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Abstract Background The low live birth rate and difficult decision-making of the in vitro fertilization (IVF) treatment regimen bring great trouble to patients and clinicians. Based on the retrospective clinical data of patients undergoing the IVF cycle, this study aims to establish classification models for predicting live birth outcome (LBO) with machine learning methods. Methods The historical data of a total of 1405 patients undergoing IVF cycle were first collected and then analyzed by univariate and multivariate analysis. The statistically significant factors were identified and taken as input to build the artificial neural network (ANN) model and supporting vector machine (SVM) model for predicting the LBO. By comparing the model performance, the one with better results was selected as the final prediction model and applied in real clinical applications. Results Univariate and multivariate analysis shows that 7 factors were closely related to the LBO (with P

ABSTRACT Background Contiguous gene deletion in the short arm of chromosome 4 is linked to various neurodevelopmental disorders. Methods In this study, we conducted peripheral blood chromosome G‐banding karyotyping and whole‐exome sequencing (WES) on a proband presenting with anal atresia, global developmental delay, lymphocytosis, and other multisystem anomalies. Additionally, chromosome G‐banding karyotyping was also carried out on the proband's parents and brother. Results The 7‐month‐old proband was found to have a 26.738 Mb 4p15.33‐p14 deletion as identified by chromosome G‐banding karyotyping and WES. Conclusion We identified a patient with proximal 4p deletion syndrome by karyotype and WES analysis, which might explain some of his phenotypes. Our research enhances clinicians' knowledge of this rare condition, and offers valuable genetic counseling to the affected family. Further research is necessary to identify the causative gene or critical region associated with proximal 4p deletion syndrome.

Abstract Disc cutters are essential for full-section hard-rock tunnel boring machines. The performance of these devices directly affects tunnel engineering costs and duration. This paper proposes a sinusoidal variable cross-section (VCS) cutter ring and design method and establishes a digital model. Rock-like materials are simulated with a finite element model, and the model validity is verified via rock simulation mechanics tests. A disc cutter rolling rock simulation model for a linear cutting machine is also established, and simulation tests are performed for single- and three-cutter rolling using sinusoidal VCSs and constant cross-section (CCS) cutter models, respectively. The stress and energy changes for the cutters and rock-like material damage area were compared via simulation, confirming that some sinusoidal VCS cutter rings do less work on rock-like materials and cause larger crushing areas under the same engineering parameters; therefore, these cutter rings have smaller specific energies. The sinusoidal VCS cutter ring performance is 7% greater than that of CCS on average under single-cutter simulation, and the intermediate cutter performance of the intermediate cutter is 9% greater than that of CCS on average under three-cutter simulation. Thus, sinusoidal VCS cutter rings offer improved rock damage performance, and further research and application of this technology will improve the working efficiency of tunnel boring machines.

BackgroundAdrenocortical carcinoma (ACC) is a rare malignant tumor that occurs in the adrenal cortex. It has a high degree of malignancy and comparatively poor overall prognosis. Surgery is the standard curative therapy for localized ACC patients. The combination regimen of etoposide, doxorubicin, cisplatin (EDP) plus mitotane has been considered as the standardized chemotherapy regimen for advanced ACC. However, new effective regimens are emerging for specific conditions in metastatic ACC.Case presentationWe report a case of a 66-year-old man diagnosed with metastatic ACC who had a large left adrenal mass (110 mm × 87 mm) and multiple metastases in both lungs. The patient was treated with EP and sintilimab for six cycles; anlotinib was introduced after the third cycle. Follow-ups after the second to fourth cycles found significantly reduced lung metastases with all imaging examinations indicating partial response (PR) status. The patient received maintenance therapy thereafter with sintilimab plus anlotinib. Until recently, the patient’s lung metastases and the left adrenal gland area mass (39mm × 29mm) have disappeared, and no disease progression has been observed. The progression-free survival of this patient has been extended to approximately 31 months, in sharp contrast to a median survival time of 12 months for majority of advanced ACC. The main adverse events during treatment were appetite loss and grade I myelosuppression and revealed only grade I hypertension and grade I hypothyroidism.ConclusionThis case highlights the remarkable response of our patient’s ACC to treatment with a novel combination of EP and sintilimab combined with anlotinib. Our findings suggest a safe and more effective combination therapeutic option for patients with adrenocortical carcinoma.

