Three grinding stones from Shizitan Locality 14 (ca. 23,000-19,500 calendar years before present) in the middle Yellow River region were subjected to usewear and residue analyses to investigate human ...adaptation during the last glacial maximum (LGM) period, when resources were generally scarce and plant foods may have become increasingly important in the human diet. The results show that these tools were used to process various plants, including Triticeae and Paniceae grasses, Vigna beans, Dioscorea opposita yam, and Trichosanthes kirilowii snakegourd roots. Tubers were important food resources for Paleolithic hunter-gatherers, and Paniceae grasses were exploited about 12,000 y before their domestication. The long tradition of intensive exploitation of certain types of flora helped Paleolithic people understand the properties of these plants, including their medicinal uses, and eventually led to the plants' domestication. This study sheds light on the deep history of the broad spectrum subsistence strategy characteristic of late Pleistocene north China before the origins of agriculture in this region.
The lithic assemblage from Shizitan 29, a late Upper Paleolithic open-air site in Shanxi, China, provides evidence for the earliest, well-dated microblade production in East Asia, ca. 26/24 Ka cal ...BP. To pursue a behavioral rather than traditional typological understanding of this key adaptive technology, we apply a techno-functional approach that enables us to reconstruct the entire operational sequence in behavioral terms through the derivation of technical objectives. This methodology can serve as a model to be applied to other assemblages for greater understanding of the origins and spread of the broadly distributed eastern Asian Late Pleistocene microblade industries. Within the eight cultural layers at Shizitan 29, microblade production abruptly appears at the top of Layer 7 following earlier core-and-flake production, supporting hypotheses of microblade technology arising within adaptive strategies to worsening Late Glacial Maximum environments. Significantly, reconstruction of the operational sequence supports microblade technology being introduced into the North China Loess Plateau from regions further north. It also allows us to re-think microblades' relationship in behavioral terms with earlier limited examples of East Asian blade production and the evolution and spread of microblade technology, providing new insights into the adaptive relationships between subsequent microblade productions.
Yin Yang 1 (YY1) is a multifunctional protein regulating both gene transcription and protein modifications. Recent studies reveal a proliferative role of YY1 in oncogenesis. Consistently, YY1 ...overexpression has been observed in various human malignancies and its levels correlate with poor prognoses of many types of cancers. In this review, we focus on the signaling pathways and regulatory proteins that YY1 modulates to promote tumor cell growth, proliferation, migration and metastasis. We also discuss the signals and molecules that regulate YY1 expression and function in cancer-related context. Based on the expression feature and regulatory activities in tumor cells, YY1 possesses a great potential as a biomarker for many cancers and can serve as a therapeutic target clinically to impede cancer development and progression or sensitize cancer cells to anticancer drugs.
Receptors are macromolecules that transmit information regulating cell proliferation, differentiation, migration and apoptosis, play key roles in oncogenic processes and correlate with the prognoses ...of cancer patients. Thus, targeting receptors to constrain cancer development and progression has gained widespread interest. Small molecule compounds of natural origin have been widely used as drugs or adjuvant chemotherapeutic agents in cancer therapies due to their activities of selectively killing cancer cells, alleviating drug resistance and mitigating side effects. Meanwhile, many natural compounds, including those targeting receptors, are still under laboratory investigation for their anti-cancer activities and mechanisms. In this review, we classify the receptors by their structures and functions, illustrate the natural compounds targeting these receptors and discuss the mechanisms of their anti-cancer activities. We aim to provide primary knowledge of mechanistic regulation and clinical applications of cancer therapies through targeting deregulated receptors.
Clinical named entity recognition (CNER) is important for medical information mining and establishment of high-quality knowledge map. Due to the different text features from natural language and a ...large number of professional and uncommon clinical terms in Chinese electronic medical records (EMRs), there are still many difficulties in clinical named entity recognition of Chinese EMRs. It is of great importance to eliminate semantic interference and improve the ability of autonomous learning of internal features of the model under the small training corpus.
From the perspective of deep learning, we integrated the attention mechanism into neural network, and proposed an improved clinical named entity recognition method for Chinese electronic medical records called BiLSTM-Att-CRF, which could capture more useful information of the context and avoid the problem of missing information caused by long-distance factors. In addition, medical dictionaries and part-of-speech (POS) features were also introduced to improve the performance of the model.
