Damage evolution law of multi-hole blasting igneous rock and quantitative evaluation model of damage degree based on fractal theory and clustering algorithm.

The geological phenomenon of igneous rock invading coal seam is widely distributed, which induces mining risk and affects efficient mining. The pre-splitting blasting method of igneous rock is feasible but difficult to implement accurately, resulting in unnecessary safety and environmental pollution risks. In this paper, the blasting model with penetrating structural plane and the multi-hole blasting model with different hole spacing were established based on the Riedel-Hiermaier-Thoma (RHT) damage constitutive to explore the stress wave propagation law under detonation. The damage cloud diagram and damage degree algorithm were used to quantitatively describe the spatio-temporal evolution of blasting damage. The results show that the explosion stress wave presents a significant reflection stretching effect under the action of the structural plane, which can effectively aggravate the presplitting blasting degree of the rock mass inside the structural plane. The damage range of rock mass is synchronously evolved with the change of blasting hole spacing. The blasting in the igneous rock intrusion area of the 21,914 working face is taken as an application example, and the damage degree of rock mass is reasonably evaluated by the box-counting dimension and K-means clustering method, which proves the effectiveness of the blasting scheme and provides reference value for the implementation of related blasting projects.

Evaluation of the effectiveness of preventive nursing measures for pressure injuries in patients in the neurology intensive care unit.

BACKGROUND: Patients in neurology intensive care units (ICU) are prone to pressure injuries (PU) due to factors such as severe illness, long-term bed rest, and physiological dysfunction. PU not only causes pain and complications to patients, but also increases medical burden, prolongs hospitalization time, and affects the recovery process. AIM: To evaluate and optimize the effectiveness of pressure injury prevention nursing measures in neurology ICU patients. METHODS: A retrospective study was conducted, and 60 patients who were admitted to the ICU of the Department of Neurology were selected and divided into an observation group and a control group according to the order of admission, with 30 people in each group. The observation group implemented pressure injury prevention and nursing measures, while the control group adopted routine care. RESULTS: Comparison between observation and control groups following pressure injury prevention nursing intervention revealed significantly lower incidence rates in the observation group compared to the control group at 48 h (8.3% vs 26.7%), 7 d (16.7% vs 43.3%), and 14 d (20.0% vs 50.0%). This suggests a substantial reduction in pressure injury incidence in the observation group, with the gap widening over time. Additionally, patients in the observation group exhibited quicker recovery, with a shorter average time to get out of bed (48 h vs 72 h) and a shorter average length of stay (12 d vs 15 d) compared to the control group. Furthermore, post-intervention, patients in the observation group reported significantly improved quality of life scores, including higher scores in body satisfaction, feeling and function, and comfort (both psychological and physiological), indicating enhanced overall well-being and comfort following the implementation of pressure injury prevention nursing measures. CONCLUSION: Implementing pressure injury preventive care measures for neurology ICU patients will have better results.

Study on the policy implementation effect of serious Illness medical insurance in the ethnic minority autonomous area of Western China

Objective: To evaluate the implementation effect of serious illness medical insurance in Guang Xi Zhuang Autonomous Region of western China. Study design: Through the collection of 2017-2021 Guang Xi serious illness medical insurance specific policy making such as fund usage, serious illness compensation, medical expenses data, and data analysis of a serious illness medical insurance effect. Method: Literature research, Policy text analysis, quantitative data collection method, using Excel and SPSS 19.0 data descriptive statistical analysis and comparative analysis. Results: Serious illness medical insurance has had some effect, e.g., from 2017 to 2021, the utilization rate of serious illness medical insurance fund in Guang Xi was 109.49% and 103.87% respectively, the fund balance rate was -9.45% and -8.54% respectively, and the accumulated balance was -2.3871 million CNY and -70.7955 million CNY. Conclusion: The serious illness medical insurance has reduced the burden of large medical expenses of patients to a certain extent, but the fund is under too much pressure, and there is a payment deficit. The coverage and security of serious illness medical insurance need to be expanded and strengthened, and the cooperation mechanism with commercial insurance institutions should be gradually explored to improve the serious illness medical insurance.

