Background:While the treatment of metastatic renal cell carcinoma(mRCC)is evolving due to immune checkpoint inhibitors(ICIs),optimal strategies for later lines of therapy have yet to be defined.The combination of lenv...Background:While the treatment of metastatic renal cell carcinoma(mRCC)is evolving due to immune checkpoint inhibitors(ICIs),optimal strategies for later lines of therapy have yet to be defined.The combination of lenvatinib and everolimus represents a viable option,and the present review aimed to summarize its activity,effectiveness,and safety.Methods:A systematic review of the literature was conducted using PubMed,targeting studies published between 2018 and 2025.Eligible studies included English-language prospective and retrospective trials reporting survival outcomes in mRCC patients treated with lenvatinib and everolimus after at least one ICI-containing regimen.Results:Nine studies met the inclusion criteria,encompassing a total of 441 patients.The lenvatinib and everolimus combination was primarily used in the third and subsequent lines of therapy.Median overall survival ranged from 7.5 to 24.5 months,while median progression-free survival was more consistent,between 6.1 and 6.7 months,except for one study reporting 12.9 months.Objective response rates varied widely(14.0%–55.7%).Adverse events of grade≥3 did not exceed the expected rate,with diarrhoea and proteinuria as the most reported events.Dose reductions and treatment discontinuations due to toxicity occurred but were generally lower than in prior pivotal trials.Conclusions:Real-world evidence suggests that lenvatinib and everolimus represent an effective and safe option after ICI failure in mRCC patients.Nevertheless,the lack of randomized phase III trials and the heterogeneity of existing studies highlight the need for more robust prospective research to guide post-ICI therapeutic strategies.展开更多
As the proportion of composite materials used in aircraft continues to increase, the electromagnetic Shielding Effectiveness (SE) of these materials becomes a critical factor in the electromagnetic safety design of ai...As the proportion of composite materials used in aircraft continues to increase, the electromagnetic Shielding Effectiveness (SE) of these materials becomes a critical factor in the electromagnetic safety design of aircraft structures. The assessment of electromagnetic SE for Slotted Composite Structures(SCSs) is particularly challenging due to their complex geometries and there remains a lack of suitable models for accurately predicting the SE performance of these intricate configurations. To address this issue, this paper introduces SCS-Net, a Deep Neural Network (DNN) method designed to accurately predict the SE of SCS. This method considers the impacts of various structural parameters, material properties and incident wave parameters on the SE of SCSs. In order to better model the SCS, an improved Nicolson-Ross-Weir (NRW) method is introduced in this paper to provide an equivalent flat structure for the SCS and to calculate the electromagnetic parameters of the equivalent structure. Additionally, the prediction of SE via DNNs is limited by insufficient test data, which hinders support for large-sample training. To address the issue of limited measured data, this paper develops a Measurement-Computation Fusion (MCF) dataset construction method. The predictions based on the simulation results show that the proposed method maintains an error of less than 0.07 dB within the 8–10 GHz frequency range. Furthermore, a new loss function based on the weighted L1-norm is established to improve the prediction accuracy for these parameters. Compared with traditional loss functions, the new loss function reduces the maximum prediction error for equivalent electromagnetic parameters by 47%. This method significantly improves the prediction accuracy of SCS-Net for measured data, with a maximum improvement of 23.88%. These findings demonstrate that the proposed method enables precise SE prediction and design for composite structures while reducing the number of test samples needed.展开更多
Africa can draw inspiration from China’s multi-pronged approach to fighting poverty.Without a doubt,China’s poverty alleviation is a success that has not been achieved by any country I can think of.There is so much ...Africa can draw inspiration from China’s multi-pronged approach to fighting poverty.Without a doubt,China’s poverty alleviation is a success that has not been achieved by any country I can think of.There is so much that Africa can learn from China in this regard.African nations can draw inspiration from the effectiveness of China’s governance in delivering results.展开更多
BACKGROUND Blonanserin,a novel antipsychotic,has demonstrated efficacy in treating both positive and negative symptoms.However,limited research exists on its dose-dependent effectiveness and safety in patients with an...BACKGROUND Blonanserin,a novel antipsychotic,has demonstrated efficacy in treating both positive and negative symptoms.However,limited research exists on its dose-dependent effectiveness and safety in patients with and without prominent nega-tive symptoms(PNS).AIM To evaluate the effectiveness and safety of blonanserin monotherapy for first-episode schizophrenia in real-world clinical settings and to explore the efficacy and safety of different doses of blonanserin for patients with PNS and without PNS.METHODS A 12-week,multicenter,prospective post-marketing surveillance was conducted.In this study,we included patients with first-episode schizophrenia who received blonanserin monotherapy.Patients were divided into those with PNS and without PNS,based on the Brief Psychiatric Rating Scale(BPRS)negative symptoms subscale scores.Additionally,patients were labeled as high-dose and low-dose was evaluated through the incidence of adverse drug reactions(ADRs).RESULTS A total of 653 patients were included in the analysis,with 613 completing the study.The BPRS total score decreased significantly from 47.94±16.31 at baseline to 26.88±9.47 at 12 weeks(P<0.001).A significant interaction of PNS×dose×time was observed for BPRS total scores(F=3.47,P=0.040)and negative symptom subscale scores(F=6.76,P=0.002).In the PNS group,the high-dose group showed greater reductions in BPRS total scores(P=0.001)and negative symptom subscale scores(P=0.003)than the low-dose group in week 12.In the without PNS group,no significant difference was observed between the high-dose and low-dose groups at any visit.Most adverse reactions were mild or moderate,with extrapyramidal symptoms(9.3%)being most common;1.5%of patients gained≥7%body weight at 12 weeks.CONCLUSION Blonanserin effectively alleviated the clinical symptoms of first-episode schizophrenia with an acceptable safety profile.High-dose blonanserin is particularly beneficial for patients with PNS in the acute phase of first-episode schizophrenia.However,due to the limitation of ADR reporting the real world,the ADR incidence observed in this study may be underestimated.展开更多
