Explore the vast range of titles available.

To ensure the safe construction of prefabricated buildings and improve the efficiency of the safe evacuation of construction personnel after a fire caused by improper operation during construction, this study used the PyroSim software to numerically simulate a fire situation based on the size and volume of a prefabricated building construction site. The variation rules of smoke visibility, CO concentration, and ambient temperature in the construction site of prefabricated buildings were analyzed and the available safe evacuation time was determined. Moreover, the Pathfinder software was used for simulation in combination with the physical attributes of personnel, evacuation speed, and personnel proportions. The time required for safe evacuation was determined and the factors influencing the evacuation time, such as the quantity and location of stacked prefabricated components, machinery, and appliances, and the number of on-site construction personnel, were analyzed. The data collected by the temperature sensor, CO concentration sensor, and visibility sensor reveal that the visibility and crash time are the key factors restricting the efficiency of personnel avoidance and evacuation. At 400 s, the visibility at the escape exit of the prefabricated apartment construction site was lower than 5 m. The crashing time of the building was 360 s, which is the critical point for casualties. The first emergency evacuation simulation took 398.7 s. The required safe evacuation time (T REST ) > available safe evacuation time (T ASET ), and the original site layout cannot facilitate the safe evacuation of all construction workers. The evacuation time can be effectively reduced by re-planning the stacking positions of prefabricated construction site components, construction equipment, and other items, and reducing the number of personnel in the construction plane. The results of the second simulation reveal that the safe evacuation time (T REST ) is 355.2 s. Because it is required that the safety evacuation time (T REST ) < available safe evacuation time (T ASET ), the results are in line with the emergency evacuation requirements. The findings of this study can provide a theoretical basis for the rational planning of evacuation passages at the construction sites of prefabricated buildings and assist the management of construction site safety.

It is very common that taxi is used as a feeder mode to/from a metro station especially in third-tier cities of China. But research on taxi-metro integrated use is rather limited. This paper investigates the relationship between feeder-related built environment and taxi-metro integrated use by using taxi trajectory data in Lanzhou, China. Firstly, regression models are developed to explore the transfer distance of access/egress trips during peak hours. Then, the catchment area is delineated for collecting feeder-related environment variables. Finally, several negative binomial regressions are employed to examine the relationships between feeder-related built environment and taxi-metro integrated use during peak hours on weekdays. The results reveal that (a) people prefer to use taxi as feeder mode for metro access during morning peak hours and for metro egress during evening peak hours; (b) the transfer distance of taxi-metro integrated use is about 3.8 km; (c) higher mixed land use generates more taxi-metro integrated use during evening peak hours. Higher proportion of residential land use attracts more taxi-metro integrated use for metro access during morning peak hours. Those findings will help transport planners to develop tailored land-use interventions to improve transit accessibility and promote the sustainable multimodal travel.

Optimizing prescription practices for surgical patients is crucial due to the complexity and sensitivity of their medication regimens. To enhance medication safety and improve patient outcomes by introducing a machine learning (ML)-based warning model integrated into a pharmacist-led Surgical Medicines Prescription Optimization and Prediction (SMPOP) service. A retrospective cohort design with a prospective implementation phase was used in a tertiary hospital. The study was divided into three phases: (1) Data analysis and ML model development (1 April 2019 to 31 March 2022), (2) Establishment of a pharmacist-led management model (1 April 2022 to 31 March 2023), and (3) Outcome evaluation (1 April 2023 to 31 March 2024). Key variables, including gender, age, number of comorbidities, type of surgery, surgery complexity, days from hospitalization to surgery, type of prescription, type of medication, route of administration, and prescriber's seniority were collected. The data set was divided into training set and test set in the form of 8:2. The effectiveness of the SMPOP service was evaluated based on prescription appropriateness, adverse drug reactions (ADRs), length of hospital stay, total hospitalization costs, and medication expenses. In Phase 1, 6,983 prescriptions were identified as potential prescription errors (PPEs) for ML model development, with 43.9% of them accepted by prescribers. The Random Forest (RF) model performed the best (AUC = 0.893) and retained high accuracy with 12 features (AUC = 0.886). External validation showed an AUC of 0.786. In Phase 2, SMPOP services were implemented, which effectively promoted effective communication between pharmacists and physicians and ensured the successful implementation of intervention measures. The SMPOP service was fully implemented. In Phase 3, the acceptance rate of pharmacist recommendations rose to 71.3%, while the length of stay, total hospitalization costs, and medication costs significantly decreased ( < 0.05), indicating overall improvement compared to Phase 1. SMPOP service enhances prescription appropriateness, reduces ADRs, shortens stays, and lowers costs, underscoring the need for continuous innovation in healthcare.