Objetivo: evaluar el efecto de la implementación de seguros médicos para enfermedades graves en la Región Autónoma Guang Xi Zhuang, al oeste de China. Diseño del estudio: a través de la recopilación de pólizas de seguro médico específicas para enfermedades graves de la región de Guang Xi entre 2017-2021, como por ejemplo: uso de fondos, compensación por enfermedades graves, datos de gastos médicos y análisis de datos del efecto de seguros médicos para enfermedades graves. Método: investigación de literatura, análisis de textos de políticas públicas, metodología de recolección de datos cuantitativos utilizando Excel y SPSS 19.0, análisis estadístico descriptivo de datos y análisis comparativo. Resultados: el seguro médico para enfermedades graves ha demostrado tener efectos, tales como: entre 2017 y 2021, la tasa de utilización de fondos de seguros médicos para enfermedades graves en Guang Xi fue de 109,49 % y 103,87 % respectivamente, las tasas de saldo del fondo fue de -9,45 % y -8,54 % respectivamente y el saldo acumulado fue de -2,3871 millones de CNY y -70,7955 millones de CNY. Conclusión: El seguro médico para enfermedades graves ha reducido en cierta medida la carga de los grandes gastos médicos de los pacientes, pero al existir un déficit de pagos está bajo demasiada presión. Por ello, es necesario ampliar y fortalecer la cobertura y seguridad del seguro médico para enfermedades graves, y explorar gradualmente mecanismos de cooperación con instituciones de seguros comerciales.

Objetivo: Avaliar o efeito da implementação de seguro médico para doenças graves na Região Autônoma de Guang Xi Zhuang da China Ocidental. Desenho do Estudo: Através da coleta de políticas específicas de seguro médico para doenças graves de Guang Xi 2017-2021, uso de fundos, compensação por doenças graves, dados de despesas médicas e análise de dados de um efeito de seguro médico para doenças graves. Método: Pesquisa na literatura, análise do texto da política, método de coleta de dados quantitativos usando Excel e SPSS 19.0, análise estatística descritiva de dados e análise comparativa. Resultados: Seguro médico de doenças graves teve um certo efeito. Em 2017 e 2021, a taxa de utilização do fundo de seguro médico para doenças graves em Guang Xi foi 109,49% e 103,87% respectivamente, a taxa de saldo do fundo foi -9,45% e -8,54% respectivamente e o saldo acumulado foi -2,3871 milhões de yuans e -70,7955 milhões de yuans. Conclusão: O seguro médico para doenças graves reduziu o ônus de grandes despesas médicas dos pacientes até certo ponto mas o fundo está sob demasiada pressão e há um déficit de pagamentos. A cobertura e segurança do seguro médico de doenças graves necessitam ser expandidas e fortalecidas, e o mecanismo de cooperação com instituições de seguros comerciais deve ser gradualmente explorado para melhorar o seguro médico para doenças graves.

Medical staff evaluation on 'the effect of medical alliance policy on hierarchical diagnosis and treatment'.

Introduction: Medical alliances are essential for constructing an hierarchical diagnosis and treatment (HDT) system; therefore, it is crucial to promote such alliances and evaluate their effectiveness in this regard from the medical staff perspective. This study thus investigated and analyzed the evaluations of medical staff in China concerning the effect of medical alliances on promoting HDT with the intention to encourage further establishment of medical alliances and HDT under China's new medical reform. Methods: A total of 616 medical staff personnel from 3 medical alliances in Fujian Province were surveyed, and data were analyzed using SPSS 20.0 software. Results: The level of medical institutions, posts and satisfaction with their medical alliances influenced the evaluation of medical alliance effectiveness in resolving the problem of expensive medical services. Primary medical institutions are more inclined toward policy formulation and related work; thus, the interests of primary hospitals can be guaranteed. However, tertiary hospitals must provide additional workforce, material, and financial resources to support primary hospitals. Discussion: Therefore, it is necessary to coordinate the interests of the medical staff at different levels of medical institutions. The study makes a significant contribution to the literature because it highlights the effect of medical alliances in promoting hierarchical diagnosis and treatment.

Blasting profile evaluation of sand-mud interbedded surrounding rock during the large-span tunnel construction.

