Cabozantinib in combination with immune checkpoint inhibitors for renal cell carcinoma: a systematic review and meta-analysis.

Context: Cabozantinib combined with immune checkpoint inhibitors (ICIs) has brought a new therapeutic effect for the medical treatment of renal cell carcinoma (RCC). Objectives: We performed a meta-analysis of randomized controlled trials and single-arm trials to evaluate the efficacy and safety of cabozantinib plus ICIs in RCC. Methods: We extracted data from PubMed, Cochrane, Medline and Embase databases, and rated literature quality through Cochrane risk of bias tool and MINORS. RevMan5.3 software was used to analyze the results of randomized controlled trials and single-arm trials. Results: A total of 7 studies were included. Treatment with cabozantinib plus ICIs improved PFS [HR 0.75, (95%CI: 0.52, 1.08), p = 0.12] and the OS [HR 0.80, (95%CI: 0.60, 1.07), p = 0.13] in randomized controlled trials. Meanwhile, the result of the ORR in randomized controlled trials was [risk ratio (RR) 1.37, (95%CI: 1.21, 1.54), p < 0.00001] and in single-arm trials was [risk difference (RD) 0.49, (95%CI: 0.26, 0.71), p < 0.0001]. Conclusion: Cabozantinib plus ICIs prolonged the PFS and OS, and improved ORR in patients with RCC. Our recommendation is to use cabozantinib plus ICIs to treat advanced RCC, and to continuous monitor and manage the drug-related adverse events. Systematic Review Registration: identifier CRD42023455878.

Comparative efficacy and safety of cabozantinib for malignant tumors: a systematic review and meta-analysis.

OBJECTIVES: To provide a more comprehensive understanding of the efficacy and safety profile of cabozantinib versus placebo in malignant tumors, we conducted a systematic review and meta-analysis. This involved analyzing a collection of published randomized controlled trials to assess the outcomes. METHODS: We used RevMan5.3 software to evaluate the outcomes of the collected studies. The primary outcome we focused on was progression-free survival (PFS), and the secondary outcomes included overall survival (OS) and disease control rate (DCR). RESULTS: Our findings revealed that compared to placebo, cabozantinib significantly extended the PFS of patients [hazard ratios (HR) 0.37, 95% confidence intervals (CI): 0.32, 0.43, p < 0.00001]. Additionally, cabozantinib improved the OS of patients [HR 0.78, 95%CI: 0.68, 0.91, p = 0.002]. While it is important to note that cabozantinib was associated with a higher likelihood of causing digestive, cutaneous, and cardiovascular related adverse events [relative risk (RR) 4.40, 95% CI: 3.10, 6.25, p < 0.00001]. CONCLUSION: Based on our analysis, cabozantinib significantly prolonged the PFS and OS of patients with malignant tumors (p < 0.01). We recommend the use of cabozantinib in treating advanced malignant tumors. However, it is important to continuously monitor and manage the drug-related adverse events. REGISTRATION: PROSPERO (No. CRD42023449261).

Prioritized experience replay in path planning via multi-dimensional transition priority fusion.

Introduction: Deep deterministic policy gradient (DDPG)-based path planning algorithms for intelligent robots struggle to discern the value of experience transitions during training due to their reliance on a random experience replay. This can lead to inappropriate sampling of experience transitions and overemphasis on edge experience transitions. As a result, the algorithm's convergence becomes slower, and the success rate of path planning diminishes. Methods: We comprehensively examines the impacts of immediate reward, temporal-difference error (TD-error), and Actor network loss function on the training process. It calculates experience transition priorities based on these three factors. Subsequently, using information entropy as a weight, the three calculated priorities are merged to determine the final priority of the experience transition. In addition, we introduce a method for adaptively adjusting the priority of positive experience transitions to focus on positive experience transitions and maintain a balanced distribution. Finally, the sampling probability of each experience transition is derived from its respective priority. Results: The experimental results showed that the test time of our method is shorter than that of PER algorithm, and the number of collisions with obstacles is less. It indicated that the determined experience transition priority accurately gauges the significance of distinct experience transitions for path planning algorithm training. Discussion: This method enhances the utilization rate of transition conversion and the convergence speed of the algorithm and also improves the success rate of path planning.

