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A transgenic mouse line with a 58 kb fragment deletion shows skeletal defects

Pre-siting of UAV stations for traffic accident assessment considering road dispersion

This paper investigates the issue of pre-site selection for drone stations with the aim of enhancing the rapid assessment capability of urban road traffic accidents. Firstly, the influence of traffic accidents on urban traffic is analyzed, and the potential application of drones in rapid response at the accident scene is explored. A minimization model is constructed with the goal of minimizing the cost of accident handling and reducing traffic congestion. To solve this problem, we improved the simulated annealing algorithm by combining the multi-neighborhood strategy, adaptive neighborhood size, and adding a taboo list, and verified the effectiveness of the algorithm. The validity of the model is tested through simulation examples, and the impact of the drone coverage radius and the distribution of accident points on the model performance is explored through sensitivity analysis, providing management insights for the pre-site selection of drone stations.

Ultrasound imaging of the perithyroid fascial space: a comparative analysis with anatomical correlations

Therapeutic hypothermia for neonatal hypoxic ischaemic encephalopathy in Sub-Saharan Africa: A scoping review

Introduction There are divergent views and limited data regarding therapeutic hypothermia (TH) for neonatal hypoxic ischaemic encephalopathy (HIE) in sub-Saharan Africa (SSA). Our aim was to map and synthesize the published literature describing the use of TH for HIE in SSA, and the associated outcomes. Method We searched Pubmed, Scopus, Google Scholar, and Web of Science from 1 January 1996 to 31 December 2023 for research studies, protocols, feasibility studies and surveys on term and near-term babies with HIE (population) treated with TH (concept) in SSA (context). Results Thirty records were included: Three surveys, one feasibility study and 26 publications describing 23 studies of 21 cohorts, cooling 1420 babies in South Africa, Uganda, and Ghana. There were five studies recruiting at follow-up, five pilot studies, one randomised controlled trial, one case series, and 10 birth cohorts. The methods and design of the studies were highly variable and often inadequate. Only three studies with adequately described and validated cooling methods, non-selective sequential recruitment, and neurological outcomes were identified. Two studies of babies from birth, both with intensive care facilities, reported survival with normal/mildly abnormal outcome in 71% at discharge in one study, and 71% at 12 months in another, with 16% cerebral palsy (CP) in survivors, and only 16% loss to follow-up. The third study, which only included clinic attenders after TH without intensive care, reported 7% CP in survivors, but 36% loss to follow-up. Conclusions Data from the adequately described TH studies in SSA indicate outcomes at discharge and twelve months which are similar to global norms. However, these data are limited to South Africa. Interpretation of other studies was limited by loss to follow-up, variable methodology and exclusion of babies with severe HIE in some studies. There is a need for standardised definitions to facilitate interpretation in TH studies.

A hybrid differential evolution particle swarm optimization algorithm based on dynamic strategies

What went wrong at 23andMe? Why the genetic-data giant risks collapse

Bilateral internal iliac artery ligation in trauma patients with severe pelvic hemorrhage: A systematic review

Introduction Severe pelvic hemorrhage significantly contributes to mortality in trauma patients, yet the most effective treatment for severe pelvic injuries remains unclear. This systematic review evaluates the mortality and morbidity associated with bilateral internal iliac artery ligation (BIIAL) in patients experiencing severe hemorrhage from traumatic pelvic fractures. Methods Comprehensive searches were conducted in MEDLINE PubMed, EMBASE, and Cochrane databases until February 7, 2024, to identify relevant articles. The risk of bias in observational studies was assessed using the ROBINS-I tool, which evaluates bias risk in nonrandomized intervention studies. The primary outcome was mortality following BIIAL, with the secondary outcome being complications related to the procedure. Results The review included eight studies, all observational. The overall mortality rate after BIIAL ranged from 45.0% to 76.9%. Ischemic complications from BIIAL were infrequent. A high and unclear risk of bias due to confounding and participant selection was noted across the studies. Four studies highlighted distinct indications for BIIAL compared to angioembolization. BIIAL was employed for patients with severe hemodynamic instability or when angiography was not available. Conclusion Due to geographical limitations and significant heterogeneity among the studies reviewed, the true effect size of BIIAL remains indeterminate. Nevertheless, further prospective studies with robust designs are necessary. BIIAL holds potential as a viable option when angioembolization is not accessible or in cases of critical patient instability.

Assessing the diagnostic accuracy of machine learning algorithms for identification of asthma in United States adults based on NHANES dataset

Correction: Human-machine interactions with clinical phrase prediction system, aligning with Zipf’s least effort principle?