Context: Ultrasound (US) is the most economical and widely used method for detecting lesions in parathyroid regions. Identifying typically parathyroid adenomas as hypoechoic nodules with clear margins. However, 10 % of lesions exhibit atypical features, such as the dual concentric sign, and the cognition of them still needs to be improved. Objective: To promote understanding of clinical and histopathological features for parathyroid lesions with the dual concentric echo sign and to investigate its pathogenesis and methods for distinguishing from cervical lymph nodes to improve US diagnostic accuracy. Methods: Retrospectively, patients were categorized into three groups: Group 1, with 36 patients showing parathyroid lesions with dual concentric echo signs; Group 2, with 40 patients displaying classic hypoechoic parathyroid lesions; and Group 3, comprising 36 patients with identified lymph nodes, which were all examined from January 2018 to December 2019. The clinical data on demographics, clinical symptoms, serum levels, histopathologic findings, and US image characteristics were thoroughly reviewed. Results: According to the clinical data, no significant differences in demographics or lesion sizes were observed in Group 1 and Group 2 (p > 0.05). No significant variances were noted in biochemical markers, including PTH, T-25OHD, and ALP. However, a notable difference was identified in adjusted serum calcium levels, which were significantly lower in Group 1 compared to Group 2 (p

The issue of aircraft icing poses a substantial threat to flight safety. In order to investigate more efficient anti-icing and de-icing technologies, a comparative analysis was conducted on the de-icing characteristics of three types of actuator materials under varying conditions. Initially, experimental research was undertaken to analyze the temperature traits of three actuators under ice-free conditions. Three power densities were chosen for the experiment: 0.170 W/cm2, 0.727 W/cm2, and 1.427 W/cm2. The research findings revealed distinct characteristics: plasma actuators and resistance wire actuators exhibited a strip-like high-temperature region during operation, with well-defined boundaries between the high-temperature and low-temperature zones, whereas ceramic-based semiconductor actuators showcased a uniform high-temperature region. As energy consumption rose, the thermal equilibrium temperatures of all three types tended to converge, with resistance wire actuators operating at 1.427 W/cm2, showing the highest temperature rise rate at that power density. Subsequently, experimental research was carried out on the de-icing performance of three actuators under icing conditions at a specific power density. Following 120 s of de-icing, the ice layer covering the surface of the plasma actuator completely melted, forming a cavity. Conversely, the ice layer on the ceramic-based semiconductor actuator remained partially intact in a strip shape. Ice deposits were still visible on the surface of the resistance wire actuator. This observation highlights the remarkable de-icing speed of the plasma actuator. The propulsive force of plasma generated on the fluid inside the ice layer enhances heat transfer efficiency, thereby accelerating the de-icing process of the plasma actuator at the same power density. The analysis of the de-icing performance of these three novel types of actuators establishes a robust groundwork for exploring more effective aircraft de-icing methods. Furthermore, it furnishes theoretical underpinning for the advancement of composite anti-icing and de-icing strategies.

Background: Adipokines and inflammatory cytokines (ADICs) play important roles in type 2 diabetes mellitus (T2DM). This study aimed to compare the changes of ADIC levels (ΔADICs) in patients with newly diagnosed T2DM treated with different antihyperglycemic agents, and further investigate the impact of these changes on metabolic indices, β-cell function and insulin resistance (IR). Methods: Four hundred and sixteen patients with newly diagnosed T2DM from 25 centers in China randomly received 48-week intervention with exenatide, insulin or pioglitazone. Anthropometric and laboratory data, indices of β-cell function and IR, and levels of AIDCs, including interleukin-1 beta (IL-1β), interferon-gamma (IFN-γ), leptin, and fibroblast growth factor 21 (FGF21) were detected at baseline and the end of the study. Results: In total, 281 participants (68 % male, age: 50.3 ± 9.4 years) completed the study. After 48- week treatment, IL-1β and IFN-γ were significantly decreased with exenatide treatment (P