Objective:To evaluate the value of humanistic nursing care during pediatric nebulization treatment.Methods:From January 2024 to June 2024,250 pediatric patients receiving nebulization treatment were given routine care...Objective:To evaluate the value of humanistic nursing care during pediatric nebulization treatment.Methods:From January 2024 to June 2024,250 pediatric patients receiving nebulization treatment were given routine care and included in the control group.From July 2024 to December 2024,250 pediatric patients receiving nebulization treatment were given full humanistic care by nurses and included in the observation group.The differences in patient compliance,symptom resolution time,parental satisfaction,and emotional scores were compared.Results:The compliance of pediatric nebulization patients in the observation group was higher than that in the control group(P<0.05).The disappearance time of inflammation,cough,expectoration,fever,and hospital stay in the observation group were shorter than those in the control group(P<0.05).Parental satisfaction with pediatric nebulization in the observation group was higher than that in the control group(P<0.05).The scores of anxiety(SAS)and depression(SDS)among parents of pediatric nebulization patients in the observation group were lower than those in the control group(P<0.05).Conclusion:The application of nurses’full humanistic care in pediatric nebulization treatment can promote the resolution of respiratory system symptoms,optimize patients’lung function,improve patient cooperation,and is highly effective and feasible.展开更多
Introduction:This study examined the application of targeted education strategies for nursing students of different MBTI types to enhance students’theoretical and practical grades.Nursing students have different pers...Introduction:This study examined the application of targeted education strategies for nursing students of different MBTI types to enhance students’theoretical and practical grades.Nursing students have different personalities,therefore learning behaviors are significantly different.It is worth exploring whether teaching methods influence these differences and can be improved through specific education strategies.Methods:Experimental research methods and Questionnaire survey methods were used to test the effect of MBTI with different personality types on the implementation of targeted education strategies.Results:There was a significant correlation between MBTI and teaching effect(p<0.005).Targeted changes in education strategies could effectively improve teaching effect(p<0.005),improve teaching quality(p<0.005),and improve nursing students’professional identity(p<0.005).Conclusion:The results showed that targeted changes in education strategies can effectively improve teaching effectiveness,teaching quality,and nursing students’sense of occupational identity.展开更多
Objective:This study aims to determine the effectiveness of giving a combination of Fe tablets and beetroot juice in increasing hemoglobin(Hb)levels of pregnant women with anemia in the Mataram City area.Methods:This ...Objective:This study aims to determine the effectiveness of giving a combination of Fe tablets and beetroot juice in increasing hemoglobin(Hb)levels of pregnant women with anemia in the Mataram City area.Methods:This study was designed with quasi-experimental design with pre-test and post-test with control design.The location of this study was conducted in the city of Mataram on pregnant women with anemia.The sample of this study was pregnant women with mild anemia based on inclusion and exclusion criteria,divided into 2 groups:a control group and a treatment group of 15 respondents each,bringing the total respondents to 30 people.Analysis of Hb level measurement results was carried out using the independent sample t-test.Results:The results obtained in the treatment group(combination of beet juice and Fe tablets)were the mean pre-test of 9.93 mg/dL and post-test of 11.90 mg/dL(P-value=0.000),which means there is effectiveness in increasing hemoglobin levels while in the control group.Comparison of increased Hb levels of the control group and significantly different treatments marked by a P value of 0.001.Conclusions:the combination of Fe tablets and beetroot juice is effective in increasing Hb levels of pregnant women with anemia in the Mataram City area.展开更多
Surgical nursing education has long grappled with a tension between traditional lecture-based models and actual practice needs.Students have difficulty converting theory into functional nursing skills in the passive f...Surgical nursing education has long grappled with a tension between traditional lecture-based models and actual practice needs.Students have difficulty converting theory into functional nursing skills in the passive format of knowledge acquisition.As medical education concepts have been renewed,the goals of educating nursing talents with independent judgment and adaptability to clinical practice have evolved into a significant direction of teaching reform.To this end,the“flipped classroom”model that blends lecture with discussion,through the mechanism of“internalized absorption”and“discussion”in the classroom,represents both a new teaching model that meets the need for integration of surgical nursing knowledge and an approach to skill application.This model reconstructs the teaching and learning process by providing a bridge for students to transfer from understanding knowledge to clinical thinking,thus providing a path forward for the dilemma of the separation of theory and practice in surgical nursing education.展开更多
BACKGROUND Gastric cancer is a major global health issue,and the perioperative period critic-ally influences patient outcomes.The different effects of sevoflurane inhalation anesthesia and propofol total intravenous a...BACKGROUND Gastric cancer is a major global health issue,and the perioperative period critic-ally influences patient outcomes.The different effects of sevoflurane inhalation anesthesia and propofol total intravenous anesthesia on intraoperative stability,postoperative complications,and long-term oncologic outcomes in patients with gastric cancer undergoing radical gastrectomy remain unclear.AIM To compare the effects of sevoflurane inhalation anesthesia and propofol total in-travenous anesthesia on clinical outcomes,including intraoperative indicators,postoperative complications,adverse effects,pain scores,and survival.METHODS This single-center retrospective cohort study included 204 patients who underw-ent radical gastrectomy for gastric cancer from February 2019 to December 2022.Patients were assigned to either the sevoflurane group(n=103)or the propofol group(n=101)based on intraoperative anesthetic regimen.Standardized protoc-ols for anesthesia management,intraoperative monitoring,and postoperative analgesia were applied.Baseline characteristics;intraoperative metrics;adverse events;complications;Visual Analog Scale(VAS)scores at 2,4,6,24,and 48 hours;and survival outcomes were retrospectively collected.Group comparisons were performed usingχ2 for categorical variables,t test for continuous variables,RESULTS Baseline demographic and clinical characteristics were similar between groups.No significant differences were observed in intraoperative indicators or most 30-day postoperative outcomes,including length of stay,emergency department visits,and readmission rates.The propofol group showed elevated mean VAS pain score at 24 hours postoperatively,but no differences were found at other time points.The propofol group also had significantly higher postoperative nausea incidence and transiently higher systolic/diastolic blood pressure and heart rate at the time of incision than the sevoflurane group.No significant differences were seen in overall rates or severity of postoperative complications,intraoperative adverse events,or in overall survival and progression-free survival.CONCLUSION In patients undergoing radical gastrectomy for gastric cancer,sevoflurane and propofol anesthesia demonstrated similar profiles regarding intraoperative safety,postoperative complications,adverse events,postoperative pain,and long-term survival.The selection of anesthesia can be personalized without significantly affecting periop-erative or oncologic outcomes.展开更多
