Establishing and clinically validating a machine learning model for predicting unplanned reoperation risk in colorectal cancer.

BACKGROUND: Colorectal cancer significantly impacts global health, with unplanned reoperations post-surgery being key determinants of patient outcomes. Existing predictive models for these reoperations lack precision in integrating complex clinical data. AIM: To develop and validate a machine learning model for predicting unplanned reoperation risk in colorectal cancer patients. METHODS: Data of patients treated for colorectal cancer (n = 2044) at the First Affiliated Hospital of Wenzhou Medical University and Wenzhou Central Hospital from March 2020 to March 2022 were retrospectively collected. Patients were divided into an experimental group (n = 60) and a control group (n = 1984) according to unplanned reoperation occurrence. Patients were also divided into a training group and a validation group (7:3 ratio). We used three different machine learning methods to screen characteristic variables. A nomogram was created based on multifactor logistic regression, and the model performance was assessed using receiver operating characteristic curve, calibration curve, Hosmer-Lemeshow test, and decision curve analysis. The risk scores of the two groups were calculated and compared to validate the model. RESULTS: More patients in the experimental group were ≥ 60 years old, male, and had a history of hypertension, laparotomy, and hypoproteinemia, compared to the control group. Multiple logistic regression analysis confirmed the following as independent risk factors for unplanned reoperation (P < 0.05): Prognostic Nutritional Index value, history of laparotomy, hypertension, or stroke, hypoproteinemia, age, tumor-node-metastasis staging, surgical time, gender, and American Society of Anesthesiologists classification. Receiver operating characteristic curve analysis showed that the model had good discrimination and clinical utility. CONCLUSION: This study used a machine learning approach to build a model that accurately predicts the risk of postoperative unplanned reoperation in patients with colorectal cancer, which can improve treatment decisions and prognosis.

Highly Moisture-Resistant Flexible Thin-Film-Based Triboelectric Nanogenerator for Environmental Energy Harvesting and Self-Powered Tactile Sensing.

Triboelectric nanogenerator (TENG) has been demonstrated as a sustainable energy utilization method for waste mechanical energy and self-powered system. However, the charge dissipation of frictional layer materials in a humid environment severely limits their stable energy supply. In this work, a new method is reported for preparing polymer film as a hydrophobic negative friction material by solution blending poly(vinylidene fluoride-co-hexafluoropropylene) (PVDF-HFP) and polyvinyl chloride (PVC), doping with titanium dioxide (TiO2) nanoparticles, and further surface patterning modification. The P-TENG composed of the PVDF-HFP/PVC/TiO2 composite film with optimized hydrophobic performance (WCA = 124°) achieved an output voltage of 235 V and a short-circuit current of 35 µA, which is approximately three times that of the bare PVDF-HFP-based TENG. Under charge excitation, the transferred charge of the P-TENG can reach 35 nC. When the external load resistance is 5.5 MΩ, the output peak power density can reach 1.4 W m-2. Meanwhile, the hydrophobic surface layer with a rough surface structure enables the device to overcome the influence of water molecules on charge transfer in a humid environment, quickly recover, and maintain a high output. The P-TENG can effectively monitor finger flexibility and strength and realize real-time evaluation of the exercise state and hand fatigue of the elderly and rehabilitation trainers. It has broad application prospects in self-powered intelligent motion sensing, soft robotics, human-machine interaction, and other fields.

Regioselective Deacetylation in Nucleosides and Derivatives.

Nucleoside analogues are a promising class of natural compounds in the pharmaceutical industry, and many antiviral, antibacterial and anticancer drugs have been created through structural modification of nucleosides scaffold. Acyl protecting groups, especially the acetyl group, play an important role in the protection of hydroxy groups in nucleoside synthesis and modification; consequently, numerous methodologies have been put forth for the acetylation of free nucleosides. However, for nucleosides that contain different O- and N-based functionalities, selective deprotection of the acetyl group(s) in nucleosides has been studied little, despite its practical significance in simplifying the preparation of partially or differentially substituted nucleoside intermediates. In this mini-review, recent approaches for regioselective deacetylation in acetylated nucleosides and their analogues are summarized and evaluated. Different regioselectivities (primary ester, secondary ester, full de-O-acetylation, and de-N-acetylation) are summarized and discussed in each section.