The sand-mud interbedded surrounding rock contains discontinuities, such as horizontal bedding, joints, weak planes and weak interlayers. Drilling and blasting construction in this kind of surrounding rock is very likely to cause very serious over-/under-excavation phenomenon and excessive damage to surrounding rock, and the contour flatness after smooth blasting of the tunnel is also difficult to be guaranteed, which increases subsequent construction procedures and reduces production efficiency. In order to effectively evaluate the smooth blasting effect of the sand-mud interbedded surrounding rock tunnel, taking a tunnel project in southwest China as the research background, the blasting numerical simulation of the sand-mud interbedded surrounding rock tunnel was carried out using the dynamic analysis program, and the corresponding blasting optimization scheme was obtained. Subsequently, based on fuzzy mathematical theory, the evaluation system of blasting effect of sand-mud interbedded tunnel was established by combining the evaluation criteria of tunnel smooth blasting quality. Immediately afterwards, the weights of each influencing factor index were determined, and the blasting shaping effect of the original blasting scheme and the optimized blasting scheme was evaluated. Finally, the results have shown that the optimized tunnel blasting profile effect was better than the original blasting scheme. The corresponding research results have certain guiding significance for similar tunnel blasting effect evaluation and blasting parameter design.

Research on factor analysis and method for evaluating grouting effects using machine learning.

The evaluation of grouting effects constitutes a critical aspect of grouting engineering. With the maturity of the grouting project, the workload and empirical characteristics of grouting effect evaluation are gradually revealed. In the context of the Qiuji coal mine's directional drilling and grouting to limestone aquifer reformation, this study thoroughly analyzes the influencing factors of grouting effects from geological and engineering perspectives, comparing these with various engineering indices associated with drilling and grouting. This led to the establishment of a "dual-process, multi-parameter, and multi-factor" system, employing correlation analysis to validate the selected indices' reasonableness and scientific merit. Utilizing the chosen indices, eight high-performing machine learning models and three parameter optimization algorithms were employed to develop a model for assessing the effectiveness of directional grouting in limestone aquifers. The model's efficacy was evaluated based on accuracy, recall, precision, and F-score metrics, followed by practical engineering validation. Results indicate that the "dual-process, multi-parameter, multi-factor" system elucidates the relationship between influencing factors and engineering parameters, demonstrating the intricacy of evaluating grouting effects. Analysis revealed that the correlation among the eight selected indicators-including the proportion of boreholes in the target rock strata, drilling length, leakage, water level, pressure of grouting, mass of slurry injected, permeability properties of limestone aquifers before being grouted, permeability properties of limestone aquifers after being grouted-is not substantial, underscoring their viability as independent indicators for grouting effect evaluation. Comparative analysis showed that the Adaboost machine learning model, optimized via a genetic algorithm, demonstrated superior performance and more accurate evaluation results. Engineering validation confirmed that this model provides a more precise and realistic assessment of grouting effects compared to traditional methods.

Reducing carbon emissions at the expense of firm physical capital investments and growing financialization? Impacts of carbon trading policy from a regression discontinuity design.

This study examines the effects of China's carbon trading policy on firm emissions and explores its impact mechanisms through financial and physical asset investments. The empirical analysis utilizes a fuzzy regression discontinuity design based on a sample of 427 industrial firms in China between 2014 and 2019. The results indicate that China's carbon trading policy incentivized firms to increase their financial investments while simultaneously discouraging physical capital investments. These shifts in investment patterns helped firms achieve their emission reduction targets. The study reveals that carbon trading policy in China has contributed to the financialization of firms, resulting in the erosion of firm assets and a decline in their overall competitiveness. Based on these findings, some policy recommendations are put forward.

A Combined Method of Seismic Monitoring and Transient Electromagnetic Detection for the Evaluation of Hydraulic Fracturing Effect in Coal Burst Prevention.