Hydraulic fracturing techniques are commonly used to enhance the production of tight reservoirs.Generally,the effect of hydraulic fracturing can be appraised through hydraulic fracturing experiments in the laboratory,...Hydraulic fracturing techniques are commonly used to enhance the production of tight reservoirs.Generally,the effect of hydraulic fracturing can be appraised through hydraulic fracturing experiments in the laboratory,in which acoustic emission(AE)is often used to monitor the fracturing process.At present,the number of AE events and spatial distribution of AE locations are the two main factors commonly conside red in hydraulic fracturing effectiveness evaluatio n.Howeve r,these commonly used evaluation methods overlook two crucial aspects:the connectivity among fractures and the tensile and shear properties of fractures induced by hydraulic fracturing.In this technical note,we consider the influence of these two previously overlooked aspects on the evaluation of hydraulic fracturing effectiveness by establishing a connected fracture model using AE data.The proposed approach links up AE events based on their spatio-temporal relationship and builds a fracture network called the connection model.Then,the characteristic of the fracture network is represented by the fractal dimension to reveal the complexity of fractures in the network.We extract the tensile-shear properties of each fracture based on the inversion of AE events'focal mechanism.Finally,based on the pre-known fracturing effectiveness of a fracture network,we compare the connection model of AE events in several triaxial hydraulic experiments.Our findings indicate that a comprehensive evaluation of hydraulic fracturing effectiveness can be achieved by considering both the connectivity of AE locations and the tensile-shear properties of AE events.This work aims to provide a more rational method for characterizing rock fracture networks and evaluating rock fracturing effects using AE data.展开更多
This paper employs Granger causality analysis and the generalized impulse response function(GIRF)to study the higher-order moment spillover effects among Bitcoin,stock markets,and foreign exchange markets in the U.S.U...This paper employs Granger causality analysis and the generalized impulse response function(GIRF)to study the higher-order moment spillover effects among Bitcoin,stock markets,and foreign exchange markets in the U.S.Using intraday high-frequency data,the research focuses on the interactions across higher-order moments,including volatility,jumps,skewness,and kurtosis.The results reveal significant bidirectional spillover effects between Bitcoin and traditional financial assets,particularly in terms of volatility and jump behavior,indicating that the cryptocurrency market has become a crucial component of global financial risk transmission.This study provides new theoretical perspectives and policy recommendations for global asset allocation,market regulation,and risk management,underscoring the importance of proactive management measures in addressing the complex risk interactions between cryptocurrencies and traditional financial markets.展开更多
With the evolution of society,education reform continues to progress,and increasing attention is being paid to the learning outcomes and overall academic quality of junior high school students.As a core subject at thi...With the evolution of society,education reform continues to progress,and increasing attention is being paid to the learning outcomes and overall academic quality of junior high school students.As a core subject at this stage,the effectiveness of Chinese language teaching directly influences students’overall academic performance.Therefore,enhancing the effectiveness of junior high school Chinese classroom teaching has become a key focus for educators.Against this backdrop,this paper explores the significance of building an effective classroom environment in junior high school Chinese teaching and provides an in-depth analysis of strategies to improve teaching effectiveness.The goal is to assist teachers in creating efficient classrooms,fostering students’interest in learning,enhancing their overall competence in Chinese,and ultimately improving teaching quality to contribute to the overall advancement of Chinese language education.展开更多
Chronic obstructive pulmonary disease(COPD)is a common chronic respiratory disease that severely affects patients’quality of life.Current clinical treatments primarily rely on medication,with limited rehabilitation o...Chronic obstructive pulmonary disease(COPD)is a common chronic respiratory disease that severely affects patients’quality of life.Current clinical treatments primarily rely on medication,with limited rehabilitation options and uncertain efficacy.Home-based exercise rehabilitation,as a non-pharmacological therapy,can promote the improvement of respiratory muscle function and cardiopulmonary endurance,exerting a positive preventive effect on COPD.However,due to factors such as the home environment and lack of health knowledge,COPD patients face numerous difficulties in accepting home-based exercise rehabilitation.This article reviews domestic and international research on the feasibility and effectiveness of home-based exercise rehabilitation for COPD,aiming to provide references for medical workers to better implement home-based exercise rehabilitation for COPD,assist patients in performing rehabilitation exercises at home,improve their quality of life,reduce hospitalization rates,and lower medical costs.展开更多
Objective The objective of our study was to evaluate the vaccine effectiveness(VE)of the pentavalent rotavirus vaccine(RV5)among<5-year-old children in three provinces of China during 2020-2024 via a propensity sco...Objective The objective of our study was to evaluate the vaccine effectiveness(VE)of the pentavalent rotavirus vaccine(RV5)among<5-year-old children in three provinces of China during 2020-2024 via a propensity score-matched test-negative case-control study.Methods Electronic health records and immunization information systems were used to obtain data on acute gastroenteritis(AGE)cases tested for rotavirus(RV)infection.RV-positive cases were propensity score matched with RV-negative controls for age,visit month,and province.Results The study included 27,472 children with AGE aged 8 weeks to 4 years at the time of AGE diagnosis;7.98%(2,192)were RV-positive.The VE(95%confidence interval,CI)of 1-2 and 3 doses of RV5 against any medically attended RV infection(inpatient or outpatient)was 57.6%(39.8%,70.2%)and 67.2%(60.3%,72.9%),respectively.Among children who received the 3rd dose before turning 5 months of age,3-dose VE decreased from 70.4%(53.9%,81.1%)(<5 months since the 3rd dose)to 63.0%(49.1%,73.0%)(≥1 year since the 3rd dose).The three-dose VE rate was 69.4%(41.3%,84.0%)for RVGE hospitalization and 57.5%(38.9%,70.5%)for outpatient-only medically attended RVGE.Conclusion Three-dose RV5 VE against rotavirus gastroenteritis(RVGE)in children aged<5 years was higher than 1-2-dose VE.Three-dose VE decreased with time since the 3rd dose in children who received the 3rd dose before turning five months of age,but remained above 60%for at least one year.VE was higher for RVGE hospitalizations than for medically attended outpatient visits.展开更多
