Optimization of Hospital Drug Management Model under the Supervision of Internet Plus Medical Health.

Objective: This study aims to investigate the use of proton pump inhibitors (PPIs) among inpatients in a hospital and analyze the rationality of their use. Methods: We analyzed the medication records of 1986 inpatients from January 2023 to June 2023, focusing on patients using PPIs under the "Internet + medical service" model. Additionally, we compared and analyzed the drug use patterns, including dosage form, dosage, medication frequency, average daily cost, and sales amount, between two groups: those treated before and after the implementation of the "Internet + medical service" model. The control group comprised 1962 inpatients treated with PPIs from July 2022 to December 2022. We also compared drug inventory time, account coincidence rate, error rate, and nursing satisfaction between the two periods. Results: Among the hospitalized patients using PPIs, 892 cases were male (44.91%) and 1094 cases were female (55.09%). Regarding age distribution, 456 cases were aged 18-45 (22.96%), 845 cases were aged 46-65 (42.55%), and 685 cases were over 65 years old (34.49%). The top 10 departments with the highest frequency of PPI use included gastroenterology (8.36%), oncology, hematology, trauma orthopedics (6.95% each), cardiovascular medicine, neurology (6.39% each), general surgery (6.29%), respiratory, critical care (5.84%), renal rheumatology, immunology (5.79%), and spine surgery (5.59%). Omeprazole enteric-coated capsules accounted for the highest proportion (25.08%), followed by rabeprazole enteric-coated tablets (22.96%) and pantoprazole sodium enteric-coated tablets (20.04%). After implementing the "Internet + medical service" model, there was a reduction in irrational PPI use, medication error rates, and inventory time. Moreover, the account coincidence rate and satisfaction rate increased significantly (P < .05). Conclusion: The utilization of PPIs in hospitals is notably high. Implementing the "Internet + medical service" model can effectively improve the rationality of PPI use. Clinicians should adhere to relevant indications when prescribing PPIs and conduct drug interventions to prevent overuse.

Structural colours in diverse Mesozoic insects.

Structural colours, nature's most pure and intense colours, originate when light is scattered via nanoscale modulations of the refractive index. Original colours in fossils illuminate the ecological interactions among extinct organisms and functional evolution of colours. Here, we report multiple examples of vivid metallic colours in diverse insects from mid-Cretaceous amber. Scanning and transmission electron microscopy revealed a smooth outer surface and five alternating electron-dense and electron-lucent layers in the epicuticle of a fossil wasp, suggesting that multilayer reflectors, the most common biophotonic nanostructure in animals and even plants, are responsible for the exceptional preservation of colour in amber fossils. Based on theoretical modelling of the reflectance spectra, a reflective peak of wavelength of 514 nm was calculated, corresponding to the bluish-green colour observed under white light. The green to blue structural colours in fossil wasps, beetles and a fly most likely functioned as camouflage, although other functions such as thermoregulation cannot be ruled out. This discovery not only provides critical evidence of evolution of structural colours in arthropods, but also sheds light on the preservation potential of nanostructures of ancient animals through geological time.

IGFBP2 Plays an Essential Role in Cognitive Development during Early Life.

Identifying the mechanisms underlying cognitive development in early life is a critical objective. The expression of insulin-like growth factor binding protein 2 (IGFBP2) in the hippocampus increases during neonatal development and is associated with learning and memory, but a causal connection has not been established. Here, it is reported that neurons and astrocytes expressing IGFBP2 are distributed throughout the hippocampus. IGFBP2 enhances excitatory inputs onto CA1 pyramidal neurons, facilitating intrinsic excitability and spike transmission, and regulates plasticity at excitatory synapses in a cell-type specific manner. It facilitates long-term potentiation (LTP) by enhancing N-methyl-d-aspartate (NMDA) receptor-dependent excitatory postsynaptic current (EPSC), and enhances neurite proliferation and elongation. Knockout of igfbp2 reduces the numbers of pyramidal cells and interneurons, impairs LTP and cognitive performance, and reduces tonic excitation of pyramidal neurons that are all rescued by IGFBP2. The results provide insight into the requirement for IGFBP2 in cognition in early life.