Thermal stability of Ni3ZnC0.7: As tunable additive for biomass-derived carbon sheet composites with efficient microwave absorption.

With the rapidly development of radar detection technology and the increasingly complex application environment in military field and electromagnetic pollution surrounded by electron devices, increasingly demand is needed for electromagnetic wave absorbent materials with high absorption efficiency and thermal stability. Herein, a novel Ni3ZnC0.7/Ni loaded puffed-rice derived carbon (RNZC) composites are successfully prepared by vacuum filtration of metal-organic frameworks gel precursor together with layered porous-structure carbon and followed by calcination. The Ni3ZnC0.7 particles uniformly decorate on the surface and pores of puffed-rice derived carbon. The puffed-rice derived carbon@Ni3ZnC0.7/Ni-400 mg (RNZC-4) sample displayed the best electromagnetic wave absorption (EMA) performances among the samples with different Ni3ZnC0.7 loading. The minimum reflection loss (RLmin) of the RNZC-4 composite reaches -39.9 dB at 8.6 GHz, while widest effective absorption bandwidth (EAB) of RNZC-4 for RL < -10 dB can reach 9.9 GHz (8.1-18 GHz, 1.49 mm). High porosity and large specific surface area promote the multiple reflection-absorption effect of the incident electromagnetic waves. The Ni3ZnC0.7 nanoparticles provide a large number of interfaces and dipole factors. Analysis reveals that the RNZC-4 remained general stability under 400 °C with formation of a small amount of NiO and ZnO phases. Surprisingly, at such high temperature, the absorbing properties of the material are improved rather than decreased. Obviously, the material still maintains good electromagnetic wave performance at high temperature, and implies that the absorber shows good performance stability. Therefore, our preparations exhibit potential applications under extreme conditions and a new insight for the design and application of bimetallic carbides.

Phase Transformation and Performance of Mg-Based Hydrogen Storage Material by Adding ZnO Nanoparticles.

ZnO nanoparticles in a spherical-like structure were synthesized via filtration and calcination methods, and different amounts of ZnO nanoparticles were added to MgH2 via ball milling. The SEM images revealed that the size of the composites was about 2 µm. The composites of different states were composed of large particles with small particles covering them. After the absorption and desorption cycle, the phase of composites changed. The MgH2-2.5 wt% ZnO composite reveals excellent performance among the three samples. The results show that the MgH2-2.5 wt% ZnO sample can swiftly absorb 3.77 wt% H2 in 20 min at 523 K and even at 473 K for 1 h can absorb 1.91 wt% H2. Meanwhile, the sample of MgH2-2.5 wt% ZnO can release 5.05 wt% H2 at 573 K within 30 min. Furthermore, the activation energies (Ea) of hydrogen absorption and desorption of the MgH2-2.5 wt% ZnO composite are 72.00 and 107.58 KJ/mol H2, respectively. This work reveals that the phase changes and the catalytic action of MgH2 in the cycle after the addition of ZnO, and the facile synthesis of the ZnO can provide direction for the better synthesis of catalyst materials.

Cloud and snow detection of remote sensing images based on improved Unet3.

Cloud detection is an important step in remote sensing image processing and a prerequisite for subsequent analysis and interpretation of remote sensing images. Traditional cloud detection methods are difficult to accurately detect clouds and snow with very similar features such as color and texture. In this paper, the features of cloud and snow in remote sensing images are deeply extracted, and an accurate cloud and snow detection method is proposed based on the advantages of Unet3+ network in feature fusion. Firstly, color space conversion is performed on remote sensing images, RGB images and HIS images are used as input of Unet3+ network. Resnet 50 is used to replace the Unet3+ feature extraction network to extract remote sensing image features at a deeper level, and add the Convolutional Block Attention Module in Resnet50 to improve the network's attention to cloud and snow. Finally, the weighted cross entropy loss is constructed to solve the problem of unbalanced sample number caused by high proportion of background area in the image. The results show that the proposed method has strong adaptability and moderate computation. The mPA value, mIoU value and mPrecision value can reach 92.76%, 81.74% and 86.49%, respectively. Compared with other algorithms, the proposed method can better eliminate all kinds of interference information in remote sensing images of different landforms and accurately detect cloud and snow in images.

