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OBJECTIVE: To examine the factors influencing hospital discharge readiness among Chinese patients who have undergone enterostomy. METHODS: In this descriptive, cross-sectional study, researchers recruited patients with colorectal cancer who underwent enterostomy at a tertiary hospital in Guangdong Province, China, via convenience sampling between January 2021 and January 2023. Participants completed the Readiness for Hospital Discharge Scale, Ostomy Self-care Ability Scale, and Stoma-Quality of Life-Chinese Questionnaire (Chinese version) at the time of hospital discharge. Univariate, correlation, and multiple linear regression analyses were performed to explore the impact of self-care ability, quality of life, and other clinicodemographic characteristics on patients' readiness for hospital discharge. RESULTS: Of the 200 questionnaires distributed, 177 (88.5%) were completed and included in the final analysis. The median scores for the factors considered in this study were as follows: Readiness for Hospital Discharge Scale was 148.00 (interquartile range [IQR], 117.50, 164.00), self-care intention of the Ostomy Self-care Ability Scale was 36.00 (IQR, 34.00, 40.00), self-care knowledge of the Ostomy Self-care Ability Scale was 17.00 (IQR, 15.00, 19.00), self-care skill of the Ostomy Self-care Ability Scale was 5.00 (IQR, 3.00, 6.00), and the total score for quality of life was 60.00 (IQR, 49.00, 69.00). Multiple linear regression analysis identified several key factors explaining 48.2% of the variance in global readiness for hospital discharge: global quality of life (ß = .347, P < .001), self-care knowledge (ß = .259, P < .001), leakage during hospitalization (ß = -0.241, P < .001), monthly family income (ß = .148, P = .008), stoma siting before surgery (ß = .130, P = .020), and self-care intention (ß = .127, P = .035). CONCLUSIONS: The readiness for hospital discharge among patients undergoing enterostomy in this study was high. Factors such as quality of life, self-care knowledge, leakage during hospitalization, monthly family income, stoma siting before surgery, and self-care intention after undergoing enterostomy influenced the patients' readiness for hospital discharge. Therefore, future studies should focus on developing interventions to enhance patients' readiness for hospital discharge.
Subject(s)
Enterostomy , Patient Discharge , Quality of Life , Self Care , Humans , Cross-Sectional Studies , Male , Female , Middle Aged , Aged , Quality of Life/psychology , China , Surveys and Questionnaires , Self Care/methods , Adult , Colorectal Neoplasms/surgeryABSTRACT
Anxiety is a prevalent mental illness known for its high incidence, comorbidity, and tendency to recur, posing significant societal and individual burdens. Studies have highlighted Interleukin-19 (IL-19) as having potential relevance in neuropsychiatric disorders. Our previous research revealed that IL-19 overexpression in colonies exacerbated anxiety-related behaviors induced by dextran sodium sulfate/stress. However, the precise role and molecular mechanisms of IL-19 in anxiety regulation remain uncertain. In this study, we initiated an acute restraint stress (ARS)-induced anxious mouse model and identified heightened expression of IL-19 and IL-20Rα in the medial prefrontal cortex (mPFC) of ARS mice. Notably, IL-19 and IL-20Rα were predominantly present in the excitatory pyramidal neurons of the mPFC under both basal and ARS conditions. Utilizing the adeno-associated virus (AAV) strategy, we demonstrated that IL-19 overexpression in the mPFC induced anxiety-related behaviors and elevated stress susceptibility. Additionally, we observed decreased protein levels of brain-derived neurotrophic factor (BDNF) and postsynaptic density protein 95 (PSD95) in the mPFC of IL-19 overexpression mice, accompanied by reduced phosphorylation of in the p38, JNK, and Erk signaling pathways. These findings emphasize the role of IL-19 in modulating anxiety-related behaviors within the mPFC and suggest its potential as a pathological gene and therapeutic target for anxiety.
