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Sepsis is a serious threat to human life. Early prediction of high-risk populations for sepsis is necessary especially in elderly patients. Artificial intelligence shows benefits in early warning. The aim of the study was to construct an early machine warning model for elderly sepsis patients and evaluate its performance. We collected elderly patients from General Hospital of Ningxia Medical University emergency department and intensive care unit from 01 January 2021 to 01 August 2023. The clinical data was divided into a training set and a test set. A total of 2976 patients and 12 features were screened. We used 8 machine learning models to build the warning model. In conclusion, we developed a model based on XGBoost with an AUROC of 0.971, AUPRC of 0.862, accuracy of 0.95, specificity of 0.964 and F1 score of 0.776. Of all the features, baseline APTT played the most important role, followed by baseline lymphocyte count. Higher level of baseline APTT and lower level of baseline lymphocyte count may indicate higher risk of sepsis occurrence. We developed a high-performance early warning model for sepsis in old age based on machine learning in order to facilitate early treatment but also need further external validation.

A major challenge in vaccine formulations is the stimulation of both the humoral and cellular immune response for well-defined antigens with high efficacy and safety. Adjuvant research has focused on developing particulate carriers to model the sizes, shapes and compositions of microbes or diseased cells, but not antigen fluidity and pliability. Here, we develop Pickering emulsions--that is, particle-stabilized emulsions that retain the force-dependent deformability and lateral mobility of presented antigens while displaying high biosafety and antigen-loading capabilities. Compared with solid particles and conventional surfactant-stabilized emulsions, the optimized Pickering emulsions enhance the recruitment, antigen uptake and activation of antigen-presenting cells, potently stimulating both humoral and cellular adaptive responses, and thus increasing the survival of mice upon lethal challenge. The pliability and lateral mobility of antigen-loaded Pickering emulsions may provide a facile, effective, safe and broadly applicable strategy to enhance adaptive immunity against infections and diseases.

Magnetic hyperthermia (MH) has been introduced clinically as an alternative approach for the focal treatment of tumors. MH utilizes the heat generated by the magnetic nanoparticles (MNPs) when subjected to an alternating magnetic field (AMF). It has become an important topic in the nanomedical field due to their multitudes of advantages towards effective antitumor therapy such as high biosafety, deep tissue penetration, and targeted selective tumor killing. However, in order for MH to progress and to realize its paramount potential as an alternative choice for cancer treatment, tremendous challenges have to be overcome. Thus, the efficiency of MH therapy needs enhancement. In its recent 60-year of history, the field of MH has focused primarily on heating using MNPs for therapeutic applications. Increasing the thermal conversion efficiency of MNPs is the fundamental strategy for improving therapeutic efficacy. Recently, emerging experimental evidence indicates that MNPs-MH produces nano-scale heat effects without macroscopic temperature rise. A deep understanding of the effect of this localized induction heat for the destruction of subcellular/cellular structures further supports the efficacy of MH in improving therapeutic therapy. In this review, the currently available strategies for improving the antitumor therapeutic efficacy of MNPs-MH will be discussed. Firstly, the recent advancements in engineering MNP size, composition, shape, and surface to significantly improve their energy dissipation rates will be explored. Secondly, the latest studies depicting the effect of local induction heat for selectively disrupting cells/intracellular structures will be examined. Thirdly, strategies to enhance the therapeutics by combining MH therapy with chemotherapy, radiotherapy, immunotherapy, photothermal/photodynamic therapy (PDT), and gene therapy will be reviewed. Lastly, the prospect and significant challenges in MH-based antitumor therapy will be discussed. This review is to provide a comprehensive understanding of MH for improving antitumor therapeutic efficacy, which would be of utmost benefit towards guiding the users and for the future development of MNPs-MH towards successful application in medicine.

Based on the connotation of high-quality economic development (HQED) in China, this study uses panel data of 30 provinces (cities and regions) in China from 2005 to 2019 to construct an evaluation index system of HQED with three dimensions of “economic development—social life—ecological environment,” and establishes a fuzzy comprehensive evaluation model to calculate the HQED index. The results show that the high-quality development level of China’s economy shows an upward trend of fluctuation, but the development level is still low and there are obvious regional differences. The eastern region enjoys the highest level of HQED, followed by the central region and western region. The panel data regression model is further established to analyze the impact of environmental regulation on economic development. It is found that there is an inverted u-shaped relationship between environmental regulation and HQED, and there is a “cost compliance” effect between environmental regulation and quantitative economic development. Strict environmental regulation measures will inhibit economic quantity growth. The results of heterogeneity analysis show that environmental regulation has different impacts on the economic development of the three regions due to the differences in resource endowment. The influence of environmental regulation on economic development in eastern China is similar to that in the whole country. However, in the central region, there is an “innovation compensation” effect between environmental regulation and HQED, and a “U” shape relationship between environmental regulation and quantitative economic development. In western China, the enhancement of environmental regulation will inhibit high-quality and quantitative economic development.

