Effect of corneal cross-linking on biomechanical changes following transepithelial photorefractive keratectomy and femtosecond laser-assisted LASIK.

Purpose: To evaluate the change in corneal biomechanics in patients with postoperative ectasia risk when combining two common laser vision correction procedures (tPRK and FS-LASIK) with cross-linking (in tPRK Xtra and FS-LASIK Xtra). Methods: The study included 143 eyes of 143 myopic, astigmatic patients that were divided into non-cross-linked refractive surgery groups (non-Xtra groups, tPRK and FS-LASIK) and cross-linked groups (Xtra groups, tPRK Xtra and FS-LASIK Xtra) according to an ectasia risk scoring system. The eyes were subjected to measurements including the stress-strain index (SSI), the stiffness parameter at first applanation (SP-A1), the integrated inverse radius (IIR), the deformation amplitude at apex (DA), and the ratio of deformation amplitude between apex and 2 mm from apex (DARatio2mm). The measurements were taken preoperatively and at 1, 3, and 6 months postoperatively (pos1m, pos3m, and pos6m). Posterior demarcation line depth from the endothelium (PDLD) and from the ablation surface (DLA) were recorded at pos1m. Results: SP-A1 significantly decreased, while IIR, deformation amplitude, and DARatio2mm increased significantly postoperatively in all four groups (p < 0.01)-all denoting stiffness decreases. In the FS-LASIK group, the changes in IIR, DA, and DARatio2mm were 32.7 ± 15.1%, 12.9 ± 7.1%, and 27.2 ± 12.0% respectively, which were significantly higher (p < 0.05) compared to 20.1 ± 12.8%, 6.4 ± 8.2%, and 19.7 ± 10.4% in the FS-LASIK Xtra group. In the tPRK group, the change in IIR was 27.3 ± 15.5%, significantly larger than 16.9 ± 13.4% in the tPRK Xtra group. The changes of SSI were minimal in the tPRK (-1.5 ± 21.7%, p = 1.000), tPRK Xtra (8.4 ± 17.9%, p = 0.053), and FS-LASIK Xtra (5.6 ± 12.7%, p = 0.634) groups, but was significant in the FS-LASIK group (-12.1 ± 7.9%, p < 0.01). After correcting for baseline biomechanical metrics, preoperative bIOP and the change in central corneal thickness (△CCT) from pre to pos6m, the changes in the IIR in both FS-LASIK and tPRK groups, as well as DA, DARatio2mm and SSI in the FS-LASIK group remained statistically greater than their corresponding Xtra groups (all p < 0.05). Most importantly, after correcting for these covariates, the changes in DARatio2mm in the FS-LASIK Xtra became statistically smaller than in the tPRK Xtra (p = 0.017). Conclusion: The statistical analysis results indicate that tPRK Xtra and FS-LASIK Xtra effectively reduced the biomechanical losses caused by refractive surgery (tPRK and FS-LASIK). The decrease in corneal overall stiffness was greater in FS-LASIK than in tPRK, and the biomechanical enhancement of CXL was also higher following LASIK than after tPRK.

Electron-Induced Nonmonotonic Pressure Dependence of the Lattice Thermal Conductivity of θ-TaN.

Recent theoretical and experimental research suggests that θ-TaN is a semimetal with high thermal conductivity (κ), primarily due to the contribution of phonons (κ_{ph}). By using first-principles calculations, we show a nonmonotonic pressure dependence of the κ of θ-TaN. κ_{ph} first increases until it reaches a maximum at around 60 GPa, and then decreases. This anomalous behavior is a consequence of the competing pressure responses of phonon-phonon and phonon-electron interactions, in contrast to the known materials BAs and BP, where the nonmonotonic pressure dependence is caused by the interplay between different phonon-phonon scattering channels. Although TaN has phonon dispersion features similar to BAs at ambient pressure, its response to pressure is different and an overall stiffening of the phonon branches takes place. Consequently, the relevant phonon-phonon scattering weakens as pressure increases. However, the increased electronic density of states near the Fermi level, and specifically the emergence of additional pockets of the Fermi surface at the high-symmetry L point in the Brillouin zone, leads to a substantial increase in phonon-electron scattering at high pressures, driving a decrease in κ_{ph}. At intermediate pressures (∼20-70 GPa), the κ of TaN surpasses that of BAs. Our Letter provides deeper insight into phonon transport in semimetals and metals where phonon-electron scattering is relevant.

