Cohort study on the treatment of BRAF V600E mutant metastatic colorectal cancer with integrated Chinese and western medicine

BACKGROUND Patients with BRAF V600E mutant metastatic colorectal cancer(mCRC)have a low incidence rate,poor biological activity,suboptimal response to conventional treatments,and a poor prognosis.In the previous cohort study on mCRC conducted by our team,it was observed that integrated Chinese and Western medicine treatment could significantly prolong the overall survival(OS)of patients with colorectal cancer.Therefore,we further explored the survival benefits in the population with BRAF V600E mutant mCRC.AIM To evaluate the efficacy of integrated Chinese and Western medicine in the treatment of BRAF V600E mutant metastatic colorectal cancer.METHODS A cohort study was conducted on patients with BRAF V600E mutant metastatic colorectal cancer admitted to Xiyuan Hospital of China Academy of Chinese Medical Sciences and Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region from January 2016 to December 2022.The patients were divided into two cohorts.RESULTS A total of 34 cases were included,with 23 in Chinese-Western medicine cohort(cohort A)and 11 in Western medicine cohort(cohort B).The median overall survival was 19.9 months in cohort A and 14.2 months in cohort B,with a statistically significant difference(P=0.038,hazard ratio=0.46).The 1-3-year survival rates were 95.65%(22/23),39.13%(9/23),and 26.09%(6/23)in cohort A,and 63.64%(7/11),18.18%(2/11),and 9.09%(1/11)in cohort B,respectively.Subgroup analysis showed statistically significant differences in median OS between the two cohorts in the right colon,liver metastasis,chemotherapy,and first-line treatment subgroups(P<0.05).CONCLUSION Integrated Chinese and Western medicine can prolong the survival and reduce the risk of death in patients with BRAF V600E mutant metastatic colorectal cancer,with more pronounced benefits observed in patients with right colon involvement,liver metastasis,combined chemotherapy,and first-line treatment.

Prospective Cohort Investigation on Physical Activity of Osteoporosis Outcomes(PAOPO)in Jidong:Objectives,Study Design,and Baseline Characteristics

Objective The aim of this study was to investigate the prospective association between physical activity(PA),independently or in conjunction with other contributing factors,and osteoporosis(OP)outcomes.Methods The Physical Activity in Osteoporosis Outcomes(PAOPO)study was a community-based cohort investigation.A structured questionnaire was used to gather the participants’sociodemographic characteristics.Bone mineral density(BMD)measurements were performed to assess OP outcomes,and the relationship between BMD and OP was evaluated within this cohort.Results From 2013 to 2014,8,471 participants aged 18 years and older were recruited from Tangshan,China’s Jidong community.Based on their PA level,participants were categorized as inactive,moderately active,or very active.Men showed higher physical exercise levels than women across the activity groups.BMD was significantly higher in the very active group than in the moderately active and inactive groups.Individuals aged>50 years are at a higher risk of developing OP and osteopenia.Conclusion The PAOPO study offers promising insights into the relationship between PA and OP outcomes,encouraging the implementation of PA in preventing and managing OP.

Plant-based dietary patterns and risk of esophageal cancer:A prospective cohort study spanning 17 years