Efficient Path Planning for Mobile Robot Based on Deep Deterministic Policy Gradient.

When a traditional Deep Deterministic Policy Gradient (DDPG) algorithm is used in mobile robot path planning, due to the limited observable environment of mobile robots, the training efficiency of the path planning model is low, and the convergence speed is slow. In this paper, Long Short-Term Memory (LSTM) is introduced into the DDPG network, the former and current states of the mobile robot are combined to determine the actions of the robot, and a Batch Norm layer is added after each layer of the Actor network. At the same time, the reward function is optimized to guide the mobile robot to move faster towards the target point. In order to improve the learning efficiency, different normalization methods are used to normalize the distance and angle between the mobile robot and the target point, which are used as the input of the DDPG network model. When the model outputs the next action of the mobile robot, mixed noise composed of Gaussian noise and Ornstein-Uhlenbeck (OU) noise is added. Finally, the simulation environment built by a ROS system and a Gazebo platform is used for experiments. The results show that the proposed algorithm can accelerate the convergence speed of DDPG, improve the generalization ability of the path planning model and improve the efficiency and success rate of mobile robot path planning.

Interventions to promote the implementation of pressure injuries prevention measures in nursing homes: a scoping review protocol.

INTRODUCTION: Currently, various guidelines and documents on the prevention of pressure injuries have been published, but there are many serious lags in the actual practice in nursing homes. So some interventions are required to promote the implementation of normative practices. There was a review of preventive interventions for pressure injuries in long-term care facilities, but there is no systematic review of how to promote the implementation of preventive measures. This review aims to summarise interventions that promote the implementation of pressure injuries prevention measures in nursing homes, explore the research scope and gaps in this field and provide evidence and striving direction for global nursing homes to improve existing preventive behaviours. METHODS AND ANALYSIS: This scoping review will combine the Arksey and O'Malley framework with further clarification and advice of the scoping review by Levac et al as methodological guidance. Systematic retrieval of relevant literature databases, grey literature and references included studies will be conducted. Two reviewers will screen titles and abstracts independently, and then screen the full text of potentially relevant articles to determine final inclusion. After that, two reviewers will extract data based on a predesigned data extraction table independently. Inductive analysis and narrative analysis will be used to collate, summarise and report the results. Finally, managers of nursing homes in China will be consulted for additional information and their viewpoints on the research findings. ETHICS AND DISSEMINATION: Since the scoping review is a secondary analysis of the literature, there is no need to apply for ethical approval. Our goal is to share the results with key stakeholders to help them find the direction of effort and improve clinical practice. Therefore, dissemination plans include publication in international journals and sharing it at conferences to inform more healthcare workers about the scope and gaps of the studies.

Multiple reflection and scattering effects of the lotus seedpod-based activated carbon decorated with Co3O4 microwave absorbent.

The lotus seedpod-based activated carbon (LSAC) is derived from pyrolysis of lotus seedpod as biomass carbon precursor, and Co3O4 is then deposited to LSAC by oxidation-precipitation and crystallization process of Co ions from Co(NO3)2 solution. The Co3O4 particles uniformly decorate on the surface and/or the inner channels of LSAC. The optimal reflection loss (RL) value of LSAC/Co3O4-paraffin wax (PW) composite reaches -39.8 dB, and the bandwidth for RL below -10 dB and -20 dB are 10.3 and 3.0 GHz, respectively, much better than that of LSAC-PW composite for the higher magnetic loss. The addition of Co3O4 particles in LSAC-PW composite significantly enhance the RL values in various thicknesses. The channels of the LSAC and decorated Co3O4 can improve the abilities of multiple scattering, dipole polarization, interface polarization and magnetic loss. This composite provides a promising method to construct high performance absorbers by using biomass carbon to tune the dielectric properties of the ferromagnetic materials.

