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تاريخ التبت : حكايات عن سقف العالم
يمثل تاريخ التبت جزءا مهما في تاريخ الصين، وتعد التبت التي توصف بأنها سقف العالم لكونها تضم أعلى نقطة من اليابسة على كوكب الأرض، وهي من المناطق تفردا وتميزا في الصين، جغرافيا وثقافيا واجتماعيا، وقد كونت التبت مع غيرها من مناطق القوميات الصينية الأخرى ظروفا مواتية للتبادلات الثقافية والاقتصادية داخل الصين نفسها، وقد اعتمد الكاتب على مؤلفات الكتاب القدامى مرجعا له أثناء تحرير هذا الكتاب.
BOOK
Effectiveness and safety of rivaroxaban versus warfarin in Taiwanese patients with end-stage renal disease and nonvalvular atrial fibrillation: A real-world nationwide cohort study
The optimal anticoagulant for end-stage renal disease patients for stroke prophylaxis is unknown. The efficacy and safety of warfarin in this population are debatable. In addition, real-world evidence of direct oral anticoagulants in patients with end-stage renal disease is limited. The aim of this study was to evaluate the clinical outcomes of rivaroxaban compared with warfarin in Taiwanese patients with end-stage renal disease with nonvalvular atrial fibrillation in a real-world setting.
This was a retrospective population-based cohort study conducted using Taiwan's National Health Insurance Research Database. Patients with nonvalvular atrial fibrillation and end-stage renal disease who started on rivaroxaban or warfarin between February 2013 and September 2017 were eligible to participate in the study. The inverse probability of treatment weighting approach was used to balance baseline characteristics. Bleeding and thromboembolic outcomes were compared using competing risk analyses. The study population consisted of 3358 patients (173 and 3185 patients on rivaroxaban and warfarin, respectively). In the rivaroxaban group, 50.8%, 38.7%, and 10.4% of the patients received 10, 15, and 20 mg of the drug, respectively. The cumulative incidence of major bleeding was similar between the two groups; however, the gastrointestinal bleeding rate was lower in the rivaroxaban group (adjusted subdistribution hazard ratio [SHR]: 0.56, 95% confidence interval [CI]: 0.34-0.91) than in the warfarin group. Furthermore, the composite risk of ischemic stroke or systemic embolism was significantly lower in the rivaroxaban group (adjusted SHR: 0.36, 95% CI: 0.17-0.79). Similar findings were observed for patients who received 10 mg of rivaroxaban.
In Taiwanese patients with end-stage renal disease and nonvalvular atrial fibrillation, rivaroxaban may be associated with a similar risk of major bleeding but a lower risk of thromboembolism compared with warfarin. The potential benefit of 10 mg of rivaroxaban in this population requires further investigation.
Journal Article
Role of S-Palmitoylation by ZDHHC13 in Mitochondrial function and Metabolism in Liver
Palmitoyltransferase (PAT) catalyses protein S-palmitoylation which adds 16-carbon palmitate to specific cysteines and contributes to various biological functions. We previously reported that in mice, deficiency of
Zdhhc13
, a member of the PAT family, causes severe phenotypes including amyloidosis, alopecia, and osteoporosis. Here, we show that
Zdhhc13
deficiency results in abnormal liver function, lipid abnormalities, and hypermetabolism. To elucidate the molecular mechanisms underlying these disease phenotypes, we applied a site-specific quantitative approach integrating an alkylating resin-assisted capture and mass spectrometry-based label-free strategy for studying the liver S-palmitoylome. We identified 2,190 S-palmitoylated peptides corresponding to 883 S-palmitoylated proteins. After normalization using the membrane proteome with TMT10-plex labelling, 400 (31%) of S-palmitoylation sites on 254 proteins were down-regulated in
Zdhhc13
-deficient mice, representing potential ZDHHC13 substrates. Among these, lipid metabolism and mitochondrial dysfunction proteins were overrepresented. MCAT and CTNND1 were confirmed to be specific ZDHHC13 substrates. Furthermore, we found impaired mitochondrial function in hepatocytes of
Zdhhc13
-deficient mice and
Zdhhc13
-knockdown Hep1–6 cells. These results indicate that ZDHHC13 is an important regulator of mitochondrial activity. Collectively, our study allows for a systematic view of S-palmitoylation for identification of ZDHHC13 substrates and demonstrates the role of ZDHHC13 in mitochondrial function and metabolism in liver.
Journal Article
A retrospective analysis of outpatient use of small-molecule targeted inhibitors for lymphoma across six regions of China (2016–2022)
This study aimed to assess national trends in prescription volumes, drug expenditures, and the pharmacoeconomic rationality of small-molecule targeted inhibitors used for lymphoma treatment among outpatients in China between 2016 and 2022.
Outpatient prescription data for patients diagnosed with lymphoma were obtained from the Hospital Prescription Analysis Cooperative Project database, which includes 77 hospitals distributed across six major regions of China. Annual trends in prescription volume and corresponding drug expenditures were examined. Pharmacoeconomic indicators associated with small-molecule targeted inhibitors were further analyzed to evaluate their cost-effectiveness and utilization patterns. Patient demographic characteristics, regional distribution, and categories of small-molecule targeted inhibitors were also analyzed.