C-reactive protein/lymphocyte ratio as a prognostic biomarker in acute pancreatitis: A cross-sectional study assessing disease severity.

BACKGROUND: The C-reactive protein/lymphocyte ratio (CLR) is a prognostic biomarker of various diseases. However, its significance in acute pancreatitis (AP) remains unknown. The main aim of this study was to investigate the association between the CLR and disease severity in patients with AP. METHODS: This cross-sectional study included 476 AP patients (mild acute pancreatitis (MAP), n =176; moderately severe acute pancreatitis (MSAP) and severe acute pancreatitis (SAP), n=300). The primary exposure of interest was the baseline CLR. The primary outcome was the incidence of moderate to severe AP. Multivariate logistic regression and restricted cubic spline analyses were performed to evaluate the association between the CLR and the incidence of moderate to severe AP. Receiver operating characteristic (ROC) analysis was conducted to assess the predictive efficacy, sensitivity, and specificity of CLR in predicting the incidence of moderate to severe AP. RESULTS: The mean age of the patients was 44±13.2 years, and 76.5% were male. The distribution of CLR was 31.6 (interquartile range, 4.5, 101.7). Moderate to severe AP occurred in 300 cases (63.0%). After multiple adjustments, CLR was independently associated with the incidence of moderate to severe AP (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.03, 1.05; P< 0.001). A nonlinear relationship was found between CLR and the incidence of moderate to severe AP, with a threshold of approximately 45. The effect size and CI below and above the threshold value were 1.061 (1.033-1.089) and 1.014 (0.997-1.031), respectively. The area under the curve (AUC) for CLR was 87.577% (95% CI: 84.443% ~ 90.710%) with an optimal cut-off value of 30.835, resulting in a sensitivity of 73.7% and a specificity of 88.6%. CONCLUSIONS: There was a nonlinear relationship with a saturation effect between the CLR and the incidence of moderate to severe AP. The CLR measured within 24 h of admission may serve as a promising biomarker for predicting the emergence of moderate to severe AP, thereby providing a more scientifically grounded basis for preventing such cases. Nonetheless, further research is warranted to validate and strengthen these findings.

Diagnostic and prognostic potential of exosome non-coding RNAs in bladder cancer: a systematic review and meta-analysis.

Background: Bladder cancer stands as the predominant malignant tumor in the urological system, presenting a significant challenge to public health and garnering extensive attention. Recently, with the deepening research into tumor molecular mechanisms, non-coding RNAs (ncRNAs) have emerged as potential biomarkers offering guidance for the diagnosis and prognosis of bladder cancer. However, the definitive role of ncRNAs in bladder cancer remains unclear. Hence, this study aims to elucidate the relevance and significance of ncRNAs through a Meta-analysis. Methods: A systematic meta-analysis was executed, including studies evaluating the diagnostic performance of ncRNAs and their associations with overall survival (OS) and disease-free survival (DFS). Key metrics such as hazard ratios, sensitivity, specificity, and diagnostic odds ratios were extracted and pooled from these studies. Potential publication bias was assessed using Deeks' funnel plot, and the robustness of the results was ascertained through a sensitivity analysis. Results: Elevated ncRNA expression showed a positive correlation with improved OS, evidenced by a hazard ratio (HR) of 0.82 (95% CI: 0.66-0.96, P<0.001). Similarly, a significant association was observed between heightened ncRNA expression and DFS, with an HR of 0.86 (95% CI: 0.73-0.99, P<0.001). Diagnostic performance analysis across 17 articles yielded a pooled sensitivity of 0.76 and a specificity of 0.83. The diagnostic odds ratio was recorded at 2.71, with the area under the ROC curve (AUC) standing at 0.85. Conclusion: Exosome ncRNAs appear to possess potential significance in the diagnostic and prognostic discussions of bladder cancer. Their relationship with survival outcomes and diagnostic measures suggests a possible clinical utility. Comprehensive investigations are needed to fully determine their role in the ever-evolving landscape of bladder cancer management, especially within the framework of personalized medicine.