Introduction: Numerous studies have explored the treatment outcomes of Nirmatrelvir-Ritonavir and Azvudine in older patients with COVID-19. However, direct comparisons between these two drugs are still relatively limited. This study aims to compare the safety and effectiveness of these two drugs in Chinese older patients with early infection to provide strategies for clinical treatment. Methods: Older COVID-19 patients (age ≥65) hospitalized during the winter 2022 epidemic in China were included and divided into Nirmatrelvir-Ritonavir and Azvudine. Demographics, medication information, laboratory parameters, and treatment outcomes were collected. All-cause 28-day mortality, delta cycle threshold (ΔCt), nucleic acid negative conversion time, and incidence of adverse events were defined as outcomes. Propensity score matching (PSM), Kaplan-Meier, Cox proportional hazards model, subgroup analysis, and nomograms were selected to evaluate the outcomes. Results: A total of 1,508 older COVID-19 patients were screened. Based on the inclusion and exclusion criteria, 1,075 patients were eligible for the study. After PSM, the final number of older COVID-19 patients included in the study was 375, and there were no significant differences in demographic characteristics between the two groups ( p > 0.05). Compared to the Azvudine group, the Nirmatrelvir-Ritonavir group showed a higher incidence of multiple adverse events (12.8% vs 5.2%, p = 0.009). The incidence of adverse events related to abnormal renal function was higher in the Nirmatrelvir-Ritonavir group compared to the Azvudine group (13.6% vs 7.2%, p = 0.045). There were no significant differences between the two groups in terms of all-cause 28-day mortality (HR = 1.020, 95% CI: 0.542 - 1.921, p = 0.951), whereas there were significant differences in nucleic acid negative conversion time (HR = 1.659, 95% CI: 1.166 - 2.360, p = 0.005) and ΔCt values (HR = 1.442, 95% CI: 1.084 - 1.918, p = 0.012). Conclusion: Azvudine and Nirmatrelvir-Ritonavir have comparable effectiveness in reducing mortality risk. Azvudine may perform better in nucleic acid negative conversion time and virus clearance and shows slightly better safety in older patients. Further studies with a larger sample size were needed to validate the result.

MicroRNAs (miRNAs) are key players in the progression of human cancers. While several miRNAs have been reported to regulate the development of tumors, the molecular mechanisms and roles of miR-149-5p in prostate carcinoma (PCa) remain unclear. Our aim was to investigate the interaction and functions of miR-149-5p and RGS17 in PCa. Microarray analysis was performed to identify the key miRNA and gene involved in PCa progression. The expression levels of miRNA and mRNA in PCa tissues and cells were verified by qRT-PCR. MTT assay, BrdU proliferation assay and wound-healing assay were applied to assess the effect of miR-149-5p and RGS17 on PCa cells' viability, proliferation, and migration ability. The association between RGS17 and miR-149-5p was identify using dual-luciferase reporter assay and Western blot assay. Data analysis indicated the reduction of miR-149-5p expression in PCa tissues and cells. Experimental investigations also showed that this miRNA suppressed the viability, proliferation and migration ability of PCa cells. RGS17 was found to be the target of miR-149-5p, and the low expression of miR-149-5p upregulated RGS17 in PCa tissues and cells. The results of the cell-function assays showed that RGS17 acted as an oncogene in PCa even though its promotive effect could be reversed by miR-149-5p. This research confirmed that by targeting and inhibiting RGS17, miR-149-5p could suppress PCa development.