An ammonite trapped in Burmese amber.

Amber is fossilized tree resin, and inclusions usually comprise terrestrial and, rarely, aquatic organisms. Marine fossils are extremely rare in Cretaceous and Cenozoic ambers. Here, we report a record of an ammonite with marine gastropods, intertidal isopods, and diverse terrestrial arthropods as syninclusions in mid-Cretaceous Burmese amber. We used X-ray-microcomputed tomography (CT) to obtain high-resolution 3D images of the ammonite, including its sutures, which are diagnostically important for ammonites. The ammonite is a juvenile Puzosia (Bhimaites) and provides supporting evidence for a Late Albian-Early Cenomanian age of the amber. There is a diverse assemblage (at least 40 individuals) of arthropods in this amber sample from both terrestrial and marine habitats, including Isopoda, Acari (mites), Araneae (spiders), Diplopoda (millipedes), and representatives of the insect orders Blattodea (cockroaches), Coleoptera (beetles), Diptera (true flies), and Hymenoptera (wasps). The incomplete preservation and lack of soft body of the ammonite and marine gastropods suggest that they were dead and underwent abrasion on the seashore before entombment. It is most likely that the resin fell to the beach from coastal trees, picking up terrestrial arthropods and beach shells and, exceptionally, surviving the high-energy beach environment to be preserved as amber. Our findings not only represent a record of an ammonite in amber but also provide insights into the taphonomy of amber and the paleoecology of Cretaceous amber forests.

Liverwort Mimesis in a Cretaceous Lacewing Larva.

Camouflage and mimicry are staples among predator-prey interactions, and evolutionary novelties in behavior, anatomy, and physiology that permit such mimesis are rife throughout the biological world [1, 2]. These specializations allow for prey to better evade capture or permit predators to more easily approach their prey, or in some cases, the mimesis can serve both purposes. Despite the importance of mimesis and camouflage in predator-avoidance or hunting strategies, the long-term history of these traits is often obscured by an insufficient fossil record. Here, we report the discovery of Upper Cretaceous (approximately 100 million years old) green lacewing larvae (Chrysopoidea), preserved in amber from northern Myanmar, anatomically modified to mimic coeval liverworts. Chrysopidae are a diverse lineage of lacewings whose larvae usually camouflage themselves with a uniquely constructed packet of exogenous debris, conveying greater stealth upon them as they hunt prey such as aphids as well as evade their own predators [3, 4]. However, no lacewing larvae today mimic their surroundings. While the anatomy of Phyllochrysa huangi gen. et sp. nov. allowed it to avoid detection, the lack of setae or other anatomical elements for entangling debris as camouflage means its sole defense was its mimicry, and it could have been a stealthy hunter like living and other fossil Chrysopoidea or been an ambush predator aided by its disguise. The present fossils demonstrate a hitherto unknown life-history strategy among these "wolf in sheep's clothing" predators, one that apparently evolved from a camouflaging ancestor but did not persist within the lineage.

Taxonomic notes on Cretarophalis patrickmuelleri Wichard, 2017 (Insecta: Neuroptera: Nevrorthidae) from the mid-Cretaceous of Myanmar, and its phylogenetic significance.

Nevrorthidae is a family of Neuroptera with low species diversity, disjunct geographic distributions, and a controversial phylogenetic status. Previous fossil records of the family are from the Eocene except for the recently described species Cretarophalis patrickmuelleri Wichard, 2017 from mid-Cretaceous Burmese amber, following earlier records of an undescribed species. However, such a significant finding of this family from Mesozoic was originally presented only with a preliminary description. Here we re-describe the species based on exquisitely preserved materials from mid-Cretaceous Burmese amber that provides for a much more detailed description, in particular of the hindwing, female genitalia, and larval head. Furthermore, distinctive morphological characters of C. patrickmuelleri with significant phylogenetic relevance are discussed. The general morphology, particularly that of the larva, has changed little between the Mesozoic and Cenozoic, and it reflects an evolutionary stasis that might correspond to their aquatic larval life-style. The present finding also supports the relictual nature of the modern nevrorthids.