Application of Convolutional Neural Network in Identifying Different Levels of Isokinetic Exercise Efforts / 法医学杂志

Objective To develop a convolutional neural network （CNN） that can identify isokinetic knee exercises moment of force-time diagrams under different levels of efforts. Methods The 200 healthy young volunteers performed concentric isokinetic right knee flexion-extension reciprocating exercises with maximal effort as well as half the effort at angular velocities of 30°/s and 60°/s twice, respectively, with an interval of 45 min. The moment of force-time diagrams were collected. The 200 subjects were randomly divided into the training set （140 subjects） and the testing set （60 subjects）. The moment of force-time diagrams from subjects in the training set were used to train CNN model, and then the fully trained model was used to predict types of curves from the testing set. Random sampling of subjects along with subsequent development of models were performed 3 times. Results Under the circumstances of isokinetic knee exercises with maximal effort and half the effort, 2 400 moment of force-time diagrams were produced, respectively. Classification accuracy rates of the CNN models after the 3 trainings were 91.11%, 90.49% and 92.08%, respectively, and the average accuracy rate was 91.23%. Conclusion The CNN models developed in this study have a good effect on differentiating isokinetic moment of force-time diagrams of maximal effort exercises from those made with half the effort, which can contribute to identifying levels of efforts exerted by subjects during isokinetic knee exercises.

The application of cluster intervention in sedation of chloral hydrate enema in infants / 中国实用护理杂志

Objective:To investigate the effect of bundles of care on pediatric hypnosis by rectal chloral hydrate.Method:A total of 368 children aged 0 to 3 years old who were treated in Dalian Children′s Hospital from December 2018 to June 2019 and were treated with chloralhydrate enemas were randomly divided into the control group (routine nursing intervention) and observation groups (bundled Intervention) 184 cases each. The chloralhydrate enemas were inserted for sedation, and the observation group added sedation while chloralhydrate enemas for sedation. After admission, record the data of each patient, and do the Ramsay sedation score after sedation. According to the sedation score, the sedation failure rate of chloralhydrate enema was increased, and the proportion of each score in the group was compared.Results:Ramsay sedation scores of the observation group and the control group after enema were 5.42 ± 1.34 and 3.14 ± 1.21, respectively. There was significant difference between the two groups ( t value was 2.08, P<0.05). The failure rates in experimental group and control group were 13.59% (25/184) and 38.59% (71/184), respectively. There was a significant difference between two groups ( χ2 value was 29.82, P<0.05). Conclusion:Bundles of care could decrease the failure rate of rectal chloral hydrate hypnosis significantly, then reduce the suffering of children. It is worth being widely used in clinic.

Chemosensory proteins of the eastern honeybee, Apis cerana: Identification, tissue distribution and olfactory related functional characterization.

Chemosensory proteins (CSPs), a class of small soluble proteins, are thought to be involved in insect chemoreceptive behavior. Here, six CSP genes, AcerCSP1-6 from Apis cerana, were cloned and characterized from worker bees' antennae. Results revealed that the AcerCSPs' amino acid sequences shared high similarity with the homologous genes of Apis mellifera, but low similarity with other insect species. Compared with corresponding CSPs of A. mellifera, AcerCSPs (1, 3, 4, and 6) exhibit quite similar gene expression profiling. On the contrary, AcerCSP2 showed a higher expression level in the forager antennae and legs than CSP2 of A. mellifera. Furthermore, AcerCSP5 was not specifically expressed in larvae, unlike CSP5 of A. mellifera. In a ligand-binding assay, AcerCSP1 and AcerCSP2, which exhibited the highest expression in antennae of A. cerana, had a stronger affinity with candidate floral chemicals and pheromones than AcerCSP4, the results of which was supported by docking analysis, suggesting that the relevance of them with A. cerana olfactory functions. Taken together, these results suggest that despite the quasi-similarity of protein sequences between A. cerana and A. mellifera, differences in tissue expression and functional characteristics between the two species still exist, indicating that homologous proteins potentially perform different tasks even in related species.

