In this paper, a fuzzy multi-attribute decision analysis approach (FMADAA) was developed for supporting the evaluation of water resources security in nine provinces within the Yellow River basin. A ...numerical approximation system and a modified left-right scoring approach were adopted to cope with the uncertainties in the acquired information. Also, four conventional multi-attribute decision analysis (MADA) methods were implemented in the evaluation model for impact evaluation, including simple weighted addition (SWA), weighted product (WP), cooperative game theory (CGT) and technique for order preference by similarity to ideal solution (TOPSIS). Moreover, several aggregation methods including average ranking procedure, Borda and Copeland methods were used to integrate the ranking results, helping rank the water resources security in those nine provinces as well as improving reliability of evaluation results. The ranking results showed that the water resources security of the entire basin was in critical condition, including the insecurity and absolute insecurity states, especially in Shanxi, Inner Mongolia and Ningxia provinces in which water resources were lower than the average quantity in China. Hence, the improvement of water eco-environment statuses in the above-mentioned provinces should be prioritized in the future planning of the Yellow River basin.
A 34-year-old female presented to the doctor with chief complaint of redness in both eyes for 1 week. The slit lamp examination showed slight eyelid swelling, water-like discharge in the conjunctival ...sac of the lower eyelid, conjunctival follicles, gray-white pseudomembrane and small lamellar subconjunctival hemorrhage on the lower palpebral conjunctiva. Physical examination showed two erythematous macules(size 5 mm×6 mm) on the left palm. One erythematous macule(size 4 mm×5 mm) was seen on the right palm. Multiple erosions were located in the skin of upper and lower lips, oral cavity and the gingival mucosa. A diagnosis of hand, foot and mouth disease was made following by dermatological consultation. After topical antiviral and steroids treatment, the disease quickly relieved.
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Undescended testis or cryptorchidism is the most common reproductive system disease in children. About 3% of full-term and 30% of premature male infants are born with one or both testicles ...undescended. Most cryptorchidism is asymptomatic and is occasionally found due to inguinal pain caused by testicular torsion. Herein, we presented a case of pediatric patient with abdominal pain as initial symptom who was found the left inguinal cryptorchidism complicated by testicular torsion, and then spontaneous remission during the color Doppler ultrasonography examination.
Here we evaluated the anti-hepatocellular carcinoma activity by the Jujube leaf green tea extracts (JLGTE). We showed that JLGTE exerted anti-proliferative, cytotoxic and pro-apoptotic activities ...against HepG2 and primary human hepatocellular carcinoma cells. It was however non-cytotoxic to the normal hepatocytes. JLGTE activated AMP-activated protein kinase (AMPK) signaling, which was required for its cytotoxicity against hepatocellular carcinoma cells. Silence of AMPKα1, via targeted short hairpin RNAs or CRISPR-Cas9 genome editing, inhibited JLGTE-induced AMPK activation and HepG2 cell apoptosis. Further, in-activation of AMPK by a dominant negative AMPKα1 (T172A) also alleviated JLGTE's cytotoxicity against HepG2 cells. On the other hand, forced-activation of AMPK by introduction of a constitutively-active AMPKα1 (T172D) mimicked JLGTE's actions and led to HepG2 cell apoptosis. These results suggest that JLGTE inhibits human hepatocellular carcinoma cells possibly via activating AMPK.
A direct and in situ digestion technique is reported for electrothermal atomic absorption spectrometric analysis of Cd in dairy products. In situ digestion methods offered high sensitivity due to the ...absence of sample dilution andminimum risk of contamination or analyte loss. Under optimized conditions, the calibration graph was linear in the range of 0–5 ng/mL, with a limit of detection of 0.012 ng/mL. The method was successfully applied in dairy product samples including milks, yogurt, and milk beverages, with spiked recoveries of 91 to 111%. The accuracy of the proposed method was also validated by wet digestion-based method.
To explore the therapeutic efficacy of nasal Continuous Positive Airway Pressure (CPAP) and aerobic exercise of different intensity in patients with Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS) ...and Type 2 Diabetes Mellitus (T2DM).
