The Chinese economy has developed rapidly since the reform and opening up, but economic growth in Northeast China has declined dramatically after the 21st century. In this context, exploring the ...characteristics of economic and industrial fluctuations in the northeast of China and their relationship is beneficial to alleviating economic fluctuations and promoting stable economic development from the perspective of industrial development. The relationship between economic and industrial fluctuations in the three provinces of Northeast China was reexamined from the angle of fluctuation components with the complete ensemble empirical mode decomposition with adaptive noise (CEEMDAN) algorithm. The results obtained are as follows: (1) In the three northeastern provinces of China, economic fluctuations were almost free from the influence of the primary industry, most affected by the secondary industry, and gradually influenced by the tertiary industry after the 21st century. (2) Regarding the short-term business cycle of each province, economic development was the most stable when the market and government participated in the development of the secondary industry simultaneously. (3) The midterm business cycle of Jilin Province was affected by the investment of equipment in secondary and tertiary industries, while that of Liaoning Province was affected by the investment of equipment in the secondary industry. (4) Investment in the equipment of the secondary industry and the construction of secondary and tertiary industries was the key to maintaining the stability of long-term business cycle in Heilongjiang Province, and that in the construction of secondary and tertiary industries was the key to maintaining the stability of long-term business cycles in Jilin and Liaoning Provinces.
Pancreatic cancer is an aggressive malignancy, which generally respond poorly to chemotherapy. Hence, novel agents that are safe and effective are highly needed. The aim of this study was to ...investigate whether piperlongumine, a natural product isolated from the fruit of the pepper Piper longum, has any efficacy against human pancreatic cancer when used either alone or in combination with gemcitabine in vitro and in a xenograft mouse model. In vitro, piperlongumine inhibited the proliferation of pancreatic cancer cell lines, potentiated the apoptotic effects of gemcitabine, inhibited the constitutive and inducible activation of NF-κB, and suppressed the NF-κB-regulated expression of c-Myc, cyclin D1, Bcl-2, Bcl-xL, Survivin, XIAP, VEGF, and matrix metalloproteinase-9 (MMP-9). Furthermore, in an in vivo xenograft model, we found piperlongumine alone significantly suppressed tumor growth and enhanced the antitumor properties of gemcitabine. These results were consistent with the downregulation of NF-κB activity and its target genes, decreased proliferation (PCNA and Ki-67), decreased microvessel density (CD31), and increased apoptosis (TUNEL) in tumor remnants. Collectively, our results suggest that piperlongumine alone exhibits significant antitumor effects against human pancreatic cancer and it further enhances the therapeutic effects of gemcitabine, possibly through the modulation of NF-κB- and NF-κB-regulated gene products.
Despite rapid advances in chemotherapy and surgical resection strategies, pancreatic cancer remains the fourth leading cause of cancer related deaths in the United States with a 5-year survival rate ...of less than 5%. Therefore, novel therapeutic agents for the prevention and treatment of pancreatic cancer are urgently needed. The aim of this study was to investigate the effect of pristimerin, a quinonemethide triterpenoid compound isolated from Celastraceae and Hippocrateaceae, on inhibition of cell proliferation and induction of apoptosis in three pancreatic cancer cells, BxPC-3, PANC-1 and AsPC-1, in both monotherapy and in combination with gemcitabine. Treatment with pristimerin decreased the cell proliferation of all three pancreatic cancer cells in a dose- and time-dependent manner. Treatment of pancreatic cancer cells with pristimerin also resulted in G1-phase arrest which was strongly associated with a marked decrease in the level of cyclins (D1 and E) and cyclin-dependent kinases (cdk2, cdk4 and cdk6 ) with concomitant induction of WAF1/p21 and KIP1/p27. Pristimerin treatment also resulted in apoptotic cell death, cleavage of caspase-3, modulation in the expressions of Bcl-2 family proteins, inhibition of the translocation and DNA-binding activity of NF-κB. In addition, pristimerin potentiated the growth inhibition and apoptosis inducing effects of gemcitabine in all three pancreatic cancer cells, at least in part, by inhibiting constitutive as well as gemcitabine-induced activation of NF-κB in both its DNA-binding activity and transcriptional activity. Taken together, these data provide the first evidence that pristimerin has strong potential for development as a novel agent against pancreatic cancer.
