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Background: Patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) are at high risk of thrombosis. However, bleeding-related complications during antithrombotic therapy remain a major barrier to effective treatment and can often lead to adverse outcomes. This meta-analysis aimed to determine the efficacy and safety of bivalirudin and heparin in patients with ACS after PCI. Methods: Randomized controlled trials (RCTs) on the efficacy and safety of bivalirudin versus heparin in patients with ACS after PCI were identified from the PubMed, Embase, Cochrane Library, CBM, CNKI, WanFang, and VIP database until August 2024. The outcomes included all-cause mortality, major adverse cardiovascular events (MACEs), incidence of recurrent myocardial infarction, stent thrombosis, short-term bleeding, revascularization, and retransfusion. Meta-analysis was performed using RevMan 5.3 and Stata 12.0 softwares. The included studies were assessed for risk of bias using the Cochrane risk-of-bias assessment tool. Results: A total of 70,199 patients from 27 randomized controlled trials (RCTs) were analyzed in this review. There were no significant differences between the bivalirudin and heparin groups in terms of all-cause mortality, major adverse cardiovascular events (MACEs), recurrent myocardial infarction, stent thrombosis within 30 days, or subacute stent thrombosis. Specifically, the incidence of short-term bleeding (P = 0.001) and retransfusion (P = 0.001) was significantly lower in the bivalirudin group compared to the heparin group. Conversely, the incidence of acute stent thrombosis (P < 0.0001) and revascularization (P = 0.009) was significantly higher in the bivalirudin group. Conclusions: Compared with heparin, bivalirudin has definite anticoagulant effect in patients with acute myocardial infarction after PCI, and the risk of bleeding and the incidence of retransfusion were lower in the bivalirudin group. This review helps doctors in PCI management choose bivalirudin or heparin more precisely based on patients' conditions for better treatment and fewer adverse events. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the value of introvoxel incoherent motion diffusion-weighted magnetic resonance imaging (IVIM-DWI) in the diagnosis of benign and malignant ovarian tumor. There were 108 patients with ovarian tumors who were selected to compare the differences of IVM-DWI parameters between benign and malignant tumors. The results showed that the IVIM-DWI parameters including apparent diffusion confident (ADC), slow diffusion confident (Disown) and fast diffusion confident score (f value) of malignant tumor were lower than that of benign tumor (P$0. 05). The area under ROC curve of ADC, Slow and f value in the diagnosis of malignant ovarian tumor were 0. 816, 0. 915 and 0. 852, respectively (P$0. 05). ADC and Disown were negatively correlated with carbohydrate antigen 125(CA125) (r= -- 0. 457 and --0. 553, P$0. 05). The ADC in patients whit Hal stage was significantly lower than that of patients I -- (P$0. 05). In a word, IVIM-DWI parameters have a certain value in the diagnosis of benign and malignant ovarian tumors, and the ADC, Do levels are corrected with CA125 and Hal stage of patients with malignant tumors. [ABSTRACT FROM AUTHOR]

Objective: To systematically evaluate the differences in the efficacy of commonly used topical commercial Chinese polyherbal preparations (CCPPs) for vulvovaginal candidiasis (VVC), and to provide evidence-based reference for clinical drug regimens. Methods: Computer searched major Chinese and English literature databases, and collected randomized controlled trials (RCTs) of external use of CCPPs combined with conventional treatment (CT, test group) versus CT alone (control group) in patients with VVC. After screening the literature, the quality of the included studies was assessed using the risk of bias assessment tool recommended in 5.3 of the Cochrane Handbook. Outcome data for each outcome measure were extracted and a network meta-analysis was performed using Stata 15.0. Results: A total of 74 RCTs with a total of 8,151 patients were included, nine interventions were involved. The results of network meta-analysis showed that, Fufang Shajiziyou suppository combined with CT was more effective in improving the negative conversion rate and controlling the recurrence rate of Candida albicans. Kangfu gel combined with CT had the better effect in relieving pruritus. Baofukang suppository combined with CT was the most effective in reducing leukorrhea. Fufukang spray combined with CT had fewer adverse reactions. Conclusion: The addition of CCPPs to CT may acquire a better curative effect in patients with VVC and external does not significantly increase the occurrence of adverse reactions. However, due to the low quality of the included literature, larger-scale, higher-quality clinical studies are still needed. Systematic Review Registration: PROSPERO, NO: CRD42023410244. [ABSTRACT FROM AUTHOR]

This article examines the intertwined history of local divination schools and divination instructors during the Yuan–Ming transition through a microhistory of the Zhu family—a diviner family who, as newcomers to Suzhou, carefully navigated the turbulent dynastic transition. Based on broader prosopographical research of Yuan and Ming divination school instructors, this study draws two main conclusions regarding social and institutional history during this crisis period. First, the Zhu family, representing lesser elites whose status depended on state institutions, survived the Yuan–Ming transition by building local networks, transforming their expertise, and manipulating narratives of their family history. Second, despite the Ming founder's order for the re-establishment of local divination schools, it was the diviner families, seeking to recover from the dynastic transition, who played a key role in restoring the local institution. This study extends our understanding of the scope of the fourteenth-century crisis, its diverse manifestations across social groups, and the manipulation of crisis narratives for various purposes. It also proposes a bottom-up approach to engage with the Yuan–Ming social and institutional continuity and rupture. [ABSTRACT FROM AUTHOR]

With the recent popularity of applying large-scale deep neural network-based models for natural language processing (NLP), attention to develop methods for text data augmentation is at its peak, since the limited size of training data tends to significantly affect the accuracy of these models. To this end, we propose a novel text data augmentation technique called Intelligent Masking with Optimal Substitutions Text Data Augmentation (IMOSA). IMOSA, developed for labelled sentences, can identify the most favourable sentences and locate the appropriate word combinations in a particular sentence to replace and generate synthetic sentences with a meaning closer to the original sentence, while also significantly increasing the diversity of the dataset. We demonstrate that the proposed technique notably improves the performance of classifiers based on attention-based transformer models through the extensive experiments for five different text classification tasks which are performed under the low data regime in a context-aware NLP setting. The analysis clearly shows that IMOSA effectively generates more sentences using favourable original examples and completely ignores undesirable examples. Furthermore, the experiments carried out confirm IMOSA's ability to add diversity to the augmented dataset using multiple distinct masking patterns against the same original sentence, which remarkably adds variety to the training dataset. IMOSA consistently outperforms the two key masked language model-based text data augmentation techniques, and demonstrates a robust performance against the critical challenging NLP tasks. [ABSTRACT FROM AUTHOR]