The effect of prednisolone ingestion and acute exercise on lipocalin-2 and its variants in young men: a pilot randomised crossover study

Correction: Parity and post-reproductive mortality among U.S. Black and White women: Evidence from the Health and Retirement Study

Publisher Correction: Antioxidant activity of Micractinium sp. (Chlorophyta) extracts against H2O2 induced oxidative stress in human breast adenocarcinoma cells

LazyAct: Lazy actor with dynamic state skip based on constrained MDP

Deep reinforcement learning has achieved significant success in complex decision-making tasks. However, the high computational cost of policies based on deep neural networks restricts their practical application. Specifically, each decision made by an agent requires a complete neural network computation, leading to a linear increase in computational cost with the number of interactions and agents. Inspired by human decision-making patterns, which involve reasoning only on critical states in continuous decision-making tasks without considering all states, we introduce the LazyAct algorithm. This algorithm significantly reduces the number of inferences while preserving the quality of the policy. Firstly, we incorporate a state skipping branch into the actor network to bypass states with minimal impact. Subsequently, we establish optimization objectives for single-agent and multi-agents inference, incorporating cost constraints based on the IMPALA and MAPPO frameworks, respectively. Finally, we utilize pre-training and fine-tuning techniques to train the policy network. Extensive experimental results indicate that LazyAct reduces the number of inferences by approximately 80% and 40% in single-agent and multi-agents scenarios, respectively, while sustaining comparable policy performance. The inferences reduction significantly decreases the time and FLOPs required by the LazyAct algorithm to complete tasks. Code is available here https://www.dropbox.com/scl/fo/wyoqo6q9gyt86zobfgbvx/h?\rlkey=0moyxsnoiisfs9y4h89hsou1l&dl=0.

Author Correction: Lower urinary dysfunction as a long-term effect of childhood vincristine treatment, with potential influences by sex and dose

Long term cost-effectiveness analysis of IDegLira in the treatment of type 2 diabetes patients compared to GLP-1RA added to basal insulin after IDegLira entered the national reimbursement drug list in China

Background Degludec insulin liraglutide injection is the world’s first and only approved basal insulin GLP-1RA injection in China (GLP-1RA stands for Glucagon-Like Peptide-1 Receptor Agonist. This study aimed to evaluate the long-term cost-effectiveness of IDegLira versus GLP-1RA added to basal insulin regimen (combined regimen) for patients with type 2 diabetes in China. Methods Based on the perspective of the health system, the study adopts the Swedish Institute for Health Economics diabetes cohort model. The baseline and clinical efficacy data in the model are from the EXTRA study. The cost includes glucose-lowering medication, background treatment cost, and complication treatment costs. The prices of IDegLira and GLP-1RA are based on the national medical insurance payment standards. Insulin adopts the national volume-based procurement average price. Other cost and utility data are sourced from published literature. The health outcome indicator is quality-adjusted life years (QALYs). The simulation time horizon is 30 years. The discounting rate of cost and health outcomes is 5%. Results In clinical output, IDegLira could reduce the cumulative incidence of various chronic complications in patients compared to the combined regimen. The eye diseases (background, proliferative retinopathy, macular edema, and visual loss) decreased by 24.4%, 41.1%, 18.9%, and 12.2%, respectively. Neuropathy decreased by 17.3%. Proteinuria and end-stage renal disease decreased by 25.9% and 17.6% respectively. Ischemic heart disease, heart failure, and myocardial infarction (stroke) decreased by 0.8%, 1.1%, and 4.7%, respectively. In the base-case analysis, IDegLira compared to the combined regimen shows an incremental cost of -34,254 CNY and an incremental QALYs of 0.436. Under the threshold of 1 times the per capita GDP of China in 2022 (85,698 CNY), IDegLira is a dominant scheme with lower cost and better health outcome. In probabilistic sensitivity analysis, the probability of IDegLira being cost-effective is 100%, indicating that the base-case analysis results are robust. Conclusion Compared with the combined regimen, the use of IDegLira for Chinese patients with type 2 diabetes can improve long-term health output, save medical costs, and is a dominant scheme.

A user-friendly software to accurately count and measure cysts from the parasitic nematode Heterodera glycines

Utilizing the subtractive proteomics approach to design ensemble vaccine against Candida lusitaniae for immune response stimulation; a bioinformatics study

