A new simplified risk assessment model enhances postoperative prophylaxis of venous thromboembolism in Chinese adult patients with inguinal hernia (CHAT-3): A prospective, multicenter, randomized controlled trial.

BACKGROUND: Venous thromboembolism (VTE) significantly affects the prognosis of surgical patients with inguinal hernia. The complex Caprini score, commonly used for postoperative VTE risk assessment, poses practical challenges for surgeons in clinical settings. METHODS: The CHAT-3 trial, a prospective, multicenter, randomized controlled trial, compared a simple three-factor model to assess VTE risk against routine practices in post-inguinal hernia surgery (IHS) patients. The patients were randomly assigned (1:1) to the intervention or control arm. The intervention group used the three-factor model to identify patients at moderate or high risk of VTE for subsequent prophylaxis according to clinical guidelines. Both groups were followed for four weeks, with randomization implemented using computer-generated sequences. The primary outcome measured was the rate of VTE prophylaxis. Secondary outcomes included time spent on VTE risk assessment (surgeon self-reported), postoperative D-dimer trends, perioperative VTE occurrence, bleeding events, and the net clinical benefit. RESULTS: Of the 1,109 participants, 508 in the experimental group and 601 in the control group completed follow-up. The three-factor model showed higher VTE prophylaxis rates in all patients (pharmacologic prophylaxis: 26.2% vs. 6.00%, P<0.001) and particularly in those at high risk (pharmacologic prophylaxis: 57.3% vs. 9.50%, P<0.001). The experimental group significantly reduced VTE risk assessment time compared to the Caprini score (1.39±0.55 min vs. 5.73±1.35 min, P<0.001). The experimental group had lower D-dimer levels (0.26±0.73 mg/L vs. 0.35±0.55 mg/L, P=0.028). In the experimental group, the patients did not experience an increased risk of VTE (0% vs. 1.66%, P=0.268) and bleeding (1.18% vs. 0.67%, P=0.558) compared to the controls. There was no significant difference in net clinical benefit, which combined VTE and bleeding events, between the experimental and control groups (1.18% vs. 0.83%, P=0.559). CONCLUSION: Applying the simple three-factor model in perioperative VTE management could quickly identify the patient with a high risk of VTE and improve the prophylaxis rate of perioperative VTE. TRIAL REGISTRATION: XXX. TRIAL REGISTRATION: ChiCTR2000033769.

Degradation of trichloroethylene by double dielectric barrier discharge (DDBD) plasma technology: Performance, product analysis and acute biotoxicity assessment.

Trichloroethylene is carcinogenic and poorly degraded by microorganisms in the environment. Advanced Oxidation Technology is considered to be an effective treatment technology for TCE degradation. In this study, a double dielectric barrier discharge (DDBD) reactor was established to decompose TCE. The influence of different condition parameters on DDBD treatment of TCE was investigated to determine the appropriate working conditions. The chemical composition and biotoxicity of TCE degradation products were also investigated. Results showed that when SIE was 300 J L-1, the removal efficiency could reach more than 90%. The energy yield could reach 72.99 g kWh-1 at low SIE and gradually decreased with the increase of SIE. The k of the Non-thermal plasma (NTP) treatment of TCE was about 0.01 L J-1. DDBD degradation products were mainly polychlorinated organic compounds and produced more than 373 mg m-3 ozone. Moreover, a plausible TCE degradation mechanism in the DDBD reactors was proposed. Lastly, the ecological safety and biotoxicity were evaluated, indicating that the generation of chlorinated organic products was the main cause of elevated acute biotoxicity.

The impact of green finance on industrial reasonability in China: empirical research based on the spatial panel Durbin model.

Green finance is an essential way to cope with environmental pollution, promote the transformation of industrial structure and upgrade, and finally construct a resource-conserving and environment-friendly society and achieve the goal of sustainable development. This study explores the influence of green finance on industrial reasonability and is based on sample data of 30 provinces in China from 2009 to 2019. Through the application of the spatial panel Durbin model with the weight matrix based on the geographical distance, the influence of green finance on the industrial structure as well as its spatial spillover effects are analyzed. The degree of industrial reasonability and the index of green finance development are also examined by applying the Theil index and the entropy method. The empirical results demonstrate two things. First, there is a strong aggregation of the spatial distribution of industrial reasonability, and the spatial pattern remains relatively constant over the 11 years. The main aggregated types are the H-H and L-L between the regions. Second, green finance can promote the industrial reasonability of this region, while it has a significant negative spatial spillover effect on the process of industrial reasonability in adjacent regions.