Objective: Plant-based diets have multiple health benefits for cancers;however, little is known about the association between plant-based dietary patterns and esophageal cancer(EC).This study presents an investigation of the prospective associations among three predefined indices of plant-based dietary patterns and the risk of EC.Methods: We performed endoscopic screening for 15,709 participants aged 40-69 years from two high-risk areas of China from January 2005 to December 2009 and followed the cohort until December 31, 2022. The overall plant-based diet index(PDI), healthful plant-based diet index(h PDI), and unhealthful plant-based diet index(u PDI), were calculated using survey responses to assess dietary patterns. We applied Cox proportional hazard regression to estimate the multivariable hazard ratios(HRs) and 95% confidence intervals(95% CIs) of EC across 3plant-based diet indices and further stratified the analysis by subgroups.Results: The final study sample included 15,184 participants in the cohort. During a follow-up of 219,365person-years, 176 patients with EC were identified. When the highest quartile was compared with the lowest quartile, the pooled multivariable-adjusted HR of EC was 0.50(95% CI, 0.32-0.77) for h PDI. In addition, the HR per 10-point increase in the h PDI score was 0.42(95% CI, 0.27-0.66) for ECs. Conversely, u PDI was positively associated with the risk of EC, and the HR was 1.80(95% CI, 1.16-2.82). The HR per 10-point increase in the u PDI score was 1.90(95% CI, 1.26-2.88) for ECs. The associations between these scores and the risk of EC were consistent in most subgroups. These results remained robust in sensitivity analyses.Conclusions: A healthy plant-based dietary pattern was associated with a reduced risk of EC. Emphasizing the healthiness and quality of plant-based diets may be important for preventing the development of EC.

Association of alcohol consumption with aortic aneurysm and dissection risk:results from the UK Biobank cohort study

BACKGROUND:Previous studies have reported inconsistent results with positive,negative,and J-shaped associations between alcohol consumption and the hazard of aortic aneurysm and dissection(AAD).This study aimed to examine the connections between weekly alcohol consumption and the subsequent risk of AAD.METHODS:The UK Biobank study is a population-based cohort study.Weekly alcohol consumption was assessed using self-reported questionnaires and the congenital risk of alcohol consumption was also evaluated using genetic risk score(GRS).Cox proportional hazards models were used to estimate hazard ratios(HRs)with 95% confidence intervals(CIs)for the associations between alcohol consumption and AAD.Several sensitivity analyses were performed to assess the robustness of the results.RESULTS:Among the 388,955 participants(mean age:57.1 years,47.4% male),2,895 incident AAD cases were documented during a median follow-up of 12.5 years.Compared with never-drinkers,moderate drinkers(adjusted HR:0.797,95%CI:0.646-0.984,P<0.05)and moderate-heavy drinkers(adjusted HR:0.794,95%CI:0.635-0.992,P<0.05)were significantly associated with a decreased risk of incident AAD.Interaction-based subgroup analysis revealed that the protective effect of moderate drinking was reflected mainly in participants younger than 65 years and women.CONCLUSION:Our findings support a protective effect of moderate alcohol consumption on AAD,but are limited to participants younger than 65 years and women.

Who can benefit more from its twelve-week treatment:A prospective cohort study of blonanserin for patients with schizophrenia

BACKGROUND Blonanserin(BNS)is a well-tolerated and effective drug for treating schizophrenia.AIM To investigate which types of patients would obtain the most benefit from BNS treatment.METHODS A total of 3306 participants were evaluated in a 12-week,prospective,multicenter,open-label post-marketing surveillance study of BNS.Brief psychiatric rating scale(BPRS)scores were calculated to evaluate the effectiveness of BNS,and its safety was assessed with the incidence of adverse drug reactions.Linear regression was used to screen the influencing factors for the reduction of BPRS total score,and logistic regression was used to identify patients with a better response to BNS.RESULTS The baseline BPRS total score(48.8±15.03)decreased to 27.7±10.08 at 12 weeks(P<0.001).Extrapyramidal symptoms(14.6%)were found to be the most frequent adverse drug reactions.The acute phase,baseline BPRS total score,current episode duration,number of previous episodes,dose of concomitant antipsychotics,and number of types of sedative-hypnotic agents were found to be independent factors affecting the reduction of BPRS total score after treatment initiation.Specifically,patients in the acute phase with baseline BPRS total score≥45,current episode duration<3 months,and≤3 previous episodes derived greater benefit from 12-week treatment with BNS.CONCLUSION Patients in the acute phase with more severe symptoms,shorter current episode duration,fewer previous episodes,and a lower psychotropic drug load derived the greatest benefit from treatment with BNS.

