Artificial intelligence promotes shared decision-making through recommending tests to febrile pediatric outpatients

BACKGROUND:To promote the shared decision-making(SDM)between patients and doctors in pediatric outpatient departments,this study was designed to validate artificial intelligence(AI)-initiated medical tests for children with fever.METHODS:We designed an AI model,named Xiaoyi,to suggest necessary tests for a febrile child before visiting a pediatric outpatient clinic.We calculated the sensitivity,specificity,and F1 score to evaluate the efficacy of Xiaoyi’s recommendations.The patients were divided into the rejection and acceptance groups.Then we analyzed the rejected examination items in order to obtain the corresponding reasons.RESULTS:We recruited a total of 11,867 children with fever who had used Xiaoyi in outpatient clinics.The recommended examinations given by Xiaoyi for 10,636(89.6%)patients were qualified.The average F1 score reached 0.94.A total of 58.4%of the patients accepted Xiaoyi’s suggestions(acceptance group),and 41.6%refused(rejection group).Imaging examinations were rejected by most patients(46.7%).The tests being time-consuming were rejected by 2,133 patients(43.2%),including rejecting pathogen studies in 1,347 patients(68.5%)and image studies in 732 patients(31.8%).The difficulty of sampling was the main reason for rejecting routine tests(41.9%).CONCLUSION:Our model has high accuracy and acceptability in recommending medical tests to febrile pediatric patients,and is worth promoting in facilitating SDM.

Genome-wide investigation to assess copy number variants in the Italian local chicken population

Background Copy number variants(CNV)hold significant functional and evolutionary importance.Numerous ongoing CNV studies aim to elucidate the etiology of human diseases and gain insights into the population structure of livestock.High-density chips have enabled the detection of CNV with increased resolution,leading to the identification of even small CNV.This study aimed to identify CNV in local Italian chicken breeds and investigate their distribution across the genome.Results Copy number variants were mainly distributed across the first six chromosomes and primarily associated with loss type CNV.The majority of CNV in the investigated breeds were of types 0 and 1,and the minimum length of CNV was significantly larger than that reported in previous studies.Interestingly,a high proportion of the length of chromosome 16 was covered by copy number variation regions(CNVR),with the major histocompatibility complex being the likely cause.Among the genes identified within CNVR,only those present in at least five animals across breeds(n=95)were discussed to reduce the focus on redundant CNV.Some of these genes have been associated to functional traits in chickens.Notably,several CNVR on different chromosomes harbor genes related to muscle development,tissue-specific biological processes,heat stress resistance,and immune response.Quantitative trait loci(QTL)were also analyzed to investigate potential overlapping with the identified CNVR:54 out of the 95 gene-containing regions overlapped with 428 QTL associated to body weight and size,carcass characteristics,egg production,egg components,fat deposition,and feed intake.Conclusions The genomic phenomena reported in this study that can cause changes in the distribution of CNV within the genome over time and the comparison of these differences in CNVR of the local chicken breeds could help in preserving these genetic resources.

Vitamin D deficiency among outpatients and hospitalized patients with diabetic foot ulcers:A systematic review and meta-analysis

BACKGROUND The definition of diabetic foot syndrome(DFS)varies depending on the location and resources.Few classifications are available according to the indication.DF ulcers and vitamin D deficiency are common diseases among patients with diabetes.Previous literature has shown an association between DF ulcer(DFU)and vitamin D deficiency.However,the available meta-0analysis was limited by substantial bias.AIM To investigate the association between DFUs and vitamin D levels.METHODS We searched PubMed,MEDLINE,and Cochrane Library,EBSCO,and Google Scholar for studies comparing vitamin D levels and DF.The keywords DFU,DFS,diabetic septic foot,vitamin D level,25-hydroxy vitamin D,vitamin D status,and vitamin D deficiency were used.The search engine was set for articles published during the period from inception to October 2022.A predetermined table was used to collect the study information.RESULTS Vitamin D level was lower among patients with DFU compared to their counterparts[odds ratio(OR):-5.77;95%confidence interval(CI):-7.87 to-3.66;χ2 was 84.62,mean difference,9;I2 for heterogeneity,89%;P<0.001 and P for overall effect<0.001].The results remained robust for hospitalized patients(OR:-6.3295%CI:-11.66 to-0.97;χ2 was 19.39;mean difference,2;I2 for heterogeneity,90%;P=0.02).CONCLUSION Vitamin D was lower among outpatients and hospitalized patients with DFUs.Further larger randomized controlled trials are needed.