Background:Transrectal(TR)and transperineal(TP)biopsies are commonly used methods for diagnosing prostate cancer.However,their comparative effectiveness in conjunction with machine learning(ML)techniques remains under...Background:Transrectal(TR)and transperineal(TP)biopsies are commonly used methods for diagnosing prostate cancer.However,their comparative effectiveness in conjunction with machine learning(ML)techniques remains underexplored.This study aimed to evaluate the predictive accuracy of ML algorithms in detecting prostate cancer using data derived from TR and TP biopsies.Methods:The clinical records of patients who underwent prostate biopsy at King Saud University Medical City and King Faisal Specialist Hospital and Research Centerin Riyadh,Saudi Arabia,between 2018 and 2025 were analyzed.Data were used to train and testMLmodels,including eXtreme Gradient Boosting(XGBoost),Decision Tree,Random Forest,and Extra Trees.Results:The two datasets are comparable.The models demonstrated exceptional performance,achieving accuracies of up to 96.49%and 95.56%on TP and TR biopsy datasets,respectively.The area under the curve(AUC)values were also high,reaching 0.9988 for TP and 0.9903 for TR biopsy predictions.Conclusion:These findings highlight the potential of MLto enhance the diagnostic accuracy of prostate cancer detection irrespective of the biopsy method.However,TP biopsy data showed marginally higher accuracy,possibly because of the lower risk of contamination.While ML holds great promise for transforming prostate cancer care,further research is needed to address limitations.Collaboration between clinicians,data scientists,and researchers is crucial to ensure the clinical relevance and interpretability of ML models.展开更多
This research investigates the effectiveness of climate-related development aid in Indonesia’s climate mitigation.Specific objectives include assessing the contribution of official development assistance(ODA)to reduc...This research investigates the effectiveness of climate-related development aid in Indonesia’s climate mitigation.Specific objectives include assessing the contribution of official development assistance(ODA)to reducing CO_(2) emissions and evaluating the implementation of the Busan Principles of aid effectiveness to achieve Indonesia’s mitigation priorities and targets.We utilize a new primary dataset based on interviews with the most knowledgeable stakeholders of ODA on climate change mitigation.Additionally,we use secondary data from the annual Rio Marker and the Common Reporting Standard data of the Organization for Economic Co-operation and Development.The results show a significant correlation between climate-related development aid and CO_(2) emission reduction in Indonesia.Additionally,the implementation of the Busan Principles enhances aid management by fostering project ownership and increasing the involvement of civil society and private sector.The study has implications for devising an effective climate change mitigation strategy for Indonesia.It is suggested that the government of Indonesia exercise greater flexibility and dynamism in engaging with development partners.展开更多
Evaluation of backfilling effectiveness plays a crucial role in the geological environment management and restoration of abandoned open-pit quarries,providing a scientific basis for subsequent greening efforts.Backfil...Evaluation of backfilling effectiveness plays a crucial role in the geological environment management and restoration of abandoned open-pit quarries,providing a scientific basis for subsequent greening efforts.Backfill soil,predominantly composed of silty clay,demonstrates high water retention capacity and elevated moisture content,leading to a pronounced resistivity contrast with the bedrock exposed by quarrying activities.To investigate the distribution of backfill soil subsurface and assess backfilling effectiveness in the study area,this study conducted a comprehensive geophysical investigation utilizing the high-density electrical resistivity tomography(ERT).A total of 19 ERT survey lines were deployed across three distinct areas in Liuyao Village,Huaibei City,Anhui Province,China.The inversion results,derived from both two-dimensional(2D)and three-dimensional(3D),reveal distinct electrical properties of the subsurface materials:the backfill soil layer shows low resistivity features,the fill stone layer exhibits medium to high resistivity,and the bedrock shows the highest resistivity.The 2D inversion results,from the data measured using the Wenner array effectively capture the spatial distribution and structural features of the backfill soil layer.The findings indicate a gradual east-west thinning of the clay layer within the quarry.Furthermore,the northern pit area exhibits a uniform distribution of backfill soil layer,indicative of effective backfilling operations.In contrast,the southern pit area lacks a well-defined clay layer,suggesting suboptimal backfilling effectiveness.展开更多
Objective:To explore the impact of parenting care guidance combined with preventive healthcare on child family parenting.Methods:Ninety-two child families were included as research subjects and randomly divided into a...Objective:To explore the impact of parenting care guidance combined with preventive healthcare on child family parenting.Methods:Ninety-two child families were included as research subjects and randomly divided into a control group and an observation group,with 46 cases in each group.The former implemented basic preventive healthcare,while the latter simultaneously carried out parenting care guidance combined with preventive healthcare.The intervention results of the two groups were compared.Results:The observation group had a higher awareness rate of family parenting knowledge and a higher formation rate of healthy behaviors,P<0.05.At the same time,parents’parenting anxiety scores were lower,and family health management ability scores were higher,P<0.05.Moreover,the observation group showed higher scores in children’s social skills,P<0.05.Conclusion:Parenting care guidance combined with preventive healthcare can effectively improve the status of child family parenting,and it is worthy of promotion and application.展开更多
The study analyzed the effect of dental caries prevention strategies on caries incidence,oral hygiene status and parental satisfaction.The results showed that the comprehensive application of multiple prevention strat...The study analyzed the effect of dental caries prevention strategies on caries incidence,oral hygiene status and parental satisfaction.The results showed that the comprehensive application of multiple prevention strategies can significantly reduce the incidence of dental caries,improve oral hygiene and improve parental satisfaction.By reviewing the literature at home and abroad in recent years,this paper aims to explore the effect of childhood caries prevention strategies in oral clinical application,and provides scientific basis and practical guidance for the prevention of childhood caries in oral clinical work.展开更多
