Search

BackgroundPrevention measures for palliative care and the provision of discharge planning services for inpatients in Taiwan before and during the COVID-19 pandemic had not been investigated. This study was aimed to investigate the factors associated with heightened palliative care needs and increased mortality rates.MethodsThis research adopts a retrospective case–control study design. The investigation encompasses patients admitted before the pandemic (from January 1, 2019, to May 31, 2019) and during the COVID-19 pandemic (from January 1, 2020, to May 31, 2020). The case group consisted of 231 end-of-life inpatients during the pandemic, control group was composed of the pool of inpatients with pre-pandemic and matched with cases by sex and age in a 1:1 ratio.ResultsThe results showed that the prevalence of respiratory failure symptoms (p = 0.004), residing in long-term care facilities (p = 0.017), palliative care needs assessment scores (p = 0.010), as well as the provision of guidance for nasogastric tube feeding (p = 0.002), steam inhalation (p = 0.003), turning and positioning (p

As global population growth and the use of household appliances increase, residential electricity consumption has surged, leading to challenges in maintaining a balanced electrical load. This surge often results in localized and intermittent power outages, adversely affecting residential electricity reliability and the profitability of power supply companies. Addressing this, we propose a novel CNN-BiLSTM-SA model, combining Convolutional Neural Network (CNN), Bidirectional Long Short-Term Memory (BiLSTM), and Self-Attention (SA) mechanisms, to accurately predict residential electricity consumption. The model integrates temporal feature extraction through the CNN module, correlation capture via BiLSTM, and intrinsic feature analysis using SA mechanisms, enhancing predictive accuracy. Our experimental results demonstrate the model’s precision, outperforming existing methods in key performance metrics. Additionally, ablation studies affirm the synergistic design of CNN-BiLSTM-SA’s network components, contributing to its overall efficacy.

Abstract Background and objective Cancer ratio (CR), which is defined as serum lactate dehydrogenase (LDH) to pleural fluid adenosine deaminase (ADA) ratio, has been reported to be a useful diagnostic marker for malignant pleural effusion (MPE). Whether its diagnostic accuracy is affected by age remains unknown. This study aimed to investigate the effects of age on the diagnostic accuracy of CR. Methods The participants in this study were from a prospective cohort (SIMPLE cohort, n = 199) and a retrospective cohort (BUFF cohort, n = 158). All participants were patients with undiagnosed pleural effusion (PE). We used receiver operating characteristic (ROC) curves to evaluate the diagnostic accuracy of CR. The effect of age on the diagnostic accuracy of CR was investigated by adjusting the upper limit of age for participant enrolment. Results Eighty-eight MPE patients were verified in the SIMPLE cohort, and thirty-five MPE patients were verified in the BUFF cohort. The AUCs of CR in the SIMPLE and BUFF cohorts were 0.60 (95% CI: 0.52–0.68) and 0.63 (95% CI: 0.54–0.71), respectively. In both cohorts, the AUCs of CR decreased with the advancement of age. Conclusion Age can affect the diagnostic accuracy of CR for MPE. CR has limited diagnostic value in older patients. Key message Cancer ratio is a promising diagnostic marker for malignant pleural effusion. This study revealed that its diagnostic accuracy decreased in older patients. Its diagnostic accuracy is overestimated by previous studies using tuberculosis and pneumonia patients as controls.

Abstract Background T cell acute lymphoblastic leukemia (T-ALL) defines a group of hematological malignancies with heterogeneous aggressiveness and highly variable outcome, making therapeutic decisions a challenging task. We tried to discover new predictive model for T-ALL before treatment by using a specific pipeline designed to discover aberrantly active gene. Results The expression of 18 genes was significantly associated with shorter survival, including ACTRT2, GOT1L1, SPATA45, TOPAZ1 and ZPBP (5-GEC), which were used as a basis to design a prognostic classifier for T-ALL patients. The molecular characterization of the 5-GEC positive T-ALL unveiled specific characteristics inherent to the most aggressive T leukemic cells, including a drastic shut-down of genes located on the mitochondrial genome and an upregulation of histone genes, the latter characterizing high risk forms in adult patients. These cases fail to respond to the induction treatment, since 5-GEC either predicted positive minimal residual disease (MRD) or a short-term relapse in MRD negative patients. Conclusion Overall, our investigations led to the discovery of a homogenous group of leukemic cells with profound alterations of their biology. It also resulted in an accurate predictive tool that could significantly improve the management of T-ALL patients.

