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Background Given that prioritization for liver transplantation (LT) is based primarily on the model for end-stage liver disease (MELD) scores, patients with lower MELD scores, who experience chronic anemia and recurrent hypotension due to gastrointestinal bleeding (GIB), tend to be marginalized. Methods A total of 581 patients with no evidence of acute kidney injury (AKI) or chronic kidney disease 2 months before LT constituted a retrospective cohort. Within this cohort, a nested case–control study was conducted that included 134 patients with preoperative GIB (GIB(+)) and 246 matched patients without preoperative GIB (GIB(−)). A subgroup analysis was conducted based on the occurrence of AKI (AKI(− /+)) within 2 months prior to LT. Results The incidence of preoperative AKI was significantly higher in patients with GIB(+) compared with patients with GIB(−) (14.9% vs 8.1%, P =0.039), along with higher rates of postoperative complications and prolonged hospital stay; however, long-term survival rates were similar between the two groups. Subgroup analysis also revealed that the postoperative incidence of AKI and mortality rates at 60 days were elevated in patients with preoperative GIB(+) AKI(+) compared with patients with GIB(+) AKI(−). Furthermore, 5-year survival rates were significantly lower for patients with GIB(+) AKI(+) (65.0% vs 82.5%, P  = 0.040). However, no significant difference was observed between the two subgroups of AKI(+) (GIB(+) versus GIB(−)) and the two subgroups of AKI(−) in relation to postoperative complications, short-term mortality, and long-term survival rates. Conclusions Patients who experience preoperative GIB face an elevated risk of developing AKI, which is significantly correlated with a poorer prognosis for LT. A more proactive approach is needed to assess the transplant priority of patients with GIB on the waiting list.

The bridge reinforcement methods, each method has its advantages and disadvantages. The load-bearing capacity of bridge members is controlled by the ultimate strain of concrete in the compression zone or the ultimate strain of reinforcement in the tension zone, so the selection of the bridge reinforcement method is affected by the section reinforcement ratio. When the reinforcement ratio of the section is between the minimum reinforcement ratio and the critical reinforcement ratio, we should choose the beam bottom reinforcement plan; when the section reinforcement ratio is between the critical reinforcement ratio and the maximum reinforcement ratio, it should be adopted Reinforcement method of bridge deck reinforcement layer.

The construction of bridge engineering projects is developing towards large spans, large volumes and more complex spatial structures. The current bridge construction based on two-dimensional drawings has been difficult to meet the needs of project construction. With the help of BIM software, this paper takes the construction project as the main body, integrates construction organizations such as the surrounding terrain and landforms and construction facilities of the construction site into the BIM software to form a complete three-dimensional simulation diagram, so that the entire project is modeled and parameterized. In order to achieve the project collision checking, heavy and difficult construction scheme simulation, engineering rapid statistics, information exchange and complete 4D construction simulation, effective guidance to the construction site, to provide an efficient and orderly construction management and technical support.

The current study aimed to explore mental health problems in patients diagnosed with cancer during the COVID-19 pandemic. A cluster sampling, cross-sectional survey with 6213 cancer patients was conducted in one of the largest cancer centers in China. The socio-demographic and clinical characteristics, psychosomatic conditions, interpersonal relationships and social support, COVID-19 infection-related psychological stress, and mental health status were measured. Medical conditions were extracted from patients’ electronic healthcare records. Among the 6213 cancer patients, 23.4% had depression, 17.7% had anxiety, 9.3% had PTSD, and 13.5% had hostility. Hierarchical liner regression models showed that having a history of mental disorder, excessive alcohol consumption, having a higher frequency of worrying about cancer management due to COVID-19, having a higher frequency feeling of overwhelming psychological pressure from COVID-19, and having a higher level of fatigue and pain were the predominant risk factors for mental health problems in cancer patients. However, there were only 1.6% of them were seeking psychological counseling during COVID-19. We also revealed the protective factors associated with lower risk of mental health problems among cancer patients. The present study revealed a high prevalence of mental health problems and gaps in mental health services for cancer patients, which also indicated high distress from COVID-19-elevated risks. We call for systematic screening of mental health status for all cancer patients, and developing specific psychological interventions for this vulnerable population.

Artificial intelligence (AI)-based methods have emerged as powerful tools to transform medical care. Although machine learning classifiers (MLCs) have already demonstrated strong performance in image-based diagnoses, analysis of diverse and massive electronic health record (EHR) data remains challenging. Here, we show that MLCs can query EHRs in a manner similar to the hypothetico-deductive reasoning used by physicians and unearth associations that previous statistical methods have not found. Our model applies an automated natural language processing system using deep learning techniques to extract clinically relevant information from EHRs. In total, 101.6 million data points from 1,362,559 pediatric patient visits presenting to a major referral center were analyzed to train and validate the framework. Our model demonstrates high diagnostic accuracy across multiple organ systems and is comparable to experienced pediatricians in diagnosing common childhood diseases. Our study provides a proof of concept for implementing an AI-based system as a means to aid physicians in tackling large amounts of data, augmenting diagnostic evaluations, and to provide clinical decision support in cases of diagnostic uncertainty or complexity. Although this impact may be most evident in areas where healthcare providers are in relative shortage, the benefits of such an AI system are likely to be universal.A natural language processing system can support physicians in diagnostic assessments by extracting clinical information from electronic medical records to accurately predict diagnosis in pediatric patients.