The impact of Y content on the microstructure,mechanical properties,and electromagnetic interference shielding effectiveness(EMI SE)of the Mg-6Zn-xY-1La-0.5Zr alloy was investigated.After the extrusion treatment of Mg...The impact of Y content on the microstructure,mechanical properties,and electromagnetic interference shielding effectiveness(EMI SE)of the Mg-6Zn-xY-1La-0.5Zr alloy was investigated.After the extrusion treatment of Mg-6Zn-xY-1La-0.5Zr alloy,the large grains that did not experience dynamic recrystallization were elongated along the extrusion direction,and the small-sized dynamic recrystallized grains were distributed around the large grains.The Mg-6Zn-1Y-1La-0.5Zr alloy demonstrated a favorable balance between strength and plasticity,exhibiting ultimate tensile strength,yield strength,and elongation values of 332.3 MPa,267.3 MPa,and 16.2%,respectively.Moreover,the EMI SE within the frequency range of 30-1500 MHz changes from 79 to 110 dB,aligning with the electromagnetic shielding requirements of many high-strength applications.展开更多
文摘Background:While the treatment of metastatic renal cell carcinoma(mRCC)is evolving due to immune checkpoint inhibitors(ICIs),optimal strategies for later lines of therapy have yet to be defined.The combination of lenvatinib and everolimus represents a viable option,and the present review aimed to summarize its activity,effectiveness,and safety.Methods:A systematic review of the literature was conducted using PubMed,targeting studies published between 2018 and 2025.Eligible studies included English-language prospective and retrospective trials reporting survival outcomes in mRCC patients treated with lenvatinib and everolimus after at least one ICI-containing regimen.Results:Nine studies met the inclusion criteria,encompassing a total of 441 patients.The lenvatinib and everolimus combination was primarily used in the third and subsequent lines of therapy.Median overall survival ranged from 7.5 to 24.5 months,while median progression-free survival was more consistent,between 6.1 and 6.7 months,except for one study reporting 12.9 months.Objective response rates varied widely(14.0%–55.7%).Adverse events of grade≥3 did not exceed the expected rate,with diarrhoea and proteinuria as the most reported events.Dose reductions and treatment discontinuations due to toxicity occurred but were generally lower than in prior pivotal trials.Conclusions:Real-world evidence suggests that lenvatinib and everolimus represent an effective and safe option after ICI failure in mRCC patients.Nevertheless,the lack of randomized phase III trials and the heterogeneity of existing studies highlight the need for more robust prospective research to guide post-ICI therapeutic strategies.
基金supported by the National Natural Science Foundation of China(Nos.62101020 and 62141405)the Special Scientific Research Project of Civil Aircraft,China(No.MJZ5-2N22).
文摘As the proportion of composite materials used in aircraft continues to increase, the electromagnetic Shielding Effectiveness (SE) of these materials becomes a critical factor in the electromagnetic safety design of aircraft structures. The assessment of electromagnetic SE for Slotted Composite Structures(SCSs) is particularly challenging due to their complex geometries and there remains a lack of suitable models for accurately predicting the SE performance of these intricate configurations. To address this issue, this paper introduces SCS-Net, a Deep Neural Network (DNN) method designed to accurately predict the SE of SCS. This method considers the impacts of various structural parameters, material properties and incident wave parameters on the SE of SCSs. In order to better model the SCS, an improved Nicolson-Ross-Weir (NRW) method is introduced in this paper to provide an equivalent flat structure for the SCS and to calculate the electromagnetic parameters of the equivalent structure. Additionally, the prediction of SE via DNNs is limited by insufficient test data, which hinders support for large-sample training. To address the issue of limited measured data, this paper develops a Measurement-Computation Fusion (MCF) dataset construction method. The predictions based on the simulation results show that the proposed method maintains an error of less than 0.07 dB within the 8–10 GHz frequency range. Furthermore, a new loss function based on the weighted L1-norm is established to improve the prediction accuracy for these parameters. Compared with traditional loss functions, the new loss function reduces the maximum prediction error for equivalent electromagnetic parameters by 47%. This method significantly improves the prediction accuracy of SCS-Net for measured data, with a maximum improvement of 23.88%. These findings demonstrate that the proposed method enables precise SE prediction and design for composite structures while reducing the number of test samples needed.
文摘Africa can draw inspiration from China’s multi-pronged approach to fighting poverty.Without a doubt,China’s poverty alleviation is a success that has not been achieved by any country I can think of.There is so much that Africa can learn from China in this regard.African nations can draw inspiration from the effectiveness of China’s governance in delivering results.
文摘BACKGROUND Blonanserin,a novel antipsychotic,has demonstrated efficacy in treating both positive and negative symptoms.However,limited research exists on its dose-dependent effectiveness and safety in patients with and without prominent nega-tive symptoms(PNS).AIM To evaluate the effectiveness and safety of blonanserin monotherapy for first-episode schizophrenia in real-world clinical settings and to explore the efficacy and safety of different doses of blonanserin for patients with PNS and without PNS.METHODS A 12-week,multicenter,prospective post-marketing surveillance was conducted.In this study,we included patients with first-episode schizophrenia who received blonanserin monotherapy.Patients were divided into those with PNS and without PNS,based on the Brief Psychiatric Rating Scale(BPRS)negative symptoms subscale scores.Additionally,patients were labeled as high-dose and low-dose was evaluated through the incidence of adverse drug reactions(ADRs).RESULTS A total of 653 patients were included in the analysis,with 613 completing the study.The BPRS total score decreased significantly from 47.94±16.31 at baseline to 26.88±9.47 at 12 weeks(P<0.001).A significant interaction of PNS×dose×time was observed for BPRS total scores(F=3.47,P=0.040)and negative symptom subscale scores(F=6.76,P=0.002).In the PNS group,the high-dose group showed greater reductions in BPRS total scores(P=0.001)and negative symptom subscale scores(P=0.003)than the low-dose group in week 12.In the without PNS group,no significant difference was observed between the high-dose and low-dose groups at any visit.Most adverse reactions were mild or moderate,with extrapyramidal symptoms(9.3%)being most common;1.5%of patients gained≥7%body weight at 12 weeks.CONCLUSION Blonanserin effectively alleviated the clinical symptoms of first-episode schizophrenia with an acceptable safety profile.High-dose blonanserin is particularly beneficial for patients with PNS in the acute phase of first-episode schizophrenia.However,due to the limitation of ADR reporting the real world,the ADR incidence observed in this study may be underestimated.