Risk assessment and validation of farmland abandonment based on time series change detection.

Farmland abandonment, a widespread phenomenon during land-use transition, leads to a cycling or vanishing evolution of farmland resources. As urbanization advances, an increasing number of agricultural laborers migrate from rural to urban areas, causing ongoing farmland abandonment. However, in contrast to the abandoned information extraction and driving mechanisms revelation, the potential risk of farmland abandonment has received insufficient attention. This study took Yangtze River Economic Belt of China as study area, selected multiple aspects to construct a risk assessment system for farmland abandonment, and applied time series change detection to verify the results. The results showed that (1) farmland abandonment risk, with a regional average value of 0.0978, has strong spatial heterogeneity, with high values clustering in Yunnan-Guizhou and Sichuan-Chongqing mountainous areas and low values distributed in the midstream and downstream plains and the Sichuan Basin. (2) The proportion of farmland area gradually decreased as the risk grade increased. Farmland, with low abandonment risk, occupied an area of 204,837 km2, constituting the highest percentage of 35.18% among the overall farmland, and was mainly distributed in the provinces of Jiangsu and Anhui. The area of farmland with high risk was 16,458 km2, only accounting for 2.83%, the majority of which was clustered in Sichuan and Yunnan provinces. (3) The Normalized Difference Vegetation Index (NDVI) time series change detection validated the reliability of the risk assessment system. Samples of farmland having low abandonment risk indeed had the lowest abandonment rate of 10%, and those which indicated high risk had the highest abandonment rate of 32%. We propose differentiated managements for farmland resources with high and low abandonment risk from the perspective of sustainable use. This study provides a more reasonable and scientific system for farmland abandonment risk assessment and helps to fill the research gap.

A triton X-100 assisted PMAxx-qPCR assay for rapid assessment of infectious African swine fever virus.

Introduction: African Swine Fever (ASF) is a highly infectious disease of pigs, caused by African swine fever virus (ASFV). The lack of vaccines and drugs makes strict disinfection practices to be one of the main measurements to curb the transmission of ASF. Therefore, it is important to assess if all viruses are inactivated after disinfection or after long time exposure in their natural conditions. Currently, the infectivity of ASFV is determined by virus isolation and culture in a biosafety level 3 (BSL-3) laboratory. However, BSL-3 laboratories are not readily available, need skilled expertise and may be time consuming. Methods: In this study, a Triton X-100 assisted PMAxx-qPCR method was developed for rapid assessment of infectious ASFV in samples. PMAxx, an improved version of propidium monoazide (PMA), can covalently cross-link with naked ASFV-DNA or DNA inside inactivated ASFV virions under assistance of 0.1% (v/v) TritonX-100, but not with ASFV-DNA inside live virions. Formation of PMAxx-DNA conjugates prevents PCR amplification, leaving only infectious virions to be detected. Under optimum conditions, the limit of detection of the PMAxx-qPCR assay was 2.32log10HAD50/mL of infectious ASFV. Testing different samples showed that the PMAxx-qPCR assay was effective to evaluate intact ASFV virions after treatment by heat or chemical disinfectants and in simulated samples such as swine tissue homogenate, swine saliva swabs, and environmental swabs. However, whole-blood and saliva need to be diluted before testing because they may inhibit the PCR reaction or the cross-linking of PMAxx with DNA. Conclusion: The Triton X-100 assisted PMAxx-qPCR assay took less than 3 h from sample to result, offering an easier and faster way for assessing infectious ASFV in samples from places like pig farms and pork markets.

The nonequilibrium cost of accurate information processing.