We investigated the influence of geometrical parameters of the orifice plate on the cavitation structures, and optimized these parameters by using a surrogate-based model with special emphasis on the concentration of hydroxyl radical released. The results show that for the orifice plate of the hydrodynamic cavitation system, the possible location of the inception of the cavity spreads to throat and divergent section of the venturi geometry. Based on the surrogate model and global sensitivity assessment, the diameter of throat D t and diameter of inlet D in significantly influenced the size of the cavity, while the length of throat L t had little effect on both cavitation intensity and flow rate. It should be noted that when L t is decreased, the size of cavity would be slightly decreased but the flow rate increased clearly. The increase of the diverging section is in favor of the size of cavity. By comparing the experimental measurements on the concentration of Methylene blue, the optimum geometry of the orifice plate for best cavitational activity is proposed.

Objective To systematically evaluate the efficacy of subcutaneous tocilizumab in the treatment of patients with severe COVID-19 and provide evidence for the rational use of subcutaneous tocilizumab in patients with severe COVID-19. Methods This meta-analysis was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We searched the Cochrane Library, PubMed, Embase, CNKI, SinoMed, and Wanfang Medical Network electronic databases up to 11 January 2023 to identify relevant studies. To obtain the most recent clinical studies of subcutaneous injection of tocilizumab for the treatment of patients with severe COVID-19, we also searched the preprint platforms medRxiv and ChinaXiv. Furthermore, we searched ClinicalTrials.gov for relevant unpublished studies. The studies were screened based on the PICOS principle. The included studies were classified and evaluated for quality based on research type. The RevMan 5.3 software was used to conduct the meta-analysis, and a descriptive analysis was performed to examine relevant outcome indicators. Results Five observational studies were obtained, involving a total of 498 patients (240 patients in the subcutaneous injection group and 258 patients in the intravenous injection group). All of the studies were of the highest quality. The meta-analysis of the included studies revealed that the mortality rate of patients who received subcutaneous tocilizumab to treat COVID-19 was not significantly higher than that of the intravenous injection group [23.3% (45/193) vs. 18.4% (39/212), RD = 0.06, 95% CI = − 0.01 ~ 0.13, P  = 0.11]. Furthermore, there was no significant difference in the proportion of patients requiring mechanical ventilation between the two groups [24.5% (35/143) vs. 22% (35/159), RD = 0.03, 95% CI = − 0.07 ~ 0.12, P  = 0.56]. Conclusions The meta-analyses do not provide evidence that subcutaneous and intravenous tocilizumab formulations for the treatment of severe COVID-19 infection differ regarding their effectiveness. Considering that the meta-analyses cannot replace an appropriately powered non-inferiority study, subcutaneous formulations still need to be used with caution and only when intravenous formulations are in short supply. At present, there is a lack of randomized controlled trials of subcutaneous injection of tocilizumab for the treatment of severe COVID-19, and more clinical research should be conducted.

Injecting external CO 2 into soft and low-permeability coal seams can improve CH 4 extraction efficiency, and also benefit in CO 2 sequestration. However, the distribution law of damage zone around borehole in soft coal seam and its effect on the efficiency of CO 2 injection promoted CH 4 extraction are not clear. In this paper, a multi-physics coupling mathematical model considering damage effect is established for simulating the process of CO 2 injection promoted CH 4 extraction in soft and low-permeability coal seam. The distribution of damage zone and permeability around boreholes under different diameters and coal strengths are analyzed. The gas pressure and gas content in coal seam during CO 2 injection promoted CH 4 extraction when the model considered damage effect are compared with that of ignored. The results show that small borehole diameter corresponds to narrow damage zone around the borehole in coal seam. The damage zone expands with the increase of the borehole diameter. The damage zone increases exponentially with the borehole diameter, while decreases exponentially with the compressive strength of coal seam. The highest permeability in the damage zone has increased by nearly 300 times under the condition of simulated case. CH 4 pressure around the extraction borehole reduces, and the reduction area expands with the increase of time. Compared with the result of considering the damage effect, the reduction area of ignoring it is smaller, and the reducing speed is slower. The integrated effect of CO 2 injection and CH 4 extraction leads to rapid decrease of CH 4 content in coal seam near the boreholes. The CO 2 pressure and content increase around the injection borehole, and the increasing area gradually extends to the whole coal seam. In soft coal seams, failure to consider the damage effect will underestimate the efficiency of CH 4 extraction and CO 2 sequestration, resulting conservative layout of boreholes.