文摘Objective:To evaluate the value of humanistic nursing care during pediatric nebulization treatment.Methods:From January 2024 to June 2024,250 pediatric patients receiving nebulization treatment were given routine care and included in the control group.From July 2024 to December 2024,250 pediatric patients receiving nebulization treatment were given full humanistic care by nurses and included in the observation group.The differences in patient compliance,symptom resolution time,parental satisfaction,and emotional scores were compared.Results:The compliance of pediatric nebulization patients in the observation group was higher than that in the control group(P<0.05).The disappearance time of inflammation,cough,expectoration,fever,and hospital stay in the observation group were shorter than those in the control group(P<0.05).Parental satisfaction with pediatric nebulization in the observation group was higher than that in the control group(P<0.05).The scores of anxiety(SAS)and depression(SDS)among parents of pediatric nebulization patients in the observation group were lower than those in the control group(P<0.05).Conclusion:The application of nurses’full humanistic care in pediatric nebulization treatment can promote the resolution of respiratory system symptoms,optimize patients’lung function,improve patient cooperation,and is highly effective and feasible.
文摘Introduction:This study examined the application of targeted education strategies for nursing students of different MBTI types to enhance students’theoretical and practical grades.Nursing students have different personalities,therefore learning behaviors are significantly different.It is worth exploring whether teaching methods influence these differences and can be improved through specific education strategies.Methods:Experimental research methods and Questionnaire survey methods were used to test the effect of MBTI with different personality types on the implementation of targeted education strategies.Results:There was a significant correlation between MBTI and teaching effect(p<0.005).Targeted changes in education strategies could effectively improve teaching effect(p<0.005),improve teaching quality(p<0.005),and improve nursing students’professional identity(p<0.005).Conclusion:The results showed that targeted changes in education strategies can effectively improve teaching effectiveness,teaching quality,and nursing students’sense of occupational identity.
基金supported by Muhammadiyah Research Grant (RisetMu) Batch Ⅵ (No. 1687.186/PD/I.3/D/2022)
文摘Objective:This study aims to determine the effectiveness of giving a combination of Fe tablets and beetroot juice in increasing hemoglobin(Hb)levels of pregnant women with anemia in the Mataram City area.Methods:This study was designed with quasi-experimental design with pre-test and post-test with control design.The location of this study was conducted in the city of Mataram on pregnant women with anemia.The sample of this study was pregnant women with mild anemia based on inclusion and exclusion criteria,divided into 2 groups:a control group and a treatment group of 15 respondents each,bringing the total respondents to 30 people.Analysis of Hb level measurement results was carried out using the independent sample t-test.Results:The results obtained in the treatment group(combination of beet juice and Fe tablets)were the mean pre-test of 9.93 mg/dL and post-test of 11.90 mg/dL(P-value=0.000),which means there is effectiveness in increasing hemoglobin levels while in the control group.Comparison of increased Hb levels of the control group and significantly different treatments marked by a P value of 0.001.Conclusions:the combination of Fe tablets and beetroot juice is effective in increasing Hb levels of pregnant women with anemia in the Mataram City area.
文摘Surgical nursing education has long grappled with a tension between traditional lecture-based models and actual practice needs.Students have difficulty converting theory into functional nursing skills in the passive format of knowledge acquisition.As medical education concepts have been renewed,the goals of educating nursing talents with independent judgment and adaptability to clinical practice have evolved into a significant direction of teaching reform.To this end,the“flipped classroom”model that blends lecture with discussion,through the mechanism of“internalized absorption”and“discussion”in the classroom,represents both a new teaching model that meets the need for integration of surgical nursing knowledge and an approach to skill application.This model reconstructs the teaching and learning process by providing a bridge for students to transfer from understanding knowledge to clinical thinking,thus providing a path forward for the dilemma of the separation of theory and practice in surgical nursing education.
文摘BACKGROUND Gastric cancer is a major global health issue,and the perioperative period critic-ally influences patient outcomes.The different effects of sevoflurane inhalation anesthesia and propofol total intravenous anesthesia on intraoperative stability,postoperative complications,and long-term oncologic outcomes in patients with gastric cancer undergoing radical gastrectomy remain unclear.AIM To compare the effects of sevoflurane inhalation anesthesia and propofol total in-travenous anesthesia on clinical outcomes,including intraoperative indicators,postoperative complications,adverse effects,pain scores,and survival.METHODS This single-center retrospective cohort study included 204 patients who underw-ent radical gastrectomy for gastric cancer from February 2019 to December 2022.Patients were assigned to either the sevoflurane group(n=103)or the propofol group(n=101)based on intraoperative anesthetic regimen.Standardized protoc-ols for anesthesia management,intraoperative monitoring,and postoperative analgesia were applied.Baseline characteristics;intraoperative metrics;adverse events;complications;Visual Analog Scale(VAS)scores at 2,4,6,24,and 48 hours;and survival outcomes were retrospectively collected.Group comparisons were performed usingχ2 for categorical variables,t test for continuous variables,RESULTS Baseline demographic and clinical characteristics were similar between groups.No significant differences were observed in intraoperative indicators or most 30-day postoperative outcomes,including length of stay,emergency department visits,and readmission rates.The propofol group showed elevated mean VAS pain score at 24 hours postoperatively,but no differences were found at other time points.The propofol group also had significantly higher postoperative nausea incidence and transiently higher systolic/diastolic blood pressure and heart rate at the time of incision than the sevoflurane group.No significant differences were seen in overall rates or severity of postoperative complications,intraoperative adverse events,or in overall survival and progression-free survival.CONCLUSION In patients undergoing radical gastrectomy for gastric cancer,sevoflurane and propofol anesthesia demonstrated similar profiles regarding intraoperative safety,postoperative complications,adverse events,postoperative pain,and long-term survival.The selection of anesthesia can be personalized without significantly affecting periop-erative or oncologic outcomes.