Background: Pleural fluid (PF) carcinoembryonic antigen (CEA) is a widely used diagnostic marker for malignant pleural effusion (MPE). Recent studies revealed that PF to serum CEA was also a promising diagnostic parameter for MPE. Objective: We aimed to investigate whether PF to serum CEA ratio and delta CEA (PF minus serum CEA) provided added value to PF CEA in diagnosing MPE. Methods: Patients with pleural effusion in a retrospective cohort (BUFF) and a prospective cohort (SIMPLE) were included. The clinical characteristics of the patients were extracted from their medical records. The diagnostic value of CEA ratio and delta CEA was estimated by a receiver operating characteristics (ROC) curve, net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Results: A total of 148 patients in the BUFF cohort and 164 patients in the SIMPLE cohort were enrolled. The BUFF cohort had 46 MPE patients and 102 benign pleural effusion (BPE) patients, and the SIMPLE cohort had 85 MPE patients and 79 BPE patients. In both cohorts, MPE patients had significantly higher PF CEA, serum CEA, CEA ratio, and delta CEA. The area under ROC curves (AUCs) of PF CEA, CEA ratio, and delta CEA were 0.78 (95% CI: 0.67–0.88), 0.80 (95% CI: 0.72–0.89) and 0.83 (95% CI: 0.75–0.91) in the BUFF cohort, and 0.89 (95% CI: 0.83–0.94), 0.86 (95% CI: 0.80–0.92), and 0.84 (95% CI: 0.78–0.91) in the SIMPLE cohort. The differences between the AUCs of PF CEA, CEA ratio, and delta CEA did not reach statistical significance. The continuous NRI and IDI of CEA ratio and delta CEA were

This study endeavors to formulate a comprehensive methodology for establishing a Geological Knowledge Base (GKB) tailored to fracture-cavity reservoir outcrops within the North Tarim Basin. The acquisition of quantitative geological parameters was accomplished through diverse means such as outcrop observations, thin section studies, unmanned aerial vehicle scanning, and high-resolution cameras. Subsequently, a three-dimensional digital outcrop model was generated, and the parameters were standardized. An assessment of traditional geological knowledge was conducted to delineate the knowledge framework, content, and system of the GKB. The basic parameter knowledge was extracted using multiscale fine characterization techniques, including core statistics, field observations, and microscopic thin section analysis. Key mechanism knowledge was identified by integrating trace elements from filling, isotope geochemical tests, and water-rock simulation experiments. Significant representational knowledge was then extracted by employing various methods such as multiple linear regression, neural network technology, and discriminant classification. Subsequently, an analogy study was performed on the karst fracture-cavity system (KFCS) in both outcrop and underground reservoir settings. The results underscored several key findings: (1) Utilization of a diverse range of techniques, including outcrop observations, core statistics, unmanned aerial vehicle scanning, high-resolution cameras, thin section analysis, and electron scanning imaging, enabled the acquisition and standardization of data. This facilitated effective management and integration of geological parameter data from multiple sources and scales. (2) The GKB for fracture-cavity reservoir outcrops, encompassing basic parameter knowledge, key mechanism knowledge, and significant representational knowledge, provides robust data support and systematic geological insights for the intricate and in-depth examination of the genetic mechanisms of fracture-cavity reservoirs. (3) The developmental characteristics of fracturecavities in karst outcrops offer effective, efficient, and accurate guidance for fracture-cavity research in underground karst reservoirs. The outlined construction method of the outcrop geological knowledge base is applicable to various fracture-cavity reservoirs in different layers and regions worldwide. [ABSTRACT FROM AUTHOR]