Idiom Comprehension of Chinese Patients With Aphasia: A Case Study

Previous studies on idiom comprehension of patients with aphasia(PWAs)mainly focused on Indo-European speakers,examining whether PWAs could correctly extract the target meaning of idioms,while among Chinese PWAs,idiom familiarity,context and other variables affecting idiom comprehension were rarely studied.Hence,this study aims to explore whether Chinese PWAs can correctly comprehend the target meaning of idioms,and further investigate the role of familiarity and context.For three Chinese PWAs,this study adopted the string-to-word matching task,taking Chinese four-character idioms as the experimental stimuli,and provided decoy words containing target meaning,literal meaning,unrelated abstract meaning and unrelated concrete meaning as the matching words of idiom items by manipulating the familiarity and contextual presence of idiom items.The results suggested that the PWAs could not correctly extract the target meaning of idioms and presented both the literal meaning tendency and the weak abstract meaning tendency,and the influence of familiarity on the comprehension of idioms was stronger than that of context.These results support the Graded Salience Hypothesis.

Coffee consumption and risk of type 2 diabetes mellitus in Asians:A meta-epidemiological study of population-based cohort studies

BACKGROUND Previous systematic reviews have consistently reported that coffee consumption has a preventive effect on the occurrence of type 2 diabetes mellitus(T2DM).However,further evaluations between coffee consumption and the risk of T2DM in Asian populations are needed.AIM To conduct a meta-epidemiological study on systematic reviews evaluating the association between coffee consumption and the risk of T2DM in Asian people.METHODS The selection criterion was defined as a population-based prospective cohort study evaluating the association between coffee consumption and the risk of T2DM in Asian populations,reporting the adjusted relative risk(RR)and its 95%confidence interval(CI)for potential confounders.A fixed-effect model metaanalysis was applied to calculate the summary RR and its 95%CI in less than 50%of the I2 value indicating the level of heterogeneity.A two-stage fixed-effects doseresponse meta-analysis(DRMA)was performed to calculate the risk per unit dose(a cup per day).RESULTS A total of seven studies were selected in this meta-epidemiological study.The risk of T2DM in Asian populations was significantly reduced in the highest to the lowest dose group(summary RR=0.73,95%CI:0.66-0.82;I2 value=0.0%).The DRMA showed that drinking one cup of coffee per day reduced the risk of T2DM in Asian populations by 8%(RR=0.92,95%CI:0.90-0.95).CONCLUSION These findings support the conclusion that coffee consumption has a protective effect on the occurrence of T2DM in Asian men and women.

Benefits of Dielectric Oil Regeneration Systems in Power Transmission Networks: A Case Study

The criticality of transformers and reactors in the power transmission network and the paramount importance of ensuring their reliability through maintenance of the insulating oil is known. This paper presents a comprehensive examination of the efficacy and economic viability of a dielectric oil regeneration system, as implemented by the Transmission System Maintenance Department (TSMD) of the Independent Power Transmission Operator (IPTO), Greece’s sole transmission operator. Through a detailed chemical analysis and performance evaluation, we assess the impact of the regeneration system on treated insulating oil quality over multiple cycles. The study reveals that the electrical properties of the insulating oil are fully restored after regeneration, negating the need to fully replace it, while the investment becomes cost-neutral within weeks from the commissioning of the regeneration system. This economic analysis, coupled with the system’s environmental benefits of reducing waste oil generation, positions the dielectric oil regeneration system as a compelling solution for the maintenance of power transmission assets.