In order to mitigate the risk of roof-dominated coal burst in underground coal mining, horizontal long borehole staged hydraulic fracturing technology has been prevailingly employed to facilitate the weakening treatment of the hard roof in advance. Such weakening effect, however, can hardly be evaluated, which leads to a lack of a basis in which to design the schemes and parameters of hydraulic fracturing. In this study, a combined underground-ground integrated microseismic monitoring and transient electromagnetic detection method was utilized to carry out simultaneous evaluations of the seismic responses to each staged fracturing and the apparent resistivity changes before and after all finished fracturing. On this basis, the comparable and applicable fracturing effects on coal burst prevention were evaluated and validated by the distribution of microseismic events and their energy magnitude during the mining process. Results show that the observed mining-induced seismic events are consistent with the evaluation results obtained from the combined seismic-electromagnetic detection method. However, there is a limited reduction effect on resistivity near the fractured section that induces far-field seismic events. Mining-induced seismic events are concentrated primarily within specific areas, while microseismic events in the fractured area exhibit high frequency but low energy overall. This study validates the rationality of combined seismic-electromagnetic detection results and provides valuable insights for optimizing fracturing construction schemes as well as comprehensively evaluating outcomes associated with underground directional long borehole staged hydraulic fracturing.

Application of Acoustic Radiation Force Pulse Imaging Technology in the Evaluation of the Efficacy of Calf Intermuscular Vein Thrombosis.

BACKGROUND: The continuous advancement in ultrasound technology has given rise to Acoustic Radiation Force Impulse (ARFI) elastography, which boasts non-invasiveness, ease of operation, rapid inspection, and high accuracy. It has been successfully employed in detecting tissue hardness across various diseases. This study aims to investigate the application of acoustic radiation force pulse imaging technology in evaluating the efficacy of calf intermuscular vein thrombosis. METHODS: This study is retrospective in nature, involving a total of 120 patients diagnosed with calf intermuscular venous thrombosis (MCVT) who were admitted to our hospital. These patients were selected retrospectively as the subjects for our research. They were subsequently divided into two groups: the control group and the observation group. The control group received standard nursing care and simple pressure therapy, while the observation group underwent anticoagulant drug treatment. The shear wave elastic hardness of both groups was measured, with the recording of ultrasonic elasticity scores and the average elastic modulus value (E-mean, in kPa). Furthermore, a comparison was made between the two groups regarding thrombus disappearance time, blood flow patency, and the clinical treatment effect. RESULTS: At the 1, 3, and 6-month marks of the treatment period, the ultrasonic elasticity scores in the observation group were consistently higher compared to those in the control group. Additionally, the shear wave elastic hardness in the observation group was consistently lower than that in the control group, and these differences were found to be statistically significant (p < 0.05). The total effective rates for the control and observation groups were 83.33% and 95.00%, respectively. Notably, the clinical total effective rate in the observation group was significantly higher than that in the control group, and this difference was statistically significant (p < 0.05). The thrombus disappearance time in the observation group was significantly shorter than that in the control group, and the blood flow rate was significantly higher than in the control group, with both differences being statistically significant (p < 0.05). CONCLUSION: ARFI plays a crucial role in assessing the efficacy of MCVT by effectively revealing the hardness and location of the patient's thrombus tissue. This technology aids doctors in gaining a more precise understanding of the deep vein thrombosis condition. Notably, ARFI is characterized by high safety levels and exhibits positive effects due to its painless and non-invasive nature.

Integrated pretreatment diffusion kurtosis imaging and serum squamous cell carcinoma antigen levels: a biomarker strategy for early assessment of radiotherapy outcomes in cervical cancer.

OBJECTIVE: This study aims to explore the utility of pretreatment DKI parameters and serum SCC-Ag in evaluating the early therapeutic response of cervical cancer to radiotherapy. MATERIALS AND METHODS: A total of 33 patients diagnosed with cervical cancer, including 31 cases of cervical squamous cell carcinoma and two cases of adenosquamous carcinoma, participated in the study. All patients underwent conventional MRI and DKI scans on a 3T magnetic resonance scanner before radiotherapy and after ten sessions of radiotherapy. The therapeutic response was evaluated based on the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. Patients were categorized into a response group (RG), comprising Complete Remission (CR) and Partial Remission (PR), and a non-response group (NRG), comprising Stable Disease (SD) and Progressive Disease (PD). LASSO was employed to select pretreatment DKI parameters, and ROC curves were generated for the selected parameters and serum SCC-Ag. RESULTS: Significant differences were observed in pretreatment MD, Da, Dr, MK, Ka, Kr, and SCC-Ag between the RG and NRG groups (P < 0.01). However, no significant differences were noted for FA and FAK (P = 0.441&0.928). The two selected parameters (MD and MK) demonstrated area under the curve (AUC), sensitivity, and specificity of 0.810, 0.769, 0.850 and 0.827, 0.846, 0.750, respectively. The combination of MD and MK exhibited an improved AUC of 0.901, sensitivity of 0.692, and specificity of 1.000, with a higher Youden index compared to the individual parameters. Conversely, the AUC, sensitivity, and specificity of the combination of MD, MK, and SCC-Ag were 0.852, 0.615, and 1.000, with a Youden index of 0.615. CONCLUSION: Pretreatment MD, MK, and SCC-Ag demonstrate potential clinical utility, with the combined application of MD and MK showing enhanced efficacy in assessing the early therapeutic response of cervical cancer to radiotherapy. The addition of SCC-Ag did not contribute further to the assessment efficacy.