Subject(s)
Anxiety , Brain-Derived Neurotrophic Factor , Interleukins , MAP Kinase Signaling System , Prefrontal Cortex , Stress, Psychological , Animals , Prefrontal Cortex/metabolism , Brain-Derived Neurotrophic Factor/metabolism , Anxiety/metabolism , Mice , Male , MAP Kinase Signaling System/physiology , Interleukins/metabolism , Stress, Psychological/metabolism , Mice, Inbred C57BL , Behavior, Animal/physiology , Disease Models, Animal , p38 Mitogen-Activated Protein Kinases/metabolismABSTRACT
ABSTRACT: Tendon injury produces intractable pain and disability in movement, but the medications for analgesia and restoring functional integrity of tendon are still limited. In this study, we report that proteinase-activated receptor 2 (PAR2) activation in dorsal root ganglion (DRG) neurons contributes to chronic pain and tendon histopathological changes produced by Achilles tendon partial transection injury (TTI). Tendon partial transection injury increases the expression of PAR2 protein in both somata of DRG neurons and their peripheral terminals within the injured Achilles tendon. Activation of PAR2 promotes the primary sensory neuron plasticity by activating downstream cAMP-PKA pathway, phosphorylation of PKC, CaMKII, and CREB. Blocking PAR2 signaling by PAR2 small-interference RNA or antagonistic peptide PIP delays the onset of TTI-induced pain, reverses the ongoing pain, as well as inhibits sensory nerve sprouting, and promotes structural remodeling of the injured tendon. Vitamin B complex (VBC), containing thiamine (B1), pyridoxine (B6), and cyanocobalamin (B12), is effective to ameliorate TTI-induced pain, inhibit ectopic nerve sprouting, and accelerate tendon repair, through suppressing PAR2 activation. These findings reveal a critical role of PAR2 signaling in the development of chronic pain and histopathological alterations of injured tendon following Achilles tendon injury. This study suggests that the pharmaceuticals targeting PAR2, such as VBC, may be an effective approach for the treatment of tendon injury-induced pain and promoting tendon repair.
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BACKGROUND: Oxidative stress and inflammatory responses play essential roles in cerebral ischemia/reperfusion (I/R) injury. Electroacupuncture (EA) is widely used as a rehabilitation method for stroke in China; however, the underlying mechanism of action remains unclear. Peroxisome proliferator-activated receptor gamma (PPAR-γ) has been reported to impact anti-inflammatory and anti-oxidative effects. OBJECTIVE: This study investigated the role of PPAR-γ in EA-mediated effects and aimed to illuminate its possible mechanisms in cerebral I/R. METHODS: In this study, male Sprague-Dawley (SD) rats with middle cerebral artery occlusion/reperfusion (MCAO/R) injury were treated with EA at LI11 and ST36 for 30 min daily after MCAO/R for seven consecutive days. The neuroprotective effects of EA were measured by neurobehavioral evaluation, triphenyltetrazolium chloride staining, hematoxylin-eosin staining and transmission electron microscopy. Oxidative stress, inflammatory factors, neural apoptosis and microglial activation were examined by enzyme-linked immunosorbent assay, immunofluorescence and reverse transcriptase polymerase chain reaction. Western blotting was used to assess PPAR-γ-mediated signaling. RESULTS: We found that EA significantly alleviated cerebral I/R-induced infarct volume, decreased neurological scores and inhibited I/R-induced oxidative stress, inflammatory responses and microglial activation. EA also increased PPAR-γ protein expression. Furthermore, the protective effects of EA were reversed by injection of the PPAR-γ antagonist T0070907. CONCLUSION: EA attenuates cerebral I/R injury by regulating oxidative stress, neuronal death and neuroinflammation via stimulation of PPAR-γ.
Subject(s)
Brain Ischemia , Electroacupuncture , Oxidative Stress , PPAR gamma , Rats, Sprague-Dawley , Reperfusion Injury , Animals , PPAR gamma/metabolism , PPAR gamma/genetics , Male , Reperfusion Injury/therapy , Reperfusion Injury/metabolism , Reperfusion Injury/immunology , Rats , Brain Ischemia/metabolism , Brain Ischemia/therapy , Neurons/metabolism , Humans , Neuroinflammatory Diseases/therapy , Neuroinflammatory Diseases/etiology , Neuroinflammatory Diseases/immunology , Neuroinflammatory Diseases/metabolism , Cell Death , Disease Models, AnimalABSTRACT
Tetrazoles and their derivatives possess various biological activities, such as antibacterial, anti-fungal, and other activities. However, these compounds may induce specific cumulative and toxic effects in living organisms. Therefore, quantitative structure-activity relationship (QSAR) models were constructed to study the acute oral toxicity of tetrazoles in rats and mice. The toxicity data of 111 tetrazole compounds were collected using the ChemIDplus, ChEMBL and ECHA databases as response variables, while the PaDEL-descriptor generated the 2D descriptors as independent variables. The models were developed and validated following the OECD guidelines by the DTC-QSAR tool. Three QSAR models were successfully established for the oral routes of rat and mouse and the intraperitoneal route of mouse, respectively. The scatter plots showed high consistency between the training and test data sets. All the models successfully met the external and internal validation criteria. Most of the descriptors kept in the final models exhibited positive correlations with toxicity, whereas only 6 descriptors exhibited negative associations. Several chemicals were identified as response or structural outliers, based on the standardized residuals and leverage values. In conclusion, the findings of this investigation demonstrate that the proposed QSAR models hold promise in forecasting the acute toxicity of recently developed or synthesized tetrazole compounds, thereby mitigating potential risks to human health and the environment.