Accurate information processing is crucial both in technology and in nature. To achieve it, any information processing system needs an initial supply of resources away from thermal equilibrium. Here we establish a fundamental limit on the accuracy achievable with a given amount of nonequilibrium resources. The limit applies to arbitrary information processing tasks and arbitrary information processing systems subject to the laws of quantum mechanics. It is easily computable and is expressed in terms of an entropic quantity, which we name the reverse entropy, associated to a time reversal of the information processing task under consideration. The limit is achievable for all deterministic classical computations and for all their quantum extensions. As an application, we establish the optimal tradeoff between nonequilibrium and accuracy for the fundamental tasks of storing, transmitting, cloning, and erasing information. Our results set a target for the design of new devices approaching the ultimate efficiency limit, and provide a framework for demonstrating thermodynamical advantages of quantum devices over their classical counterparts.

Influence of Internet Celebrity Medical Experts on COVID-19 Vaccination Intention of Young Adults: An Empirical Study From China.

With the continuous expansion of COVID-19, many medical experts with the characteristics of "Internet Celebrities" are increasingly influencing people's vaccination behavior, which is crucial for overall social welfare. To explore the influence of Internet celebrity medical experts on people's vaccination against COVID-19, this study constructed a conceptual model of COVID-19 vaccination intention based on the professionalism, morality, interaction dimension, and information content of Internet celebrity medical experts, to generate perceived value by establishing a trusting relationship between them and the influenced people. The empirical analysis shows that interactivity and information content are important factors determining the influence of Internet celebrity medical experts. In the context of high demands for COVID-19 vaccines, it is more effective to influence vaccination intention through strong demand than through generating trust. The empirical analysis shows that Internet celebrity medical experts have a significant role in COVID-19 vaccination, and interactivity and information content are two important factors determining the influence. Through the connection of information-demand, Internet celebrity medical experts can greatly influence the perceived value, by coaction with trust to influence the final intention. Therefore, the COVID-19 vaccination persuasion information released by Internet celebrity medical experts should be elaborately organized and demonstrated, especially from the demand aspect, and government could put more resources to support the information to spread.

An assessment of liver lesions using a combination of CEUS LI-RADS and AFP.

PURPOSE: To improve noninvasive diagnosis of HCC using a combination of CE US LI-RADS and alpha-fetoprotein (AFP). METHODS: 757 solitary liver nodules from 757 patients at risk of HCC with CE US and serum AFP test were categorized as LR-1 to LR-5 through LR-M according to CE US LI-RADS version 2017. In LR-3, LR-4, and LR-M nodules, those with AFP > 200 ng/ml were reclassified as mLR-5. Nodules with LR-5 and mLR-5 were reclassified as definitely HCC to modify CE US LI-RADS. Diagnostic performance was assessed with specificity, sensitivity, and PPV. RESULTS: The sensitivity, specificity, and PPV of LR-5 as a predictor of HCC were 64.7%, 97.8%, and 98.9%, respectively. 32.1% patients with solitary liver nodule had AFP greater than 200 ng/ml, of which 98.8% were HCC (25.8%, 7.5%, 2.5% assigned to LR-M, LR-4, LR-3, respectively) and 1.2% were Combined Hepatocellular Cholangiocarcinoma. After modification, the sensitivity increased to 79.6% (P < 0.001), while specificity and PPV remained high (96.6% and 98.7%, P > 0.050). CONCLUSION: The combination of CE US LI-RADS and AFP for diagnosing HCC improved diagnostic sensitivity significantly, while maintaining high PPV and specificity in patients with the solitary liver nodule.

A low-cost and effective bagasse-based magnetic porous biochar as an adsorbent for solid phase extraction of triazine herbicides in brown sugar.

A rapid and sensitive approach for enriching and extracting triazines from brown sugar samples was developed by combining magnetic dispersive solid-phase extraction and HPLC/UV. In this work, a magnetic porous biochar (MPB) derived from low-cost bagasse was prepared and successfully employed as an adsorbent. A particular emphasis was placed on optimizing the extraction conditions, including the amount of MPB, extraction time, pH, type and volume of eluent, and salt concentration. Under optimized MSPE conditions, the method showed satisfactory linearity over concentration ranges of 2-200 µg L-1 for four triazines, with correlation coefficient values no less than 0.9981. Low limits of detection (0.27-0.33 µg L-1), good recoveries (81.7-100.7%), and satisfactory repeatability (RSDs ≤ 8.1%) were also demonstrated with respect to the analytical performance. The results demonstrated that the developed method was simple, rapid, sensitive, and efficient, indicating that it could extract and enrich trace triazines from real samples.