Can single disease payment impact hospitalization expenses and quality in district hospital? A case study in Fujian, China.

BACKGROUND: China is exploring payment reform methods for patients to address the escalating issue of increasing medical costs. While most district hospitals were still in the stage of Single Disease Payment (SDP) due to conditions, there is a scarcity of research on comprehensive assessment of SDP. This study aims to evaluate the implementation of SDP in a district hospital, and provided data support and scientific reference for improving SDP method and accelerating medical insurance payment reform at district hospitals. METHODS: Data was collected from 2337 inpatient medical records at a district hospital in Fuzhou, China from 2016 to 2021. These diagnoses principally included type 2 diabetes, planned cesarean sections, and lacunar infarction. Structural variation analysis was conducted to examine changes in the internal cost structure and dynamic shifts in medical expenses for both the insured (treatment group) and uninsured (control group) patients, pre- and post-implementation of the SDP policy on August 1, 2018. The difference-in-differences (DID) method was employed to assess changes in hospitalization expenses and quality indicators pre- and post-implementation. Furthermore, subjective evaluation of medical quality was enhanced through questionnaire surveys with 181 patients and 138 medical staff members. RESULTS: The implementation of SDP decreased the medical expenses decreased significantly (P < 0.05), which can also optimize the cost structure. The drug cost ratio descended significantly, and the proportion of laboratory fee rose slightly. The changes in infection rate, cure rate, and length of stay indicated enhanced medical quality (P < 0.05). The satisfaction of inpatients with SDP was high (89.2%). Medical staff expressed an upper middle level of satisfaction (77.2%) but identified difficulties with the implementation such as "insufficient coverage of disease types". CONCLUSION: After the implementation of SDP in district hospitals, considerable progress has been achieved in restraining medical expenses, coupled with notable enhancements in both medical quality and patient satisfaction levels. However, challenges persist regarding cost structure optimization and underutilization of medical resources. This study suggests that district hospitals can expedite insurance payment reform by optimizing drug procurement policies, sharing examination information, and strengthening the management of medical records.

[Study on the implementation effect evaluation of Specifications of Air Sampling for Hazardous Substances Monitoring in the Workplace (GBZ 159-2004)].

Systematically evaluate the implementation of Specifications of Air Sampling for Hazardous Substances Monitoring (GBZ 159-2004) , so as to provide technical basis for the future standard revision. The semi-structured interview method was used to interview the industry experts from centers for disease control and prevention, occupational disease prevention and control hospitals/institutes, employers, third-party technical service institutions and universities, and the induction method was used to refine the topics and relevant suggestions. Some technical indicators of GBZ 159 are not suitable for the current actual work of occupational health, and need to be revised and improved urgently. The revised GBZ 159 should comply with the current situation of China's industrial development and the development of occupational health testing equipment in the new era, and improve the relevant technical requirements of sampling quality control.

Evaluation of physical education teaching effect using Random Forest model under artificial intelligence.