Subject(s)
Quantitative Structure-Activity Relationship , Tetrazoles , Rats , Mice , Animals , Humans , Administration, Oral , Databases, Factual , Tetrazoles/toxicityABSTRACT
HOAc-promoted construction of chroman-4-ones with a sulfur atom and an α-carbonyl quaternary carbon center directly from ortho-hydroxyacetophenones and DMSO is described. In these unique reactions, DMSO is activated by HOAc and provides three different units (CH2, CH2OH, and CH2SMe) in the target molecules. This reaction displays good substrate scope and reaction yields with a series of substitutes. The mechanism showed that the three units were formed in sequential order.
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BACKGROUND: Although programmed cell death protein 1 (PD-1)/ programmed cell death-ligand protein 1 (PD-L1) checkpoint blockade immunotherapy demonstrates great promise in cancer treatment, poor infiltration of T cells resulted from tumor immunosuppressive microenvironment (TIME) and insufficient accumulation of anti-PD-L1 (αPD-L1) in tumor sites diminish the immune response. Herein, we reported a drug-loaded microbubble delivery system to overcome these obstacles and enhance PD-L1 blockade immunotherapy. METHODS: Docetaxel (DTX) and imiquimod (R837)-loaded microbubbles (RD@MBs) were synthesized via a typical rotary evaporation method combined with mechanical oscillation. The targeted release of drugs was achieved by using the directional "bursting" capability of ultrasound-targeted microbubble destruction (UTMD) technology. The antitumor immune response by RD@MBs combining αPD-L1 were evaluated on 4T1 and CT26 tumor models. RESULTS: The dying tumor cells induced by DTX release tumor-associated antigens (TAAs), together with R837, promoted the activation, proliferation and recruitment of T cells. Besides, UTMD technology and DTX enhanced the accumulation of αPD-L1 in tumor sites. Moreover, RD@MBs remolded TIME, including the polarization of M2-phenotype tumor-associated macrophages (TAMs) to M1-phenotype, and reduction of myeloid-derived suppressor cells (MDSCs). The RD@MBs + αPD-L1 synergistic therapy not only effectively inhibited the growth of primary tumors, but also significantly inhibited the mimic distant tumors as well as lung metastases. CONCLUSION: PD-L1 blockade immunotherapy was enhanced by RD@MBs delivery system.
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Immunotherapy shows great promise on treating tumors. However, insufficient antigen exposure and immunosuppressive tumor microenvironment (TME) caused by hypoxia impose a serial of constraints on the therapeutic efficacy. In this study, we developed an oxygen-carrying nanoplatform loaded with perfluorooctyl bromide (PFOB, a second-generation of perfluorocarbon-based blood substitute), IR780 (a photosensitizer) and imiquimod (R837, an immune adjuvant) to reprogram immunosuppressive TME and reinforce photothermal-immunotherapy. The obtained oxygen-carrying nanoplatforms (abbreviated as IR-R@LIP/PFOB) show highly efficient oxygen release behavior and excellent hyperthermia performance upon laser irradiation, thus achieving the attenuation of the inherent tumor hypoxia and the exposure of tumor associated antigens in situ, and transforming the immunosuppressive TME to an immunosupportive one. We found that the photothermal therapy of IR-R@LIP/PFOB together with anti-programmed cell death protein-1 (anti-PD-1) would elicit a robust antitumor immunity by increasing the tumor-infiltrating frequencies of cytotoxic CD8+ T cells and tumoricidal M1-phenotype macrophages, while reducing immunosuppressive M2-phenotype macrophages and regulatory T cells (Tregs). This study presents these oxygen-carrying IR-R@LIP/PFOB nanoplatforms are potent in removing some negative impacts of immunosuppressive TME caused by hypoxia, and suppressing tumor growth by initiating antitumor immune responses, especially in combination with anti-PD-1 immunotherapy.