Origin of spiders and their spinning organs illuminated by mid-Cretaceous amber fossils.

Understanding the genealogical relationships among the arachnid orders is an onerous task, but fossils have aided in anchoring some branches of the arachnid tree of life. The discovery of Palaeozoic fossils with characters found in both extant spiders and other arachnids provided evidence for a series of extinctions of what was thought to be a grade, Uraraneida, that led to modern spiders. Here, we report two extraordinarily well-preserved Mesozoic members of Uraraneida with a segmented abdomen, multi-articulate spinnerets with well-defined spigots, modified male palps, spider-like chelicerae and a uropygid-like telson. The new fossils, belonging to the species Chimerarachne yingi, were analysed phylogenetically in a large data matrix of extant and extinct arachnids under a diverse regime of analytical conditions, most of which resulted in placing Uraraneida as the sister clade of Araneae (spiders). The phylogenetic placement of this arachnid fossil extends the presence of spinnerets and modified palps more basally in the arachnid tree than was previously thought. Ecologically, the new fossil extends the record of Uraraneida 170 million years towards the present, thus showing that uraraneids and spiders co-existed for a large fraction of their evolutionary history.

First description of female of Haplosialodes liui Huang et al., 2016 (Megaloptera: Sialidae) from Cretaceous Burmese amber.

A female of the alderfly species, Haplosialodes liui Huang et al., 2016, from the mid-Cretaceous Burmese amber is described for the first time. Systematic position of the genus Haplosialodes Huang et al., 2016 is briefly discussed.

First description of female of Haplosialodes liui Huang et al., 2016 (Megaloptera: Sialidae) from Cretaceous Burmese amber.

A female of the alderfly species, Haplosialodes liui Huang et al., 2016, from the mid-Cretaceous Burmese amber is described for the first time. Systematic position of the genus Haplosialodes Huang et al., 2016 is briefly discussed.

Extreme adaptations for probable visual courtship behaviour in a Cretaceous dancing damselfly.

Courtship behaviours, frequent among modern insects, have left extremely rare fossil traces. None are known previously for fossil odonatans. Fossil traces of such behaviours are better known among the vertebrates, e.g. the hypertelic antlers of the Pleistocene giant deer Megaloceros giganteus. Here we describe spectacular extremely expanded, pod-like tibiae in males of a platycnemidid damselfly from mid-Cretaceous Burmese amber. Such structures in modern damselflies, help to fend off other suitors as well as attract mating females, increasing the chances of successful mating. Modern Platycnemidinae and Chlorocyphidae convergently acquired similar but less developed structures. The new findings provide suggestive evidence of damselfly courtship behaviour as far back as the mid-Cretaceous. These data show an unexpected morphological disparity in dancing damselfly leg structure, and shed new light on mechanisms of sexual selection involving intra- and intersex reproductive competition during the Cretaceous.

Mycophagous rove beetles highlight diverse mushrooms in the Cretaceous.

Agaricomycetes, or mushrooms, are familiar, conspicuous and morphologically diverse Fungi. Most Agaricomycete fruiting bodies are ephemeral, and their fossil record is limited. Here we report diverse gilled mushrooms (Agaricales) and mycophagous rove beetles (Staphylinidae) from mid-Cretaceous Burmese amber, the latter belonging to Oxyporinae, modern members of which exhibit an obligate association with soft-textured mushrooms. The discovery of four mushroom forms, most with a complete intact cap containing distinct gills and a stalk, suggests evolutionary stasis of body form for ∼99 Myr and highlights the palaeodiversity of Agaricomycetes. The mouthparts of early oxyporines, including enlarged mandibles and greatly enlarged apical labial palpomeres with dense specialized sensory organs, match those of modern taxa and suggest that they had a mushroom feeding biology. Diverse and morphologically specialized oxyporines from the Early Cretaceous suggests the existence of diverse Agaricomycetes and a specialized trophic interaction and ecological community structure by this early date.