African swine fever virus (ASFV) is the causative agent of the epidemic of African swine fever (ASF), with virulent strains having a mortality rate of up to 100% and presenting devastating impacts on animal farming. Since ASF was first reported in China in 2018, ASFV still exists and poses a potential threat to the current pig industry. Low-virulence and genotype I strains of ASFV have been reported in China, and the prevention and control of ASF is more complicated. Insufficient understanding of the interaction of ASFV with the host immune system hinders vaccine development. Physical barriers, nonspecific immune response and acquired immunity are the three barriers of the host against infection. To escape the innate immune response, ASFV invades monocytes/macrophages and dendritic cells, thereby inhibiting IFN expression, regulating cytokine expression and the body’s inflammatory response process. Meanwhile, in order to evade the adaptive immune response, ASFV inhibits antigen presentation, induces the production of non-neutralizing antibodies, and inhibits apoptosis. Recently, significant advances have been achieved in vaccine development around the world. Live attenuated vaccines (LAVs) based on artificially deleting specific virulence genes can achieve 100% homologous protection and partial heterologous protection. The key of subunit vaccines is identifying the combination of antigens that can effectively provide protection and selecting carriers that can effectively deliver the antigens. In this review, we introduce the epidemic trend of ASF and the impact on the pig industry, analyze the interaction mechanism between ASFV and the body’s immune system, and compare the current status of potential vaccines in order to provide a reference for the development of effective ASF vaccines.

This study investigated the effects of Periplaneta americana residue (PAR) on the immune function, antioxidant capacity, and transcriptome of Sanhuang chickens. Six hundred 30-day-old Sanhuang chickens were divided into six groups with diets of varying PAR replacement of soybean meal from 0 to 100% in increments of 20%. Samples were taken on day 100. The results indicated that PAR did not significantly affect growth performance (p > 0.05). PAR significantly elevated the levels of IL-1β, IL-2, TNF-α, IgA, IgG, and IgM in both the serum and spleen (p < 0.05). Moreover, it markedly increased the GSH-Px, T-AOC, SOD, and CAT levels in the serum and liver (p < 0.05) and reached optimal levels of immune factors and antioxidant indicators at diet 2. Transcriptomic analysis revealed that substituting PAR for soybean meal downregulated genes associated with immune diseases and infectious disease pathways. Substituting soybean meal with PAR enhanced the resistance of Sanhuang chickens to pathogenic factors and oxidative stress, with no impact on growth performance. The optimal improvement was observed with diet 2.

The heterogeneity of functional cardiomyocytes arises during heart development, which is essential to the complex and highly coordinated cardiac physiological function. Yet the biological and physiological identities and the origin of the specialized cardiomyocyte populations have not been fully comprehended. Here we report a previously unrecognised population of cardiomyocytes expressing Dbh gene encoding dopamine beta-hydroxylase in murine heart. We determined how these myocytes are distributed across the heart by utilising advanced single-cell and spatial transcriptomic analyses, genetic fate mapping and molecular imaging with computational reconstruction. We demonstrated that they form the key functional components of the cardiac conduction system by using optogenetic electrophysiology and conditional cardiomyocyte Dbh gene deletion models. We revealed their close relationship with sympathetic innervation during cardiac conduction system formation. Our study thus provides new insights into the development and heterogeneity of the mammalian cardiac conduction system by revealing a new cardiomyocyte population with potential catecholaminergic endocrine function. Catecholaminergic transmitters are critical signalling effectors known to be released by sympathetic nerves and adrenomedullary endocrine cells in response to physiological stress. In this paper, the authors demonstrate a uniquely distributed group of catecholaminergic cardiomyocytes with key regulatory roles in cardiac excitation conduction.

Due to the long path and the point-like distribution of tower positions in the transmission line project, most of the material transportation in the construction needs to be transported by manpower, and the manpower transport involves the reasonable design and calculation of the manpower distance, while the manpower distance involves the follow-up Construction safety, construction cost and construction efficiency. Therefore, when carrying out construction design and budget estimation, it is often necessary to count the average manpower distance of material transportation, especially for hills, mountains and other terrains. However, most of the existing manpower distances are set based on subjective experience, which leads to manual labor distances. The error is large, resulting in chaotic construction management, large differences in construction costs, inability to guarantee construction safety, and low construction efficiency. Based on this, in this paper, the mountain is equivalent to a cone, and the mathematical model of the equidistant cone helix is used for modeling, and the arc length calculation formula is used to calculate the distance of manual climbing, which is used as the artificial distance of the tower. The research results of this paper realize the objective calculation of manual transportation distance, greatly reduce the data error, reduce the construction cost difference, and improve the construction safety and efficiency.

Pathological hypertrophy underlies sudden cardiac death due to its high incidence of occurrence of ventricular arrhythmias. The alteration of transmural electrophysiological properties in hypertrophic cardiac murine tissue has never been explored previously. In this dataset, we have for the first time conducted high-throughput simultaneous optical imaging of transmembrane potential and calcium transients (CaT) throughout the entire hypertrophic murine hearts at high temporal and spatial resolution. Using ElectroMap, we have conducted multiple parameters analysis including action potential duration/calcium transient duration, conduction velocity, alternans and diastolic interval. Voltage-calcium latency was measured as time difference between action potential and CaT peak. The dataset therefore provides the first high spatial resolution transmural electrophysiological profiling of the murine heart, allowing interrogation of mechanisms driving ventricular arrhythmias associated with pathological hypertrophy. The dataset allows for further reuse and detailed analyses of geometrical, topological and functional analyses and reconstruction of 2-dimensional and 3-dimentional models. Measurement(s) transmembrane potential • calcium transient Technology Type(s) high-throughput simultaneous optical imaging Sample Characteristic - Organism Mus musculus Machine-accessible metadata file describing the reported data: https://doi.org/10.6084/m9.figshare.16910542