A multi-center clinical trial of natural calcined bone repair material in repairing bone defect after tooth extraction / 实用口腔医学杂志

Objective:To study the efficacy and safety of natural calcined bone repair material(NCBM)in repairing bone defect af-ter tooth extraction.Methods:A randemized,double-blinded,parallel,positive control(Bio-Oss)and multi-center clinical trial was employed.Imaging examination was used as the main efficacy evaluation index,surgical wound healing,rejection reaction,bone me-tabolic changes,bone infection signs were the subordinate efficacy evaluation indexes,the incidence of adverse reactions was observed for safety evaluation.Results:280 cases were included,269 cases completed the trial.In NCBMand Bio-Oss group the effective rate of imaging examination was 93.08% and 93.70%(P >0.05)respectively.The wound healing time of the 2 groups was less than 7 days,no rejection reaction,bone metabolic change and bone infection sign were observed.The incidence of adverse events in NCBM and the Bio-Oss group was 0.72% and 2.14%(P >0.05)respectively.Conclusion:The efficacy and safety between natural cal-cined bone repair material is not inferior to Bio-Oss in repairing bone defect after tooth extraction.

Research on HPLC fingerprints of different processed Morinda officinalis / 中草药

Objective: To establish an HPLC fingerprint of anthraquinone components and to provide the basis for quality standard and processing principle of processed Morinda officinalis (Morindae Officinalis Radix). Methods: HPLC method was employed and Ecosil ODS C18 column (250 mm × 4.6 mm, 5 μm) was used at temperature of 28°C. The mobile phase was methanol-0.1% phosphoric acid solution with gradient elution. The detection wavelength was 277 nm. The experimental data were analyzed by computer aided similarity evaluation software. Results: HPLC fingerprint for anthraquinone components of different processed products of M. officinalis was established. Five chromatographic peaks of M. officinalis, morinda pulp, and salt-steamed M. officinalis and six chromatographic peaks of licorice-processed M. officinalis were respectively identified. The quality difference of M. officinalis among ten-origins reached significant level. The difference of anthraquinone components was not significant among the various processed products, but the content was changed. Liquiritigenin was found in licorice-processed M. officinalis. Conclusion: The method is accurate, repeatable, and reliable, which can be used to identify different processed M. officinalis.

History and processing research on herbal juice / 药学实践杂志

The literatures of classic and modern application of herbal juice , like ginger juice, licorice juice, rice water, evodia rutaecarpa juice, black soya bean juice, bile, etc were collected.The history and successive changes of the processing research of herbal juice used as processing excipient were summarized , which could offer the reference to the modern processing excipient of herbal juice .

Reflection on course arrangement in the course of clinical pharmacy for stomatology / 中华医学教育探索杂志

The original teaching of clinical pharmacy for stomatology course did not let students aware of the importance of drugs in the treatment of oral diseases. The original teaching framework was rearranged:decentralizing knowledge of oral diseased related clinical pharmacy into several mod-ules;setting general knowledge into the oral basic medical module;adding the practice of visiting the pharmacy and manufacturing laboratory. Teaching process was closely combined with clinics and was integrated with disease-centered oral medicine curriculum integration system. Students responded that the teaching effect was better. The rearranged teaching method can enhance students' attention on drug treatment for oral diseases,improve their ability of clinical medication and promote the teaching quality.

Comparison of three different time points of starting treadmill training in spinal cord injured rats.

OBJECTIVE: It has been widely acknowledged that early treadmill training plays an important role in rewiring neurons in a functionally meaningful manner in spinal cord injury (SCI) treatment. However, it is still unclear how early to start treadmill training to obtain the most efficacious results after SCI. The purpose of this study was to find the earliest time point when treadmill training was most effective in rewiring neurons. METHODS: The rats were randomly divided into five groups: a sham group, control group, and three treadmill groups based on training start time post-injury: a 24 h group, 48 h group, and 72 h group. RESULTS: The results revealed that in the 72 h group, Basso, Beattie, and Bresnaham scores increased and apoptotic cells decreased significantly compared to the other groups. There were no statistically differences in neuron counting and 5-bromo-2V-deoxyuridine assays between the groups. CONCLUSION: These results indicated that the best start time for treadmill training is 72 h after SCI.