With shared routes of transmission, HBV and HCV co-infection are estimated to occur more in subjects with HIV. This study aimed to characterize and describe the prevalence of HBV and HCV co-infections in a cohort of newly diagnosed HIV+ subjects living in China. We conducted a cross-sectional study among newly diagnosed HIV+ subjects aged 18–100 who participated in surveys on the national HIV molecular epidemiology in 2015 and 2023. (The epidemiological table survey is located in the national database alongside serologic testing). The chi-square test was used to identify changes in infections between the studying populations in 2015 and 2023, and conditional logistic regression models were fit to identify risk factors for each co-infection. Among the 11,024 newly diagnosed HIV+ subjects who were surveyed (n = 4501 in 2015; n = 6523 in 2023), the prevalence of HBV, HCV, and HBV/HCV in 2023 was lower than that in 2015, respectively. No decrease was observed in HCV co-infection in men who had sex with men (MSM) in North China, Northeast China, and East China. Increasing recognition among those at high risk of heterosexual transmission and those with low educational backgrounds is paramount to the prevention and control of HIV/HBV/HCV infections.

Discus fish, Symphysodon spp., have a unique parental care strategy where the fry feed on their parents’ skin mucus after hatching. Here, lipidomics was employed to compare the skin mucus lipid profiles of male or female discus fish during parental and non-parental care. By multivariate statistical analysis, clear separations were found between parental and non-parental female and between parental and non-parental male discus. In the comparison between female discus in the parental and non-parental stages, a total of 107 differentially expressed lipids (DELs) were observed, of which 23 showed increased levels during parental care. For male discus, a total of 108 DELs were found, of which 46 displayed increased levels during parental care. The main DELs were phosphatidyl ethanolamine and phosphatidylinositol, mainly involved in arachidonic acid and sphingolipid metabolism pathways. Further, by comparing parental male and female discus, we found 47 DELs involved in the glycerophospholipid metabolism pathway. Diglyceride showed a higher concentration in the skin mucus of parental females, while phospholipids showed a higher level in that of parental males. Our results revealed changes in the skin mucus lipid profiles of discus fish during parental care, as well as sex-dependent differences between parental fish.

The double-wedge configuration is a typical characteristic shape of the rudder surface of high-speed aircraft. The impact of the shock wave/boundary layer interaction and the shock wave/shock wave interaction resulting from the double wedge on aircraft aerodynamics cannot be ignored. The aerodynamic performance of the aircraft would be seriously affected. Accordingly, to reduce the wave drag, and to relieve the thermal load and pressure load, flow control is required for the shock wave/shock wave interaction and the shock wave/boundary layer interaction induced by the double-wedge configuration. In this paper, double-wedge shock wave/shock wave interaction is controlled by a high-energy surface arc discharge array and observed by high-speed schlieren flow field measurement at Mach 8. The 30-channel discharge array is set on the primary wedge plane, and actuation is generated. Hypersonic V shock wave/shock wave interaction is effectively controlled by the shock wave array induced by the high-energy surface arc discharge array, which makes the shock wave/shock wave interaction structure disappear or intermittent. The potential control mechanism is to reduce strong shock wave interaction by transforming the type of shock wave interaction. Therefore, the ability of plasma array actuation to control complex shock wave/shock wave interaction is verified, which provides a new method for hypersonic shock wave/shock wave interaction control.

Underdeveloped reading comprehension skills can limit academic success; a particular challenge for English language learners (ELLs). The current study investigated whether a web-based text structure strategy, delivered via the Intelligent Tutoring of Structure Strategy (ITSS) program to adult Chinese ELLs, improved students' use of reading strategies and/or overall reading comprehension. Using a quasi-experimental nonequivalent control group design, 207 adult Chinese ELLs from four classes were assigned to intervention or control groups. The intervention group utilized the ITSS to support their English reading instruction, whereas the control group was exposed to only traditional instruction. Our results indicate that the ITSS intervention had a statistically significant positive effect on adult Chinese ELLs' reading comprehension ([beta] = 3.07, p < 0.001) with Cohen's d = 0.43, as measured by the College English Test--4 (CET-4). Furthermore, we found that Chinese ELLs reported using more higher-order reading strategies (p < 0.01) after the intervention and there was no significant change of reported reading strategy usage for the control group from pretest and post-test. However, the current study did not provide evidence that the change in use of reading strategies mediated the relationship between the intervention/control condition and Chinese ELLs' reading comprehension.