Based on China Conference on Knowledge Graph and Semantic Computing (CCKS) 2017 and 2018 Chinese EMRs corpus, our BiLSTM-Att-CRF model finally achieved better performance than other widely-used models without additional features(F1-measure of 85.4% in CCKS 2018, F1-measure of 90.29% in CCKS 2017), and achieved the best performance with POS and dictionary features (F1-measure of 86.11% in CCKS 2018, F1-measure of 90.48% in CCKS 2017). In particular, the BiLSTM-Att-CRF model had significant effect on the improvement of Recall.
Our work preliminarily confirmed the validity of attention mechanism in discovering key information and mining text features, which might provide useful ideas for future research in clinical named entity recognition of Chinese electronic medical records. In the future, we will explore the deeper application of attention mechanism in neural network.
Background Telemedicine is beneficial for improving treatment efficiency and reducing medical expenses of cancer patients. This study focuses on cancer patients participating in teleconsultations ...through a regional telemedicine platform in China, analyzes the consultation process, and provides references for the clinical application of telemedicine. Methods We collected information on teleconsultations of cancer patients conducted from 2015 to 2022 through the regional telemedicine platform. Utilizing SPSS 23.0 software, we conducted descriptive analysis to summarize the distribution of patient gender, age, region, and disease types. The ordinal logistic regression analysis was adopted to analyze the factors influencing the waiting time and consultation duration for teleconsultations. Results From 2015 to 2022, a total of 23,060 teleconsultations were conducted for cancer patients via regional telemedicine platform, with an average growth rate of 11.09%. The main types of consultations were for lung cancer, liver cancer, and breast cancer, accounting for 18.14%, 10.49%, and 9.46% respectively. 57.05% of teleconsultations had a waiting time of less than 24 h, while patient age, consultation expert level, and disease type were the main factors influencing the waiting time. 50.06% of teleconsultations had a duration of more than 20 min, and the inviting hospital level and the title of invited consultant were the main factors influencing the consultation duration. Conclusions In China, telemedicine has been widely employed in the clinical diagnosis and treatment of cancers, covering various types of oncological diseases. However, the waiting time for teleconsultations was generally more than 12 h, indicating the need to enhance consultation scheduling and allocate more expert resources to further optimize the efficiency of teleconsultations. Additionally, further exploration is required for remote health management of outpatients with cancers outside the hospital. Keywords: Telemedicine, Cancer treatment, Regional telemedicine service platform, Efficiency, Satisfaction
Background
Telemedicine that combines information technology and health care augments the operational model of traditional medical services and brings new opportunities to the medical field. China ...promotes telemedicine with great efforts, and its practices in the deployment of telemedicine platforms and delivery of services have become important references for the research and development in this field.
Objective
Our work described in this paper focuses on a regional telemedicine platform that was built in 2014. We analyzed the system design scheme and remote consultations that were conducted via the system to understand the deployment and service delivery processes of a representative telemedicine platform in China.
Methods
We collected information on remote consultations conducted from 2015 to 2020 via the regional telemedicine platform that employs a centralized architectural system model. We used graphs and statistical methods to describe the changing trends of service volume of remote consultation, geographical and demographic distribution of patients, and waiting time and duration of consultations. The factors that affect consultation duration and patient referral were analyzed by multivariable linear regression models and binary logistic regression models, respectively. The attitudes toward telemedicine of 225 medical practitioners and 225 patients were collected using the snowball sampling method.
Results
The regional telemedicine platform covers all levels of medical institutions and hospitals in all 18 cities of Henan Province as well as some interprovince hospitals. From 2015 to 2020, 103,957 remote medical consultations were conducted via the platform with an annual increasing rate of 0.64%. A total of 86.64% (90,069/103,957) of medical institutions (as clients) that applied for remote consultations were tier 1 or 2 and from less-developed regions; 65.65% (68,243/103,945) of patients who applied for remote consultations were aged over 50 years. The numbers of consultations were high for departments focusing in the treatment of chronic diseases such as neurology, respiratory medicine, and oncology. The invited experts were mainly experienced doctors with senior professional titles. Year of consultation, tier of hospital, consultation department, and necessity of patient referral were the main factors affecting the duration of consultations. In surveys, we found that 60.4% (136/225) of medical practitioners and 53.8% (121/225) of patients had high satisfaction and believed that telemedicine is of vital importance for the treatment of illness.
Conclusions
The development of telemedicine in China shows a growing trend and provides great benefits especially to medical institutions located in less developed regions and senior citizens who have less mobility. Cases of remote consultations are mainly for chronic diseases. At present, the importance and necessity of telemedicine are well recognized by both patients and medical practitioners. However, the waiting time needs to be further reduced to improve the efficiency of remote medical services.