Investigating the Air Quality Parameters in Louisiana’s Industrial Corridor: A Baton Rouge Case Study

In a local context, sustainable development entails utilizing the current resources—material and immaterial, measurable and immeasurable, popular and unpopular—of the community in a manner that avoids overexploitation and ensures intergenerational equity. This approach prioritizes the safety and health of local citizens, placing communal productivity above corporate profitability. This research aims to assess air quality surrounding 28 chemical industry sites in Baton Rouge, Louisiana, to understand the environmental and health impacts of industrial pollutants, with a focus on environmental justice. Air quality pollutants, including PM2.5, PM10, O3, NO2, CO, and SO2, were monitored for 75 days during the Summer, using the BreezoMeter app. Python, Mapize, and QGIS software technologies were utilized for data analysis and visualization. Findings indicate a reduction in NO2 and CO levels, compared to existing literature. However, the persistent challenge of particulate matter suggests areas for further environmental management efforts. Additionally, the research suggests a significant disparity in air pollution exposure, probably affecting marginalized communities. Although the nature of the study might not fully capture annual pollution trends, the findings highlight the urgent need for the chemical industry to adopt efficient production methods and for policymakers to enhance air quality standards and enforcement, particularly in pollution-sensitive areas. The disproportionate impact of air pollution on vulnerable communities calls for a more inclusive approach to environmental justice, ensuring equitable distribution of clean air benefits and community involvement in pollution management decisions.

Performance of a Combined Energy System Consisting of Solar Collector, Biogas Dry Reforming and Solid Oxide Fuel Cell: An Indian Case Study

An energy production system consisting of a solar collector, biogas dry reforming reactor and solid oxide fuel cell (SOFC) was assumed to be installed in Kolkata, India. This study aims to understand the impact of climate conditions on the performance of solar collectors with different lengths of parabolic trough solar collector (dx) and mass flow rate of heat transfer fluid (m). In addition, this study has evaluated the amount of H2 produced by biogas dry reforming (GH2), the amount of power generated by SOFC (PSOFC) and the maximum number of possible households (N) whose electricity demand could be met by the energy system proposed, considering the performance of solar collector with the different dx and m. As a result, the optimum dx was found to be 4 m. This study revealed that the temperature of heat transfer fluid (Tfb) decreased with the increase in m. Tfb in March, April and May was higher than that in other months, while Tfb from June to December was the lowest. GH2, PSOFC and N in March, April and May were higher than those in other months, irrespective of m. The optimum m was 0.030 kg/s.

Marketing Strategies for Reading Promotion Activities in Academic Libraries:A Case Study of the University of Shanghai for Science and Technology

In the contemporary digital age,traditional reading habits have been compromised by digital media,a situation that has forced academic libraries to adopt proactive marketing approaches to promote reading among students and faculty.This article investigates the implementation of marketing strategies in promoting reading activities within academic libraries,taking the University of Shanghai for Science and Technology as a case study.The paper explores various marketing strategies employed by academic libraries,including market segmentation,utilization of new media platforms,and the creation of personalized content for readers.Drawing from an extensive literature review and real-world examples,the study establishes a framework for marketing reading promotion activities tailored to academic libraries.These findings underscore how effective marketing strategies can enhance user participation,expand library influence,and optimize resource utilization.

Case Analysis of Hypokalemia Induced by Irbesartan-Hydrochlorothiazide: A Case Study

Irbesartan-hydrochlorothiazide is a commonly used antihypertensive drug,but potential adverse reactions such as hypokalemia should not be overlooked.This study analyzes a case of hypokalemia induced by irbesartan-hydrochlorothiazide,exploring the drug’s association with hypokalemia and clinical treatment strategies.The patient experienced symptoms of muscle weakness and palpitations after taking irbesartan-hydrochlorothiazide and was diagnosed with hypokalemia through laboratory tests.Reviewing the patient’s medication history and disease progression,it was hypothesized that the drug’s potassium-wasting effect was the direct cause of the hypokalemia.After discontinuing the medication and initiating potassium supplementation,the patient’s potassium levels returned to normal,and symptoms significantly improved,further confirming the link between hypokalemia and the medication.This case suggests that clinicians should consider the risk of hypokalemia when treating hypertension,especially in patients with chronic kidney disease,the elderly,or those at risk for electrolyte disturbances.For patients who have already developed hypokalemia,potassium supplementation and adjustment of the treatment regimen are recommended to prevent further deterioration.Timely discontinuation of potential causative drugs is also advised.In summary,ensuring medication safety and preventing potential complications has significant clinical importance in recognizing and managing hypokalemia induced by irbesartan-hydrochlorothiazide.Future research should focus on optimizing treatment protocols and developing more effective strategies for preventing and managing related adverse reactions to improve patient quality of life.