Prescription volumes and amounts for small-molecule targeted inhibitors in lymphoma treatment have increased annually. Furthermore, their use is supported by pharmacoeconomic evidence indicating rational and efficient medication utilization. There was a statistically significant increase in total prescriptions (
< 0.005) and overall medication expenditures (
< 0.005).
Between 2016 and 2022, the prescription volume of small-molecule targeted inhibitors for lymphoma increased annually, indicating their expanding clinical use. Since 2020, despite continued growth in prescriptions, drug costs have risen at a slower rate than prescriptions. This reflects that medical insurance negotiation and centralized procurement policies have effectively reduced economic burden without limiting their access to these inhibitors. Pharmacoeconomic indicators also confirm that the use of these drugs has been both reasonable and efficient, allowing for increased drug utilization while reducing financial strain.
Journal Article
A retrospective analysis of small molecule targeting inhibitor usage for lung cancer among outpatients in six major regions of China (2016–2022)
This study aimed to evaluate national trends in amounts, prescription volumes, and the rationality of drug use in pharmacoeconomics associated with small molecule targeting inhibitors for lung cancer treatment among adult patients in China from 2016 to 2022.
Prescription data for outpatients diagnosed with lung cancer were extracted from the Hospital Prescription Analysis Cooperative Project database, covering hospitals across six major regions of 77 hospitals. Annual trends in prescription volumes and associated expenditures were analyzed. Additionally, pharmacoeconomic indicators related to small molecule targeting inhibitors were assessed to evaluate cost-effectiveness and utilization patterns. Demographic profiles, regional sources of patients, and classification of small molecule targeting inhibitors were examined.
Prescription volumes and amounts for small molecule targeting inhibitors in lung cancer treatment have increased annually. Since 2020, expenditure levels have stabilized. Furthermore, their use is supported by pharmacoeconomic evidence indicating rational and efficient medication utilization. There was a statistically significant increase in total prescriptions (P
< 0.001) and overall medication expenditures (P
< 0.001).
Between 2016 and 2022, the prescription volume of small molecule targeted inhibitors for lung cancer rose yearly, showing their expanding clinical use. Since 2020, despite continued growth in prescriptions, drug costs have stabilized or slightly decreased. This reflects that China's medical insurance negotiation and centralized procurement policies have effectively reduced patients' economic burden without limiting their access to these inhibitors. Pharmacoeconomic indicators also confirm that the use of these drugs has been both reasonable and efficient, allowing for increased drug utilization while reducing patients' financial strain.
Journal Article
Development of a Dual MOS Electronic Nose/Camera System for Improving Fruit Ripeness Classification
Electronic nose (E-nose) systems have become popular in food and fruit quality evaluation because of their rapid and repeatable availability and robustness. In this paper, we propose an E-nose system that has potential as a non-destructive system for monitoring variation in the volatile organic compounds produced by fruit during the maturing process. In addition to the E-nose system, we also propose a camera system to monitor the peel color of fruit as another feature for identification. By incorporating E-nose and camera systems together, we propose a non-destructive solution for fruit maturity monitoring. The dual E-nose/camera system presents the best Fisher class separability measure and shows a perfect classification of the four maturity stages of a banana: Unripe, half-ripe, fully ripe, and overripe.
Journal Article
Forensic-based investigation-optimized extreme gradient boosting system for predicting compressive strength of ready-mixed concrete
Regulations mandate testing concrete’s compressive strength after the concrete has cured for 28 days. In the ideal situation, cured strength equals the target strength. Advanced estimation of concrete’s compressive strength can facilitate quality management, improve safety, and present economic advantages in sustainable use. Basic statistical methods cannot effectively predict concrete’s strength or its non-linear relationships with the proportions of its constituent materials. In this study, a baseline model for predicting concrete’s compressive strength was constructed using a state-of-the-art machine-learning method. Most related studies have used sets of concrete mix design results concerning concrete specimens for laboratory-produced concrete specimens as training sets and have obtained simple models through regression; however, these models have been unsuitable for onsite prediction of the compressive strength of concrete with the various mix designs. Control over mix proportions is high in laboratories, resulting in low variation; onsite manual operation and environmental factors cause significant variations in assessment data. In this study, machine-learning techniques and a newly developed metaheuristic optimization algorithm were applied to big long-term data from 75 concrete plants to construct the optimal machine-learning model. Our self-developed forensic-based investigation algorithm was employed to fine-tune the hyperparameters of the extreme gradient boosting model and to improve the model’s generalizability. The lowest mean absolute percentage error (MAPE) obtained using this model was 9.29%, which was smaller than the lowest MAPE achieved using the conventional simple regression with the water-to-binder (W/B) ratio (12.73%). The traditional method tends to overestimate the actual compressive strength. Finally, a convenient expert system was developed that facilitates the use of the proposed model by onsite engineers for quality management. This system expedites the judgment of whether a mixed design is reasonable, reducing production costs while maintaining the safety of concrete structures. It can be widely applied in practice and function as an effective decision-making tool.
