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Objective: To investigate the value of machine learning and traditional Cox regression models in predicting postoperative survivorship in patients with adenocarcinoma of the esophagogastric junction (AEG).Methods: This study analyzed clinicopathological data from 203 patients. The Cox proportional risk model and four machine learning models were constructed and internally validated. ROC curves, calibration curves, and clinical decision curves (DCA) were generated. Model performance was assessed using the area under the curve (AUC), while calibration curves determined the fit and clinical significance of the model.Results: The AUC values of the 3-year survival in the validation set for the Cox regression model, extreme gradient boosting, random forest, support vector machine, and multilayer perceptron were 0.870, 0.901, 0.791, 0.832, and 0.725, respectively. The AUC values of 5-year survival in the validation set for each model were 0.915, 0.916, 0.758, 0.905, and 0.737, respectively. The internal validation AUC values for the four machine learning models, extreme gradient boosting, random forest, support vector machine, and multilayer perceptron, were 0.818, 0.772, 0.804, and 0.745, respectively.Conclusion: Compared with Cox regression models, machine learning models do not need to satisfy the assumption of equal proportionality or linear regression models, can include more influencing variables, and have good prediction performance for 3-year and 5-year survival rates of AEG patients, among which, XGBoost models are the most stable and have significantly better prediction performance than other machine learning methods and are practical and reliable.

The article presents materials that make it possible to understand the reason for the absence of one of the classic signs of inflammatory processes in patients with acute pneumonia. The peculiarities of the functional significance of the lungs for the body are the reason that in the case of inflammation in the tissues of the organ, nature has provided for the presence of a more important adaptive mechanism instead of pain as a signal sign. Understanding the causes of the absence of pain in pneumonia in the initial period, which is most responsible for timely and effective care for these patients, allows us to look at the pathogenesis of the disease from a new point of view, which is of fundamental importance for the correction and selection of pathogenetic means of care.

In this report, we describe a case of a small bowel obstruction in the immediate postoperative period following an abdominal myomectomy. After failing conservative management, the patient underwent diagnostic laparoscopy, and the exposed tail of an absorbable barbed V-loc™ (Covidien™, Mansfield, MA, USA) suture used during the myomectomy was identified as the nidus of the small bowel obstruction. While barbed-suture-related bowel obstruction is a known rare complication that is well described in the general surgery literature, it is less documented in gynecological surgery literature. We anticipate the risk to be higher after multiple myomectomy, as postoperative contracture of the uterus can cause protrusion and exposure of the barbed suture tail. Though barbed suture can be safely used for hysterotomy closure during myomectomy, surgeons who opt to use barbed suture during myomectomy should be aware of this potential complication, take intra-operative measures to reduce the risk of postoperative tail protrusion and maintain a high index of suspicion for bowel obstruction in the immediate postoperative period.

The combustion properties of energetic materials have been extensively studied in the scientific literature. With the rapid advancement of data science and artificial intelligence techniques, predicting the performance of solid rocket propellants (SRPs) has become a key focus for researchers globally. Understanding and forecasting the characteristics of SRPs are crucial for analyzing and modeling combustion mechanisms, leading to the development of cutting-edge energetic materials. This study presents a methodology utilizing artificial neural networks (ANN) to create multifactor computational models (MCM) for predicting the burning rate of solid propellants. These models, based on existing burning rate data, can solve direct and inverse tasks, as well as conduct virtual experiments. The objective functions of the models focus on burning rate (direct tasks) and pressure (inverse tasks). This research lays the foundation for developing generalized combustion models to forecast the effects of various catalysts on a range of SRPs. Furthermore, this work represents a new direction in combustion science, contributing to the creation of a High-Energetic Materials Genome that accelerates the development of advanced propellants.

Periodontal diseases are a consequence of the host’s inflammatory and immune mechanisms against dysbiotic bacterial plaque. Given the role of probiotics in biofilm control and modulation of dysbiosis, this study assessed the efficacy of a specific strain of Lactobacillus Reuteri, DSM 17938, in the treatment of stage II and III periodontitis. 36 patients were randomly allocated into two groups: group A, the treated group; and Group B, the control group. The treated group and the control group both underwent initial periodontal debridement. Patients received medications after undergoing periodontal debridement. Clinical parameters were assessed at baseline and at 21 days. All parameters evaluated, Probing Depth (PD), Full Mouth Bleeding score (FMBS), and Full Mouth Plaque Score (FMPS) showed a reduction over time in both groups. The treated group showed a better reduction (p = 0.05) for PD. As far as the depth of probing is concerned, the decrease observed between the control group and the group treated with probiotics is such as to be considered statistically significant and since the average of the values for the treated group is higher than that of the control group, the use of probiotics has an efficacy of medium statistical importance in the treatment of periodontal disease.