Lumbar disc herniation (LDH) is a prevalent degenerative spinal disease with low back pain and neurological deficits. Puerarin, a major active component of leguminous plants, has anti-inflammatory and antioxidant effects, but its molecular mechanisms in regulating LDH remain unclear. GSE124272 transcriptomic data (8 LDH patients, 8 healthy controls) were integrated. Co-expression modules and hub genes were identified via WGCNA. LDH-associated genes were screened by combining limma-based differential analysis with CTD and GeneCard databases. Puerarin targets were predicted via CTD and SwissTargetPrediction, with overlapping genes with LDH selected for AutoDock-based molecular docking. An inflammatory model of THP1-M0 macrophages was established by LPS/ATP induction. The expressions of SOD2, NLRP3, and CD206 were detected by qPCR and Western blot, while the secretion levels of inflammatory cytokines were measured by ELISA. 27 co-expression modules and 969 hub genes were yielded via WGCNA. 36 key LDH-associated genes were identified by combining differential analysis and disease databases. SOD2 and NLRP3 were identified as overlapping genes between puerarin targets and LDH-associated genes. Favorable binding of puerarin to both proteins was demonstrated by molecular docking (NLRP3: −9.8 kcal/mol; SOD2: −7.1 kcal/mol). mRNA levels of SOD2 and M2 marker CD206 were significantly upregulated, while NLRP3 mRNA/protein levels were downregulated, and secretion of IL-6, IL-1β, and TNF-α was suppressed by puerarin. Puerarin may exert regulatory effects on LDH by targeting SOD2 and NLRP3, inhibiting inflammatory responses and promoting M2 macrophage polarization. This study provided novel potential targets and a theoretical basis for the clinical treatment of LDH. •WGCNA and network pharmacology identify NLRP3 and SOD2 as core targets of puerarin relevant to LDH.•Molecular docking verifies stable binding of puerarin to NLRP3 (-9.8 kcal/mol) and SOD2 (-7.1 kcal/mol).•In LPS/ATP-treated THP1 cells, puerarin modulates NLRP3 and SOD2, suppresses inflammation, and promotes M2 polarization.

The arterial signal coordination is an effective method to improve traffic operational efficiency and reduce vehicle delay. In this paper, a two-stage arterial signal coordination model under dynamic traffic demands is established, and the signal timing and offset are adjusted according to the dynamic traffic demands. The objective is to minimize the expected intersection delay and the overflow of the coordinated direction. In the first stage, a calculation model for intersection signal timing based on phase clearing reliability is proposed by the reverse causal-effect modeling approach, which can calculate the signal timing of each intersection in real time. In the second stage, an offset calculation model is established to achieve the goal of minimizing delay in the coordinated direction, which can calculate the offset of trunk coordination in real time. The concept of phase clearance reliability is introduced in the model, which can dynamically adjust the balance between the coordinated phase and the non-coordinated phase, thus taking the overall control efficiency of intersections into account. We then develop an algorithm to solve the problem and then apply the model and the solution algorithm to an arterial road with three intersections to investigate and compare its performance with the Allsop’s method and the Webster’s method. A comparison between the proposed coordinated two-stage logic and a coordinated actuated logic is also conducted in the case study to show the advantages and disadvantages.