Emissions, measurement, and control of odor in livestock farms: A review.

Odor emissions from intensive livestock farms have attracted increased attention due to their adverse impacts on the environment and human health. Nevertheless, a systematic summary regarding the characteristics, sampling detection, and control technology for odor emissions from livestock farms is currently lacking. This paper compares the development of odor standards in different countries and summarizes the odor emission characteristics of livestock farms. Ammonia, the most common odor substance, can reach as high as 4100 ppm in the compost area. Sampling methods for point and area source odor emissions are introduced in this paper, and odor analysis methods are compared. Olfactometers, odorometers, and the triangle odor bag method are usually used to measure odor concentration. Odor control technologies are divided into three categories: physical (activated carbon adsorption, masking, and dilution diffusion), chemical (plant extract spraying, wet scrubbing, combustion, non-thermal plasma, and photocatalytic oxidation), and biological (biofiltration, biotrickling, and bioscrubbing). Each technology is elucidated, and the performance in the removal of different pollutants is summarized. The application scopes, costs, operational stability, and secondary pollution of the technologies are compared. The generation of secondary pollution and long-term operation stability are issues that should be considered in future technological development. Lastly, a case analysis for engineering application is conducted.

Functional Assessment of Kinesin-7 CENP-E in Spermatocytes using In Vivo Inhibition, Immunofluorescence and Flow Cytometry.

In eukaryotes, meiosis is essential for genome stability and genetic diversity in sexual reproduction. Experimental analyses of spermatocytes in testes are critical for the investigations of spindle assembly and chromosome segregation in male meiotic division. The mouse spermatocyte is an ideal model for mechanistic studies of meiosis, however, the effective methods for the analyses of spermatocytes are lacking. In this article, a practical and efficient method for the in vivo inhibition of kinesin-7 CENP-E in mouse spermatocytes is reported. A detailed procedure for testicular injection of a specific inhibitor GSK923295 through abdominal surgery in 3-week-old mice is presented. Furthermore, described here is a series of protocols for tissue collection and fixation, hematoxylin-eosin staining, immunofluorescence, flow cytometry and transmission electron microscopy. Here we present an in vivo inhibition model via abdominal surgery and testicular injection, that could be a powerful technique to study male meiosis. We also demonstrate that CENP-E inhibition results in chromosome misalignment and metaphase arrest in primary spermatocytes during meiosis I. Our in vivo inhibition method will facilitate mechanistic studies of meiosis, serve as a useful method for genetic modifications of male germ lines, and shed a light on future clinical applications.

Trigeminal neuralgia associated with multiple sclerosis: A multimodal assessment of brainstem plaques and response to Gamma Knife radiosurgery.

BACKGROUND: Gamma Knife radiosurgery (GKRS) is a minimally invasive procedure for trigeminal neuralgia secondary to multiple sclerosis (MS-TN). Patients with MS-TN experience suboptimal response rates to treatment, and the relationship between trigeminal microstructure and treatment outcome is poorly understood. OBJECTIVE: To characterize imaging features of MS-TN pain and GKRS response. METHODS: 3 T diffusion-weighted imaging (DWI), T1-w, T2-w, and fluid-attenuated inversion recovery (FLAIR) sequences were acquired for 18 MS-TN patients undergoing GKRS. Brainstem plaques were standardized into a common space to determine plaque distribution. Ratio of T1-w/T2-w or "myelin maps (MM)" was generated. Multi-tensor tractography was used to delineate the radiosurgical target (RT), root entry zone (REZ), and proximal pontine segment (PPS) of the trigeminal nerves. RESULTS: Laterality of MS-TN is associated with increased axial diffusivity at the PPS, whereas decreased MM at the PPS correlated with poor GKRS response. Preoperatively, GKRS responders have higher fractional anisotropy at the RT, higher axial diffusivity at the REZ, and higher MM intensities at the PPS. CONCLUSION: This study demonstrates that diffusivities and MM intensities are important correlates of pain and treatment response, respectively. Overall, preoperative multimodal assessment of the central trigeminal pathway is a better indicator of GKRS response than postoperative assessment of the reduction in fractional anisotropy peripherally.