Introduction: The current gold standard for SARS-CoV-2 diagnosis by real-time RT-PCR has limitations of gene numbers that can be detected. In this study, we developed a low-cost and high-throughput next-generation sequencing technology that can overcome the limitations of RT-PCR. Methodology: A targeted sequencing panel (TSP) consisting of approximately 500 amplicons was designed that can simultaneously detect a broad range of gene loci of SARS-CoV-2 and genes for the most common viruses of respiratory infectious viruses in a single run of up to 96 samples. 448 samples and 31 control samples were examined independently with both TSP and RT-PCR, results were compared for accuracy and other indicators. Results:  TSP identified 50 SARS-CoV-2 positive samples with a 99.33% match to RT-PCR results. It is not surprising that TSP also identified multiple viral infections from 96 samples, whereas RT-PCR could not. TSP demonstrated its ability to conclude diagnosis for those undecided from RT-PCR tests. Conclusion: Our data demonstrated that TSP is a fast and accurate test for detecting multiple pathogen infections of the respiratory tract.

Background: Systemic sclerosis-associated pulmonary arterial hypertension (SSc-PAH) is characterized by pulmonary arterial remodeling resulting in right ventricular failure and death if untreated. Despite therapeutic advances, there is survival variability within the SSc-PAH population. The aim of this study was to delineate high-risk subgroups of SSc-PAH using readily available clinical parameters.Methods: We analyzed data from the PHAROS database, a prospective observational registry of incident SSc-PAH patients. Latent class modeling was performed based on trends in 6MWD over time. We compared survival between the clusters regarding baseline clinical parameters and changes in these parameters over time.Results: We identified four unique groups within 103 patients meeting our inclusion criteria, based on trajectories of 6MWD. Patients in Cluster 4 exhibited a decline in 6MWD over time and had the worst prognosis with a median survival of 3 years. Patients in Cluster 3, with the lowest baseline 6MWD, were associated with lower median survival (5 years) when compared to Clusters 1 and 2 (> 9 and 7 years, respectively), despite an improvement in 6MWD over time. There were no meaningful changes in SF-36 and WHO functional class between the clusters, but BNP trended higher over time in the higher-risk clusters. Conclusion: We identified high-risk subsets of SSc-PAH characterized by significantly worse survival. Incident SSc-PAH patients with a decline in 6MWD over time or low baseline 6MWD had worse survival when compared to SSc-PAH patients who demonstrated relatively stable or mild reduction in 6MWD over time.

Introduction: The use of local anesthesia (LA) prior to arterial blood gas sampling is recommended but is not widely used. We tested the hypothesis that intradermal administration of local anesthesia would be as effective as subcutaneous administration in reducing pain from arterial blood gas sampling.Aims: The primary aim of this study was to evaluate the effect of intradermal and subcutaneous lignocaine on patient-perceived pain during arterial blood gas sampling. The secondary aims were to evaluate if different routes of LA administration had an impact on the difficulty and complications of ABG sampling.Methods: We undertook a randomized, single-blind, placebo-controlled trial in New Zealand. We enrolled patients attending a nurse-led outpatient oxygen clinic who were 18 to 90 years of age and who had an oxygen saturation of 93% or less at rest. Patients were randomly assigned to receive intradermal 1% lignocaine, subcutaneous 1% lignocaine, or subcutaneous normal saline. Patients and nurse assessors were blinded to the treatment allocation. The primary endpoint was a patient-assessed pain score using a graphic rating scale (0-10).Results: 135 patients were randomized (54 patients in the intradermal lignocaine group, 54 patients in the subcutaneous lignocaine group, and 27 in the subcutaneous saline group). The mean patient-assessed pain score for the intradermal lignocaine group was 1.8 (+/- 1.1), which was a relative reduction of 47% (95% C.I. 31%-59%, p < 0.0001) from the mean patient-assessed pain score of 3.4 (+/- 1.1) for the subcutaneous saline group. The mean patient-assessed pain score for the subcutaneous lignocaine group was 2.1 (+/- 1.1), which was also a significant relative reduction of 36% (95% C.I. 17%-51%, p = 0.0001) compared to the subcutaneous saline group. Intradermal lignocaine reduced pain more than subcutaneous lignocaine, with a relative pain reduction difference of 20% (95% CI -4%-49%, p = 0.05). Bruising was more frequent in the subcutaneous lignocaine group (9.3%) than in the intradermal (0%) and saline groups (0%). Conclusion: Intradermal lignocaine is at least as effective as subcutaneous lignocaine for reducing patient-perceived pain from arterial blood gas sampling and results in less bruising.