PD1+CD4+ T cells promote receptor editing and suppress autoreactivity of CD19+CD21low B cells within the lower respiratory airways in adenovirus pneumonia.

Human adenovirus (HAdV) pneumonia poses a major health burden for young children, however, factors that contribute to disease severity remain elusive. We analyzed immune cells from bronchoalveolar lavage (BAL) of children with HAdV pneumonia and found that CD19+CD21low B cells were significantly enriched in the BAL and were associated with increased autoantibody concentrations and disease severity. Myeloid cells, PD-1+CD4+ T helper cells and CD21low B cells formed tertiary lymphoid structures within the respiratory tracts. Myeloid cells promoted autoantibody production by expressing high amounts of B cell activating factor (BAFF). In contrast, PD-1+CD4+ T helper cells induced production of IgG1 and IgG3 antibodies but suppressed autoreactive IgGs by initiating B cell receptor editing. In summary, this study reveals cellular components involved in protective versus autoreactive immune pathways in the respiratory tract, and these findings provide potential therapeutic targets for severe HAdV lower respiratory tract infections.

Voxelated bioprinting of modular double-network bio-ink droplets.

Analogous of pixels to two-dimensional pictures, voxels-in the form of either small cubes or spheres-are the basic building blocks of three-dimensional objects. However, precise manipulation of viscoelastic bio-ink voxels in three-dimensional space represents a grand challenge in both soft matter science and biomanufacturing. Here, we present a voxelated bioprinting technology that enables the digital assembly of interpenetrating double-network hydrogel droplets made of polyacrylamide/alginate-based or hyaluronic acid/alginate-based polymers. The hydrogels are crosslinked via additive-free and biofriendly click reaction between a pair of stoichiometrically matched polymers carrying norbornene and tetrazine groups, respectively. We develop theoretical frameworks to describe the crosslinking kinetics and stiffness of the hydrogels, and construct a diagram-of-state to delineate their mechanical properties. Multi-channel print nozzles are developed to allow on-demand mixing of highly viscoelastic bio-inks without significantly impairing cell viability. Further, we showcase the distinctive capability of voxelated bioprinting by creating highly complex three-dimensional structures such as a hollow sphere composed of interconnected yet distinguishable hydrogel particles. Finally, we validate the cytocompatibility and in vivo stability of the printed double-network scaffolds through cell encapsulation and animal transplantation.

Transformation of Metal-Organic Framework from Kinetic to Thermodynamic Product for Controlled Delivery of Vitamin C.

A biocompatible metal-organic framework (MOF), named HSTC-4, constructed using the flexible 4,4'-oxybis(benzoic acid) (OBA), was developed to enable efficient loading and controlled release of vitamin C (VC) through a combination of strategies involving ligand length, structure design, and metal selection. The kinetic product HSTC-4 demonstrates a propensity for transforming into the thermodynamically stable HSTC-5 under external stimuli, such as photoillumination and vacuum heating, as witnessed by single-crystal to single-crystal transformation. Density functional theory (DFT) calculations reveal that the VC guest molecules exhibit stronger binding affinity with HSTC-5 due to its narrower pores compared to HSTC-4, resulting in a slower release of VC from VC@HSTC-5. Furthermore, precise control over VC release can be achieved by introducing surface modifications involving SiO2 onto the structure of VC@HSCT-5, while simultaneously adjusting environmental factors such as pH and temperature conditions. Preliminary cell culture experiments and cytotoxicity assays highlight the biocompatibility of HSTC-5, suggesting that it is a promising platform for sustained drug delivery and diverse biomedical applications.

[Spatiotemporal Evolution Characteristics of Carbon Sources and Carbon Sinks and Carbon Balance Zoning in the Yangtze River Delta Region].