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M2-like tumor-associated macrophages (TAMs) typically exhibit numerous tumor-promoting properties. Reducing the abundance of M2-like TAMs would shed light on the relief of immunosuppressive tumor microenvironment (TME), activation of the host immune system, infiltration of CD8+ T cells into the TME and restoring the function of the infiltrating T cells, which collectively inhibits tumor growth. Therefore, targeted depletion of M2-like TAMs can be a promising immunotherapy approach. In this study, we rationally constructed an M2-like TAMs-targeted nanoliposome, which encapsulates zoledronic acid (ZA) in the core, loads hematoporphyrin monomethyl ether (HMME, a typical sonosensitizer) in the lipid bilayer, and modifies M2pep peptide (the targeting unit) on the surface (designated as M-H@lip-ZA). Our aim is to validate the effectiveness of M-H@lip-ZA nanoliposomes to remodel TME via targeted depletion of M2-like TAMs for cancer immunotherapy. Through the M2pep peptide, M-H@lip-ZA can be efficiently delivered to M2-like TAMs. In the meantime, reactive oxygen species (ROS) resulting from sonodynamic therapy (SDT), together with inner ZA that shows high affinity and cytotoxicity to TAMs, can effectively deplete M2-like TAMs and remodel TME (normalize tumor vasculatures, strengthen intertumoral perfusion, ease tumor hypoxia, increase immune-promoting cytokines and decrease immunosuppressive cytokines). The tumor growth can be effectively inhibited. This work proposed a new paradigm for cancer immunotherapy via targeted depletion of M2-like TAMs. STATEMENT OF SIGNIFICANCE: ⢠M2-like TAMs-targeted nanoliposome (M-H@lip-ZA) was designed and prepared. ⢠Sonodynamic therapy (SDT), together with zoledronic acid (ZA) that shows high affinity and cytotoxicity to tumor-associated macrophages (TAMs), can effectively deplete M2-like TAMs. Subsequently, immune-promoting tumor microenvironment (TME) can be formed, which includes normalized tumor vasculatures, enhanced intertumoral perfusion, relieved tumor hypoxia, increased immune-promoting cytokines, and decreased immunosuppressive cytokines. ⢠The targeted depletion of M2-like TAMs is a promising cancer immunotherapy approach.
Subject(s)
Neoplasms , Tumor-Associated Macrophages , Humans , Zoledronic Acid/pharmacology , Macrophages , CD8-Positive T-Lymphocytes , Tumor Microenvironment , Neoplasms/pathology , Cytokines/pharmacology , Peptides/pharmacology , Immunotherapy/methodsABSTRACT
OBJECTIVE: To assess the efficacy of Sanyrene liquid dressing (Urgo Medical) in preventing radiation dermatitis (RD) among patients with cancer after radiotherapy. DATA SOURCES: The authors searched the China National Knowledge Infrastructure, SinoMed, WanFang Data, PubMed, Web of Science, EMBASE, and the Cochrane Library databases for articles published from inception to January 2021. STUDY SELECTION: The preliminary search identified 146 studies. After removing duplicates, applying exclusion criteria, and screening titles and abstracts, 19 studies met the inclusion criteria. DATA EXTRACTION: A standardized form was constructed to extract data from eligible studies. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. DATA SYNTHESIS: The authors identified a total of 19 studies involving 1,508 patients that assessed the effectiveness of Sanyrene liquid dressing in preventing RD in patients with cancer after radiotherapy. The findings suggested that Sanyrene decreases the total incidence of RD (odds ratio [OR], 5.00; 95% CI, 2.77-9.03; P < .00001), as well as the incidence of RD grade 2 (OR, 0.55; 95% CI, 0.36-0.85; P = .007), grade 3 (OR, 0.22; 95% CI, 0.09-0.57; P = .002), and grade 4 (OR, 0.32; 95% CI, 0.13-0.78; P = .01). In addition, in comparison with controls, Sanyrene liquid dressing improves the cure rate (OR, 8.18; 95% CI, 4.03-16.60; P < .00001) and delays the occurrence of RD (mean difference, 3.69; 95% CI, 3.03-4.36; P < .00001). CONCLUSIONS: Sanyrene liquid dressing can decrease both the total incidence of RD and the incidence of RD above grade 2. It also improves the cure rate and delays the occurrence of RD. Thus, Sanyrene may be a superior option for preventing RD after radiotherapy. However, the findings were assessed as moderate- to low-quality evidence and more high-quality trials are needed to support this result.