German universities of applied sciences have provided a large number of technical talents to society, and have made significant contributions to the enhancement of German education and industry. Drawing on the professional construction experience of German universities of applied sciences, this paper summarizes the path of civil engineering materials courses in China's high-level applied universities. The proposals for curriculum reform were discussed. Colleges and universities can cultivate professionals with strong hands-on abilities, strong exploration abilities, and a scientific research spirit. In addition, this paper puts forward that China needs to make changes from three levels: the country, universities, and teachers. Based on learning from the experience of collaborative education between teaching and scientific research in German universities, we have embarked on a road of education with China characteristics.

The regulatory effect of new synthetic thienopyrimidine derivatives on the growth and photosynthesis of wheat (Triticum aestivum L.) variety Svitlana in the vegetative phase was studied. The regulatory effect of new synthetic thienopyrimidine derivatives was compared with the regulatory effect of auxin IAA (1H-indol-3-yl)acetic acid) or synthetic plant growth regulators Methyur (sodium salt of 6-methyl-2-mercapto-4-hydroxypyrimidine) and Kamethur (potassium salt of 6-methyl-2-mercapto-4-hydroxypyrimidine). After 2 weeks, morphometric parameters (such as average length of shoots and roots (mm), average biomass of 10 plants (g)) and biochemical parameters (such as content of photosynthetic pigments (µg/ml)) of wheat plants grown from seeds treated with synthetic thienopyrimidine derivatives, or auxin IAA, or synthetic plant growth regulators Methyur and Kamethur at a concentration of 10-6M, were measured and compared with similar parameters of control wheat plants grown from seeds treated with distilled water. The regulatory effect of new synthetic thienopyrimidine derivatives on the morphometric and biochemical parameters of wheat plants was similar or higher compared to the regulatory effect of auxin IAA, or synthetic plant growth regulators Methyur and Kamethur. The relationship between the chemical structure of new synthetic thienopyrimidine derivatives and their regulatory effect on the growth and photosynthesis of wheat plants was revealed. The most biologically active thienopyrimidine derivatives are proposed to be used as new synthetic physiological analogues of auxins and cytokinins to improve growth and increase photosynthesis of wheat (Triticum aestivum L.)variety Svitlana in the vegetative phase.

Porphyrias are a group of inherited metabolic disorders of haem biosynthesis, involving a deficiency in the enzyme uroporphyrinogen decarboxylase. In this case report we present a case of a patient with porphyria cutanea tarda (PCT). A 40-year-old man on hemodialysis after a kidney transplant rejection reaction, complaining of skin changes, with a history of smoking and alcohol intake. Treated with Fusidic acid Betamethasone cream, and erythropoietin. Porhyria cutanea tarda can be considered in a patient who complains of skin changes. History of alcohol intake, smoking, high ferritin levels, and increased hepatic markers can raise suspicion of disease. In patients with ESRD treatment with erythropoietin, SPF 50+ sun cream, Fusidic acid, and Betamethasone can be effective.

The Canadian healthcare system, grappling with issues like systemic and intelligently established structural anti-black racism, including indigenous nations; even within Pathology and Laboratory Medicine Communities: and deteriorating outcomes, sees potential in AI to address challenges, though concerns exist regarding exacerbating discriminatory practices. In clinical pathology, AI demonstrates superior diagnostic accuracy compared to pathologists in a study, emphasizing its potential to improve healthcare. However, AI governance is crucial to navigating ethical, legal, and societal concerns. The Royal College of Physicians of Canada acknowledges the transformative impact of AI in healthcare but stresses the need for responsible AI tools co-developed by diverse teams. Despite positive attitudes towards AI in healthcare, concerns about patient safety, privacy, and autonomy highlight the necessity for comprehensive education, engagement, and collaboration. Legal concerns, including liability and regulation, pose challenges, emphasizing the need for a robust regulatory framework. AI application in healthcare is categorized as high-risk, demanding stringent regulation to ensure safety, efficacy, and fairness. A parallel is drawn to drug regulation processes, suggesting a similar approach for AI. The lack of transparency in AI-based decision-making raises ethical questions, necessitating measures to address biases and ensure patient privacy. Social accountability is crucial to prevent AI from exacerbating health disparities and harming marginalized communities. In conclusion, while AI offers potential benefits in clinical pathology, a cautious approach with comprehensive governance measures is essential to mitigate risks and ensure ethical AI integration into healthcare.