YY1-induced lncRNA00511 promotes melanoma progression via the miR-150-5p/ADAM19 axis.

Increasing evidence indicates that long noncoding RNAs (lncRNAs) are therapeutic targets and key regulators of tumors development and progression, including melanoma. Long intergenic non-protein-coding RNA 511 (LINC00511) has been demonstrated as an oncogenic molecule in breast, stomach, colorectal, and lung cancers. However, the precise role and functional mechanisms of LINC00511 in melanoma remain unknown. This study confirmed that LINC00511 was highly expressed in melanoma cells (A375 and SK-Mel-28 cells) and tissues, knockdown of LINC00511 could inhibit melanoma cell migration and invasion, as well as the growth of subcutaneous tumor xenografts in vivo. By using Chromatin immunoprecipitation (ChIP) assay, it was demonstrated that the transcription factor Yin Yang 1 (YY1) is capable of binding to the LINC00511 promoter and enhancing its expression in cis. Further mechanistic investigation showed that LINC00511 was mainly enriched in the cytoplasm of melanoma cells and interacted directly with microRNA-150-5p (miR-150-5p). Consistently, the knockdown of miR-150-5p could recover the effects of LINC00511 knockdown on melanoma cells. Furthermore, ADAM metallopeptidase domain expression 19 (ADAM19) was identified as a downstream target of miR-150-5p, and overexpression of ADAM19 could promote melanoma cell proliferation. Rescue assays indicated that LINC00511 acted as a competing endogenous RNA (ceRNA) to sponge miR-150-5p and increase the expression of ADAM19, thereby activating the PI3K/AKT pathway. In summary, we identified LINC00511 as an oncogenic lncRNA in melanoma and defined the LINC00511/miR-150-5p/ADAM19 axis, which might be considered a potential therapeutic target and novel molecular mechanism the treatment of patients with melanoma.

A meta-analysis of the risk factors for surgical site infection in patients with colorectal cancer.

The purpose of the meta-analysis was to evaluate and compare the surgical site infection (SSI) risk factors in patients with colorectal cancer (CC). The results of this meta-analysis were analysed, and the odds ratio (OR) and mean difference (MD) with 95% confidence intervals (CIs) were calculated using dichotomous or contentious random or fixed-effect models. For the current meta-analysis, 23 examinations spanning from 2001 to 2023 were included, encompassing 89 859 cases of CC. Clean-contaminated surgical site wounds had significantly lower infections (OR, 0.36; 95% CI, 0.20-0.64, p < 0.001) compared to contaminated surgical site wounds in patients with CCs. Males had significantly higher SSIs (OR, 1.18; 95% CI, 1.12-1.24, p < 0.001) compared to females in patients with CC. American Society of Anesthesiology score ≥3 h had a significantly higher SSI (OR, 1.42; 95% CI, 1.18-1.71, p < 0.001) compared to <3 score in patients with CCs. Body mass index ≥25 had significantly higher SSIs (OR, 1.54; 95% CI, 1.11-2.14, p = 0.01) compared to <25 in patients with CCs. The presence of stoma creation had a significantly higher SSI rate (OR, 2.28; 95% CI, 1.37-3.79, p = 0.001) compared to its absence in patients with CC. Laparoscopic surgery had significantly lower SSIs (OR, 0.68; 95% CI, 0.59-0.78, p < 0.001) compared to open surgery in patients with CC. The presence of diabetes mellitus had a significantly higher SSI rate (OR, 1.24; 95% CI, 1.15-1.33, p < 0.001) compared to its absence in patients with CCs. No significant difference was found in SSI rate in patients with CCs between <3 and ≥3 h of operative time (OR, 1.07; 95% CI, 0.75-1.51, p = 0.72), between the presence and absence of blood transfusion (OR, 1.60; 95% CI, 0.69-3.66, p = 0.27) and between the presence and absence of previous laparotomies (OR, 1.47; 95% CI, 0.93-2.32, p = 0.10). The examined data revealed that contaminated wounds, male sex, an American Society of Anesthesiology score ≥3 h, a body mass index ≥25, stoma creation, open surgery and diabetes mellitus are all risk factors for SSIs in patients with CC. However, operative time, blood transfusion and previous laparotomies were not found to be risk factors for SSIs in patients with CC. However, given that several comparisons had a small number of chosen research, consideration should be given to their values.