This work aims to optimize the physical education (PE) teaching effect based on deep learning (DL) to cultivate high-level college students better. Firstly, the present situation of college teachers' teaching ability is surveyed to realize the deficiencies in teaching. Secondly, an optimization algorithm is proposed to improve the node splitting mode. This algorithm can solve the problem of single and similar node splitting modes in the Random Forest (RF) algorithm. The independent node splitting method Iterative Dichotomiser 3 and Classification and Regression Tree in the algorithm are recombined, and new splitting rules are obtained through adaptive parameter selection. Finally, the scheme designed is tested. The results suggest: The results suggest: (1) During the training of the proposed algorithm, although the loss curve at 4550 and 6800 points has a small crest, the error of the network loss function shows a downward trend and tends to be flat; (2) Compared with unoptimized Genetic Algorithm (GA) and Genetic Algorithm-Back Propagation (GA-BP), the proposed algorithm shows better performance both in terms of time consumption and accuracy (time consumption is less than 5.4 ms, and accuracy is more than 95 %). In a word, using the GA-BP-RF algorithm proposed to improve the PE teaching effect is feasible. The proposed model provides ideas for applying DL technology to improve teachers' teaching abilities.

Training for Supervisors to Improve Sustainable Employment of Employees with a work Disability: A Longitudinal Effect and Process Evaluation from an Intervention Study with Matched Controls.

PURPOSE: Supervisors play a crucial role in sustainable employment of employees with a work disability. The 'Mentorwijs' (literal translation: Mentorwise) training was developed to train supervisors in knowledge, attitudes and skills needed to guide these employees. This study evaluated the effect of 'Mentorwijs' on employees' employment and supervisors' behavioral outcomes. METHODS: Register- and questionnaire data were obtained from 73 employees and 1,526 matched controls to measure employment (≥ 1/month, ≥ 12 h/week and ≥ 3 consecutive months (≥ 1 h/month)) during a 12-month follow-up period. Questionnaire data were obtained from 127 supervisors who followed the 'Mentorwijs' training, to assess their knowledge, self-efficacy, intention to adopt and applied behaviors. RESULTS: Employment for ≥ 1 h/month did not significantly improve after 3 (ß = 0.05; CI=-0.07-0.16), 6 (ß = 0.07; CI=-0.04-0.18), 9 (ß = 0.08; CI=-0.02-0.18) and 12 (ß = 0.01; CI=-0.08-0.10) months among employees whose supervisors followed 'Mentorwijs' compared to those who did not. Significant effects were found after 8 months (ß = 0.11; CI = 0.01-0.21). Comparable effects were found for employment ≥ 12 hour/week and ≥ 3 consecutive months (≥ 1 hour/month). Supervisors' knowledge and self-efficacy significantly improved as a result of 'Mentorwijs', but no effects were found for intention to adopt and applied behaviors. CONCLUSIONS: 'Mentorwijs' is a promising training to improve the guidance of employees with a work disability. Further research is needed to examine how long-term effects of 'Mentorwijs' on employment can be sustained.

The effects of supramolecular nicotinamide combined with supramolecular salicylic acid on chloasma.

OBJECTIVE: To observe the efficacy and safety of supramolecular salicylic acid monotherapy and supramolecular nicotinamide in the treatment of chloasma. METHODS: A total of 28 female patients with chloasma diagnosed in the dermatology outpatient department of our hospital were randomly divided into an experimental group and a control group, with 14 cases in each group. All patients were treated with 30% supramolecular salicylic acid every 2 weeks, for a total of 8 treatments. The experimental group was treated with 10% supramolecular nicotinamide once in the morning and once in the evening, and the control group was a blank control. Before each exfoliation treatment, subjects were photographed with a VISIA skin detector, and skin image analysis and modified melasma area and severity index (MASI) score were performed. RESULTS: According to the MMASI decrease rate (%) before and after treatment, the effective rate of the experimental group was 64.29%, and the effective rate of the control group was 14.29%. The results of the GriffithS10 and VISIA were improved. During the whole treatment, there was one mild adverse reaction in both groups. CONCLUSION: Salicylic acid stripping combined with nicotinamide in the treatment of chloasma is safe and effective, can improve skin conditions, and can be widely applied in clinical practice.

Efficacy and safety of adalimumab biosimilar (HS016) in inflammatory bowel disease from the real-world study.