High-power, high-purity, nanosecond (ns) one-dimensional HG0n laser beams are proposed and demonstrated by using Nd:YAG cascaded slabs with a large aspect ratio. The HG0n laser beams are generated by ...adjusting the pump distribution, the intracavity apertures, and the tilt angle of the output coupler (OC). By controlling the gain and loss of HG0n modes of different orders, the high-purity, one-dimensional, high-order HG0n laser beams with orders 1 to 9 (HG01 to HG09) are produced, and their beam quality factors M2 align well with the theoretical predictions. Meanwhile, the large aspect ratio slab provides an ideal amplifier for the strip-shaped HG0n laser beams, and further power scaling is achieved by seeding the generated HG0n laser beams into an amplifier with an identical slab module. For the HG09 mode, the average power is amplified from 289 mW to 4.73 W with 294 ns pulse width, corresponding to a peak power of 32 kW. Moreover, above 5 W average power is achieved for all HG01 to HG08 modes. Hopefully, this scheme provides a solution for high-power and high-purity HG0n laser beam generation based on the slab-shaped configuration.
Dual-layer spectral-detector dual-energy computed tomography angiography (DLCTA) can distinguish components of carotid plaques. Data on identifying symptomatic carotid plaques in patients using DLCTA ...are not available.
In this prospective observational study, patients with carotid plaques were enrolled and received DLCTA. The attenuation for both polyenergetic image and virtual monoenergetic images (40, 70, 100, and 140 keV), as well as
-effective value, were recorded in the noncalcified regions of plaques. Logistic regression models were used to assess the association between attenuations of DLCTA and the presence of symptomatic carotid plaques. In total, 100 participants (mean±SD age, 64.37±8.31 years; 82.0% were men) were included, and 36% of the cases were identified with the symptomatic group. DLCTA parameters were different between 2 groups (symptomatic versus asymptomatic: computed tomography CT 40 keV, 152.63 interquartile range (IQR), 70.22-259.78 versus 256.78 IQR, 150.34-408.13; CT 70 keV, 81.28 IQR, 50.13-119.33 versus 108.87 IQR, 77.01-165.88; slope
, 0.91 IQR, 0.35-1.87 versus 1.92 IQR, 0.96-3.00;
-effective value, 7.92 IQR, 7.53-8.46 versus 8.41 IQR, 7.94-8.92), whereas no difference was found in conventional polyenergetic images. The risk of symptomatic plaque was lower in the highest tertiles of attenuations in CT 40 keV (adjusted odds ratio OR, 0.243 95% CI, 0.078-0.754), CT 70 keV (adjusted OR, 0.313 95% CI, 0.104-0.940),
effective values (adjusted OR, 0.138 95% CI, 0.039-0.490), and slope
(adjusted OR, 0.157 95% CI, 0.046-0.539), with all
values and
trends <0.05. The areas under the curve for CT 40 keV, CT 70 keV, slope 40 to 140 keV, and
-effective values were 0.64, 0.61, 0.64, and 0.63, respectively.
Parameters of DLCTA might help assist in distinguishing symptomatic carotid plaques. Further studies with a larger sample size may address the overlap and improve the diagnostic accuracy.
We examined the feasibility of estimating the spatial distribution of urban populations based on first-aid calls based on one high-density place, the Shanghai urban area and one low-density place, ...the Nanhai District of Foshan City in Guangdong Province. We aggregated the population and the total number of first-aid calls on digital maps divided by grids based on a Geographic Information System (GIS). Geographically weighted regression was applied to test the correlation between the population distribution simulated by first-aid call data and the actual residency. The impact of different population densities, different grid cell sizes and different types of first-aid calls on simulation correlation were tested. We found that the use of first-aid call data could explain 60-95% of the actual population distribution in Shanghai using a grid with 1000*1000 m cell size, while the Nanhai experience was that first-aid calls could only explain 4-76% of the actual population distribution using a grid with 2000*2000 m cell size. Thus, the higher the population density, the better the simulation effect. For a high-population density area, the overall accuracy of simulation can reach as high as 0.878 at the 1-km2 resolution. However, there are different kinds of first-aid calls and for the best estimation of the population distribution in densely populated areas, we suggest using first-aid calls from people requiring acute medical care rather than all first-aid call data.
Chronic subdural hematoma (CSDH) is a neurological condition with high recurrence rates, primarily observed in the elderly population. Although several risk factors have been identified, predicting ...CSDH recurrence remains a challenge. Given the potential of machine learning (ML) to extract meaningful insights from complex data sets, our study aims to develop and validate ML models capable of accurately predicting postoperative CSDH recurrence.
Data from 447 CSDH patients treated with consecutive burr-hole irrigations at Wenzhou Medical University's First Affiliated Hospital (December 2014-April 2019) were studied. 312 patients formed the development cohort, while 135 comprised the test cohort. The Least Absolute Shrinkage and Selection Operator (LASSO) method was employed to select crucial features associated with recurrence. Eight machine learning algorithms were used to construct prediction models for hematoma recurrence, using demographic, laboratory, and radiological features. The Border-line Synthetic Minority Over-sampling Technique (SMOTE) was applied to address data imbalance, and Shapley Additive Explanation (SHAP) analysis was utilized to improve model visualization and interpretability. Model performance was assessed using metrics such as AUROC, sensitivity, specificity, F1 score, calibration plots, and decision curve analysis (DCA).