Li B, Chen BW, Xia LS. The Initial Experience of Laparoscopic Management for Type VI Choledochal Cyst in Children. J Laparoendosc Adv Surg Tech A. 2024 Mar;34(3):280-283. doi: 10.1089/lap.2023.0229. Epub 2023 Oct 16. PMID: 37844069. Dumitrascu T, Lupescu I, Ionescu M. The Todani classification for bile duct cysts: an overview. Acta Chir Belg. 2012 Sep-Oct;112(5):340-5. doi: 10.1080/00015458.2012.11680849. PMID: 23175921. Dutta S, Jain A, Reddy A, Nelamangala Ramakrishnaiah VP. Anomalous Pancreaticobiliary Duct Junction in an Unusual Case of Synchronous Gallbladder and Bile Duct Malignancy. Cureus. 2021 Feb 13;13(2):e13331. doi: 10.7759/cureus.13331. PMID: 33738174; PMCID: PMC7959653. Xia HT. Standardized Surgical Management for Cystic Dilation of the Bile Ducts Based on Clinical and Pathological Studies: A Narrative Review. Gastroenterol Res Pract. 2020 Sep 15;2020:3432786. doi: 10.1155/2020/3432786. PMID: 33014038; PMCID: PMC7512076.

In order to study the molecular mechanism of the antioxidant effect of enzymatically hydrolyzed tuna dark meat peptides, this article uses alkaline protease to enzymatically hydrolyze tuna dark meat, and at the same time performs peptide sequencing using matrix-assisted laser dissociation time-of-flight mass spectrometry (MALDI TOF/TOF). Discovery Studio (DS) performed molecular docking. Finally, the antioxidant effect was verified through DPPH clearance experiments. The results show that the dominant peptide sequences in the tuna dark meat hydrolyzed polypeptides  are LAPGQ, GGGDPI, and PLRLP; through molecular simulation methods (Discover Studio, DS), the potential target of the above-mentioned enzymatic polypeptides was screened out to be Keap1, thus predicting antioxidant activity. It provides theoretical support for further research on enzymatic peptides. Through DPPH clearance experiments, it was found that both the enzymatic hydrolysate and LAPGQ, GGGDPI, and PLRLP have antioxidant activity, confirming their effects.

Inflammation is a natural response of the body to defend itself against potential threats and can be reduced through physical activity, proper nutrition, and the use of herbal medicines, which are medicinal plants. In the study, we aim to examine the anti-inflammatory effects of the volatile and ethanolic fractions of two commonly used medicinal plants, Equisetum arvense, and Baccharis trimera. The essential oils were obtained by hydrodistillation of the fresh leaves of the plants, while the ethanolic extracts were obtained using classical methodologies. All fractions were tested for anti-inflammatory activity, evaluating their ability to stabilize the red blood cell membrane and inhibit the spreading, and phagocytosis by macrophages, at concentrations varying from 200 to 600 µg mL-1. The results of the experiments suggest that the ethanolic fraction of B. trimera shows promising results compared to the positive controls. Our investigations thus contribute to the specialized literature on the use of herbal medicines around nutrition, providing guidance for future studies on these fractions.

Forensic laboratories face a backlog of case files, affecting service delivery, causing delays. The backlog points to underfunding, poor planning, and inadequate support, hindering deoxyribonucleic acid (DNA) analysis. Resolving casework backlogs may initially seem like a straightforward and attainable measure to improve the arrest of offenders and promote justice. Longer turnaround times impede investigative leads, emphasising the need for efficient strategies and a comprehensive approach to address and prevent backlogs in forensic laboratories. No study has been published on the forensic DNA backlogs in South Africa. The article explicitly addresses one aspect of a Doctor of Philosophy study and aims to ascertain the impact of backlogs in forensic DNA case entries. The study article’s research questions included the following: “What cases are considered as backlog?”; “What is the current backlog in forensic DNA case entries in South Africa?” and “What are the main reasons for the backlog of cases involving forensic DNA?” The prompt processing of DNA evidence is vital not only for safeguarding individuals falsely accused of crimes based on circumstantial evidence but also for aiding prosecutors and providing justice for crime victims.