Objective: Adalimumab (ADA) is an effective treatment for inflammatory bowel disease (IBD), both ulcerative colitis (UC) and Crohn's disease (CD). The equal effect between the original ADA and biosimilars from Europe and the United States has been shown. However, the biosimilar of ADA is different in China. The effectiveness and safety data of ADA biosimilar (HS016) in China have yet to be discovered. Patients and methods: 91 patients (75 CD, 16 UC) received HS016 treatment and were enrolled in this study. Therapeutic response and safety profiles were analyzed. Therapeutic drug monitoring (TDM) was also carried out among nonresponse patients. After being considered as "nonresponse" (after three or 6 months of treatment), 20 patients' serum TNFα concentrations were measured and correlated to their disease severity. Results: Among active CD patients (n = 61), 75.4% (46/61) at 12 w, 73.8% (45/61) at 26 w, 50.8% (31/61) at 52 w achieved the clinical response, respectively; 55.7% (34/61) at 12 w, 65.6% (40/61) at 26 w, and 45.9% (28/61) at 52 w achieved clinical remission. The maintained remission rates of CD (n = 14) in clinical remission were 100% (14/14) at 12 w, 78.6% (11/14) at 26 w, and 63.6% (7/11) at 52 w, respectively. Among active UC patients, 37.5% (6/16) at 12 w and 50% (8/16) at 26 w achieved clinical response. Total adverse event rates were 5.5% (5/91) during 52-week visits. Due to the inadequate serum drug concentration, 30.4% (7/23) of patients had poor clinical responses. Elevations of serum anti-drug antibodies occurred in one additional patient (4.3%). Conclusion: ADA biosimilar HS016 had good efficacy and safety in Chinese IBD patients.

Construction and effect evaluation of prediction model for red blood cell transfusion requirement in cesarean section based on artificial intelligence.

OBJECTIVES: This study intends to build an artificial intelligence model for obstetric cesarean section surgery to evaluate the intraoperative blood transfusion volume before operation, and compare the model prediction results with the actual results to evaluate the accuracy of the artificial intelligence prediction model for intraoperative red blood cell transfusion in obstetrics. The advantages and disadvantages of intraoperative blood demand and identification of high-risk groups for blood transfusion provide data support and improvement suggestions for the realization of accurate blood management of obstetric cesarean section patients during the perioperative period. METHODS: Using a machine learning algorithm, an intraoperative blood transfusion prediction model was trained. The differences between the predicted results and the actual results were compared by means of blood transfusion or not, blood transfusion volume, and blood transfusion volume targeting postoperative hemoglobin (Hb). RESULTS: Area under curve of the model is 0.89. The accuracy of the model for blood transfusion was 96.85%. The statistical standard for the accuracy of the model blood transfusion volume is the calculation of 1U absolute error, the accuracy rate is 86.56%, and the accuracy rate of the blood transfusion population is 45.00%. In the simulation prediction results, 93.67% of the predicted and actual cases in no blood transfusion surgery; 63.45% of the same predicted blood transfusion in blood transfusion surgery, and only 20.00% of the blood transfusion volume is the same. CONCLUSIONS: In conclusion, this study used machine learning algorithm to process, analyze and predict the results of a large sample of cesarean section clinical data, and found that the important predictors of blood transfusion during cesarean section included preoperative RBC, surgical method, the site of surgery, coagulation-related indicators, and other factors. At the same time, it was found that the overall accuracy of the AI model was higher than actual blood using. Although the prediction of blood transfusion volume was not well matched with the actual blood using, the model provided a perspective of preoperative identification of high blood transfusion risks. The results can provide good auxiliary decision support for preoperative evaluation of obstetric cesarean section, and then promote the realization of accurate perioperative blood management for obstetric cesarean section patients.

[Dumai moxibustion combined with low-dose tadalafil for erectile dysfunction: Evaluation of therapeutic effect].