Origin of Sexy Prime Numbers, Origin of Cousin Prime Numbers, Equations from Supposedly Prime Numbers, Origin of the Mersenne Number, Origin of the Fermat Number

We have found through calculations that the differences between the closest supposed prime numbers other than 2 and 3 defined in the articles are: 2;4: and 6. For those whose difference is equal to 6, we showed their origin then we classified them into two categories according to their classes, we showed in which context two prime numbers which differ from 6 are called sexy and in what context they are said real sexy prime. For those whose difference is equal to 4, we showed their origin then we showed that two prime numbers which differ from 4, that is to say two cousin prime numbers, are successive. We made an observation on the supposed prime numbers then we established two pairs of equations from this observation and deduced the origin of the Mersenne number and that of the Fermat number.

Preliminary Identification of a Prime Number Other Than 2 and 3, the Origin of Twin Prime Numbers, the Structure of the Chain of Prime Numbers and the Set of Prime Numbers Less Than a Given Integer

The application of the Euclidean division theorem for the positive integers allowed us to establish a set which contains all the prime numbers and this set we called it set of supposedly prime numbers and we noted it Esp. We subsequently established from the previous set the set of non-prime numbers (the set of numbers belonging to this set and which are not prime) denoted Enp. We then extracted from the set of supposedly prime numbers the numbers which are not prime and the set of remaining number constitutes the set of prime numbers denoted Ep. We have deduced from the previous set, the set of prime numbers between two natural numbers. We have explained during our demonstrations the origin of the twin prime numbers and the structure of the chain of prime numbers.

Study on the Risk Factors of Central Venous-Related Bloodstream Infection in Outpatients

Objective:To analyze the risk factors of catheter-related bloodstream infection in outpatients and propose feasible prevention and control measures.Methods:The medical records of outpatients with peripherally inserted central catheter(PICC)from January 2020 to December 2021 were selected for retrospective analysis,and the factors that may be related to the occurrence of catheter-related bloodstream infection were analyzed by logistic multivariate analysis.Results:The incidence rate of catheter-related bloodstream infection among the enrolled patients was 4.78%.It was found that age,duration of catheterization,catheter site,number of punctures,and diabetes were all risk factors for catheter-associated bloodstream infection,and the differences were statistically significant.Conclusion:Age,duration of catheterization,catheterization site,and diabetes are all risk factors for catheter-related bloodstream infection,and medical personnel should fully understand and learn more about these risk factors and actively develop countermeasures to reduce the risk of catheter-related bloodstream infection.

Outpatient management of obscure gastrointestinal bleeding:A new perspective in high-risk patients

Mid-gastrointestinal bleeding accounts for approximately 5%-10%of all gastrointestinal bleeding cases,and vascular lesions represent the most frequent cause.The rebleeding rate for these lesions is quite high(about 42%).We hereby recommend that scheduled outpatient management of these patients could reduce the risk of rebleeding episodes.

Construction of a New Model of Contactless Medical Services for Outpatients Based on the Project-Achieving Quality Control Circle

Objective: To carry out empirical research on the role of project-achieving quality control circle (QCC) in constructing a new model of contactless medical service for outpatients. Methods: A QCC, consisting of information office members from a grade A tertiary hospital in Wenzhou, was established to conduct a research project with the theme “Constructing a new model of contactless medical service based on outpatients’ experience.” According to the ten steps and PDCA cycle, an analysis was carried out before and after the QCC activities, focusing on improving pre-consultation services, providing steward-like services, and facilitating post-consultation management. Results: After the QCC activities, the mobile appointment rate, missed appointment rate, the proportion of smart check-ins, and the average check-in time were 55.68%, 4.02%, 39.75%, and 8.24 ± 3.66 min, respectively;in contrast, before the activities, they were 32.00%, 7.88%, 0.00%, and 14.96 ± 4.98 min, respectively;the difference between the two groups was statistically significant (χ2 = 3480.112, 4994.496;Fisher’s exact probability = 963788.570;t = 5.323, P < 0.001). Many experts have also visited the hospital to learn about this system, thus rendering social and economic benefits. Conclusion: Project-achieving QCC activities are suitable for complex situations, such as constructing a new model of contactless medical service, and can significantly improve outpatient service quality, enhance patients’ experience, and improve the abilities of circle members.