The aging global population requires a new social model to meet the growing social, economic, and physical needs of seniors. Western social models need to be reconsidered in light of examples that support communal ways of living, which are sustainable through smart city design for more supportive geriatric care systems. To address the complex problems of geriatric care in this growing aging population with specific needs related to increased lifespan and limited financial resources, the use of emerging technologies, such as artificial intelligence (AI) and the Internet of Things (IoT), should be considered. As retirement ages rise and funds for retirement continue to decrease automated and sustainable solutions need to be sought. The ethical need to consider citizens not as customers but as decision-makers and to validate the ethical nature of medical decisions made for and by individuals should also be prioritized. This study provides recommendations for a smart city design and highlights the need for reflection on the ethics, modernization, and management of geriatric care. It suggests that technological devices can benefit health system reform by facilitating problem-solving. Overall, this new model integrates communal living and non-Western values with emerging technologies to address the growing need for geriatric care and the well-being of seniors.

Cells have emerged as highly promising vehicles for delivering drugs due to their unique advantages. They have the ability to bypass immune recognition, navigate biological barriers, and reach difficult-to-access tissues through sensing and active movement. Over the past couple of decades, extensive research has been conducted to understand how cell carriers can overcome biological barriers and influence drug effectiveness. This has resulted in the development of engineered cells for targeted drug delivery to specific tissues. Despite the presence of exciting developments, a comprehensive understanding of the challenges and potential strategies is necessary for the effective clinical application of cell-based drug carriers. This review provides an overview of recent progress and novel concepts in cell-based drug carriers, as well as their potential for translation into clinical practice. Additionally, we delve into important factors and emerging strategies for designing the next generation of cell-based delivery technologies, with a particular emphasis on achieving greater accuracy and targeted drug administration.

Introduction: In the latest WHO classification of central nervous system tumors, Mitotic Index (MI) counted on Phosphohistone-H3 stained slides (pHH3-MI) has been suggested as a valid proliferative marker in various tumors including in the evaluation of meningioma grading.We aim to report our own experience in assessing the efficiency of the anti-pHH3 antibody as a grading tool for meningiomas.Methods: A retrospective study was conducted on a series of 40 meningiomas diagnosed from March 2020 to April 2021 at the Pathology Department of the Military Hospital of Tunis. We attempted immunohistochemistry and compared MI assessed on both pHH3 and HE-stained slides.Results: According to the HE-MI and pHH3-MI, the 40 cases of meningiomas were respectively divided into 35 versus 29 grade 1 cases, four versus eight grade 2 cases, and one versus three grade 3 cases. A highly significant correlation was found between pHH3-MI and HE-MI (p < 0.001). A significantly higher sensitivity in the pHH3 counting method was reported in our study. Discussion: we found, in accordance with the literature, that pHH3-MI is more reliable and accurate in mitotic counting, therefore exhibiting a high sensitivity in tumor grading, reported by an upgrade within 22,5% of the cases.Conclusion: PHH3-MI count facilitated a rapid reliable grading of meningiomas. However, molecular characteristics that could have a potentially significant impact on tumor progression should be the subject of further research.

Sensory and sensorimotor conflicts can lead to sensory and motor efficiency disturbances, such as pain and less efficient motor control. Vertical heterophoria (VH) and vertical orthophoria (VO) are respectively the latent vertical misalignment of the eyes when the retinal images are dissociated, or not. Mild VH (< 0.57°) could indicate the presence of a conflict resulting from eye refraction problems and/or a disruption of the somaesthetic cues. Canceling the conflict(s) can immediately restore VO, making it possible to observe an improvement in the mobility of spinal and peripheral joints, the performance in the motor and balance tests after initial alternation, and a decrease in pain. The Maddox Rod Test was used to detect mild VH but doesn’t determine the sensory conflict origin. The aim of this retrospective study is to show its use as a landmark in which sensory afferent conflict could induce symptoms (i.e. pain; decreased range of motion; nonoptimal postural and motor control) and how to manage it, analyzing data from 525 subjects. The clinical process is intended to inhibit or neutralize afferent signals involved in the sensorimotor loops required by the central nervous system in motor control in order to spot the locus of conflict (stomatognathic system, pelvis, plantar afferences, piercings (body art) or/and eye refraction problems). This investigation protocol based on VH detection provides trackers for the therapeutic intervention in the management of nonspecific chronic pain, non-contact injuries, and prevention, and a key role for practitioners in the multidisciplinary management required for patients/athletes, in the world of work/health.