Subject(s)
Dermatitis , Neoplasms , Humans , Bandages , ChinaABSTRACT
BACKGROUND: Titanium mesh exposure after cranioplasty is a possible complication and is usually managed by mesh removal and flap transfer, but the advantages of the rigid prosthesis are then lost. This study aimed to present our experience with negative pressure wound therapy combined with soft tissue dilation for retaining the titanium mesh in patients with mesh exposure after cranioplasty. METHODS: This retrospective study included patients treated between 01/2016 and 05/2019 at the Jiangyin Hospital Affiliated to Southeast University School of Medicine. The wound was cleaned, and a cystic space was created for the tissue dilator, which was used with a self-designed negative pressure dressing. After the target dilation was achieved, the repair was conducted while retaining the titanium mesh. RESULTS: Eight patients were included (seven males and one female; 53.6 ± 8.8 (range, 43-65) years of age). The exposed mesh area ranged from 1 × 1 to 4 × 5.5 cm. The thinning scalp area around the exposed mesh ranged from 3.6 × 3.8 to 4 × 5.5 cm. Five patients had positive wound cultures and received sensitive antibiotics. The dilator embedding time was 20-28 days. The time of negative pressure wound therapy was 25-33 days. The hospital stay was 30-41 days. Primary wound healing was achieved in all eight patients. There were no signs of recurrence after 6-18 months of follow-up. The cranial CT scans were unremarkable. CONCLUSIONS: Negative pressure wound therapy combined with soft tissue dilation for exposed titanium mesh after cranioplasty might help retain the titanium mesh.
Subject(s)
Plastic Surgery Procedures , Postoperative Complications , Skull , Surgical Mesh , Adult , Aged , Female , Humans , Male , Middle Aged , Postoperative Complications/etiology , Postoperative Complications/surgery , Plastic Surgery Procedures/adverse effects , Retrospective Studies , Skull/surgery , Surgical Mesh/adverse effects , TitaniumABSTRACT
Purpose: Chronic obstructive pulmonary disease (COPD) is one of the main risk factors for lung carcinomas. This study aimed to analyze and construct a model to assess scientific publications on the relationship between COPD and lung carcinomas. Patients and Methods: A literature search of the Web of Science database was performed for publications until November 2, 2021. Microsoft Excel and CiteSpace software were used to perform bibliometric and visual analysis of source journals, countries/regions, institutions, authors, research areas, and hot topics of selected publications. Results: A total of 2175 publications on the relationship between COPD and lung carcinomas were identified. The annual number of papers published and the total annual citation frequency in the field of COPD and lung carcinoma show an upward trend, and the current research hot topics are health, disease risk factors, disease burden, prevention and serious complications. The top three countries/regions with the number of published articles are the United States, China, and the United Kingdom. The author with the most signatures was Castaldi PJ of USA, followed by Xian JF of China. The lack of multinational/regional multi-center research illustrated that the distribution of research forces is unbalanced. Conclusion: According to this study, researchers can identify hot topics and explore new research directions in research of the relationship between COPD and lung carcinomas.
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Background: Infection with syphilis is still a major public health problem. The precise data for syphilis seroprevalence in the populations will help to develop a strategy for prevention and treatment of it. However, the data for syphilis prevalence in continuous years among volunteer blood donors in China is rare. Methods: A retrospective study for Treponema pallidum (TP) antibody in blood donors was conducted from January 2010 to December 2019 at the Blood Center of Zhejiang Province, China. TP antibody was detected with two different reagents using enzyme-linked immunosorbent assay and the only sample which was reactive in the two reagents was defined as seropositive. Results: A total of 992,646 volunteer blood donors were analyzed and the positive rate of TP antibody in the blood donors was 0.43%. From 2010 to 2019, the positive rates of TP antibody were 0.53%, 0.51%, 0.51%, 0.43%, 0.36%, 0.18%, 0.11%, 0.12%, 0.11%, and 0.10%, respectively. The positive rates of TP antibody were significantly different among blood donor age group (p < 0.001), with the highest positive rate in 45-54-years-old group (0.93%). The positive rates of TP antibody in male and female blood donors were 0.44% and 0.41%, respectively. The positive rate was 0.57% among the first-time blood donors, which was significantly higher than that of the repeat blood donors (0.17%). The positive rate of TP antibody in blood donors decreased gradually with the increase of educational level. Conclusion: The syphilis seroprevalence is low in the blood donors of the Hangzhou area, and the positive rate of blood donors is associated with age, educational level, and times of blood donation. Increasing the number of repeat blood donations is helpful to improve blood safety.