Mastering the spatiotemporal evolution laws of carbon sources and sinks is of great significance to promote the coordinated development of regional low-carbon, improve the science of carbon reduction and sink increase policies, and realize the goal of "double carbon." Taking 41 cities in the Yangtze River Delta Region as the research object, this study analyzed the spatiotemporal evolution characteristics of carbon sources and sinks in the Yangtze River Delta Region from 2000 to 2020 and conducted the carbon balance zoning. The results were as follows： ① The carbon emissions increased rapidly in the Yangtze River Delta Region from 2000 to 2011 but with some fluctuations after 2011. Carbon sinks increased slowly in the Yangtze River Delta Region from 2000 to 2020. The regional differences in carbon emissions and carbon sinks were significant, and the spatial pattern was relatively stable. ② The carbon compensation rate in the Yangtze River Delta Region showed a downward trend, and the carbon productivity, energy utilization efficiency, and carbon ecological support capacity were constantly enhanced. Interregional differences were the main source of carbon compensation rate in the Yangtze River Delta Region. Both the carbon compensation rate and carbon ecological support coefficient showed a spatial pattern of "high in the west and low in the east, high in the south and low in the north." The areas with high carbon economy contributive coefficient were concentrated in the central and southern areas of the Yangtze River Delta regions, and the areas with low carbon economy contributive coefficient were concentrated in Anhui Province. ③ Based on the carbon economy contributive coefficient and the carbon ecological support coefficient, cities in the Yangtze River Delta Region were classified into low-carbon maintenance areas, economic development areas, carbon sink development areas, and comprehensive optimization areas. Recommendations were proposed for each category of cities in order to promote the coordinated development of regional low-carbon and realize the goal of "double carbon".

Study on temperature field in the process of induction heat treatment with current assisted weld double side method.

At present, in the process of weld induction heat treatment, the common method is to carry out centralized induction heating in the weld area, which will lead to large radial temperature difference of the weld, poor controllability of temperature distribution and easy to cause the defects of residual stress concentration in the weld area. To solve the above problems, this paper adopts the two-sided method to conduct induction heating on both sides of the weld, and at the same time, the auxiliary pulse current is passed into the weld to improve the quality of the weld. ANSYS finite element software is used to establish a multi-field coupling prediction model of electric-magnetic-thermal structure, and explore the distribution law of the auxiliary pulse current and the temperature field of the weld. Finally, an experimental study of pulsed current assisted two-sided induction heating is carried out. Temperature test and metallographic test were carried out respectively to verify the effectiveness of pulsed current assisted induction heating technology.

Integrating Polyoxometalates and Silver Clusters into Atomically Precise Molecular Heterojunction.

The Ag cluster-POM assemblies have been shown to possess interesting and potentially useful properties. However, there is no precedent example of atomically precise Ag cluster-POM assemblies showing heterojunction effects in photocatalysis. Herein, the synthesis and total structure determination of the periodically distributed molecular heterojunction [Ag12(SCy)6(CH3CN)12(PW12O40)]n (Ag12-PW12) are reported. The assembly of Ag/W clusters into 3D network can endow the resulting binary structure with an aesthetic topology and unique physicochemical properties. More remarkably, the incorporation of Ag12 cluster with PW12 can efficiently facilitate the separation of photogenerated electrons and holes, thus significantly promoting the catalytic efficiency in selective oxidation of sulfides. The Ag12-PW12 heterojunction can be recovered and reused five times with no drastic change in the catalytic performance. This research is expected to assist in the rational design of cluster-based heterojunction catalysts. The increase of catalytic activity of the Ag12-PW12 assembly in comparison with the unassembled Ag12 and PW12 clusters is attributed to the synergistic effect of Ag12 and PW12 clusters, offering the splendid opportunity for deciphering structure-reactivity relationship of heterostructure-coupled photosystem.

A lumped parameter model for evaluating coronary artery blood supply capacity.

