraepithelial neoplasia grade 2 or worse and grade 3 or worse for baseline-negative women under routine conditions in primary health care settings in rural areas across China. Meaning It is reasonable to incorporate hrHPV testing (polymerase chain reaction–based testing for urban areas, hybrid capture–based testing for rural areas) as a primary screening method into China’s current national screening program., This randomized clinical trial compares the results of high-risk human papillomavirus testing vs current primary screening approaches, assessing screening performance, cost-effectiveness, and service system capacity within China’s national cervical cancer screening program., Importance Evidence is needed regarding the introduction of high-risk human papillomavirus (hrHPV) testing into China’s national cervical cancer screening program. Objective To evaluate hrHPV testing as a new screening modality for the national program. Design, Setting, and Participants This population-based, multicenter, open-label, randomized clinical trial took place across 20 primary health care centers in urban and rural areas across China. At least 3000 women aged 35 to 64 years per site were invited to participate, for a total of 60 732 women evaluated. Interventions At baseline, women were randomly assigned to cytology, hrHPV testing, or visual inspection with acetic acid and Lugol iodine (VIA/VILI) (rural only). Women who tested positive for hrHPV were randomized into cytology-triage, VIA/VILI-triage (rural only), or direct colposcopy arms. Regarding primary or triaging tests, women with cytological abnormalities or who tested positive with VIA/VILI were referred to colposcopy. After 24 months, combined screening of cytology, hrHPV testing, and VIA/VILI was performed, and all women with positive results were referred to colposcopy. Main Outcomes and Measures The primary outcomes were cervical intraepithelial neoplasia grade 2 or worse (CIN2+) and CIN3+ yields. The secondary outcome was colposcopy referral rate. Results A total of 60 732 women were included in this study, with median (interquartile range) age of 47 (41-52) years. Among urban women, 8955 were randomized to cytology and 18 176 to hrHPV genotyping; among rural women, 11 136 were randomized to VIA/VILI, 7080 to cytology, and 15 385 to hrHPV testing. Participants who tested positive for hrHPV with direct colposcopy had higher risk ratios for disease yields at baseline (urban hrHPV vs cytology, CIN2+ 2.2 [95% CI, 1.6-3.2] and CIN3+ 2.0 [95% CI, 1.2-3.3]; rural hrHPV vs cytology, 2.6 [95% CI, 1.9-4.0] and 2.7 [95% CI, 2.0-3.6]; rural hrHPV vs VIA/VILI, 2.0 [95% CI, 1.6-2.3] and 2.3 [95% CI, 1.8-3.1]). At 24 months, baseline-negative women in the hrHPV arm had significantly lower risk ratios than those with cytology, or VIA/VILI for CIN2+ (0.3 [95% CI, 0.2-0.5], 0.3 [95% CI, 0.2-0.6]) and CIN3+ (0.3 [95% CI, 0.1-0.6], 0.4 [95% CI, 0.2-0.8]) in rural sites. The colposcopy referral rate for hrHPV-positive rural women was reduced to 2.8% by cytology triage, with significantly higher CIN2+ yields than cytology (2.1 [95% CI, 1.3-2.6]) or VIA/VILI arm (1.6 [95% CI, 1.03-2.1]). Genotyping for hrHPV with cytology triage significantly reduced the colposcopy referral rate compared with cytology (0.8 [95% CI, 0.7-0.9]) for urban women. Conclusions and Relevance In this randomized clinical trial, testing for hrHPV was an effective primary screening method in primary health care centers. Incorporating hrHPV testing (polymerase chain reaction–based for urban areas, hybrid capture-based for rural areas) into China’s national screening program is reasonable. Trial Registration Chinese Clinical Trial Registry Identifier: ChiCTR1900022530

This study aimed to investigate the correlation between homocysteine (HCY), C-reactive protein (CRP), lipid levels, and sleep quality in perimenopausal and postmenopausal women. We collected data from 217 patients (perimenopause and postmenopausal) who visited the gynecological endocrine outpatient department of our hospital between January 2017 and January 2019. The quality and patterns of sleep were measured using the Pittsburgh Sleep Quality Index, and relationships between HCY, CRP, lipid levels, and sleep quality were analyzed according to a Pittsburgh Sleep Quality Index ≥ 8. There were significant differences in age, education level, and occupation among patients with different levels of sleep quality (P