Investigation into atmospheric PM2.5-borne PAHs in Eastern cities of China: concentration, source diagnosis and health risk assessment.

This study investigated PM2.5-PAHs associations collected in Beijing, Jinan, and Shanghai in Eastern China. The results indicated that PM2.5 concentrations in Beijing, Jinan, and Shanghai were 125.7 µg m(-3) (18.6-355.5 µg m(-3)), 115.9 µg m(-3) (44.2-345.4 µg m(-3)), and 85.1 µg m(-3) (24.3-232.8 µg m(-3)), respectively. The PAH concentrations in terms of PM2.5 in Beijing, Jinan, and Shanghai ranged from 23.2 to 819.8 ng m(-3), 25.7 to 727.1 ng m(-3), and 8.5 to 133.9 ng m(-3), respectively. PAH concentrations were found to be positively correlated with PM2.5 concentration in Beijing and Shanghai. The compositions of PAHs in PM2.5 in Beijing and Jinan were almost the same: 11% low ring, 80-82% middle ring, and 7-9% high ring. However, Shanghai had a different composition. Source apportionment indicated that the incomplete combustion of coal and diesel and gasoline emissions were the main sources of PAHs in PM2.5 in all three cities, whereas Shanghai had a greater contribution from liquid fossil fuels. The values for the health risk assessment estimated by the benzo[a]pyrene equivalent concentration in Beijing and Jinan were 2.39 × 10(-6) and 2.57 × 10(-6), respectively, thus both exceeding the 1 × 10(-6) limit (USEPA) considered likely to pose an inhalation cancer risk to people. Shanghai, however, had a risk estimate of 5.05 × 10(-7), which is still in a safe range. This study is the first to simultaneously monitor the PAHs in PM2.5 in three cities in Eastern China and may point to a long-range transportation of PM2.5-PAHs from Beijing to Jinan and partially to Shanghai.

HIV treatment as prevention: optimising the impact of expanded HIV treatment programmes.

Until now, decisions about how to allocate ART have largely been based on maximising the therapeutic benefit of ART for patients. Since the results of the HPTN 052 study showed efficacy of antiretroviral therapy (ART) in preventing HIV transmission, there has been increased interest in the benefits of ART not only as treatment, but also in prevention. Resources for expanding ART in the short term may be limited, so the question is how to generate the most prevention benefit from realistic potential increases in the availability of ART. Although not a formal systematic review, here we review different ways in which access to ART could be expanded by prioritising access to particular groups based on clinical or behavioural factors. For each group we consider (i) the clinical and epidemiological benefits, (ii) the potential feasibility, acceptability, and equity, and (iii) the affordability and cost-effectiveness of prioritising ART access for that group. In re-evaluating the allocation of ART in light of the new data about ART preventing transmission, the goal should be to create policies that maximise epidemiological and clinical benefit while still being feasible, affordable, acceptable, and equitable.

[Comparative study on four kinds of assessment methods of post-marketing safety of Danhong injection].

OBJECTIVE: To study the adverse reaction of Danhong injection with four kinds of methods, central monitoring method, chart review method, literature study method and spontaneous reporting method, and to compare the differences between them, explore an appropriate method to carry out post-marketing safety evaluation of traditional Chinese medicine injection. METHOD: Set down the adverse reactions' questionnaire of four kinds of methods, central monitoring method, chart review method, literature study method and collect the information on adverse reactions in a certain period. Danhong injection adverse reaction information from Henan Province spontaneous reporting system was collected with spontaneous reporting method. Carry on data summary and descriptive analysis. RESULT: Study the adverse reaction of Danhong injection with four methods of central monitoring method, chart review method, literature study method and spontaneous reporting method, the rates of adverse events were 0.993%, 0.336%, 0.515%, 0.067%, respectively. Cyanosis, arrhythmia, hypotension, sweating, erythema, hemorrhage dermatitis, rash, irritability, bleeding gums, toothache, tinnitus, asthma, elevated aminotransferases, constipation, pain are new discovered adverse reactions. CONCLUSION: The central monitoring method is the appropriate method to carry out post-marketing safety evaluation of traditional Chinese medicine injection, which could objectively reflect the real world of clinical usage.