Renal fibrosis is a common feature of various chronic kidney diseases. However, the underlying mechanism remains poorly understood. The CXC chemokine receptor (CXCR) family plays a role in renal fibrosis; however, the detailed mechanisms have not been elucidated. In this study, we investigated the potential role of CXCR7 in mediating renal fibrosis. CXCR7 expression is decreased in unilateral ischemia–reperfusion injury (UIRI) and unilateral ureteral obstruction mouse models. Furthermore, CXCR7 was specifically expressed primarily in the Lotus Tetragonolobus Lectin-expressing segment of tubules, was slightly expressed in the peanut agglutinin-expressing segment, and was barely expressed in the Dolichos biflorus agglutinin-expressing segment. Administration of pFlag-CXCR7, an overexpression plasmid for CXCR7, significantly inhibited the activation of β-catenin signaling and protected against the progression of epithelial-to-mesenchymal transition (EMT) and renal fibrosis in a UIRI mouse model. Using cultured HKC-8 cells, we found that CXCR7 significantly downregulated the expression of active β-catenin and fibrosis-related markers, including fibronectin, Collagen I, and α-SMA. Furthermore, CXCR7 significantly attenuated TGF-β1-induced changes in β-catenin signaling, EMT and fibrosis. These results suggest that CXCR7 plays a crucial role in inhibiting the activation of β-catenin signaling and the progression of EMT and renal fibrosis. Thus, CXCR7 could be a novel therapeutic target for renal fibrosis. [ABSTRACT FROM AUTHOR]

BackgroundA diversity of microorganisms is associated with human health and exists in a state of dynamic equilibrium. This diversity has direct implications for the assessment of susceptibility to infectious diseases, especially human papillomavirus (HPV) infection.MethodsHere, we investigated the relationships between HPV infection and vaginal, cervical, and gut microbiota composition and assessed the levels of genital immune mediators. We selected a multiethnic area in Yunnan Province, China, to collect samples from healthy women of childbearing age. A total of 82 healthy women of childbearing age were included in this study. Vaginal, cervical, and rectal swabs were collected to analyze the microbial community, and cytokines were analyzed in some samples.FindingsDifferent proportions and types of HPV infection were detected in cervical (44%), vaginal (18%), and rectal (18%) swabs. HPV detected in cervical swabs was generally a high-risk type, while low-risk HPV types were primarily detected in vaginal and rectal swabs. There were some differences in this proportion as well as in the microbial community composition among different ethnic groups. Rectal samples exhibited the highest diversity index, while vaginal samples displayed the lowest diversity index. Lactobacillus dominated most of the vaginal samples, was decreased in HPV-positive samples, and differed among different ethnic groups. However, the sequence proportion of Lactobacillus in the cervix exhibited the opposite trend in those affected by HPV infection. The dynamic balance between the potential pathogens Gardnerella and Lactobacillus determines the health of the female genital system.InterpretationThis study constitutes the first step toward personalized medicine for women’s reproductive health, wherein differences between the genital microbiomes of individuals would be considered in risk assessment and for subsequent disease diagnosis and treatment.

Cancer persists as a worldwide disease that contributes to high morbidity and mortality rates. As a class of non-coding RNA, microRNAs (miRNAs) are one kind of important regulators in cancer and frequently implicated in tumor development and progression. Emerging experiments have suggested that miRNA-195–5p (miR-195–5p) can regulate neoplastic processes in many pathways. For instance, miR-195–5p can not only regulate proliferation, migration and invasion of tumor cells but also promote tumor cell apoptosis. Furthermore, low expression of miR-195–5p could induce drug resistance. Our review focuses on the expression of miR-195–5p in various tumors and elucidates the related mechanisms of which miR-195–5p participates in tumor biology, as well as summarizes the roles of miR-195–5p in tumor progression. We believe that miR-195–5p might have potential utility as a novel diagnostic biomarker and therapeutic target for cancer.