OBJECTIVE: To investigate the clinical effect of dumai (governor meridian) moxibustion combined with low-dose tadalafil in the treatment of ED with decline of vital gate fire. METHODS: We enrolled in this study 130 ED patients with decline of vital gate fire who met the inclusion criteria and equally randomized them into a control and an experimental group, the former treated with low-dose tadalafil tablets at 5 mg once a day while the latter by dumai moxibustion once a week in addition, all for 4 weeks. Of the total number of subjects, 62 in the control group and 63 in the experimental group completed the experiment. We recorded the scores on IIEF-5, Erection Quality Scale (EQS), Erection Hardness Scale (EHS), TCM symptoms and Treatment Satisfaction Scale (TSS) as well as the penile hemodynamic parameters peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index (RI) before and after treatment and compared them between the two groups. RESULTS: The total response rate was significantly higher in the experimental group than in the control (87.30% vs 66.13%, P < 0.05). IIEF-5, EQS, EHS and TSS scores, PSV and RI were markedly increased while TCM symptoms and EDV remarkably decreased in both groups after treatment (P < 0.05), even more significantly in the experimental than in the control group (P < 0.05). CONCLUSION: Dumai moxibustion combined with low-dose tadalafil can improve erectile function, increase penile blood flow velocity and alleviate clinical symptoms in ED patients with decline of vital gate fire, with definite clinical effect and safety.

Application of radiomics based on chest CT-enhanced dual-phase imaging in the immunotherapy of non-small cell lung cancer.

OBJECTIVE: To explore the value of applying computed tomography (CT) radiomics based on different CT-enhanced phases to determine the immunotherapeutic efficacy of non-small cell lung cancer (NSCLC). METHODS: 106 patients with NSCLC who underwent immunotherapy are randomly divided into training (74) and validation (32) groups. CT-enhanced arterial and venous phase images of patients before treatment are collected. Region-of-interest (ROI) is segmented on the CT-enhanced images, and the radiomic features are extracted. One-way analysis of variance and least absolute shrinkage and selection operator (LASSO) are used to screen the optimal radiomics features and analyze the association between radiomics features and immunotherapy efficacy. The area under receiver-operated characteristic curves (AUC) along with the sensitivity and specificity are computed to evaluate diagnostic effectiveness. RESULTS: LASSO regression analysis screens and selects 6 and 8 optimal features in the arterial and venous phases images, respectively. Applying to the training group, AUCs based on CT-enhanced arterial and venous phase images are 0.867 (95% CI:0.82-0.94) and 0.880 (95% CI:0.86-0.91) with the sensitivities of 73.91% and 76.19%, and specificities of 66.67% and 72.19%, respectively, while in validation group, AUCs of the arterial and venous phase images are 0.732 (95% CI:0.71-0.78) and 0.832 (95% CI:0.78-0.91) with sensitivities of 75.00% and 76.00%, and specificities of 73.07% and 75.00%, respectively. There are no significant differences between AUC values computed from arterial phases and venous phases images in both training and validation groups (P < 0.05). CONCLUSION: The optimally selected radiomics features computed from CT-enhanced different-phase images can provide new imaging marks to evaluate efficacy of the targeted therapy in NSCLC with a high diagnostic value.

Evaluation method for restoration effect of different sections of small and medium-sized rivers: A case study of the Qingyi River, China.

Due to severe disturbances caused by rapid urbanization and industrialization, river ecosystems have evolved into complex natural-social composite ecosystems. At present, there is no unified evaluation method for the effect of river restoration in China. The existing research fails to fully integrate the "natural-social" characteristics of rivers, and pays less attention to the river section scale, which is not conducive to the development of accurate pollution control work. In this paper, we first put forward the division method of river section type which conforms to the "nature-society" dual attribute characteristics of the river, and divides the river section into "ecological/service/dual" functional "urban/rural" river section. Then a method for evaluating the restoration effect of different river sections based on index weight optimization was proposed. Based on the type of river section, the weights of 17 indexes were optimized, and the common evaluation method of restoration effect-multi-index evaluation method was improved. In addition, the application and verification of the established method were carried out on the main stream of Qingyi River and its typical tributaries. The evaluation results show that only the restoration effect of Baling River decreased from average in 2019 to acceptable in 2021, and ΔH (the change of the mean score of the target factor after repair) decreased from 15.6% to 6.2%. It was found that for the river sections where the repair effect cannot be maintained stably (such as Baling River), the previous methods paid more attention to the overall effect and easily ignored the specific problems. The improved method can identify problems more easily and facilitate timely post-maintenance. To further optimize the repair effect of Qingyi River, it is suggested that the restoration effect should be strengthened from the aspects of pollution source control, water quality improvement, aquatic restoration, continuous monitoring and evaluation. The evaluation results can provide a reference for the design, operation, and maintenance of restoration projects in small and medium-sized rivers.