Our optimized ML models exhibited prediction accuracies ranging from 61.0% to 86.2% for hematoma recurrence in the validation set. Notably, the Random Forest (RF) model surpassed other algorithms, achieving an accuracy of 86.2%. SHAP analysis confirmed these results, highlighting key clinical predictors for CSDH recurrence risk, including age, alanine aminotransferase level, fibrinogen level, thrombin time, and maximum hematoma diameter. The RF model yielded an accuracy of 92.6% with an AUC value of 0.834 in the test dataset.
Our findings underscore the efficacy of machine learning algorithms, notably the integration of the RF model with SMOTE, in forecasting the recurrence of postoperative chronic subdural hematoma. Leveraging the RF model, we devised an online calculator that may serve as a pivotal instrument in tailoring therapeutic strategies and implementing timely preventive interventions for high-risk patients.
Lung cancer is one of the most common malignant tumors worldwide. Early detection is the most important factor that affects the prognosis of lung cancer patients. The distal phalanx is a highly ...unusual metastatic site of lung cancer, and is often misdiagnosed, especially when accompanied by trauma. Herein, we present the case of a 68‐year‐old male patient who injured his right little finger. We hope this rare case will help clinicians to better diagnosis acral metastases of lung cancer to prolong patient survival.
Acrometastases of the hand are extremely rare and may be the first manifestation of lung cancer, but they consider a poor prognosis marker. It is important for physicians who encounter patients with a persistent lesion at the site of a wound located in the hand to earlier diagnosis. This recognition will improve patient care and may lead to earlier diagnosis of malignancy.
Absorbing aerosols have significant influences on tropospheric photochemistry and regional climate change. Here, the direct radiative effects of absorbing aerosols at the major AERONET sites in East ...Asia and corresponding impacts on near-surface photochemical processes were quantified by employing a radiation transfer model. The average annual aerosol optical depth (AOD) of sites in China, Korea, and Japan was 1.15, 1.02 and 0.94, respectively, and the corresponding proportion of absorbing aerosol optical depth (AAOD) was 8.61%, 6.69%, and 6.49%, respectively. The influence of absorbing aerosol on ultraviolet (UV) radiation mainly focused on UV-A band (315–400 nm). Under the influence of such radiative effect, the annual mean near-surface JNO2 (JO1D) of sites in China, Korea, and Japan decreased by 16.95% (22.42%), 9.61% (13.55%), and 9.63% (13.79%), respectively. In Beijing–Tianjin–Hebei (BTH) and Yangtze River Delta (YRD) region, the annual average AOD was 1.48 and 1.29, and the AAOD was 0.14 and 0.13, respectively. The UV radiative forcing caused by aerosols dominated by black carbon (BC-dominated aerosols) on the surface was −3.19 and −2.98 W m−2, respectively, accounting for about 40% of the total aerosol radiative forcing, indicating that the reduction efficiency of BC-dominated aerosols on solar radiation was higher than that of other types of aerosols. The annual mean JNO2 (JO1D) decreased by 14.90% (20.53%) and 13.71% (18.20%) due to the BC-dominated aerosols. The daily maximum photolysis rate usually occurred near noon due to the diurnal variation of solar zenith angle and, thus, the daily average photolysis rate decreased by 2–3% higher than that average during 10:00–14:00.
To develop a set of structure and process indicators to evaluate tertiary hospitals' performance in the Healthcare Improvement Initiative, a national program with a goal to improve quality of ...patient-centered care.
A modified Delphi technique, including literature review, multidisciplinary panel meeting and anonymous rating, was used to generate a set of indicators. A practice test involving both general and special hospitals was conducted to ensure the feasibility of data collection for these indicators.
62 indicators were generated by literature review. The panel review procedure involving 39 panelists with diverse backgrounds resulted in a total of 59 indicators, which included 40 qualitative indicators and 19 quantitative indicators. In the practice test, six quantitative indicators were found unfeasible. According to the suggestion of the experts in the hospital evaluation committee, three of those indicators were kept by adjusting their data collection methods, while other three ones were discarded.
A set of 56 structure and process indicators was developed to evaluate hospitals' performance in the implementation of the Healthcare Improvement Initiative, which could be used in both general and special tertiary hospitals. Results of the indicator measurement could present a panorama of the quality of patient-centered care in tertiary hospitals nation-wide, and inform health administrators of the ways to attain the goal of the Initiative.
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