Objective: Several published articles have investigated the association between the −174 G/C (rs1800795) polymorphism in the interleukin-6 (IL-6) gene and the risk of polycystic ovary syndrome (PCOS). However, the results were inconsistent. In the present study, a meta-analysis was performed to resolve this inconsistency. Methods: Eligible studies reporting an association between the IL-6 rs1800795 polymorphism and PCOS susceptibility were included from PubMed, Embase, Web of Science, and the Cochrane Library up to December 1, 2017. The odds ratio (OR) with the 95% confidence interval (CI) was used to calculate the strength of the associations. Publication bias detection was conducted using Begg test. We used STATA 11.0 software to perform the statistical analyses. Results: Six articles detailing case-control studies were included, reporting a total of 512 cases and 606 controls. The meta-analysis results indicated that rs1800795 was associated with decreased PCOS susceptibility in the overall population under the allelic model (G vs. C, OR = 0.59, 95% CI: 0.41–0.85, P = .005), the homozygous model (GG vs. CC, OR = 0.45, 95% CI: 0.28–0.73, P = .001), heterozygous model (GG vs. CG, OR = 0.50, 95% CI: 0.26–0.95, P = .036), and the dominant model (GC + CC vs. GG, OR = 0.48, 95% CI: 0.26–0.89, P = .020). However, a threshold P value of .05 was found under the recessive model (CC vs. GG + CG, OR = 0.62, 95% CI: 0.39–1.00). Conclusions: This meta-analysis concluded that IL-6 rs1800795 polymorphism has a decreased association with PCOS risk among all populations studied. The results suggested that the IL-6 rs1800795 polymorphism is a protective factor for PCOS susceptibility. Given the limited ethnic groups and sample size, further studies are required to validate the association.

Porosity is a common defect of the aluminum alloy pulsed alternating current (AC) argon tungsten-arc welding (TIG) welding, which can cause huge damage to weld quality. The spectral information which is directly derived from the optical radiation of the arc is intrinsically related to the welding defects. Aiming at the redundancy of arc spectral, this paper proposed a method of porosity defect detection based on fast independent component analysis (fastICA) and radial basis function (RBF) network. The spectral data is collected by spectrometer, and continuous spectra are removed by calculating lower envelope twice. Then fastICA is applied to extract features from selected line spectra. Finally, the porosity defect is detected by RBF network according to the mean value in period of extracted features. Experimental results show that the proposed method can be used to detect the porosity defects during aluminum alloy pulsed TIG welding process.

Our previous demonstrated that macrophage colony‑stimulating factor (M‑CSF) stimulated the production of estradiol (E2) and progesterone (P) in luteinized granulosa cells (GCs), and that its secretion may be regulated by follicle‑stimulating hormone (FSH). The present study aimed to examine the effect of M‑CSF alone or with Letrozole treatment on the function of non‑luteinizing granulosa cells, using the COV434 cell line, and its interaction with FSH. Human luteinized granulosa cells (LGC) were isolated from the follicular fluid of superovulated infertile patients (average age, 30.8±2.1 years) undergoing an intracytoplasmic sperm injection. The LGC were cultured with various concentrations of recombinant human macrophage colony stimulating factor (rhM‑CSF; 0, 10, 25, 50 or 100 ng/ml), rhM‑CSF+Letrozole (10‑6 mol/l), rhFSH (0, 10, 25, 50 or 100 IU/ml), or rhFSH+Letrozole (10‑6 mol/l). E2 concentrations in the media were measured using ELISA. The expression levels of the FSH receptor and the M‑CSF receptor were detected via reverse transcription‑quantitative polymerase chain reaction. Following COV434 cell treatment with M‑CSF, cell proliferation was quantified using the MTS assay and protein expression was detected by western blotting. It was demonstrated that M‑CSF and FSH stimulated the production of E2. The production of FSH receptors was enhanced by rhM‑CSF or rhM‑CSF+Letrozole in vitro in a dose‑dependent manner. It was observed that rhFSH promoted the expression of the M‑CSF receptor, at a certain concentration. Proliferation of COV434 cells increased in a dose‑dependent manner following treatment with RhM‑CSF. Furthermore, M‑CSF induced the phosphorylation of c‑Jun N‑terminal kinase (JNK) and p38; however, the level of E2 in the medium was not altered when the cells were pretreated with the JNK inhibitor SP600125 or the p38 inhibitor SB203580. The present study suggested that M‑CSF may be important in regulating the response of GCs to gonadotropin and may have a promotive effect in the early phase of follicular development. The biological effects of M‑CSF may partially be attributed to activation of the JNK and p38 signaling pathways. M‑CSF may represent a novel follicular development regulator agent in the future.

To aim at the characteristic of launch vehicle flight safety control, according to the dynamic characteristic and statistical characteristic of the data respectively from the telemetry and Exterior, this paper proposes a layered multi-stage dynamic combination Kalman filtering fusion method based on the trajectory examination and the sequential fusion, solves the problem that the reliability of fusion data is reduced because of the fused sensorpsilas blunder error or losing target and gains the accurate parameter and trajectory of launch vehicle flight. It builds the description model of launch vehicle flying status under the constraint of safety flight, uses the backward reasoning and matches the fact satisfying the condition recursively in real-time, providing the actual information of launch vehicle flight to safety control supervisors. The practical application indicated that the method proposed by this paper is feasible.

(1986). Proof of the uniqueness theorem of limit cycles of generalized lienard equations. Applicable Analysis: Vol. 23, No. 1-2, pp. 63-76.

The non linear differential equation is considered. We investigate the number of nontrivial periodic solutions of this equation depending on k ≥ 0 for µ < 0 fixed. The results obtained can be used in a problem of time optimal control for the Van der Pol equation in order to describe the process of control.