Vaccines have always been one of the promising therapeutic sources against many pathogens including infectious fungi. Candida lusitaniae is also one of those fungi which is responsible for different infections in human beings including vaginitis, endocarditis, endophthalmitis and blood stream infections. There is thus, a need to adopt effective therapeutic strategies to tackle such infections. Vaccine is one of those efficient therapeutic agents which stimulates immune response and prevents a certain infection to get hazardous. Keeping in view this very important concept, we have designed in-silico vaccine against C. lusitaniae by following the subtractive proteomics approach. Initially, the screening of therapeutic targets was performed to identify potent vaccine candidates from the whole proteome of C. lusitaniae. Several significant factors were taken into account in this context, such as stability index, IFN status, allergenicity, and antigenicity. As a result, four distinct proteins that were both antigenic and non-allergenic, were selected from the whole proteome. Furthermore, physiochemical investigation revealed that these vaccine candidates were stable and that their IFN status was positive. Notably, each of these proteins was non-homologous to human beings. This particular attribute of the selected proteins i.e., to be non-homologous, was made in order to possess the ability to trigger an immunological response in host (humans). Furthermore, the whole proteome (WP) vaccine was constructed accordingly. The structural modelling of all the selected vaccine candidates was then performed to proceed them further for docking with the human toll-like receptor 2 (TLR2). Afterwards, the codon optimization was executed, followed by in-silico cloning of the final vaccine construct. The pet28A plasmid was incorporated for this purpose while, the SnapGene tool was utilized for this particular analysis. Ultimately, the immune simulations were executed to assess the immune response of the designed vaccine (WP). Upon final results, it was found that highest count of IgG and IgM was achieved i.e., up to 700000 between the days 8 to 13 and then slowly neutralized till the day 30. These results signified that the designed vaccine possessed the potential to stimulate the required immune response.

Dysregulation of mTOR signalling is a converging mechanism in lissencephaly

Construction and validation of a predictive model for the risk of osteoporosis in patients with chronic kidney disease based on NHANES data

Background Chronic kidney disease (CKD) patients tend to exhibit a heightened susceptibility to osteoporosis owing to abnormalities in mineral and bone metabolism. The objective of this study was to develop and validate a nomogram for the prediction of osteoporosis risk in patients with CKD. Methods 1498 patients diagnosed with CKD were enrolled from the National Health and Nutrition Examination Survey (NHANES) data spanning 2005–2010, 2013–2014, and 2017–2018. The dataset was randomly divided into a training set and a validation set in a ratio of 7:3. Utilizing the least absolute shrinkage and selection operator (LASSO) regression technique for predictor identification, followed by employing multivariate logistic regression based on the selected predictors to construct a nomogram. The performance of the prediction model was assessed using various metrics, including the area under the receiver operating characteristic curve (AUC), calibration curve, the Hosmer-Lemeshow test, and decision curve analysis (DCA). Results The construction of the nomogram was based on five predictors, namely age, height, weight, alkaline phosphatase (ALP), and history of fracture. The AUC of 0.8511 in the training set and 0.8184 in the validation set demonstrates robust discriminability. Furthermore, the excellent calibration and clinical applicability of the model have been thoroughly validated. Conclusions Our study suggests a nomogram, providing nephrologists with a convenient and effective tool for identifying individuals at high risk of osteoporosis and avoiding adverse outcomes related to CKD.

Characteristic analysis and surgical exploration for acetabular roof fractures: Multicenter retrospective cohort study

Background Acetabular roof was a crucial structure for maintaining the stability of hip joint; however, its important role was not especially emphasized in the Letournel-Judet classification system. Acetabular roof was segmented into the roof column and roof wall in Three-column classification and fracture in this area alone was defined as A3 injury. The purpose of this study was to explore the characteristics and surgical strategy of A3 injury. Methods Patients with roof column/wall fractures received surgical management from January 2015 to 2019 January at nine level-1 trauma centers were retrospectively analyzed. Fracture data, surgical incision, operation time, blood loss, fracture healing and relevant complications were recorded to explore fracture characteristics and appropriate surgical strategy. Reduction quality was assessed based on postoperative radiographic examination. Merle d’Aubigné score was used to assess the functional outcome during the follow-up. Results A total of 60 patients met the inclusion criteria in this study. Mean operation time was 112.83±21.77 min, and mean intraoperative blood loss was 396.67±182.00 ml. Satisfactory reduction quality was obtained in 49 cases (81.67%). All fractures healed well at an average mean of 3.07 months. Satisfactory outcomes were obtained in 46 cases (76.67%), and mean Merle d’Aubigné score was 15.53±1.33 points at the final follow-up. Reduction quality and functional outcome showed no statistical difference in three subtypes (P<0.05). Reduction quality and functional outcome presented positive correlation in three subtype fractures (P<0.05). The complication rate was 11.67% (7/60) in this study. Conclusion The injury mechanism of A3 injury was the direct impaction from femoral head on acetabular roof. Reduction and fixation of A3 injury were technique demanding, and poor prognosis may be accompanied even treated by experienced surgeons. Appropriate surgical strategies (Table 5) based on fracture characteristics in three subtypes of A3 injury were the premise of accepted prognosis.