基金financial support from the subprojects of the Natural Science Foundation of China(No.42302326)the Shenzhen Science and Technology Program(JCYJ20220530113612028)+1 种基金the National Key Research and Development Program of China(Grant No.2023YFC3707905)the Fundamental Research Funds for the Central Universities(JZ2025HGTB0191)。
文摘Hydraulic fracturing techniques are commonly used to enhance the production of tight reservoirs.Generally,the effect of hydraulic fracturing can be appraised through hydraulic fracturing experiments in the laboratory,in which acoustic emission(AE)is often used to monitor the fracturing process.At present,the number of AE events and spatial distribution of AE locations are the two main factors commonly conside red in hydraulic fracturing effectiveness evaluatio n.Howeve r,these commonly used evaluation methods overlook two crucial aspects:the connectivity among fractures and the tensile and shear properties of fractures induced by hydraulic fracturing.In this technical note,we consider the influence of these two previously overlooked aspects on the evaluation of hydraulic fracturing effectiveness by establishing a connected fracture model using AE data.The proposed approach links up AE events based on their spatio-temporal relationship and builds a fracture network called the connection model.Then,the characteristic of the fracture network is represented by the fractal dimension to reveal the complexity of fractures in the network.We extract the tensile-shear properties of each fracture based on the inversion of AE events'focal mechanism.Finally,based on the pre-known fracturing effectiveness of a fracture network,we compare the connection model of AE events in several triaxial hydraulic experiments.Our findings indicate that a comprehensive evaluation of hydraulic fracturing effectiveness can be achieved by considering both the connectivity of AE locations and the tensile-shear properties of AE events.This work aims to provide a more rational method for characterizing rock fracture networks and evaluating rock fracturing effects using AE data.
文摘This paper employs Granger causality analysis and the generalized impulse response function(GIRF)to study the higher-order moment spillover effects among Bitcoin,stock markets,and foreign exchange markets in the U.S.Using intraday high-frequency data,the research focuses on the interactions across higher-order moments,including volatility,jumps,skewness,and kurtosis.The results reveal significant bidirectional spillover effects between Bitcoin and traditional financial assets,particularly in terms of volatility and jump behavior,indicating that the cryptocurrency market has become a crucial component of global financial risk transmission.This study provides new theoretical perspectives and policy recommendations for global asset allocation,market regulation,and risk management,underscoring the importance of proactive management measures in addressing the complex risk interactions between cryptocurrencies and traditional financial markets.
文摘With the evolution of society,education reform continues to progress,and increasing attention is being paid to the learning outcomes and overall academic quality of junior high school students.As a core subject at this stage,the effectiveness of Chinese language teaching directly influences students’overall academic performance.Therefore,enhancing the effectiveness of junior high school Chinese classroom teaching has become a key focus for educators.Against this backdrop,this paper explores the significance of building an effective classroom environment in junior high school Chinese teaching and provides an in-depth analysis of strategies to improve teaching effectiveness.The goal is to assist teachers in creating efficient classrooms,fostering students’interest in learning,enhancing their overall competence in Chinese,and ultimately improving teaching quality to contribute to the overall advancement of Chinese language education.
文摘Chronic obstructive pulmonary disease(COPD)is a common chronic respiratory disease that severely affects patients’quality of life.Current clinical treatments primarily rely on medication,with limited rehabilitation options and uncertain efficacy.Home-based exercise rehabilitation,as a non-pharmacological therapy,can promote the improvement of respiratory muscle function and cardiopulmonary endurance,exerting a positive preventive effect on COPD.However,due to factors such as the home environment and lack of health knowledge,COPD patients face numerous difficulties in accepting home-based exercise rehabilitation.This article reviews domestic and international research on the feasibility and effectiveness of home-based exercise rehabilitation for COPD,aiming to provide references for medical workers to better implement home-based exercise rehabilitation for COPD,assist patients in performing rehabilitation exercises at home,improve their quality of life,reduce hospitalization rates,and lower medical costs.
基金the Study on Vaccine Application Evaluation Strategies and Capacity Building (INV-006373)the National Key R&D Program of China(2024YFC2310604)
文摘Objective The objective of our study was to evaluate the vaccine effectiveness(VE)of the pentavalent rotavirus vaccine(RV5)among<5-year-old children in three provinces of China during 2020-2024 via a propensity score-matched test-negative case-control study.Methods Electronic health records and immunization information systems were used to obtain data on acute gastroenteritis(AGE)cases tested for rotavirus(RV)infection.RV-positive cases were propensity score matched with RV-negative controls for age,visit month,and province.Results The study included 27,472 children with AGE aged 8 weeks to 4 years at the time of AGE diagnosis;7.98%(2,192)were RV-positive.The VE(95%confidence interval,CI)of 1-2 and 3 doses of RV5 against any medically attended RV infection(inpatient or outpatient)was 57.6%(39.8%,70.2%)and 67.2%(60.3%,72.9%),respectively.Among children who received the 3rd dose before turning 5 months of age,3-dose VE decreased from 70.4%(53.9%,81.1%)(<5 months since the 3rd dose)to 63.0%(49.1%,73.0%)(≥1 year since the 3rd dose).The three-dose VE rate was 69.4%(41.3%,84.0%)for RVGE hospitalization and 57.5%(38.9%,70.5%)for outpatient-only medically attended RVGE.Conclusion Three-dose RV5 VE against rotavirus gastroenteritis(RVGE)in children aged<5 years was higher than 1-2-dose VE.Three-dose VE decreased with time since the 3rd dose in children who received the 3rd dose before turning five months of age,but remained above 60%for at least one year.VE was higher for RVGE hospitalizations than for medically attended outpatient visits.