Developing a highly efficient CGBE base editor in watermelon.

Cytosine and adenosine base editors (CBEs and ABEs) are novel genome-editing tools that have been widely utilized in molecular breeding to precisely modify single-nucleotide polymorphisms (SNPs) critical for plant agronomic traits and species evolution. However, conventional BE editors are limited to achieve C-to-T and A-to-G substitutions, respectively. To enhance the applicability of base editing technology in watermelon, we developed an efficient CGBE editor (SCGBE2.0) by removing the uracil glycosylase inhibitor (UGI) unit from the commonly used hA3A-CBE and incorporating the uracil-DNA glycosylase (UNG) component. Seven specific guide RNAs (sgRNAs) targeting five watermelon genes were designed to assess the editing efficiency of SCGBE. The results obtained from stably transformed watermelon plants demonstrated that SCGBE2.0 could efficiently induce C-to-G mutations at positions C5-C9 in 43.2% transgenic plants (with a maximum base conversion efficiency of 46.1%) and C-to-A mutation at position C4 in 23.5% transgenic plants (with a maximum base conversion efficiency of 45.9%). These findings highlight the capability of our integrated SCGBE2.0 editor to achieve C-to-G/A mutations in a site-preferred manner, thus providing an efficient base editing tool for precise base modification and site-directed saturated mutagenesis in watermelon.

Biomaterials derived from hard palate mucosa for tissue engineering and regenerative medicine.

Autologous materials have superior biosafety and are widely used in clinical practice. Due to its excellent trauma-healing ability, the hard palate mucosa (HPM) has become a hot spot for autologous donor area research. Multiple studies have conducted an in-depth analysis of the healing ability of the HPM at the cellular and molecular levels. In addition, the HPM has good maneuverability as a donor area for soft tissue grafts, and researchers have isolated various specific mesenchymal stem cells (MSCs) from HPM. Free soft tissue grafts obtained from the HPM have been widely used in the clinic and have played an essential role in dentistry, eyelid reconstruction, and the repair of other specific soft tissue defects. This article reviews the advantages of HPM as a donor area and its related mechanisms, classes of HPM-derived biomaterials, the current status of clinical applications, challenges, and future development directions.

Diversification of JAZ-MYC signaling function in immune metabolism.

Jasmonate (JA) re-programs metabolism to confer resistance to diverse environmental threats. Jasmonate stimulates the degradation of JASMONATE ZIM-DOMAIN (JAZ) proteins that repress the activity of MYC transcription factors. In Arabidopsis thaliana, MYC and JAZ are encoded by 4 and 13 genes, respectively. The extent to which expansion of the MYC and JAZ families has contributed to functional diversification of JA responses is not well understood. Here, we investigated the role of MYC and JAZ paralogs in controlling the production of defense compounds derived from aromatic amino acids (AAAs). Analysis of loss-of-function and dominant myc mutations identified MYC3 and MYC4 as the major regulators of JA-induced tryptophan metabolism. We developed a JAZ family-based, forward genetics approach to screen randomized jaz polymutants for allelic combinations that enhance tryptophan biosynthetic capacity. We found that mutants defective in all members (JAZ1/2/5/6) of JAZ group I over-accumulate AAA-derived defense compounds, constitutively express marker genes for the JA-ethylene branch of immunity and are more resistant to necrotrophic pathogens but not insect herbivores. In defining JAZ and MYC paralogs that regulate the production of amino-acid-derived defense compounds, our results provide insight into the specificity of JA signaling in immunity.

Automatic ICD-10 coding: Deep semantic matching based on analogical reasoning.