The coronary artery constitutes a vital vascular system that sustains cardiac function, with its primary role being the conveyance of indispensable nutrients to the myocardial tissue. When coronary artery disease occurs, it will affect the blood supply of the heart and induce myocardial ischemia. Therefore, it is of great significance to numerically simulate the coronary artery and evaluate its blood supply capacity. In this article, the coronary artery lumped parameter model was derived based on the relationship between circuit system parameters and cardiovascular system parameters, and the blood supply capacity of the coronary artery in healthy and stenosis states was studied. The aortic root pressure calculated by the aortic valve fluid-structure interaction (AV FSI) simulator was employed as the inlet boundary condition. To emulate the physiological phenomenon of sudden pressure drops resulting from an abrupt reduction in blood vessel radius, a head loss model was connected at the coronary artery's entrance. For each coronary artery outlet, the symmetric structured tree model was appended to simulate the terminal impedance of the missing downstream coronary arteries. The particle swarm optimization (PSO) algorithm was used to optimize the blood flow viscous resistance, blood flow inertia, and vascular compliance of the coronary artery model. In the stenosis states, the relative flow and fractional flow reserve (FFR) calculated by numerical simulation corresponded to the published literature data. It was anticipated that the proposed model can be readily adapted for clinical application, serving as a valuable reference for diagnosing and treating patients.

Advanced nanomedicines and immunotherapeutics to treat respiratory diseases especially COVID-19 induced thrombosis.

Immunotherapy and associated immune regulation strategies gained huge attraction in order to be utilized for treatment and prevention of respiratory diseases. Engineering specifically nanomedicines can be used to regulate host immunity in lungs in the case of respiratory diseases including coronavirus disease 2019 (COVID-19) infection. COVID-19 causes pulmonary embolisms, thus new therapeutic options are required to target thrombosis, as conventional treatment options are either not effective due to the complexity of the immune-thrombosis pathophysiology. In this review, we discuss regulation of immune response in respiratory diseases especially COVID-19. We further discuss thrombosis and provide an overview of some antithrombotic nanoparticles, which can be used to develop nanomedicine against thrombo-inflammation induced by COVID-19 and other respiratory infectious diseases. We also elaborate the importance of immunomodulatory nanomedicines that can block pro-inflammatory signalling pathways, and thus can be recommended to treat respiratory infectious diseases.

BOLERO-5: a phase II study of everolimus and exemestane combination in Chinese post-menopausal women with ER + /HER2- advanced breast cancer.

BACKGROUND: The global BOLERO-2 trial established the efficacy and safety of combination everolimus (EVE) and exemestane (EXE) in the treatment of estrogen receptor positive (ER +), HER2-, advanced breast cancer (ABC). BOLERO-5 investigated this combination in a Chinese population (NCT03312738). METHODS: BOLERO-5 is a randomized, double-blind, multicenter, placebo controlled, phase II trial comparing EVE (10 mg/day) or placebo (PBO) in combination with EXE (25 mg/day). The primary endpoint was progression-free survival (PFS) per investigator assessment. Secondary endpoints included PFS per blinded independent review committee (BIRC), overall survival (OS), overall response rate (ORR), clinical benefit rate (CBR), pharmacokinetics, and safety. RESULTS: A total of 159 patients were randomized to EVE + EXE (n = 80) or PBO + EXE (n = 79). By investigator assessment, treatment with EVE + EXE prolonged median PFS by 5.4 months (HR 0.52; 90% CI 0.38, 0.71), from 2.0 months (PBO + EXE; 90% CI 1.9, 3.6) to 7.4 months (EVE + EXE; 90% CI 5.5, 9.0). Similar results were observed following assessment by BIRC, with median PFS prolonged by 4.3 months. Treatment with EVE + EXE was also associated with improvements in ORR and CBR. No new safety signals were identified in BOLERO-5, with the incidence of adverse events in Chinese patients consistent with the safety profile of both drugs. CONCLUSION: The efficacy and safety results of BOLERO-5 validate the findings from BOLERO-2, and further support the use of EVE + EXE in Chinese post-menopausal women with ER + , HER2- ABC. NCT03312738, registered 18 October 2017.

DUSP5 regulated by YTHDF1-mediated m6A modification promotes epithelial-mesenchymal transition and EGFR-TKI resistance via the TGF-ß/Smad signaling pathway in lung adenocarcinoma.