A total of 112 patients with OSAHS and T2DM, including 53 males and 59 females, with a mean age of (66.9±7.8) years old, from the Fourth Rehabilitation Hospital of Shanghai and the Second Affiliated Hospital of Soochow University from January 2017 to December 2018 were enrolled prospectively. There were divided into two groups based on whether received nasal CPAP therapy: 50 cases in nasal CPAP+aerobic exercise group and 62 cases in aerobic exercise group. Subsequently, patients in nasal CPAP+aerobic exercise group were randomly divided into two subgroups: moderate and low intensity aerobic exercise (26 and 24 cases respectively). All patients completed nasal CPAP and (or) aerobic exercise of different intensity for 20 weeks. The therapeutic efficacy of polysomnography (PSG) pa
The identification of pathogen-associated molecular patterns, conserved microbial structures that act on Toll-like receptors, has led to a novel avenue of investigation aimed at developing a new ...generation of cancer immunotherapies. Ligation of Toll-like receptors results in the induction of robust immune responses that may be directed against tumor-associated antigens. Recent data suggest that such strategies may result in enhanced antitumor immunity. Nonetheless, as clinically effective immunotherapy for cancer remains a somewhat distant goal, attention has shifted toward multimodality approaches to cancer therapy, sometimes combining novel immune interventions and conventional treatments. The traditional view of radiation therapy as immunosuppressive has now been challenged, prompting a re-evaluation of its potential as an adjunct to immunotherapy. Radiation therapy can enhance the expression of tumor-associated antigens, induce immune-mediated targeting of tumor stroma, and diminish regulatory T cell activity. Recent evidence suggests that radiation therapy may also activate effectors of innate immunity through TLR-dependent mechanisms, thereby augmenting the adaptive immune response to cancer. In this paper, we will review evidence for enhanced tumor-directed immunity resulting from radiation exposure and early promising data suggesting synergistic effects of radiation and TLR-targeted immunotherapies.
Although gastric adenocarcinoma (GA) related ocular metastasis (OM) is rare, its occurrence indicates a more severe disease. We aimed to utilize machine learning (ML) to analyze the risk factors of ...GA-related OM and predict its risks.
This is a retrospective cohort study. The clinical data of 3532 GA patients were collected and randomly classified into training and validation sets in a ratio of 7:3. Those with or without OM were classified into OM and non-OM (NOM) groups. Univariate and multivariate logistic regression analyses and least absolute shrinkage and selection operator were conducted. We integrated the variables identified through feature importance ranking and further refined the selection process using forward sequential feature selection based on random forest (RF) algorithm before incorporating them into the ML model. We applied six ML algorithms to construct the predictive GA model. The area under the receiver operating characteristic (ROC) curve indicated the model's predictive ability. Also, we established a network risk calculator based on the best performance model. We used Shapley additive interpretation (SHAP) to identify risk factors and to confirm the interpretability of the black box model. We have de-identified all patient details.
The ML model, consisting of 13 variables, achieved an optimal predictive performance using the gradient boosting machine (GBM) model, with an impressive area under the curve (AUC) of 0.997 in the test set. Utilizing the SHAP method, we identified crucial factors for OM in GA patients, including LDL, CA724, CEA, AFP, CA125, Hb, CA153, and Ca
. Additionally, we validated the model's reliability through an analysis of two patient cases and developed a functional online web prediction calculator based on the GBM model.
We used the ML method to establish a risk prediction model for GA-related OM and showed that GBM performed best among the six ML models. The model may identify patients with GA-related OM to provide early and timely treatment.
Radiation-induced cavernomas (RIC) are common late toxicities in long-term survivors of malignancy following cerebral irradiation. However, the natural history of RIC is poorly described. We report ...the first series of long-term surveillance of RIC using modern magnetic resonance imaging (MRI) including highly sensitive susceptibility-weighted imaging (SWI). The aims of this research were to better characterise the natural history of RIC and investigate the utility of MRI-SWI for screening and surveillance.
Eligibility required long-term survivors of malignancy with previous exposure to cerebral irradiation and RIC identified on MRI-SWI surveillance. The number and size of RIC were reported on Baseline MRI-SWI and last Follow-up MRI-SWI.
In total, 113 long-term survivors with RIC underwent MRI-SWI surveillance; 109 (96%) were asymptomatic at the time of RIC diagnosis. The median age at cerebral irradiation was 9.3 years; the median radiotherapy dose was 50.4 Gy. The median time from cerebral irradiation to Baseline MRI-SWI was 17.9 years. On Baseline MRI-SWI, RIC multiplicity was present in 89% of patients; 34% had >10 RIC; 65% had RIC ≥4 mm. The median follow-up from Baseline MRI-SWI was 7.3 years. On Follow-up MRI-SWI, 96% of patients had multiple RIC; 62% had >10 RIC; 72% had RIC ≥4 mm. Of the 109 asymptomatic patients at RIC diagnosis, 96% remained free from RIC-related symptoms at 10 years. Only two required neurosurgical intervention for RIC; there was no RIC-related mortality.
RIC are commonly multiple, asymptomatic and typically increase in size and number over time. Our findings suggest that MRI-SWI for screening of RIC is unlikely to influence longer term intervention in asymptomatic cancer survivors. In the absence of neurological symptoms, assessment or monitoring of RIC are insufficient indications for MRI-SWI surveillance for long-term survivors of malignancy with past exposure to cerebral irradiation.
•We present the largest cohort of long-term cancer survivors diagnosed with RIC.•First study of modern MRI with highly sensitive SWI for long-term RIC surveillance.•RIC are commonly asymptomatic, and typically increase in size and number over time.•Screening MRI-SWI does not influence the need for long-term intervention for RIC.•In asymptomatic patients, MRI-SWI surveillance does not appear to be warranted.
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