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Aim Methods Results Conclusion This study aimed to evaluate whether integrated traditional Chinese medicine (TCM) and Western medicine (WM) is more effective than WM for acute pancreatitis (AP).Patients with AP were enrolled and divided into the TCM and WM (TCM&WM) and WM groups according to the therapeutic protocol in real clinical settings. We applied 1:3 propensity score matching, which was to adjust confounding factors. The primary outcome was mortality, whereas the secondary outcomes were organ failure, organ supportive therapies, local complications, hospitalization cost, and length of hospital stay. Sensitivity and subgroup analyses were also performed.Of 5442 patients with AP, 4691 and 751 were included in the TCM&WM and WM groups, respectively. After PSM, patient baseline characteristics were well balanced. Compared with the WM group (n = 734), the TCM&WM group (n = 2096) had lower overall mortality rate (1.7% vs. 3.4%; risk ratio, 0.482; 95% confidence interval, 0.286–0.810; p = 0.005). The TCM&WM group was associated with lower risk of persistent renal failure, multiple organ failure, and infection, lower utilization of organ supportive therapies, shortened lengths of hospital and intensive care unit stay, and lower hospital costs. Sensitivity analyses showed similar results. Subgroup analysis favored TCM&WM treatment for patients aged < 60 years, with hypertriglyceridic etiology, and with admission interval between 24 and 48 h.TCM&WM treatment can achieve lower risks of mortality and organ failure and better economic effectiveness in patients with AP than WM treatment. This study provides a promising alternative of TCM&WM treatment for AP in the real‐world setting. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to analyze the clinical characteristics of elderly patients with acute pancreatitis (AP) and investigate the effects of age on the clinical outcomes of AP. Methods: Patients aged ≥ 18 years with AP admitted within 72 h from 1 September 2013 to 31 August 2019 were included. Patients were divided into elderly (≥60 years) and non-elderly (<60 years) groups. Clinical data and outcomes were compared. Results: A total of 756 elderly and 4896 non-elderly patients with AP were included. The elderly patients had different etiological distributions and more severe clinical markers and scores. Age was an independent risk factor for mortality [odds ratio (OR): 2.911, 95% CI: 1.801–4.706, p < 0.001], intensive care unit admission (OR: 1.739, 95% CI: 1.126–2.685, p = 0.013), persistent organ failure (OR: 1.623, 95% CI: 1.326–1.987, p < 0.001), multiple organ failure (OR: 1.757, 95% CI: 1.186–2.604, p = 0.005), and infection (OR: 2.451, 95% CI: 1.994–3.013, p < 0.001). Adjusted multiple logistic regression and trend analysis confirmed the risk of the age for the outcomes. The deaths of elderly patients showed a biphasic pattern with peaks in the first and fifth weeks, in contrast to the single peak in the first week in the non-elderly patients. Conclusions: Elderly patients with AP were associated with worse clinical outcomes. It is crucial to devote considerable attention to the optimization of therapeutic approaches to reduce late mortality in this group of patients. [ABSTRACT FROM AUTHOR]

We present a rationale for bidder termination provisions that considers their effect on bidders' and targets' joint takeover gains. The provision's inclusion can create value by enabling termination when the target becomes less valuable to the bidder than on its own, but creates a trade-off because termination may also occur when the target is more valuable to the bidder than on its own. This trade-off explains why the provision is included in only some deals, and explains variation in termination fees. Inclusion of the provision is associated with larger combined announcement returns, provided that the termination fee is priced appropriately. [ABSTRACT FROM AUTHOR]

Background: Detection rate and isolation yield of circulating tumor cells (CTCs) are low in lung cancer with approaches due to CTC invasiveness and heterogeneity. In this study, on the basis of the epithelial cell adhesion molecule (EpCAM) phenotype, markers of vimentin and epidermal growth factor receptor (EGFR) phenotype were added to jointly construct a precise and efficient CTC capture system for capture of lung cancer CTCs. Methods: A CTC capture system combined with EpCAM lipid magnetic bead (Ep-LMB)/vimentin lipid magnetic bead (Vi-LMB)/EGFR lipid magnetic bead (EG-LMB) was constructed, and its performance was tested. The amount of CTC captured in the blood of patients with lung cancer was detected by immunofluorescence identification and analyzed for clinical relevance. Results: The constructed CTC capture system has low cytotoxicity. The capture efficiency of lung cancer cells in phosphate belanced solution (PBS) system was 95.48%. The capture efficiency in the blood simulation system is 94.55%. The average number of CTCs in the blood of patients with lung cancer was 9.73/2 mL. The quantity distribution of CTCs is significantly correlated with tumor staging and metastasis. The area under the curve (AUC) of CTCs for the diagnosis of lung cancer was 0.9994 (95% CI = 0.9981-1.000, P <.0001). The cutoff value was 4.5/2 mL. The sensitivity was 99.39%, and the specificity was 96.88%. Conclusion: The EpCAM/vimentin/EGFR combined capture system has feasibility and high sensitivity in the detection of lung cancer CTC typing, which can be used as an auxiliary diagnostic indicator for lung cancer and is expected to promote the clinical application of CTCs. [ABSTRACT FROM AUTHOR]

Using hand-collected data on financial asset portfolios and exploiting the 2014 oil price crisis as an exogenous cash flow shock, we investigate financial risk-taking at distressed firms. We find that distressed firms, with high debt rollover risk proxied for by short-term liabilities, substantially increase their investments in risky financial assets, including corporate debt, equity, and mortgage-backed securities. The effects are stronger for unhedged firms with low collateral assets. Overall, we provide new evidence that distressed firms take risk using financial assets camouflaged as cash reserves, which, compared to real assets, are less visible and carry lower transaction costs and accelerated payoffs. (JEL G32, G34) [ABSTRACT FROM AUTHOR]

Archaeologists frequently invoke climate change as a driving cause for ancient expansions of human populations, but geomorphic changes can also play an important role in opening or closing routes of migration. In China, archaeological evidence demonstrates that valleys in the Jialing River's watershed were important routes for the movement of Neolithic populations from the catchments of the Yellow River to the Yangtze River. Here, we examine how fluvial geomorphological regime shifts may have also influenced the migration pathways and adaptive strategies of Neolithic people into the Sichuan Basin by using a combination of sedimentological and palynological analysis at Luojiaba, an archaeological site located on one of the eastern tributaries of the Jialing River. The results show that people settled on seasonally stable landforms, including the Zhonghe River floodplain at Luojiaba (5300–4800 cal. B.P.). They carried out fishing and hunting activities on the front edge of the floodplain close to the river channel and built dwelling features on the higher ground at the back edge of the floodplain, which was not affected by seasonal floods. We hypothesize that during the Holocene Climatic Optimum before 5500 cal. B.P., high water levels as well as severe surface erosion caused by a strong East Asian Summer Monsoon (EASM) blocked pathways into the upper reaches of the Jialing River watershed. Only after a series of cold, dry climate events driven by a decrease in EASM intensity ca. 5500–5000 cal. B.P. did water levels recede significantly. This allowed alluvial aggradation to occur, which created floodplains and terraces along the valley that may have opened a new route for the migration into the Sichuan Basin. Our results reveal the human–environment dynamics surrounding Luojiaba in the uplands of southwestern China and highlight the impact of coupled climatic‐geomorphic regime shifts on human settlement and subsistence strategies, across both space and time. [ABSTRACT FROM AUTHOR]