Factors affecting rate of stroke-related death in elderly male military population A 23-year cohort study of 1268 cases in Xi'an,China

The study is the first long-term cohort study examining stroke and its subtypes among a population of Chinese elderly male retired military veterans. We reported on a 23-year cohort study examining stroke in 1 268 elderly male patients living in Xi＇an, China since 1987. The stroke-related mortality rate in this cohort was 361.50/1 x 106 per year. Cerebral hemorrhage was the dominant cause of death, with 28 cases of fatal cerebral infarction and 49 cases of fatal cerebral hemorrhage among 77 stroke-related deaths. Independent risk factors for stroke mortality included age, blood pressure, smoking, body mass index, family history of hypertension, past medical history of stroke, hypertension and hyperlipidemia. Among them, ischemic stroke mortality correlated with age, smoking, family history of hypertension and past medical history of stroke, while hemorrhagic stroke was related to blood pressure, body mass index and past medical history of hypertension. Our results indicated that maintaining appropriate levels of blood pressure and body mass, smoking cessation and prevention of hyperlipidemia can reduce the risk of stroke-related death in elderly males who are retired from military service.

Promoting Ethical Sensitivity in Nursing Education:A Systematic Review of Case Study-Based Health Education

Introduction: Nursing ethical sensitivity refers to a nurse’s capacity for thoughtful consideration of ethical issues when faced with dilemmas. In the nursing domain, ethical dilemmas arise when nurses face challenges in making sound ethical decisions during clinical practice. These challenges may stem from conflicts between personal values and professional responsibilities. Methodology: Articles downloaded from Pub Med, CNKI, and Google Scholar were reviewed. Results: After rigorous screening, a meticulous analysis was conducted, encompassing 10 articles and involving a substantial cohort of 2863 participants. Existing literature revealed variations in the ethical dilemmas faced by nurses across different departments. The ethical sensitivity of nurses also varies, with higher ethical sensitivity correlating with stronger empathetic abilities. Zhen et al. classified the causes of ethical dilemmas into four main categories: (1) Ethical dilemmas arising from personal reasons of nursing students;(2) Ethical dilemmas stemming from the actions of teachers;(3) Ethical dilemmas triggered by patients;(4) Ethical dilemmas resulting from miscellaneous reasons. Conclusion: According to literature findings, nursing ethical sensitivity was positively linked to the nurse’s ethical decision-making ability. A case study-oriented teaching program has proven effective in enhancing ethical sensitivity among nursing students.

Regolith Geochemical Studies in Kimberlitic Terrain: A Case Study from Lattavaram Kimberlite Cluster, Eastern Dharwar Craton, Southern India

Utility of geochemistry in mineral exploration is known since more than half-a-century.In reconnaissance diamond exploration,regolith geochemistry is a well known tool worldwide and helps in distinguishing bedrock

A Study on Applications and Case Studies Regarding Bluetooth Technology for Travel Time Measurement

Bluetooth technology emerged over twenty years ago and has continuously improved throughout the years to meet diverse and complex applications. Initially invented to replace the need for physical data cables, Bluetooth offers users a quick and easy way to share data files over a wireless network. Traffic engineers and transportation engineering researchers have utilized the potential opportunities that exist with Bluetooth and have implemented this technology into traffic monitoring techniques. To gain a better understanding of Bluetooth sensors and how they work, a comprehensive literature search was conducted. Twenty-five articles were studied regarding case studies of Bluetooth sensor implementation for travel time measurement. Besides reviewing the literature and previous case studies, three new case studies in the State of Delaware, USA, were also conducted and carefully analyzed. The benefits and drawbacks associated with Bluetooth technology for travel time measurements have been identified in this paper. The overall conclusion of the authors is Bluetooth alone and by itself is not a proper technology for travel time measurements. More studies need to be conducted on the accuracy and overall application, before one can confidently utilize the Bluetooth technology for travel time measurements.