Background: Lymphovascular invasion (LVI) is a significant risk factor for lymph node metastasis in gastric cancer (GC) and is closely related to the prognosis and recurrence of GC. This study aimed to establish clinical models, radiomics models and combination models for the diagnosis of GC vascular invasion. Methods: This study enrolled 146 patients with GC proved by pathology and who underwent radical resection of GC. The patients were assigned to the training and validation cohorts. A total of 1,702 radiomic features were extracted from contrast-enhanced computed tomography images of GC. Logistic regression analyses were performed to establish a clinical model, a radiomics model and a combined model. The performance of the predictive models was measured by the receiver operating characteristic (ROC) curve. Results: In the training cohort, the age of LVI negative (-) patients and LVI positive (+) patients were 62.41 ± 8.41 and 63.76 ± 10.08 years, respectively, and there were more male (n = 63) than female (n = 19) patients in the LVI (+) group. Diameter and differentiation were the independent risk factors for determining LVI (-) and (+). A combined model was found to be relatively highly discriminative based on the area under the ROC curve for both the training (0.853, 95% CI: 0.784-0.920, sensitivity: 0.650 and specificity: 0.907) and the validation cohorts (0.742, 95% CI: 0.559-0.925, sensitivity: 0.736 and specificity: 0.700). Conclusions: The combined model had the highest diagnostic effectiveness, and the nomogram established by this model had good performance. It can provide a reliable prediction method for individual treatment of LVI in GC before surgery. [ABSTRACT FROM AUTHOR]

Background: Due to the limited role of chronic pain medication in military personnel and the distress caused to the military population, mindfulness-based therapy has been considered for the follow-up treatment of military personnel with chronic pain. The purpose of this review is to explore the effect and the implementation of mindfulness-based therapy for the military population with chronic pain. Methods: The keywords for the search included "mindfulness" AND ("pain" OR "chronic pain") AND ("military" OR "veteran"). The PubMed, Embase, and Cochrane Library databases were searched. The Cochrane Collaboration tool was used to independently assess the risk of bias of the included randomized controlled trials, and the Newcastle–Ottawa Scale was used to independently assess the risk of bias of the included case–control studies. Results: A total of 175 papers were identified; 65 duplicates were excluded, and 59 papers that did not meet the inclusion criteria were excluded after reading the titles and abstracts. The remaining 51 papers were read in full, 42 of which did not meet the inclusion criteria. Nine papers met the inclusion criteria and were included in the study. The nine studies included 507 veterans and 56 active-duty female military personnel. All pain interventions were mindfulness-based therapy, and all of them were integrated into or adapted from standard mindfulness courses. The results all showed that after mindfulness-based therapy, the relevant indicators improved. Conclusions: Mindfulness-based therapy is an effective treatment method for the military population with chronic pain. The review indicates that future research should focus on the best setting for mindfulness-based therapy, including the course content and time. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is a chronic and progressive neurodegenerative disorder that affects millions of individuals worldwide. Researchers have conducted numerous studies to find accurate biomarkers for early AD diagnosis and develop more effective treatments. The main pathological hallmarks of AD are amyloid beta and Tau proteins. Other biomarkers, such as DNA, RNA, and proteins, can also be helpful in early AD diagnosis. To diagnose and treat AD promptly, it is essential to accurately measure the concentration of biomarkers in the cerebrospinal fluid or blood. However, due to the low concentrations of these biomarkers in the body, highly sensitive analytical techniques are required. To date, sensors have become increasingly important due to their high sensitivity, swift detection, and adaptable manipulation features. These qualities make them an excellent substitute for conventional instruments. Nanomaterials are commonly employed in sensors to amplify signals and improve sensitivity. This review paper summarized the integration of nanomaterials in optical sensor systems, including colorimetric, fluorescent, and surface-enhanced Raman scattering sensors for AD biomarkers detection. [ABSTRACT FROM AUTHOR]