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Oxygen-containing functional groups on the surface of carbon materials can promote the adsorption capacity of radioactive thorium ions (Th(IV)), but their effect on the adsorption of Th(IV) has not been systematically revealed. Herein, to elucidate the nature of oxygen-containing group-mediated Th(IV) adsorption, a series of graphene oxide nanoflakes (GONFs) with diï¬erent contents of oxygen-containing groups on the surface were prepared. The experimental results showed that the high adsorption of Th(IV) not only resulted from the oxygen content, but also was related to the type of oxygen-containing functional groups on GONFs. Subsequent density functional theory (DFT) calculations revealed that the high adsorption capacity for Th(IV) originated from the oxygen-containing groups and their adjacent activated sp2 carbon atoms. More importantly, the coordination of Th(IV) with oxygen functional groups induced the aggregation of GONFs, leading to the sedimentation of GONFs, which facilitated the separation of adsorbents and enabled the GONFs to be a more practical adsorbent for Th(IV). This work deepens our understanding of the role of oxygen-containing groups on Th(IV) adsorption and provides a new strategy for the design and synthesis of high-performance surface oxygen-containing carbon-based adsorbents with practical application potential.
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Objective: To explore the diagnostic value and prognostic evaluation of the autophagy-related protein expression level among patients with sepsis comorbid with acute respiratory distress syndrome. Methods: A total of 182 sepsis patients were admitted to Naval Medical Center from March 2016 to April 2020 and divided into the acute respiratory distress syndrome and non-ARDS groups. Immunoblotting was employed to identify the expression of autophagy-associated protein from participants' peripheral blood mononuclear cells. Multivariate linear regression analysis was used to examine the association between mortality and the protein expression in sepsis complicated with acute respiratory distress syndrome. Results: Among the 182 patients with sepsis included in this study, 82 patients had acute respiratory distress syndrome and 100 patients did not have acute respiratory distress syndrome. We observed that microtubule-related protein 1A/1B LC3II, Beclin-1, RAB7, and LAMP2 protein expression was significantly decreased in septic patients with ARDS, and p62 was significantly increased. Further receiver operating characteristic curve analysis showed that autophagy-related proteins had a high recognition ability in sepsis complicated with acute respiratory distress syndrome. LAMP2 protein was the best among them, and its specificity was up to 91.46%. In this study, 38 of the 82 patients with sepsis complicated with acute respiratory distress syndrome died, with a mortality rate of 46.34%. We found that the autophagy level was further inhibited in the patients with death, LC3II, Beclin-1, and RAB7. However, the lysosomal-associated membrane protein 2 levels in the survival patients were remarkably higher than that in the dead patients. In addition, the p62 level was lower in survival patients as well. Our results indicated age and SOFA score were the independent risk factors for mortality in septic patients with acute respiratory distress syndrome. Conclusion: The autophagy level is significantly inhibited in septic patients with acute respiratory distress syndrome, and autophagy-associated proteins LC3II, Beclin-1, RAB7, LAMP2, and p62 have good value for the diagnosis and prognosis evaluation of sepsis comorbid with acute respiratory distress syndrome.
