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Abstract Objectives For children with Kawasaki disease (KD) at high risk of developing coronary artery lesions and requiring retreatment with intravenous immunoglobulin (IVIG), the availability of accurate prediction models remains limited because of inconsistent variables and unsatisfactory prediction results. We aimed to construct models to predict patient's probability of IVIG retreatment combining children's individual inflammatory characteristics. Methods Clinical manifestations and laboratory examinations of 266 children with KD were retrospectively analysed to build a development cohort data set (DC) and a validation cohort data set (VC). In the DC, binary logistic regression analyses were performed using R language. Nomograms and receiver operating curves were plotted. The concordance index (C index), net reclassification index, integrated discrimination improvement index and confusion matrix were applied to evaluate and validate the models. Results Models_5V and _9V were established. Both contained variables including the percentages of CD8+ T cells, CD4+ T cells, CD3+ T cells, levels of interleukin (IL)‐2R and CRP. Model_9V additionally included variables for IL‐6, TNF‐α, NT‐proBNP and sex, with a C index of 0.86 (95% CI 0.79–0.92). When model_9V was compared with model_5V, the NRI and IDI were 0.15 (95% CI 0.01–0.30, P

Current research underscores that there are only a few evidence-based programs that teach STEM (science, technology, engineering, and mathematics) as part of their curriculum, especially for autistic students. Even fewer programs focus on engineering and design learning. Hence, we developed an informal afterschool maker program to develop autistic and non-autistic students' interests in engineering to understand their experiences learning STEM concepts and values while applying the engineering mindset to develop projects. This qualitative study aimed to explore and understand students' experiences participating in STEM activities in the maker club. We interviewed twenty-six students (seventeen autistic and nine non-autistic), nine teachers, and thirteen parents representing diverse cultural and socio-economic backgrounds across three public middle schools in a large urban metropolitan city between 2018 and 2019. Our thematic analysis yielded four themes: (1) "active participation in STEM"; (2) "curiosity about STEM topics, concepts, and practices"; (3) "capacity-building to engage in STEM learning"; and (4) "understanding of the importance of STEM education in daily life." The results of this study enabled us to understand that students were deeply engaged with the content and curriculum of our program, expanded their knowledge base about scientific concepts, used engineering-specific scientific terminologies, and engaged with the engineering design process to conceptualize, test, improvise, and problem-solve. Furthermore, this afterschool engineering education program created a safe, nurturing, and stimulating environment for students to build engineering readiness skills.

Immune system disorder is associated with metastasis of triple-negative breast cancers (TNBCs). A robust, individualized immune-related genes (IRGs)-based classifier was aimed to develop and validate in our study to precisely estimate the axillary lymph node (ALN) status preoperatively in patients with early-stage TNBC. We first analyzed RNA sequencing profiles in TNBC patients from The Cancer Genome Atlas database by using bioinformatics approaches, and screened 23 differentially expressed IRGs. A 9-gene panel was generated with an area under the curve (AUC) of 0.77 [95% confidence interval (95% CI), 0.68–0.87]. We detected the 9 ALN-status-related IRGs in the training set (n = 133) and developed a reduced and optimized five-IRGs signature, which effectively distinguished TNBC patients with ALN metastasis (AUC, 0.80; 95% CI, 0.65–0.86), and was superior to preoperative ultrasound-based ALN status (AUC, 0.73; 95% CI, 0.53–0.93). Predictive efficiency (AUC, 0.77; 95% CI 0.61–0.93) of this five-IRGs signature was validated in the validation set (n = 81). Furthermore, IRGs nomogram incorporated IRGs signature with US-based ALN status showed higher ALN status prediction efficacy than US-based ALN status and five-IRGs signature alone in both training and validation sets. IRGs nomogram may aid in identifying patients who can be exempted from axillary surgery.Novelty and impact: An immune-related genes (IRGs) nomogram was first developed and externally validated in our study, which incorporated the IRGs signature with ultrasound (US)-based axillary lymph nodes (ALN) status. IRGs nomogram is superior to IRGs signature alone for preoperative estimation of ALN metastasis in patients with triple-negative breast cancer (TNBC). It is a favourable biomarker for preoperatively predicting ALN metastasis risk and may aid in clinical decision-making in early-stage TNBCs.

During preliminary tea processing, moisture content is an important consideration affecting the tea quality. Traditionally, the moisture content of tea leaves was manually controlled by the joint action of multiple processing units, and maintaining stability was difficult. In this paper, a multi-unit collaborative strategy was proposed for controlling moisture content in preliminary tea processing. Multivariate methods including polynomial regression, radical basis function neural network (RBFNN), and least squares support vector machine (LSSVM) were used to establish models for moisture content prediction in the first fixation, second fixation, and drying units, with minimal root mean square errors (RMSEs) of 1.34%, 0.86%, and 0.13%, respectively. The combination of RBFNN and LSSVM, with a RMSE of 0.03%, was used to model the preliminary processing of whole tea. Rough set data mining technology was used to obtain the optimum ranges of moisture content and critical process parameters. Finally, a Monte Carlo simulation experiment was carried out within the optimum range, and moisture content design spaces for the single unit and the whole processing line were obtained. With the proposed approach, the stability of the final moisture content of tea can be improved, which is of great significance for improving tea quality and accelerating the automation of tea production.