Objective: To identify recurrent venous thromboembolism (VTE) after discontinuation of anticoagulation in patients with isolated distal deep vein thrombosis based on its anatomic localization (axial or muscular veins). Methods: Data were sourced from PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov databases in the time period up to October 2023. The study followed PRISMA guidelines using a registered protocol (CRD42023443029). Studies reporting recurrent VTE in patients with axial or muscular DVT were included in the analysis. Results: Five studies with a total of 1,403 participants were evaluated. The results showed a pooled odds ratio of 1.12 (95% confidence interval 0.77–1.63) between axial and muscular DVT. Heterogeneity was low (I2 = 0%, p = 0.91) and there was no significant difference in the rate of recurrent VTE between axial and muscular DVT in each subgroup. Conclusions: Muscular and axial DVT showed comparable recurrent VTE rates after anticoagulation. However, uncertainties regarding the possibility of recurrence affecting the popliteal vein or resulting in pulmonary embolism following muscular DVT anticoagulation persisted. Randomized trials in patients with isolated distal DVT are still needed to clarify its prognosis for different anatomical thrombus locations. [ABSTRACT FROM AUTHOR]

Background: Patients with coronavirus disease 2019 have a high incidence of thrombosis that decreases after recovery. When coronavirus disease 2019 is accompanied by diseases prone to thrombosis, risk of post-infection thrombotic events may increase. Case presentation: We report a case of digital ischemic gangrene in a 24-year-old Chinese female with systemic lupus erythematosus after recovery from coronavirus disease 2019. The pathogenesis was related to clinical characteristics of systemic lupus erythematosus, hypercoagulability caused by coronavirus disease 2019, and second-hit due to viral infection. Conclusion: Patients with autoimmune diseases should remain alert to autoimmune system disorders induced by severe acute respiratory syndrome coronavirus 2 and other viruses. Treatment for these patients should be strictly standardized, and appropriate anticoagulation methods should be selected to prevent thrombosis. [ABSTRACT FROM AUTHOR]

Acute promyelocytic leukemia (APL) is a type of acute myeloid leukemia. About 2% of APL is characterized by atypical rearrangements. Here we reported one APL case with atypical manifestations and morphology. A 35-year-old woman patient, mainly due to fatigue, poor appetite for over 10 days and intermittent fever for 3 days. combined with the results of flow cytometry, fusion gene and chromosome, the patient was diagnosed as AML-M3 with atypical morphology. Double induction therapy with retinoic acid and arsenous acid was immediately administrated. Idarubicin was administrated on the 18th day. A re-examination was performed in the 5th week, both the blood routine test and myelogram showed normal results, and the fusion gene turned negative, indicating complete remission. When atypical morphology occurs, peripheral blood POX staining may be performed to check the abnormal cells. Flow cytometry, chromosome analysis, and fusion gene analysis are also required for further diagnosis. [ABSTRACT FROM AUTHOR]

A critical event in the pathogenesis of kidney fibrosis is the transition of macrophages into myofibroblasts (MMT). Exosomes play an important role in crosstalk among cells in the kidney and the development of renal fibrosis. However, the role of myofibroblast-derived exosomes in the process of MMT and renal fibrosis progression remains unknown. Here, we examined the role of myofibroblast-derived exosomes in MMT and kidney fibrogenesis. In vitro, transforming growth factor-β1 stimulated the differentiation of kidney fibroblasts into myofibroblasts and promoted exosome release from myofibroblasts. RAW264.7 cells were treated with exosomes derived from myofibroblasts. We found purified exosomes from myofibroblasts trigger the MMT. By contrast, inhibition of exosome production with GW4869 or exosome depletion from the conditioned media abolished the ability of myofibroblasts to induce MMT. Mice treatment with myofibroblast-derived exosomes (Myo-Exo) exhibited severe fibrotic lesion and more abundant MMT cells in kidneys with folic acid (FA) injury, which was negated by TANK-banding kinase-1 inhibitor. Furthermore, suppression of exosome production reduced collagen deposition, extracellular matrix protein accumulation, and MMT in FA nephropathy. Collectively, Myo-Exo enhances the MMT and kidney fibrosis. Blockade of exosomes mediated myofibroblasts– macrophages communication may provide a novel therapeutic target for kidney fibrosis. [ABSTRACT FROM AUTHOR]