Subject(s)
Respiratory Distress Syndrome , Sepsis , Autophagy-Related Proteins , Humans , Leukocytes, Mononuclear , Prognosis , Sepsis/complicationsABSTRACT
Surrogate-based-constrained optimization for some optimization problems involving computationally expensive objective functions and constraints is still a great challenge in the optimization field. Its difficulties are of two primary types. One is how to handle the constraints, especially, equality constraints; another is how to sample a good point to improve the prediction of the surrogates in the feasible region. Overcoming these difficulties requires a reliable constraint-handling method and an efficient infill-sampling strategy. To perform inequality- and equality-constrained optimization of expensive black-box systems, this work proposes a hybrid surrogate-based-constrained optimization method (HSBCO), and the main innovation is that a new constraint-handling method is proposed to map the feasible region into the origin of the Euclidean subspace. Thus, if the constraint violation of an infeasible solution is large, then it is far from the origin in the Euclidean subspace. Therefore, all constraints of the problem can be transformed into an equivalent equality constraint, and the distance between an infeasible point and the origin in the Euclidean subspace represents the constraint violation of the infeasible solution. Based on the distance, the objective function of the problem can be penalized by a Gaussian penalty function, and the original constrained optimization problem becomes an unconstrained optimization problem. Thus, the feasible solutions of the original minimization problem always have a lower objective function value than any infeasible solution in the penalized objective space. To improve the optimization performance, kriging-based efficient global optimization (EGO) is used to find a locally optimal solution in the first phase of HSBCO, and starting from this locally optimal solution, RBF-model-based global search and local search strategies are introduced to seek global optimal solutions. Such a hybrid optimization strategy can help the optimization process converge to the global optimal solution within a given maximum number of function evaluations, as demonstrated in the experimental results on 23 test problems. The method is shown to achieve the global optimum more closely and efficiently than other leading methods.
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To clarify the efficiency and safety of laser-assisted hatching (LAH) application on vitrified-warmed blastocyst transfer (VBT) cycles, we designed the non-randomized concurrent control trial included 4039 VBT cycles in the Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, during the even days from November 2014 to December 2015. The VBT cycles were divided into LAH group (n = 1932) and non-LAH group (n = 2107) according to the date of blastocyst thawing. Laser-partial zona pellucida dissection was performed on all blastocysts thawed on that day every 4 days, and those blastocysts were assigned to the LAH group. There were a higher biochemical pregnancy rate (66.87% vs 63.69%; P = 0.034; rate ratio for LAH vs non-LAH group [RR], 1.050; 95% confidence interval [CI], 1.004-1.098) and an increased live birth rate (48.81% vs 45.51%; P = 0.036; RR, 1.072; 95% CI, 1.005-1.145) with comparable ectopic pregnancy, twin or multiple pregnancies, spontaneous abortion and birth defect rates of the LAH group than those of the non-LAH group. Subgroup analysis showed that live birth rate, birth defect rate, and other pregnancy outcomes were comparable for patients younger than 35 years when blastocyst transfer, patients with endometrium thickness less than 0.9 cm during ovulation or the initiation of progesterone treatment, ICSI blastocysts, AC or BC blastocysts according to Gardner morphological criteria and day 5 blastocysts of the LAH group than it of non-LAH group. LAH could be performed selectively on vitrified-warmed blastocysts before transfer for better pregnancy outcomes. Trial registration number: ChiCTR2000032975. Date of registration: May 17, 2020. Retrospectively registered.
Subject(s)
Embryo Transfer , Pregnancy Outcome , Female , Humans , Lasers , Pregnancy , Pregnancy Rate , Prospective StudiesABSTRACT
In the past several years, it has become apparent that the effectiveness of Pareto-dominance-based multiobjective evolutionary algorithms deteriorates progressively as the number of objectives in the problem, given by M , grows. This is mainly due to the poor discriminability of Pareto optimality in many-objective spaces (typically M ≥ 4 ). As a consequence, research efforts have been driven in the general direction of developing solution ranking methods that do not rely on Pareto dominance (e.g., decomposition-based techniques), which can provide sufficient selection pressure. However, it is still a nontrivial issue for many existing non-Pareto-dominance-based evolutionary algorithms to deal with unknown irregular Pareto front shapes. In this article, a new many-objective evolutionary algorithm based on the generalization of Pareto optimality (GPO) is proposed, which is simple, yet effective, in addressing many-objective optimization problems. The proposed algorithm used an "( M-1 ) + 1" framework of GPO dominance, ( M-1 )-GPD for short, to rank solutions in the environmental selection step, in order to promote convergence and diversity simultaneously. To be specific, we apply M symmetrical cases of ( M-1 )-GPD, where each enhances the selection pressure of M-1 objectives by expanding the dominance area of solutions, while remaining unchanged for the one objective left out of that process. Experiments demonstrate that the proposed algorithm is very competitive with the state-of-the-art methods to which it is compared, on a variety of scalable benchmark problems. Moreover, experiments on three real-world problems have verified that the proposed algorithm can outperform the others on each of these problems.