On the Number of Primes in the Interval (x, 2x) by an Elementary Method

An elementary formula to know the number of primes in the interval (x, 2x) close to the exact figure for a fixed x is given here. A new elementary equation is derived (a relation between prime numbers and composite numbers distributed in the interval [1, 2x]). An elementary method to know the number of primes in a given magnitude is suitably placed in the form of a general formula, and we have proved it. The general formula is applied to the terms of the equation, and a tactical simplification of the terms gives rise to an expression whose verification envisages scope for its further studies.

A novel Effective Panicle Number per Plant 4 haplotype enhances grain yield by coordinating panicle number and grain number in rice

Increasing effective panicle number per plant(EPN)is one approach to increase yield potential in rice.However,molecular mechanisms underlying EPN remain unclear.In this study,we integrated mapbased cloning and genome-wide association analysis to identify the EPN4 gene,which is allelic to NARROW LEAF1(NAL1).Overexpression lines containing the Teqing allele(TQ)of EPN4 had significantly increased EPN.NIL-EPN4^(TQ) in japonica(geng)cultivar Lemont(LT)exhibited significantly improved EPN but decreased grain number and flag leaf size relative to LT.Haplotype analysis indicated that accessions with EPN4-1 had medium EPN,medium grain number,and medium grain weight,but had the highest grain yield among seven haplotypes,indicating that EPN4-1 is an elite haplotype of EPN4 for positive coordination of the three components of grain yield.Furthermore,accessions carrying the combination of EPN4-1 and haplotype GNP1-6 of GNP1 for grain number per panicle showed higher grain yield than those with other allele combinations.Therefore,pyramiding of EPN4-1 and GNP1-6 could be a preferred approach to obtain high yield potential in breeding.

How Prime Numbers Are Interconnected and Built with Two Equations: Addition and Subtraction Rules the Function (6µ)

Are all prime numbers linked by four simple functions? Can we predict when a prime will appear in a sequence of primes? If we classify primes into two groups, Group 1 for all primes that appear before ζ (such that , for instance 5, ), an even number divisible by 3 and 2, and Group 2 for all primes that are after ζ (such that , for instance 7), then we find a simple function: for each prime in each group, , where n is any natural number. If we start a sequence of primes with 5 for Group 1 and 7 for Group 2, we can attribute a μ value for each prime. The μ value can be attributed to every prime greater than 7. Thus for Group 1, and . Using this formula, all the primes appear for , where μ is any natural number.

The wheat sucrose synthase gene TaSus1 is a determinant of grain number per spike

Some haplotypes of the sucrose synthase gene TaSus1 are associated with thousand-grain weight(TGW)in wheat(Triticum aestivum L.).However,no mutations have been identified within the gene to test this association.The effects of TaSus1 on grain number per spike(GNS)also are largely unknown.Our previous genome-wide association study identified TaSus-A1 as a candidate gene controlling fertile spikelet number per spike(FSN).In the present study,we generated two independent mutants for the three TaSus1 homoeologs by CRISPR/Cas9-mediated genome editing.The triple mutants displayed lower FSN,GNS,grain number per spikelet(GNST),and TGW than wild-type plants.In 306 hexaploid wheat accessions,two single-nucleotide polymorphisms in TaSus-A1 contributed differently to GNS.Introgression of the two alleles into a wheat genetic background confirmed their effects.The alleles differed in geographical distribution among the accessions.

Lychrel Numbers in Base 10: A Probabilistic Approach

For decades, Lychrel numbers have been studied on many bases. Their existence has been proven in base 2, 11 or 17. This paper presents a probabilistic proof of the existence of Lychrel number in base 10 and provides some properties which enable a mathematical extraction of new Lychrel numbers from existing ones. This probabilistic approach has the advantage of being extendable to other bases. The results show that palindromes can also be Lychrel numbers.