Telemedicine has demonstrated its potential in alleviating the unbalanced distribution of medical resources across different regions. Henan, a province in China with a population of approximately 100 ...million, is especially affected by a health care divide. The province has taken a proactive step by establishing a regional collaborative platform for telemedicine services provided by top-tier provincial hospitals.
We aim to identify the key factors that influence the current operationalization and effectiveness of telemedicine services in Henan province. The insights gained from this study will serve as valuable references for enhancing the efficient operation of telemedicine platforms in low- and middle-income regions.
We analyzed service reports from the performance management system of telemedicine services in Henan province throughout 2020. Using descriptive statistics and graphical methods, we examined key influencing factors, such as management competency; device configuration; and hospital capability, capacity, and service efficacy, across hospitals at 2 different tiers. In addition, we used generalized linear models and multiple linear regression models to identify key operational factors that significantly affect the service volume and efficacy of 2 major telemedicine services, namely teleconsultation and tele-education.
Among the 89 tier 3 hospitals and 97 tier 2 hospitals connected to the collaborative telemedicine platform, 65 (73%) and 55 (57%), respectively, have established standardized management procedures for telemedicine services. As the primary delivery method for telemedicine services, 90% (80/89) of the tier 3 hospitals and 94% (91/97) of the tier 2 hospitals host videoconferencing consultations through professional hardware terminals rather than generic computers. Teleconsultation is the dominant service type, with an average annual service volume per institution of 173 (IQR 37-372) and 60 (IQR 14-271) teleconsultations for tier 3 and tier 2 hospitals, respectively. Key factors influencing the service volume at each hospital include available funding, management competency, the number of connected upper tiers, and the number of professional staff. After receiving teleconsultations from tier 3 (65/89, 73%) and tier 2 (61/97, 63%) hospitals, patients reported significant improvements in their medical conditions. In addition, we observed that service efficacy is positively influenced by management competency, financial incentives, the number of connected upper or lower tiers, and the involvement of participating medical professionals.
Telemedicine has become increasingly popular in Henan province, with a notable focus on teleconsultation and tele-education services. Despite its popularity, many medical institutions, especially tier 2 hospitals, face challenges related to management competency. In addition to enhancing the effectiveness of existing telemedicine services, health care decision-makers in Henan province and other low- and middle-income regions should consider expanding the service categories, such as including remote emergency care and telesurgery, which have promise in addressing crucial health care needs in these regions.
The widespread adoption of telehealth services necessitates accurate online department selection based on patient medical records, a task requiring significant medical knowledge. Incorrect triage ...results in considerable time wastage for both patients and medical professionals. To address this, we propose an intelligent triage model based on a Bidirectional Long Short-Term Memory (Bi-LSTM) neural network with character embedding to enhance the efficiency and capacity of telehealth services.
We gathered a 1.3 GB medical dataset comprising 200,000 records, each including medical history, physical examination data, and other pertinent information found on the electronic medical record homepage. Following data preprocessing, a clinical corpus was established to train character embeddings with a medical context. These character embeddings were then utilized to extract features from patient chief complaints, and a 2-layer Bi-LSTM neural network was trained to categorize these complaints, enabling intelligent triage for telehealth services.
60,000 chief complaint-department data pairs were extracted from clinical corpus and divided into the training, validation, and test sets of 42,000, 9,000, and 9,000, respectively. The character embedding based Bi-LSTM neural network achieved a macro-precision of 85.50% and an F1 score of 85.45%.
The telehealth triage model developed in this study demonstrates strong implementation outcomes and significantly improves the efficiency and capacity of telehealth services. Character embedding outperforms word embedding, and future work will incorporate additional features such as patient age and gender into the chief complaint feature to future enhance model performance.
G-quadruplexes (G4s) can recruit transcription factors to activate gene expression, but detailed mechanisms remain enigmatic. Here, we demonstrate that G4s in the CCND1 promoter propel the motility ...in MAZ phase-separated condensates and subsequently activate CCND1 transcription. Zinc finger (ZF) 2 of MAZ is a responsible for G4 binding, while ZF3-5, but not a highly disordered region, is critical for MAZ condensation. MAZ nuclear puncta overlaps with signals of G4s and various coactivators including BRD4, MED1, CDK9 and active RNA polymerase II, as well as gene activation histone markers. MAZ mutants lacking either G4 binding or phase separation ability did not form nuclear puncta, and showed deficiencies in promoting hepatocellular carcinoma cell proliferation and xenograft tumor formation. Overall, we unveiled that G4s recruit MAZ to the CCND1 promoter and facilitate the motility in MAZ condensates that compartmentalize coactivators to activate CCND1 expression and subsequently exacerbate hepatocarcinogenesis.
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