Background: ICD-10 has been widely used in statistical analysis of mortality rates and medical reimbursement. Automatic ICD-10 coding is desperately needed because manually assigning codes is expensive, time-consuming, and labor-intensive. Diagnoses described in medical records differ significantly from those used in ICD-10 classification, making it impossible for existing automatic coding techniques to perform well enough to support medical billing, resource allocation, and research requirements. Meanwhile, most of the current automatic coding approaches are oriented toward English ICD-10. This method for automatically assigning ICD-10 codes to diagnoses extracted from Chinese discharge records was provided in this paper. Method: First, BERT creates word representations of the two texts. Second, the context representation layer incorporates contextual information into the representation of each time step of the word representations using a bidirectional Long Short-Term Memory. Third, the matching layer compares each contextual embedding of the uncoded diagnosis record against a weighted version of all contextual character embeddings of the manually coded diagnosis record. The matching strategy is element-wise subtraction and element-wise multiplication and then through a neural network layer. Fourth, the matching vectors are combined using a one-layer convolutional neural network. A sigmoid is then used to output matching results. Results: To evaluate the proposed method, 1,003,558 manually coded primary diagnoses were gathered from the homepage of the discharge medical records. The experimental results showed that the proposed method outperformed popular deep semantic matching algorithms, such as DSSM, ConvNet, ESIM, and ABCNN, and demonstrated state-of-the-art results in a single text matching with an accuracy of 0.986, a precision of 0.979, a recall of 0.983, and an F1-score of 0.981. Conclusion: The automatic ICD-10 coding of Chinese diagnoses is successful when using the proposed deep semantic matching approach based on analogical reasoning.

NLRP12-expressing dendritic cells mediate both dissemination of infection and adaptive immune responses in visceral leishmaniasis.

The NLR protein NLRP12 contributes to innate immunity, but the mechanism remains elusive. Infection of Nlrp12 -/- or wild-type mice with Leishmania infantum led to aberrant parasite tropism. Parasites replicated to higher levels in livers of Nlrp12 -/- mice than in the livers of WT mice and failed to disseminate to spleens. Most retained liver parasites resided in dendritic cells (DCs), with correspondingly fewer infected DCs in spleens. Furthermore, Nlrp12 -/- DCs expressed lower CCR7 than WT DCs, failed to migrate toward CCL19 or CCL21 in chemotaxis assays, and migrated poorly to draining lymph nodes after sterile inflammation. Leishmania-infected Nlpr12 -/- DCs were significantly less effective at transporting parasites to lymph nodes than WT DCs. Consistently, adaptive immune responses were also impaired in infected Nlrp12 -/- mice. We hypothesize that Nlrp12-expressing DCs are required for efficient dissemination and immune clearance of L. infantum from the site of initial infection. This is at least partly due to the defective expression of CCR7.

Skeletal muscle metabolism and contraction performance regulation by teneurin C-terminal-associated peptide-1.

Skeletal muscle regulation is responsible for voluntary muscular movement in vertebrates. The genes of two essential proteins, teneurins and latrophilins (LPHN), evolving in ancestors of multicellular animals form a ligand-receptor pair, and are now shown to be required for skeletal muscle function. Teneurins possess a bioactive peptide, termed the teneurin C-terminal associated peptide (TCAP) that interacts with the LPHNs to regulate skeletal muscle contractility strength and fatigue by an insulin-independent glucose importation mechanism in rats. CRISPR-based knockouts and siRNA-associated knockdowns of LPHN-1 and-3 in the C2C12 mouse skeletal cell line shows that TCAP stimulates an LPHN-dependent cytosolic Ca2+ signal transduction cascade to increase energy metabolism and enhance skeletal muscle function via increases in type-1 oxidative fiber formation and reduce the fatigue response. Thus, the teneurin/TCAP-LPHN system is presented as a novel mechanism that regulates the energy requirements and performance of skeletal muscle.

INPP4B inhibits glioma cell proliferation and immune escape via inhibition of the PI3K/AKT signaling pathway.