The first factor affecting dryland winter wheat grain yield under various mulching measures: Spike number

Water is the key factor limiting dryland wheat grain yield.Mulching affects crop yield and yield components by affecting soil moisture.Further research is needed to determine the relationships between yield components and soil moisture with yield,and to identify the most important factor affecting grain yield under various mulching measures.A long-term 9-yearifeld experiment in the Loess Plateau of Northwest China was carried out with three treatments:no mulch (CK),plastic mulch (M_(P)) and straw mulch (M_(S)).Yield factors and soil moisture were measured,and the relationships between them were explored by correlation analysis,structural equation modeling and significance analysis.The results showed that compared with CK,the average grain yields of M_(P) and M_(S) increased by 13.0and 10.6%,respectively.The average annual grain yield of the M_(P) treatment was 134 kg ha^(–1) higher than the M_(S) treatment.There were no significant differences in yield components among the three treatments (P<0.05).Soil water storage of the M_(S) treatment was greater than the M_(P) treatment,although the differences were not statistically signifiant.Soil water storage during the summer fallow period (SWSSF) and soil water storage before sowing (SWSS) of M_(S) were significantly higher than in CK,which increased by 38.5 and 13.6%,respectively.The relationship between M_(P) and CK was not statistically significant for SWSSF,but the SWSS in M_(P) was significantly higher than in CK.In terms of soil water storage after harvest (SWSH) and water consumption in the growth period(ET),there were no signi?cant differences among the three treatments.Based on the three analysis methods,we found that spike number and ET were positively correlated with grain yield.However,the relative importance of spike number to yield was the greatest in the M_(P )and M_(S) treatments,while that of ET was the greatest in CK.Suifcient SWSSF could indirectly increase spike number and ET in the three treatments.Based on these results,mulch can improve yield and soil water storage.The most important factor affecting the grain yield of dryland wheat was spike number under mulching,and ET with CK.These findings may help us to understand the main factors influencing dryland wheat grain yield under mulching conditions compared to CK.

Study of baryon number transport dynamics and strangeness conservation effects using Ω-hadron correlations

In nuclear collisions at RHIC energies, an excess of Ω hyperons over ■ is observed, indicating that Ω has a net baryon number despite s and s quarks being produced in pairs. The baryon number in Ω may have been transported from the incident nuclei and/or produced in the baryon-pair production of Ω with other types of anti-hyperons such as Ξ. To investigate these two scenarios, we propose to measure the correlations between Ω and K and between Ω and anti-hyperons. We use two versions, the default and string-melting, of a multiphase transport(AMPT) model to illustrate the method for measuring the correlation and to demonstrate the general shape of the correlation. We present the Ω-hadron correlations from simulated Au+Au collisions at ■ =7.7 and 14.6 Ge V and discuss the dependence on the collision energy and on the hadronization scheme in these two AMPT versions. These correlations can be used to explore the mechanism of baryon number transport and the effects of baryon number and strangeness conservation on nuclear collisions.

On Perron’s Formula and the Prime Numbers

The Riemann hypothesis is intimately connected to the counting functions for the primes. In particular, Perron’s explicit formula relates the prime counting function to fixed points of iterations of the explicit formula with particular relations involving the trivial and non-trivial roots of the Riemann Zeta function and the Primes. The aim of the paper is to demonstrate this relation at the fixed points of iterations of explicit formula, defined by functions of the form limT∈Ν→∞fT(zw)=zw,where, zwis a real number.

Impacts of Aggregation Methods and Trophospecies Number on the Structure and Function of Marine Food Webs

Aggregation of species with similar ecological properties is one of the effective methods to simplify food web researches.However,species aggregation will affect not only the complexity of modeling process but also the accuracy of models’outputs.Selection of aggregation methods and the number of trophospecies are the keys to study the simplification of food web.In this study,three aggregation methods,including taxonomic aggregation(TA),structural equivalence aggregation(SEA),and self-organizing maps(SOM),were analyzed and compared with the linear inverse model–Markov Chain Monte Carlo(LIM-MCMC)model.Impacts of aggregation methods and trophospecies number on food webs were evaluated based on the robustness and unitless of ecological net-work indices.Results showed that aggregation method of SEA performed better than the other two methods in estimating food web structure and function indices.The effects of aggregation methods were driven by the differences in species aggregation principles,which will alter food web structure and function through the redistribution of energy flow.According to the results of mean absolute percentage error(MAPE)which can be applied to evaluate the accuracy of the model,we found that MAPE in food web indices will increase with the reducing trophospecies number,and MAPE in food web function indices were smaller and more stable than those in food web structure indices.Therefore,trade-off between simplifying food webs and reflecting the status of ecosystem should be con-sidered in food web studies.These findings highlight the importance of aggregation methods and trophospecies number in the analy-sis of food web simplification.This study provided a framework to explore the extent to which food web models are affected by dif-ferent species aggregation,and will provide scientific basis for the construction of food webs.