BACKGROUND: Lung adenocarcinoma (LUAD) patients have a dismal survival rate because of cancer metastasis and drug resistance. The study aims to identify the genes that concurrently modulate EMT, metastasis and EGFR-TKI resistance, and to investigate the underlying regulatory mechanisms. METHODS: Cox regression and Kaplan-Meier analyses were applied to identify prognostic oncogenes in LUAD. Gene set enrichment analysis (GSEA) was used to indicate the biological functions of the gene. Wound-healing and Transwell assays were used to detect migratory and invasive ability. EGFR-TKI sensitivity was evaluated by assessing the proliferation, clonogenic survival and metastatic capability of cancer cells with treatment with gefitinib. Methylated RNA immunoprecipitation (MeRIP) and RNA immunoprecipitation (RIP) analyses established the level of m6A modification present on the target gene and the protein's capability to interact with RNA, respectively. Single-sample gene set enrichment (ssGSEA) algorithm used to investigate levels of immune cell infiltration. RESULTS: Our study identified dual-specificity phosphatase 5 (DUSP5) as a novel and powerful predictor of adverse outcomes for LUAD by using public datasets. Functional enrichment analysis found that DUSP5 was positively enriched in EMT and transforming growth factor-beta (TGF-ß) signaling pathway, a prevailing pathway involved in the induction of EMT. As expected, DUSP5 knockdown suppressed EMT via inhibiting the canonical TGF-ß/Smad signaling pathway in in vitro experiments. Consistently, knockdown of DUSP5 was first found to inhibit migratory ability and invasiveness of LUAD cells in in vitro and prevent lung metastasis in in vivo. DUSP5 knockdown re-sensitized gefitinib-resistant LUAD cells to gefitinib, accompanying reversion of EMT progress. In LUAD tissue samples, we found 14 cytosine-phosphate-guanine (CpG) sites of DUSP5 that were negatively associated with DUSP5 gene expression. Importantly, 5'Azacytidine (AZA), an FDA-approved DNA methyltransferase inhibitor, restored DUSP5 expression. Moreover, RIP experiments confirmed that YTH N6-methyladenosine RNA binding protein 1 (YTHDF1), a m6A reader protein, could bind DUSP5 mRNA. YTHDF1 promoted DUSP5 expression and the malignant phenotype of LUAD cells. In addition, the DUSP5-derived genomic model revealed the two clusters with distinguishable immune features and tumor mutational burden (TMB). CONCLUSIONS: Briefly, our study discovered DUSP5 which was regulated by epigenetic modification, might be a potential therapeutic target, especially in LUAD patients with acquired EGFR-TKI resistance.

Hydrophobic TPU/CNTs-ILs Ionogel as a Reliable Multimode and Flexible Wearable Sensor for Motion Monitoring, Information Transfer, and Underwater Sensing.

Ionogel-based sensors have gained widespread attention in recent years due to their excellent flexibility, biocompatibility, and multifunctionality. However, the adaptation of ionogel-based sensors in extreme environments (such as humid, acidic, alkaline, and salt environments) has rarely been studied. Here, thermoplastic polyurethane/carbon nanotubes-ionic liquids (TPU/CNTs-ILs) ionogels with a complementary sandpaper morphology on the surface were prepared by a solution-casting method with a simple sandpaper as the template, and the hydrophobic flexible TPU/CNTs-ILs ionogel-based sensor was obtained by modification using nanoparticles modified with cetyltrimethoxysilane. The hydrophobicity improves the environmental resistance of the sensor. The ionogel-based sensor exhibits multimode sensing performance and can accurately detect response signals from strain (0-150%), pressure (0.1-1 kPa), and temperature (30-100 °C) stimuli. Most importantly, the hydrophobic TPU/CNTs-ILs ionogel-based sensors can be used not only as wearable strain sensors to monitor human motion signals but also for information transfer, writing recognition systems, and underwater activity monitoring. Thus, the hydrophobic TPU/CNTs-ILs ionogel-based sensor offers a new strategy for wearable electronics, especially for applications in extreme environments.

Bottlebrush Polyethylene Glycol Nanocarriers Translocate across Human Airway Epithelium via Molecular Architecture-Enhanced Endocytosis.