INPP4B (Inositol polyphosphate 4-phosphatase type II) has been regarded as a suppressor of several human tumors, but its biological function, expression, and clinical significance in glioma tissues and cell lines are unclear. Notably, whether INPP4B participates in immune escape of glioma deserves urgent attention. Here, we confirmed that INPP4B expression is often downregulated in low- and high-grade human glioma tissues, in tissues from an orthotopic mouse model of brain glioma and in glioma cells. We found that INPP4B overexpression restrained the proliferation, migration, apoptosis resistance, PD-L1 expression, and T cell suppression by glioma cells, whereas INPP4B silencing had the opposite effects. Moreover, we showed that INPP4B inhibited glioma cell proliferation, migration, and PD-L1 expression by downregulating PI3K/AKT signaling. Collectively, these data support that INPP4B may inhibit glioma progression, and particularly, glioma's immune escape. Thus, INPP4B may constitute a valuable target for glioma treatment.

Spectra Stable Quantum Dots Enabled by Band Engineering for Boosting Electroluminescence in Devices.

The band level landscape in quantum dots is of great significance toward achieving stable and efficient electroluminescent devices. A series of quantum dots with specific emission and band structure of the intermediate layer is designed, including rich CdS (R-CdS), thick ZnSe (T-ZnSe), thin ZnSe (t-ZnSe) and ZnCdS (R-ZnCdS) intermediate alloy shell layers. These quantum dots in QLEDs show superior performance, including maximum current efficiency, external quantum efficiencies and a T50 lifetime (at 1000 cd/m2) of 47.2 cd/A, 11.2% and 504 h for R-CdS; 61.6 cd/A, 14.7% and 612 h for t-ZnSe; 70.5 cd/A, 16.8% and 924 h for T-ZnSe; and 82.0 cd/A, 19.6% and 1104 h for R-ZnCdS. Among them, the quantum dots with the ZnCdS interlayer exhibit deep electron confinement and shallow hole confinement capabilities, which facilitate the efficient injection and radiative recombination of carriers into the emitting layer. Furthermore, the optimal devices show a superior T50 lifetime of more than 1000 h. The proposed novel methodology of quantum dot band engineering is expected to start a new way for further enhancing QLED exploration.

High figure-of-merit and power generation in high-entropy GeTe-based thermoelectrics.

The high-entropy concept provides extended, optimized space of a composition, resulting in unusual transport phenomena and excellent thermoelectric performance. By tuning electron and phonon localization, we enhanced the figure-of-merit value to 2.7 at 750 kelvin in germanium telluride-based high-entropy materials and realized a high experimental conversion efficiency of 13.3% at a temperature difference of 506 kelvin with the fabricated segmented module. By increasing the entropy, the increased crystal symmetry delocalized the distribution of electrons in the distorted rhombohedral structure, resulting in band convergence and improved electrical properties. By contrast, the localized phonons from the entropy-induced disorder dampened the propagation of transverse phonons, which was the origin of the increased anharmonicity and largely depressed lattice thermal conductivity. We provide a paradigm for tuning electron and phonon localization by entropy manipulation, but we have also demonstrated a route for improving the performance of high-entropy thermoelectric materials.

Extended the depth of field and zoom microscope with varifocal lens.

Extending the depth of field (DOF) is especially essential in thick and 3D sample imaging. However, it's difficult to achieve both large DOF and high resolution in a zoom microscope. Currently, the use of optical sectioning to expand DOF still has the problem of inconstant magnification. Here, we develop an extended the depth of field (EDOF) and zoom microscope, which can realize EDOF with constant magnification and high resolution. Besides, the proposed microscope can achieve optical axial scanning at different NA and magnifications in real time without any mechanical movement. The proposed varifocal lens is employed to realize optical axial scanning, zooming, and keeping constant magnification when extending the DOF. Experimental results show that the proposed microscope can realize a continuous optical zoom of 10-40×, NA from 0.14 to 0.54, and the DOF of microscope can be extended to 1.2 mm.

A Semi-Automatic Data Cleaning & Coding Tool for Chinese Clinical Data Standardization.

The clinical data often have limited usefulness because of the diversified expression. Chinese clinical data standardization can improve the usability of clinical data. The complexity of data cleaning and coding for Chinese clinical data prompted the turn of low-effective manual coding into the computer-aided tool. This study established the universal data cleaning and coding process and tool for Chinese clinical data standardization, which can greatly improve human efficiency. The process included the preprocessing, text similarity algorithm, and manual review. The standardization process proved effective for the diagnosis, drug, and examination data standardization task and can be used gradually in other clinical domains. The semi-automatic data cleaning and coding can reduce the half time for standardization, and it was used in hospitals in Beijing.