Three- and Four-Dimensional Generalized Pythagorean Numbers

The Pythagorean triples (a, b | c) of planar geometry which satisfy the equation a2+b2=c2 with integers (a, b, c) are generalized to 3D-Pythagorean quadruples (a, b, c | d) of spatial geometry which satisfy the equation a2+b2+c2=d2 with integers (a, b, c, d). Rules for a parametrization of the numbers (a, b, c, d) are derived and a list of all possible nonequivalent cases without common divisors up to d2 is established. The 3D-Pythagorean quadruples are then generalized to 4D-Pythagorean quintuples (a, b, c, d | e) which satisfy the equation a2+b2+c2+d2=e2 and a parametrization is derived. Relations to the 4-square identity are discussed which leads also to the N-dimensional case. The initial 3D- and 4D-Pythagorean numbers are explicitly calculated up to d2, respectively, e2.

Complex Decision Modeling Framework with Fairly Operators and Quaternion Numbers under Intuitionistic Fuzzy Rough Context

The main goal of informal computing is to overcome the limitations of hypersensitivity to defects and uncertainty while maintaining a balance between high accuracy,accessibility,and cost-effectiveness.This paper investigates the potential applications of intuitionistic fuzzy sets(IFS)with rough sets in the context of sparse data.When it comes to capture uncertain information emanating fromboth upper and lower approximations,these intuitionistic fuzzy rough numbers(IFRNs)are superior to intuitionistic fuzzy sets and pythagorean fuzzy sets,respectively.We use rough sets in conjunction with IFSs to develop several fairly aggregation operators and analyze their underlying properties.We present numerous impartial laws that incorporate the idea of proportionate dispersion in order to ensure that the membership and non-membership activities of IFRNs are treated equally within these principles.These operations lead to the development of the intuitionistic fuzzy rough weighted fairly aggregation operator(IFRWFA)and intuitionistic fuzzy rough ordered weighted fairly aggregation operator(IFRFOWA).These operators successfully adjust to membership and non-membership categories with fairness and subtlety.We highlight the unique qualities of these suggested aggregation operators and investigate their use in the multiattribute decision-making field.We use the intuitionistic fuzzy rough environment’s architecture to create a novel strategy in situation involving several decision-makers and non-weighted data.Additionally,we developed a novel technique by combining the IFSs with quaternion numbers.We establish a unique connection between alternatives and qualities by using intuitionistic fuzzy quaternion numbers(IFQNs).With the help of this framework,we can simulate uncertainty in real-world situations and address a number of decision-making problems.Using the examples we have released,we offer a sophisticated and systematically constructed illustrative scenario that is intricately woven with the complexity ofmedical evaluation in order to thoroughly assess the relevance and efficacy of the suggested methodology.

Novel Rifle Number Recognition Based on Improved YOLO in Military Environment

Deep neural networks perform well in image recognition,object recognition,pattern analysis,and speech recog-nition.In military applications,deep neural networks can detect equipment and recognize objects.In military equipment,it is necessary to detect and recognize rifle management,which is an important piece of equipment,using deep neural networks.There have been no previous studies on the detection of real rifle numbers using real rifle image datasets.In this study,we propose a method for detecting and recognizing rifle numbers when rifle image data are insufficient.The proposed method was designed to improve the recognition rate of a specific dataset using data fusion and transfer learningmethods.In the proposed method,real rifle images and existing digit images are fusedas trainingdata,andthe final layer is transferredto theYolov5 algorithmmodel.The detectionand recognition performance of rifle numbers was improved and analyzed using rifle image and numerical datasets.We used actual rifle image data(K-2 rifle)and numeric image datasets,as an experimental environment.TensorFlow was used as the machine learning library.Experimental results show that the proposed method maintains 84.42% accuracy,73.54% precision,81.81% recall,and 77.46% F1-score in detecting and recognizing rifle numbers.The proposed method is effective in detecting rifle numbers.