Day case vs inpatient total shoulder arthroplasty: A retrospective cohort study and cost-effectiveness analysis

BACKGROUND Day case total shoulder arthroplasty(TSA)is a novel approach,not widely practiced in Europe.We conducted a retrospective cohort study of patients comparing elective day case and inpatient TSAs in our United Kingdom centre.AIM To evaluate the efficacy and cost-effectiveness of day case TSA compared to standard inpatient total shoulder arthroplasty.METHODS All patients undergoing TSA between January 2017 and July 2018 were included.Outcome measures were:Change in abduction and extension 3 mo postoperatively;30-d postoperative adverse events and re-admissions in day case and inpatient groups.We also conducted an economic evaluation of outpatient arthroplasty.Multivariate linear and logistic regression were used to adjust for demographic and operative covariates.RESULTS Fifty nine patients were included,18 d cases and 41 inpatients.There were no adverse events or re-admissions at 30 d postoperatively in either group.There were no significant differences in adjusted flexion(mean difference 16.4,95%CI:17.6-50.5,P=0.337)or abduction(mean difference:13.2,95%CI:18.4-44.9,P=0.405)postoperatively between groups.Median savings with outpatient arthroplasty were￡529(interquartile range:247.33-789,P<0.0001).CONCLUSION Day case TSA is a safe,effective procedure,with significant cost benefit.Wider use may be warranted in the United Kingdom and beyond,with potential for significant cost savings and improved efficiency.

Study design in evidence-based surgery:What is the role of case-control studies?

Randomized controlled trials(RCTs) are the gold standard in terms of study design, however, in the surgical setting conducting RCTs can often be unethical or logistically impossible. Case-control studies should become the major study design used in surgical research when RCTs are unable to be conducted and definitely replacing case series which offer little insight into surgical outcomes and disease processes.

Network Connection and Energy Radiation through Grassroots Master Teacher Studios--A Case Study Based on Distributed Perspective

Distributed leadership is a collective leadership mode in which multiple members of the organization dynamically share leadership roles according to changes in capability and environment,so as to achieve leadership sharing and leadership energy radiation.Facing the distributed leadership practice of Master Teacher Studio that really occur in education management can make our understanding and description of its original ecological and endogenous construction process more objectively,meticulously and deeply.Through the generation and expansion of the case studio with the characteristics of"grassroots",the empowerment and differentiation of leaders,the stimulation and radiation of members leadership,the generation process of"grassroots"Master Teacher Studio from the initial construction of"uniline"mode to"network"distribution connection,and the radiation process of Master Teacher Studio members'energy from"uninuclear transmission"to"multinuclear connection".Thus,it will realize the organic integration of Western distributed leadership theory and localized grassroots master teachers'studio practice.

Family Farm Development in Southern Jiangsu and Countermeasures with a Case Study

The research reviewed the concept of family farm and analyzed family farm types including unified, facility rental-oriented, employment-oriented, circular and grain＆oil based family farms, as well as corresponding demands in technology and policies. Based on the analysis, the research proposed countermeasures and suggestions. It is necessary to define the range and scale on family farm before giving policy supports. It is important to establish access system of industry and commerce capital to rural areas to guarantee the operators in need be benefited from national preferential policies. Meanwhile, new system on land transfer should be established to guarantee security system for family farm, improve socialized service system and promote government-built production facilities operated by farmers.