Color ghost imaging through the scattering media based on A-cGAN.

Ghost imaging plays an important role in the field of optical imaging. To realize color ghost imaging through the scattering media, we propose a deep learning method with high generation ability. Through our method, we can efficiently reconstruct color images with rich details, in line with human perception and close to the target color pictures. Experimental results show that our method can image through the scattering media with different scattering intensities and achieve good results even at a sampling rate of 0.1.

Automatic SNOMED CT coding of Chinese clinical terms via attention-based semantic matching.

BACKGROUND: A considerable amount of meaningful information is routinely recorded in Chinese clinical data in text format, referred to as Chinese clinical terms. The lack of coding is a major difficulty hindering the application of clinical terms. SNOMED CT is a widely used and comprehensive clinical health care terminology collection because of its coverage, granularity, clinical orientation, and logical underpinning. It is useful and efficient for automatically assigning SNOMED CT codes to Chinese clinical terms, but it still faces several problems. Current cross-language clinical term matching studies rely on external resources, such as machine translation and rule-based methods. Semantic matching methods have achieved strong performance on text matching, but few studies have been done on cross-language clinical term matching. We present an effective attention-based semantic matching algorithm to automatically cross-language code Chinese clinical terms with SNOMED CT. METHOD: Firstly, BERT was used to turn the input into word embedding. Then, the word embeddings were encoded through a BiLSTM with self-attention to focus on capturing distant relationships among words with different weights depending on their contribution to semantic matching. Then, decomposable attention was used to make semantic matching trivially parallelizable to speed up calculation. Finally, fully connected layers and a sigmoid were utilized to output matching results. RESULTS: The 29,960 manually coded Chinese clinical terms, 30,040 unmatched Chinese clinical terms and SNOMED CT codes were collected to evaluate the proposed method. Compared with the existing semantic matching method, the proposed approach achieves state-of-the-art results demonstrating the effectiveness of the method with an accuracy of 0.905, a precision of 0.856, a recall of 0.518, and an F-measure of 0.645. The proposed Chinese-English bilingual term mapping, Chinese character-level and word-level encoder, English word-level encoder, BERT model, and attention mechanism performed better than other methods. CONCLUSION: The proposed automatic SNOMED CT coding approach of Chinese clinical terms via attention-based semantic matching can improve the performance of automated SNOMED CT code assignment for Chinese clinical terms and improve the efficiency of the code assignment.

Fatigue behavior of endodontically treated maxillary premolars with MOD defects under different minimally invasive restorations.

OBJECTIVES: To analyze the stress distribution and subsequent fracture resistance of human maxillary premolars with mesial-occlusal-distal (MOD) defects restored with different minimally invasive restorations. MATERIALS AND METHODS: Seventy non-carious human maxillary premolars were selected and divided into seven groups (n = 10). Ten teeth without further preparation served as control. The remaining teeth were endodontically treated and received three restorative patterns: inlays without cusp coverage (I), onlays with palatal coverage (O), overlays with both buccal and palatal coverage (Ov). Lithium disilicate glass ceramics (EM) and machinable composite resin (LU) were used for restoration. Specimens were tested under cycling loading with tongue direction of 45° for 1.2 × 106 cycles at a 50-N load and 2.0-Hz frequency. The survival time and two fracture mode classifications were assessed. Three-dimensional models of each group were designed. The magnitude and pattern of stresses were analyzed under the same condition of the in vitro test using finite element stress analysis. RESULTS: Although the overlay model pattern produced more favorable stress distribution, three restorative patterns restored with the same material had no difference in survival curves (P > 0.05). Only the survival curve of the EM-Ov group had no statistical difference with that of the control group (P > 0.05). EM groups presented mainly interface adhesive failure, while LU groups were mainly material cohesive failure. CONCLUSION: For the endodontically treated maxillary premolars with MOD defect, the lithium disilicate glass ceramic overlay pattern can reach the best restorative effect. CLINICAL RELEVANCE: Comparing with restorative pattern, restorative material had a greater influence on the minimally invasive restoration of posterior teeth.