文摘Background:Transrectal(TR)and transperineal(TP)biopsies are commonly used methods for diagnosing prostate cancer.However,their comparative effectiveness in conjunction with machine learning(ML)techniques remains underexplored.This study aimed to evaluate the predictive accuracy of ML algorithms in detecting prostate cancer using data derived from TR and TP biopsies.Methods:The clinical records of patients who underwent prostate biopsy at King Saud University Medical City and King Faisal Specialist Hospital and Research Centerin Riyadh,Saudi Arabia,between 2018 and 2025 were analyzed.Data were used to train and testMLmodels,including eXtreme Gradient Boosting(XGBoost),Decision Tree,Random Forest,and Extra Trees.Results:The two datasets are comparable.The models demonstrated exceptional performance,achieving accuracies of up to 96.49%and 95.56%on TP and TR biopsy datasets,respectively.The area under the curve(AUC)values were also high,reaching 0.9988 for TP and 0.9903 for TR biopsy predictions.Conclusion:These findings highlight the potential of MLto enhance the diagnostic accuracy of prostate cancer detection irrespective of the biopsy method.However,TP biopsy data showed marginally higher accuracy,possibly because of the lower risk of contamination.While ML holds great promise for transforming prostate cancer care,further research is needed to address limitations.Collaboration between clinicians,data scientists,and researchers is crucial to ensure the clinical relevance and interpretability of ML models.
文摘This research investigates the effectiveness of climate-related development aid in Indonesia’s climate mitigation.Specific objectives include assessing the contribution of official development assistance(ODA)to reducing CO_(2) emissions and evaluating the implementation of the Busan Principles of aid effectiveness to achieve Indonesia’s mitigation priorities and targets.We utilize a new primary dataset based on interviews with the most knowledgeable stakeholders of ODA on climate change mitigation.Additionally,we use secondary data from the annual Rio Marker and the Common Reporting Standard data of the Organization for Economic Co-operation and Development.The results show a significant correlation between climate-related development aid and CO_(2) emission reduction in Indonesia.Additionally,the implementation of the Busan Principles enhances aid management by fostering project ownership and increasing the involvement of civil society and private sector.The study has implications for devising an effective climate change mitigation strategy for Indonesia.It is suggested that the government of Indonesia exercise greater flexibility and dynamism in engaging with development partners.
基金Supported by National Key Research and Development Program of China(No.2023YFC3707901)。
文摘Evaluation of backfilling effectiveness plays a crucial role in the geological environment management and restoration of abandoned open-pit quarries,providing a scientific basis for subsequent greening efforts.Backfill soil,predominantly composed of silty clay,demonstrates high water retention capacity and elevated moisture content,leading to a pronounced resistivity contrast with the bedrock exposed by quarrying activities.To investigate the distribution of backfill soil subsurface and assess backfilling effectiveness in the study area,this study conducted a comprehensive geophysical investigation utilizing the high-density electrical resistivity tomography(ERT).A total of 19 ERT survey lines were deployed across three distinct areas in Liuyao Village,Huaibei City,Anhui Province,China.The inversion results,derived from both two-dimensional(2D)and three-dimensional(3D),reveal distinct electrical properties of the subsurface materials:the backfill soil layer shows low resistivity features,the fill stone layer exhibits medium to high resistivity,and the bedrock shows the highest resistivity.The 2D inversion results,from the data measured using the Wenner array effectively capture the spatial distribution and structural features of the backfill soil layer.The findings indicate a gradual east-west thinning of the clay layer within the quarry.Furthermore,the northern pit area exhibits a uniform distribution of backfill soil layer,indicative of effective backfilling operations.In contrast,the southern pit area lacks a well-defined clay layer,suggesting suboptimal backfilling effectiveness.
文摘Objective:To explore the impact of parenting care guidance combined with preventive healthcare on child family parenting.Methods:Ninety-two child families were included as research subjects and randomly divided into a control group and an observation group,with 46 cases in each group.The former implemented basic preventive healthcare,while the latter simultaneously carried out parenting care guidance combined with preventive healthcare.The intervention results of the two groups were compared.Results:The observation group had a higher awareness rate of family parenting knowledge and a higher formation rate of healthy behaviors,P<0.05.At the same time,parents’parenting anxiety scores were lower,and family health management ability scores were higher,P<0.05.Moreover,the observation group showed higher scores in children’s social skills,P<0.05.Conclusion:Parenting care guidance combined with preventive healthcare can effectively improve the status of child family parenting,and it is worthy of promotion and application.
文摘The study analyzed the effect of dental caries prevention strategies on caries incidence,oral hygiene status and parental satisfaction.The results showed that the comprehensive application of multiple prevention strategies can significantly reduce the incidence of dental caries,improve oral hygiene and improve parental satisfaction.By reviewing the literature at home and abroad in recent years,this paper aims to explore the effect of childhood caries prevention strategies in oral clinical application,and provides scientific basis and practical guidance for the prevention of childhood caries in oral clinical work.
基金supported from the National Key R&D Program of China(No.2021YFB3701100)the National Natural Science Foundation of China(No.52225101)+1 种基金the Fundamental Research Funds for the Central Universities of China(Nos.2023CDJYXTD-002,2020CDJDPT001)the Graduate Research and Innovation Foundation of Chongqing,China(No.CYB23037).
文摘The impact of Y content on the microstructure,mechanical properties,and electromagnetic interference shielding effectiveness(EMI SE)of the Mg-6Zn-xY-1La-0.5Zr alloy was investigated.After the extrusion treatment of Mg-6Zn-xY-1La-0.5Zr alloy,the large grains that did not experience dynamic recrystallization were elongated along the extrusion direction,and the small-sized dynamic recrystallized grains were distributed around the large grains.The Mg-6Zn-1Y-1La-0.5Zr alloy demonstrated a favorable balance between strength and plasticity,exhibiting ultimate tensile strength,yield strength,and elongation values of 332.3 MPa,267.3 MPa,and 16.2%,respectively.Moreover,the EMI SE within the frequency range of 30-1500 MHz changes from 79 to 110 dB,aligning with the electromagnetic shielding requirements of many high-strength applications.