Sarcopenia is a syndrome characterized by progressive loss of skeletal muscle mass, strength and function, which is one of the most important clinical features of cancer malnutrition, representing a poor prognostic indicator in oncology. Sarcopenia is commonly assessed by measuring the skeletal muscle index (SMI) of the third lumbar spine (L3) using computed tomography (CT). The primary aim of this meta‐analysis was to study the association between low SMI and comprehensive clinicopathological characteristics as well as prognosis in patients with ovarian cancer. Data were searched in PubMed, EMBASE and Cochrane databases from inception to 10 June 2022. Studies evaluating the prognostic effect of SMI on ovarian cancer survival or chemotherapy‐related side effects were included. The risk of bias and study quality were assessed via the Newcastle–Ottawa Scale (NOS). The search strategy yielded 1286 hits in all three databases combined. Thirteen studies were included for qualitative and quantitative analysis, comprising 1814 patients. Our meta‐analysis revealed the significant association between low SMI and progression‐free survival (PFS) [P = 0.02; hazard ratio (HR): 1.40, 95% confidence interval (CI): 1.06–1.85], as well as 5‐year overall survival (OS) [P = 0.02; odds ratio (OR): 1.35, 95% CI: 1.05–1.74]. Low SMI was also obviously associated with body mass index (BMI) < 25 (P < 0.00001; OR: 5.08, 95% CI: 3.54–7.30), FIGO stage (P = 0.02; OR: 1.62, 95% CI: 1.06–2.45) and R0 cytoreduction (P = 0.04;OR: 1.34, 95% CI: 1.01–1.79). There was no correlation between low SMI and histological types, pathological grades and chemotherapy‐related toxicity. The quality of the evidence was relatively high according to NOS. Our meta‐analysis indicated that sarcopenia assessed by SMI was associated with poor clinical characteristics and adverse prognosis in patients with ovarian cancer. Consensus should be reached on standardized cut‐off values for defining sarcopenia in patients with ovarian cancer.

Green credit policy is an innovative measure in the financial industry and can help enterprises reduce energy consumption, reverse the situation of environmental pollution and resource waste, and promote sustainable development of the economy and society based on guiding fund flows into the green environmental protection industry. This research thus uses panel data of 30 provinces and cities in China from 2000 to 2017 to examine the impact of a green credit policy on the level of energy efficient utilization. We establish the EBM (epsilon-based measure) super-efficiency model to measure the level of energy efficient utilization in China, apply the regression discontinuity design (RDD) model to empirically study the net effect of the green credit policy on the level of energy efficient utilization, and assess the policy’s regional heterogeneity. Finds present that the level of energy efficient utilization in China exhibits a fluctuating upward trend, and there are certain spatial heterogeneities across its regions. The overall level of the eastern region’s energy efficient utilization is the best, followed by the central and western regions in that order. The results of RDD based on the national perspective indicate that the green credit policy has a significantly positive effect on the level of energy efficient utilization, while subregional regression results reveal that improvement caused by implementation of the green credit policy varies across regions in China. The performance of improving energy efficiency in the eastern region is excellent, but the improvement effect in the central and western regions is so far not desirable.

Nanomaterials are promising carriers to improve the bioavailability and therapeutic efficiency of drugs by providing preferential drug accumulation at their sites of action, but their delivery efficacy is severely limited by a series of biological barriers, especially the mononuclear phagocytic system (MPS)—the first and major barrier encountered by systemically administered nanomaterials. Herein, the current strategies for evading the MPS clearance of nanomaterials are summarized. First, engineering nanomaterials methods including surface modification, cell hitchhiking, and physiological environment modulation to reduce the MPS clearance are explored. Second, MPS disabling methods including MPS blockade, suppression of macrophage phagocytosis, and macrophages depletion are examined. Last, challenges and opportunities in this field are further discussed. Mphagocyticononuclear system (MPS) is one of the major obstacles that impede the accumulation of nanomaterials at their target sites. This Review summarizes the advanced strategies for evading the MPS clearance of nanomaterials, and discusses the challenges and opportunities in this field.