Pulmonary drug delivery is critical for the treatment of respiratory diseases. However, the human airway surface presents multiple barriers to efficient drug delivery. Here, we report a bottlebrush poly(ethylene glycol) (PEG-BB) nanocarrier that can translocate across all barriers within the human airway surface. Guided by a molecular theory, we design a PEG-BB molecule consisting of a linear backbone densely grafted by many (∼1000) low molecular weight (∼1000 g/mol) polyethylene glycol (PEG) chains; this results in a highly anisotropic, wormlike nanocarrier featuring a contour length of ∼250 nm, a cross-section of ∼20 nm, and a hydrodynamic diameter of ∼40 nm. Using the classic air-liquid-interface culture system to recapitulate essential biological features of the human airway surface, we show that PEG-BB rapidly penetrates through endogenous airway mucus and periciliary brush layer (mesh size of 20-40 nm) to be internalized by cells across the whole epithelium. By quantifying the cellular uptake of polymeric carriers of various molecular architectures and manipulating cell proliferation and endocytosis pathways, we show that the translocation of PEG-BB across the epithelium is driven by bottlebrush architecture-enhanced endocytosis. Our results demonstrate that large, wormlike bottlebrush PEG polymers, if properly designed, can be used as a carrier for pulmonary and mucosal drug delivery.

Plasma irisin associations with executive function among children in a prospective cohort.

OBJECTIVE: To examine the longitudinal associations between irisin and executive function among children, as well as the sex difference in this correlation. METHODS: The study involving 330 children aged 6-10 years conducted in Guangzhou, China. Baseline surveys and fasting blood samples were collected in 2017. Plasma irisin concentration was measured using Enzyme-Linked Immunosorbent Assay (ELISA). Executive function was assessed by the Behavior Rating Inventory of Executive Function (BRIEF) scale in 2017 and followed up after 2 years. Multivariable linear regression was used for association analysis. RESULTS: The plasma irisin concentration was 9.04±2.18 ng/mL. There was no statistical difference in plasma irisin and change values of BRIEF T-scores between boys and girls. No significant associations were found between plasma irisin and change values of BRIEF T-scores (P > 0.05) in the overall sample. Further subgroup analyses according to sex revealed that plasma irisin was negatively associated with change values of behavior regulation index (BRI, ß=-0.521, 95 %CI: -1.036 ∼ -0.006), emotional control (ß=-0.649, 95 %CI: -1.249 ∼ -0.049), working memory T-scores (ß=-0.774, 95 %CI: -1.350 ∼ -0.199) in girls. Moreover, we firstly identified a sex effect modification in the association of plasma irisin with change values of working memory T-score (Pinterference=0.012). CONCLUSIONS: Higher irisin concentration was associated with better executive function performance in girls. Further studies that included populations in other regions or countries are needed to confirm these findings.

Modeling Analysis of Complex Deformation of Woven Coating Film during the Cyclic Tensile Process.

It is difficult for the existing Burgers model to accurately depict the off-axis cyclic drawing process of woven coatings. In this paper, the mechanical deformation of woven PVC (polyvinyl chloride)-coated film at different temperatures is investigated. One-dimensional (1D) and two-dimensional (2D) constitutive models were established to characterize cyclic deformation processes. The 1D model is an improved Burgers model. The effects of the time dependence of the viscosity coefficient and the ratio of elastic to viscous deformation are considered simultaneously. The accuracy of the 1D model for predicting the cyclic nonlinear deformation at different temperatures and loading rates is improved. The 2D model is a nonlinear orthotropic model using polynomials. On the basis of the single-objective genetic algorithm, the inverse algorithm is used to obtain the shear polynomial coefficients in the tension phase and the shear modulus in the unloading phase, which circumvents performing the difficult shear test. UMAT subroutines of off-axis stretching and off-axis cyclic stretching are written separately. The intelligent inverse algorithm program consists of a single-objective genetic algorithm program, a finite element parametric modelling program, and a UMAT subroutine. The simulation results are compared with the off-axis cyclic tensile test data to validate the effectiveness and accuracy of the proposed 2D model for the analysis of the woven PVC-coated films in the tension-shear coupling state.

Predicting personalized cumulative live birth rate after a complete in vitro fertilization cycle: an analysis of 32,306 treatment cycles in China.