Graphical Abstract
Graphical Abstract
Journal Article
Pharmaco‐genetic inhibition of pyramidal neurons retards hippocampal kindling‐induced epileptogenesis
Aims Pharmaco‐genetics emerges as a new promising approach for epileptic seizures. Whether it can modulate epileptogenesis is still unknown. Methods Here, parvalbumin neurons and pyramidal neurons of the seizure focus were transfected with engineered excitatory Gq‐coupled human muscarinic receptor hM3Dq and engineered inhibitory Gi‐coupled human muscarinic receptor hM4Di, respectively. And their therapeutic value in mouse hippocampal kindling‐induced epileptogenesis was tested. Results Pharmaco‐genetic activating parvalbumin neurons limitedly retarded the progression of behavioral seizure stage and afterdischarge duration (ADD) during epileptogenesis induced by kindling. Activating parvalbumin neurons delayed seizure development only in the early stage, but accelerated it in late stages. On the contrary, pharmaco‐genetic inhibiting pyramidal neurons robustly retarded the progression of seizure stages and ADDs, which greatly delayed seizure development in both early and late stages. Although both pharmaco‐genetic therapeutics efficiently alleviated the severity of acute kindling‐induced seizures, pharmaco‐genetic inhibiting pyramidal neurons were able to reverse the enhanced synaptic plasticity during epileptogenesis, compared with that of pharmaco‐genetic activating parvalbumin neurons. Conclusion Our results demonstrated that pharmaco‐genetic inhibiting pyramidal neurons retard hippocampal kindling‐induced epileptogenesis and reverse the enhanced synaptic plasticity during epileptogenesis, compared with that of pharmaco‐genetic activating parvalbumin neurons. It suggests that pharmaco‐genetics targeting pyramidal neurons may be a promising treatment for epileptogenesis. Pharmaco‐genetic activating parvalbumin neurons of the seizure focus limitedly retarded the progression of behavioral seizure stage and afterdischarge duration (ADD) during epileptogenesis in hippocampal kindling mice. On the contrary, Pharmaco‐genetic inhibiting pyramidal neurons of the seizure focus robustly retarded epileptogenesis.
Journal Article
Comparison of an SMS text messaging and phone reminder to improve attendance at a health promotion center： A randomized controlled trial
Objective： To compare the efficacy of a short messaging service （SMS） text messaging and phone reminder to improve attendance rates at a health promotion center. Methods： A total of 1 859 participants who had scheduled appointments in the health promotion center of our hospital from April 2007 to May 2007 were enrolled in the study and randomly assigned into 3 groups： control （no reminder） group, SMS text messaging reminder group and telephone reminder group. Attendance rates and costs of interventions were collected. Results： A total of 1848 participants were eligible for analysis. Attendance rates of control, SMS and telephone groups were 80.5%, 87.5% and 88.3%, respectively. The attendance rates were significantly higher in SMS and telephone groups than that in the control group, with odds ratio 1.698, 95% confidence interval 1.224 to 2.316, P=0.001 in the SMS group, and odds ratio 1.829, 95% confidence interval 1.333 to 2.509, P〈0.001 in the telephone group. However, there was no difference between the SMS group and the telephone group （P=0.670）. The cost effectiveness analysis showed that the cost per attendance for the SMS group （0.31 Yuan） was significantly lower than that for the telephone group （0.48 Yuan）. Conclusion： SMS and telephone are effective reminders for improving attendance rate at a health promotion center. SMS reminder may be more cost-effective compared with the telephone reminder.
Journal Article
A robot arm-assisted acupuncture system with motion and force monitoring: establishment and validation
Traditional manual acupuncture faces challenges in quantifying stimulation parameters and preserving techniques consistency. This study presents a robot arm-assisted acupuncture system replicating manual manipulations with precise motion and force monitoring.
System validation was conducted through a Laser Vibrometer to measure multiple frequency-amplitude combinations, followed by comparative analysis between robotic and manual acupuncture manipulations using both motion and force monitoring. Additionally, therapeutic efficacy was evaluated through an adjuvant arthritis rat model, comparing the analgesic effects between robotic and manual acupuncture at the Zusanli acupoint.
The Laser Vibrometer validation showed high precision, with mean absolute errors below 0.2 mm across all frequency-amplitude combinations. Comparative analysis demonstrated strong similarity between robotic and manual acupuncture in needle trajectories and force distributions, with Bhattacharyya coefficients of 0.9931 and 0.9976 for Lifting-Inserting and Mountain Burning manipulations. The robotic system achieved analgesic effects comparable to manual acupuncture, significantly improving pain thresholds over control groups.
This work lays the groundwork for quantifiable, reproducible acupuncture therapy, driving the development of intelligent devices for standardized clinical applications.
Journal Article