Background: Multiple myeloma (MM) is characterized by abnormal proliferation of bone marrow clonal plasma cells. Tumor immunotherapy, a new therapy that has emerged in recent years, offers hope to patients, and studying the expression characteristics of immune-related genes (IRGs) based on whole bone marrow gene expression profiling (GEP) in MM patients can help guide personalized immunotherapy.Methods: In this study, we explored the potential prognostic value of IRGs in MM by combining GEP and clinical data from the GEO database. We identified hub IRGs and transcription factors (TFs) associated with disease progression by Weighted Gene Co-expression Network Analysis (WGCNA), and modeled immune-related prognostic signature by univariate and multivariate Cox and least absolute shrinkage and selection operator (LASSO) regression analysis. Subsequently, the prognostic ability of signature was verified by multiple statistical methods. Moreover, ssGSEA and GSEA algorithm reveled different immunological characteristics and biological function variation in different risk groups. We mapped the hub IRGs by protein-protein interaction network (PPI) and extracted the top 10 ranked genes. Finally, we conducted vitro assays on two alternative IRGs.Results: Our study identified a total of 14 TFs and 88 IRGs associated with International Staging System (ISS). Ten IRGs were identified by Cox -LASSO regression analysis, and used to develop optimal prognostic signature for overall survival (OS) in MM patients. The 10-IRGs were BDNF, CETP, CD70, LMBR, LTBP1, NENF, NR1D1, NR1H2, PTK2B and SEMA4. In different groups, risk signatures showed excellent survival prediction ability, and MM patients also could be stratified at survival risk. In addition, IRF7 and SHC1 were hub IRGs in PPI network, and the vitro assays proved that they could promote tumor progression. Notably, ssGSEA and GSEA results confirmed that different risk groups could accurately indicate the status of tumor microenvironment (TME) and activation of biological pathways.Conclusion: Our study suggested that immune-related signature could be used as prognostic markers in MM patients.

Bolting and flowering of vegetables are induced by vernalization in their early growth stage. This phenomenon is called premature bolting, and it has caused massive losses in production of vegetables such as cabbage, celery, carrot, radish, and spinach, etc. This review aimed to summarize studies on bolting and flowering pathways, physiological and biochemical changes, and underlined molecular mechanisms of various vegetable crop bolting involving genome and transcriptome analysis, and its association with vegetable breeding. This review could provide basic knowledge to carry out research on vegetable genetics and breeding and vegetable cultivation. [ABSTRACT FROM AUTHOR]

Abstract Sleep disorder (SD) has a high incidence and seriously affects quality of life, mental health and even the manifestation of physical diseases. The combination of Pinellia ternata (Chinese name: banxia) and Prunella vulgaris (Chinese name: xiakucao), known as the Banxia–Xiakucao Chinese herb pair (BXHP), is a proven Chinese herbal medicine that has been used to treat SD for thousands of years due to its significant clinical effects. However, its active pharmacological components and sedative–hypnotic mechanisms have not been fully elucidated. Thus, the present study used a systematic pharmacological approach to develop pharmacokinetic screens and target predictions via construction of a protein–protein interaction network and annotation database for SD-related and putative BXHP-related targets. Visualization, screening and integrated discovery enrichment analyses were conducted. The BXHP chemical database contains 166 compounds between the two herbal ingredients, and of these, 22 potential active molecules were screened by pharmacokinetic evaluation. The targets of 114 of the active molecules were predicted, and 34 were selected for further analysis. Finally, gene ontology and Kyoto Encyclopedia of Genes and Genomes pathway analyses suggested that BXHP can reduce inflammatory responses. and mediate immune-related and central nervous system neurotransmitters via regulation of multiple targets and pathways. The use of a systematic pharmacology-based approach in the present study further elucidated the mechanisms of action underlying BXHP for the treatment of SD from a holistic perspective and sheds light on the systemic mechanisms of action of Chinese herbal medicines in general.