Controlled-release blended fertilizer (CRBF) and densification can increase rice yield and nitrogen (N) efficiency. However, the effects of CRBF combined with densification on rice yield, N absorption, economic benefits of fertilization, and ammonia volatilization loss remain unclear. A 2-year field experiment was conducted using five treatments: no N (control, CK), conventional N application (farmer's fertilization practice, FFP), optimal N application (OPT), single basal application of CRBF (CRBF), and CRBF combined with densification (CRFDP). Moreover, rice yield, N absorption and use efficiency, economic benefit, and ammonia volatilization loss were evaluated. CRBF and CRFDP significantly increased rice dry matter, N use efficiency by 11.6%-30.5% and 90.2%-160.0%, finally increased the yield by 33.3% and 26.1% in 2021 and 2022, respectively. Compared with FFP, CRFDP with 16.7% reduction of N input significantly increased yield by 33.3% and 26.1% and economic benefit by 46.9% and 38.3% in 2021 and 2022, respectively. Compared with CRBF, CRFDP increased the total yield by 2.7% and 15.2%, economic benefit by 3.5% and 7.6%, and N absorption efficiency by 10% and 8.3% in 2021 and 2022, respectively. Compared with FFP, CRFDP reduced ammonia volatilization intensity by 62.5% and 60.8%, cumulative ammonia volatilization loss by 46.3% and 50.3% and also lowered NH4+-N of surface water by 69.0%-93.8% and 57.8%-89.7% in 2021 and 2022, respectively. The combination of CRBF and densification could improve the rice yield, economic benefit, and N use efficiency and reduce ammonia volatilization. These results might provide data and theoretical support for the high yield of rice and a new environmentally friendly and resource-efficient model of rice cultivation.

Objective To investigate the value of 18F-FDG PET/CT in diagnosis and disease evaluation of Langerhans cell histiocytosis (LCH). Methods A retrospective analysis of 31 patients with LCH confirmed by histopathology was performed. A systematic analysis of the PET/CT imaging manifestations of LCH was performed, recording patients who were treated and receiving PET/CT for efficacy evaluation. In addition, clinical and laboratory data of LCH patients were collected, and the correlation between these data and PET/CT metabolic parameters was initially investigated. Results Of the 31 patients, thirty had at least 1 PET/CT positive lesions (96.7%), and one had only skin damage without abnormalities on PET/CT. Of 31 patients, fifteen (48.4%) had single system (SS) disease (9 cases with a single site and 6 cases with multiple sites) and 16 (51.6%) had multisystem (MS) disease (6 low risk and 10 high risk cases). The incidence of LCH lesions in the bone, lymphatic system, pituitary gland, liver, soft tissue, thyroid gland, thymus, and lungs was 20 cases (64.5%), 12 cases (38.7%), 3 cases (9.7%), 2 cases (6.5%), 2 cases (6.5%), 1 case (3.2%), 1 case (3.2%), and 8 cases (25.8%), respectively. A total of 21 PET/CT follow-up scanning were performed in 13 patients receiving chemotherapy, with 13 (61.9%) partial metabolic remission (PMR), 6 (28.6%) progressive metabolic disease (PMD), and 2 (9.5%) stable metabolic disease (SMD), according to PET Response Evaluation Criteria in Solid Tumors (PRECIST) 1.0. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and Lactic Dehydrogenase (LDH) were positively correlated with TTLG (total TLG) ( R 2  = 0.3256, 0.2409, 0.4205, P  < 0.05). The Re-examine SUVmax is positively correlated with re-examine LDH ( R 2  = 0.7285, P  < 0.05). Conclusions 18F-FDG PET/CT is an effective way to diagnose and evaluate LCH. PET metabolic parameters were associated with laboratory inflammatory markers, suggesting that 18F-FDG PET/CT may be helpful in evaluating disease activity of LCH.

With the rapid increase of downward pressure on China’s economy, the stability of the property market, as an important part of the economic transformation process, also has a far-reaching impact on enterprises’ R&D investment. We select the data of Chinese large and medium-sized industrial enterprises from 1998 to 2015 as our research sample and propose a new combination measurement model based on closeness degree to measure the real estate bubble level in China accurately. The structural vector autoregressive (SVAR) theory is utilized to empirically test the dynamic relationship between the real estate bubble, corporate liquidity, and R&D investment. The results indicate that the real estate bubble level in China is increasing, and a certain risk of deviating from the safety interval in the future exists; The rapid expansion of the real estate bubble has a continuing negative impact on corporate R&D investment, that is, its \"credit mitigation effect\" is much smaller than the \"capital relocation effect,\" and industrial enterprises will fall into the so-called \"low-tech lock-in\" state. In other words, to a certain extent, the development of this kind of real estate bubble will not be conducive to the transformation and upgradation of enterprises and long-term economic growth.