Effect of rGO Coating on Interconnected Co3O4 Nanosheets and Improved Supercapacitive Behavior of Co3O4/rGO/NF Architecture.

In this study, the effect of reduced graphene oxide (rGO) on interconnected Co3O4 nanosheets and the improved supercapacitive behaviors is reported. By optimizing the experimental parameters, we achieved a specific capacitance of ~1016.4 F g-1 for the Co3O4/rGO/NF (nickel foam) system at a current density of 1 A g-1. However, the Co3O4/NF structure without rGO only delivers a specific capacitance of ~520.0 F g-1 at the same current density. The stability test demonstrates that Co3O4/rGO/NF retains ~95.5% of the initial capacitance value even after 3000 charge-discharge cycles at a high current density of 7 A g-1. Further investigation reveals that capacitance improvement for the Co3O4/rGO/NF structure is mainly because of a higher specific surface area (~87.8 m2 g-1) and a more optimal mesoporous size (4-15 nm) compared to the corresponding values of 67.1 m2 g-1 and 6-25 nm, respectively, for the Co3O4/NF structure. rGO and the thinner Co3O4 nanosheets benefit from the strain relaxation during the charge and discharge processes, improving the cycling stability of Co3O4/rGO/NF.

Debris-carrying camouflage among diverse lineages of Cretaceous insects.

Insects have evolved diverse methods of camouflage that have played an important role in their evolutionary success. Debris-carrying, a behavior of actively harvesting and carrying exogenous materials, is among the most fascinating and complex behaviors because it requires not only an ability to recognize, collect, and carry materials but also evolutionary adaptations in related morphological characteristics. However, the fossil record of such behavior is extremely scarce, and only a single Mesozoic example from Spanish amber has been recorded; therefore, little is known about the early evolution of this complicated behavior and its underlying anatomy. We report a diverse insect assemblage of exceptionally preserved debris carriers from Cretaceous Burmese, French, and Lebanese ambers, including the earliest known chrysopoid larvae (green lacewings), myrmeleontoid larvae (split-footed lacewings and owlflies), and reduviids (assassin bugs). These ancient insects used a variety of debris material, including insect exoskeletons, sand grains, soil dust, leaf trichomes of gleicheniacean ferns, wood fibers, and other vegetal debris. They convergently evolved their debris-carrying behavior through multiple pathways, which expressed a high degree of evolutionary plasticity. We demonstrate that the behavioral repertoire, which is associated with considerable morphological adaptations, was already widespread among insects by at least the Mid-Cretaceous. Together with the previously known Spanish specimen, these fossils are the oldest direct evidence of camouflaging behavior in the fossil record. Our findings provide a novel insight into early evolution of camouflage in insects and ancient ecological associations among plants and insects.

Brood care in a 100-million-year-old scale insect.

Behavior of extinct organisms can be inferred only indirectly, but occasionally rare fossils document particular behaviors directly. Brood care, a remarkable behavior promoting the survival of the next generation, has evolved independently numerous times among animals including insects. However, fossil evidence of such a complex behavior is exceptionally scarce. Here, we report an ensign scale insect (Hemiptera: Ortheziidae), Wathondara kotejai gen. et sp. nov., from mid-Cretaceous Burmese amber, which preserves eggs within a wax ovisac, and several freshly hatched nymphs. The new fossil is the only Mesozoic record of an adult female scale insect. More importantly, our finding represents the earliest unequivocal direct evidence of brood care in the insect fossil record and demonstrates a remarkably conserved egg-brooding reproductive strategy within scale insects in stasis for nearly 100 million years.