A fault accommodation zone is a type of structure that is defined as regulating displacement and strain between faults structure. Increasing numbers of fault accommodation zones are being identified in graben basins, indicating the potential exploration target and petroleum accumulation areas. This study aims to analyze the formation mechanism and development of fault accommodation zones under combined stress by a numerical simulation method considering geomechanical modeling. Using threedimensional (3-D) seismic interpretation and fractal dimension method, exampled with the Dongxin fault zone, the fault activity and fault combination pattern were conducted to quantitatively characterize the activity difference in fault accommodation zones. Combined with mechanical experiment test, a geomehcanical model was established for fault accommodation zones in a graben basin. Integrating the paleostress numerical simulations and structural physical simulation experiment, the developmental characteristics and genetic mechanism of fault accommodation zones were summarized. Influenced by multi movements and combined stresses, three significant tectonic evolution stages of the Dongxing Fault Zone (DXFZ) were distinguished: During the Es³ sedimentary period, the large difference in the stress, strain, and rupture distribution in various faults were significant, and this stage was the key generation period for the prototype of the DXFZ, including the FAZ between large-scale faults. During the Es² sedimentary period, the EW-trending symmetric with opposite dipping normal faults and the NE-SW trending faults with large scale were furtherly developed. The junction area of two secondary normal faults were prone to be ruptured, performing significant period for inheriting and developing characteristics of fault accommodation zones. During the Es¹ sedimentary period, the high-order faults in the DXFZ exhibited the obvious fault depressions and strike-slip activity, and the fault accommodation zones were furtherly inherited and developed. This stage was the molded and formative period of the FAZ, the low-order faults, and the depression in the DXFZ. [ABSTRACT FROM AUTHOR]

Background and aims: It has been demonstrated that 1,25-hydroxyvitamin-D3-24-hydroxylase, encoded by CYP24A1 gene, is a key enzyme that neutralizes the active vitamin D3 metabolite 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] in response to hepatitis C virus (HCV) infection. This study aimed to investigate whether CYP24A1 genetic variation is associated with HCV infection outcomes. Methods: 848 HCV chronically infected subjects, 507 natural clearance subjects, and 1017 uninfected controls were enrolled. Nine single nucleotide polymorphisms (SNPs) in theCYP24A1 gene were genotyped using the Sequenom MassARRAY platform. Results: After adjusting for age, gender, and routes of infection, logistic regression analyses showed that rs6013897-A was associated with an elevated risk of HCV infection (P

BackgroundChaperonin-containing TCP-1 (TRiC or CCT) was demonstrated to be involved in oncogenesis of cancers carcinogenesis and development of various malignancies. Increasing experimental evidence indicated that dysregulation of TRiC was implicated in the tumor progression of breast cancer (BCa). However, few definitive studies have addressed the diverse expression patterns and prognostic values of eight TRiC subunits. Thus, we aimed to investigate the clinical significance of TRiC subunit expression and prognostic values for their possible implications in diagnosis and treatment of BCa.MethodsBased on updated public resources and comprehensive bioinformatics analysis, we used some online databases (e.g., UALCAN, GEPIA, cBioPortal, TIMER, BC-GenExMiner, metascape, and GeneMANIA) to comprehensively explore the expression levels and the prognostic effects of eight TRiC subunits in patients with BCa.ResultsThe transcriptional levels of most subunits of the Chaperonin TRiC (CCT2, CCT3, CCT4, CCT5, CCT6A, and CCT7) were significantly elevated compared with normal breast tissues, whereas TCP1, CCT4, and CCT6B were lower in BCa tissues than in normal tissues. Besides, copy-number alterations (CNA) of eight TRiC subunits positively regulated their mRNA expressions. Furthermore, high mRNA expression of TCP1/CCT2/CCT4/CCT5/CCT6A/CCT7/CCT8 was significantly associated with poor overall survival (OS) in BCa patients. The eight subunits of the chaperonin TRiC was related to tumor purity and immune infiltration levels of BCa. Co-expression analysis showed CCT6B was negatively associated with other subunits of TRiC and other subunits of TRiC were positively correlated with each other. Additionally, TRiC and their interactive proteins were correlated with positive regulation of biological process, localization, and biological regulation.ConclusionThis study systematically illustrated the expression profiles and distinct prognostic values of chaperonin TRiC in BCa, providing insights for further investigation of subunits of the chaperonin TRiC as novel therapeutic targets and potential prognostic biomarkers in BCa.