BACKGROUND: The cumulative live birth rate (CLBR) has been regarded as a key measure of in vitro fertilization (IVF) success after a complete treatment cycle. Women undergoing IVF face great psychological pressure and financial burden. A predictive model to estimate CLBR is needed in clinical practice for patient counselling and shaping expectations. METHODS: This retrospective study included 32,306 complete cycles derived from 29,023 couples undergoing IVF treatment from 2014 to 2020 at a university-affiliated fertility center in China. Three predictive models of CLBR were developed based on three phases of a complete cycle: pre-treatment, post-stimulation, and post-treatment. The non-linear relationship was treated with restricted cubic splines. Subjects from 2014 to 2018 were randomly divided into a training set and a test set at a ratio of 7:3 for model derivation and internal validation, while subjects from 2019 to 2020 were used for temporal validation. RESULTS: Predictors of pre-treatment model included female age (non-linear relationship), antral follicle count (non-linear relationship), body mass index, number of previous IVF attempts, number of previous embryo transfer failure, type of infertility, tubal factor, male factor, and scarred uterus. Predictors of post-stimulation model included female age (non-linear relationship), number of oocytes retrieved (non-linear relationship), number of previous IVF attempts, number of previous embryo transfer failure, type of infertility, scarred uterus, stimulation protocol, as well as endometrial thickness, progesterone and luteinizing hormone on trigger day. Predictors of post-treatment model included female age (non-linear relationship), number of oocytes retrieved (non-linear relationship), cumulative Day-3 embryos live-birth capacity (non-linear relationship), number of previous IVF attempts, scarred uterus, stimulation protocol, as well as endometrial thickness, progesterone and luteinizing hormone on trigger day. The C index of the three models were 0.7559, 0.7744, and 0.8270, respectively. All models were well calibrated (p = 0.687, p = 0.468, p = 0.549). In internal validation, the C index of the three models were 0.7422, 0.7722, 0.8234, respectively; and the calibration P values were all greater than 0.05. In temporal validation, the C index were 0.7430, 0.7722, 0.8234 respectively; however, the calibration P values were less than 0.05. CONCLUSIONS: This study provides three IVF models to predict CLBR according to information from different treatment stage, and these models have been converted into an online calculator ( https://h5.eheren.com/hcyc/pc/index.html#/home ). Internal validation and temporal validation verified the good discrimination of the predictive models. However, temporal validation suggested low accuracy of the predictive models, which might be attributed to time-associated amelioration of IVF practice.

Osteolytic lesions as a presenting sign of acute myeloid leukemia: a case report.

Osteolytic lesions are infrequently observed in adult patients with acute myeloid leukemia (AML). This report details the case of a 66-year-old male patient who presented with myeloid sarcoma (MS), osteolytic lesion and pancytopenia. Effective treatments were delayed due to diagnostic challenges and the rapid progression of the disease. It is essential to consider AML in the differential diagnosis when faced with a patient presenting osteolytic lesions and pancytopenia.

A bibliometric analysis of acupuncture for cerebral infarction from 1993 to 2023.

Objective: This research aims to explore the trends and knowledge domain of acupuncture for cerebral infarction through bibliometrics. Methods: Publications related to acupuncture for cerebral infarction were retrieved from the Web of Science core collection database from 1993 to December 31, 2023. A domain knowledge graph was then constructed using VOSviewer, CiteSpace, GraphPad Prism, and Scimago Graphica. Results: The cumulative publication trend shows a steady increase over the years, with China being the most productive country. Notably, Europe exhibits significant close collaboration. Institutional cooperation is primarily observed among Chinese universities specializing in traditional Chinese medicine. Tao Jing is the most prolific author, with his highest number of publications is in "Stroke" journal, and Acupuncture Electro Therapeutics Research is the significant journal. Zhang SH is the most cited author, and Si QM is a prominent author in this field. Rehabilitation treatment after cerebral infarction emerges as a prevalent research focus, with nerve regeneration being a keyword. Long EZ's 1989 paper, published in the journal Stroke, holds significant importance. The prominent papers are Donnan et al. and Wu et al., which covers the following topics: "population-based study," "Baihui Acupoint," "memory deficits," "neurotrophic factor," and "randomized trial." Conclusion: This bibliometric analysis of acupuncture for cerebral infarction offers insights into the Web of Science database, delineates a knowledge map of countries, authors, institutions, cited authors, keywords, cited references in the field of acupuncture for cerebral infarction, which has a momentous guiding significance for quickly and accurately positioning the key information in the field.