To date, Kawasaki disease (KD) has only been able to be diagnosed and evaluated using clinical characteristics. Additionally, the therapeutic effect and cardiovascular complications could not be verified until its occurrence. The present retrospective study analyzed the dynamic alterations of inflammatory cytokines, platelet (PLT) count, and subgroups of lymphocytes, such as cluster of differentiation (CD) 8+ T cells and CD19+ B cells, under different conditions in 64 children with KD. The percentage distribution of lymphocyte subgroups and the altered neutrophil lymphocyte ratio demonstrated that the inflammatory response was dominated by the B cell-mediated humoral immune response before intravenous immunoglobulin (IVIG) treatment, but mainly by T cells via cellular cytotoxic effects after IVIG treatment. Among the different types of inflammatory cytokines, the results of the present study revealed that the altered levels of interleukin-2 receptor (IL-2R) and interleukin-10 (IL-10) were closely associated with the percentage of CD8+ T cells and CD19+ B cells. Additionally, the two cytokines exhibited more sensitive fluctuations based on the status of the children with KD in various circumstances compared with other indexes, such as the percentages of CD8+ T cells and CD19+ B cells or the PLT count. These results suggested that children with KD who are ≥4 years old may benefit from IVIG but will not benefit from decreased platelet activation or suffer less cardiovascular complications. Additionally, starting clopidogrel usage earlier as an antiplatelet strategy should be considered based on the observed continuous rise in the PLT count in children with KD receiving IVIG. In conclusion, dynamically monitoring the levels of IL-2R and IL-10 has the potential to provide indications of the intensity and development of the inflammatory response in children with KD and may contribute to the early prediction and adjustment of pathological and pharmacological effects of therapy.

Traceability of honey is highly required by consumers and food administration with the consideration of food safety and quality. In this study, a technique named laser-induced breakdown spectroscopy (LIBS) was used to fast trace geographical origins of acacia honey and multi-floral honey. LIBS emissions from elements of Mg, Ca, Na, and K had significant differences among different geographical origins. The clusters of honey from different geographical origins were visualized with principal component analysis. In addition, support vector machine (SVM) and linear discrimination analysis (LDA) were used to quantitively classify the origins. The results indicated that SVM performed better than LDA, and the discriminant results of multi-floral honey were better than acacia honey. The accuracy and mean average precision for multi-floral honey were 99.7% and 99.7%, respectively. This study provided a fast approach for geographical origin classification, and might be helpful for food traceability.

Three strategies using lamivudine have been proposed to prevent chemotherapy-induced HBV (hepatitis B virus) reactivation in the clinical setting. The purpose of this meta-analysis is to evaluate the efficacy of the early preemptive strategy, deferred preemptive strategy and therapeutic strategy in patients with HBsAg-positive breast cancer during chemotherapy.Clinical studies published from database inception until Nov 1, 2014, were included for analysis. The primary outcomes were overall survival, rate of chemotherapy disruption and virological and clinical reactivation. The secondary outcomes were the rates of HBV-related chemotherapy disruption, HBV-related mortality, YMDD mutations and withdrawal hepatitis.Four hundred and thirty patients in four studies that compared the early preemptive strategy with a therapeutic strategy were included. Application of early preemptive lamivudine was superior in reducing HBV recurrence (pooled OR: 0.12, 95% CI, 0.04 to 0.31, P< 0.0001), the incidence of HBV-related hepatitis (pooled OR: 0.13, 95% CI, 0.04 to 0.37, P< 0.0001) and the rate of chemotherapy disruption (pooled OR: 0.37, 95% CI, 0.23 to 0.60, P< 0.0001). In these two groups, no significant difference was found in overall mortality (P = 0.32), YMDD mutant rate (P = 0.13) or incidence of withdrawal hepatitis (P = 0.38). Of the two studies that compared the efficacy of an early and a deferred preemptive strategy, one showed that an early preemptive strategy significantly reduced the incidence of hepatitis (P = 0.046), whereas the other showed no significant difference (P = 0.7).An early preemptive strategy is superior to a therapeutic strategy in decreasing the incidence of HBV reactivation, incidence of HBV-related hepatitis and rate of chemotherapy disruption in patients with breast cancer. A deferred preemptive strategy might be an alternative approach to controlling viral replication.