Efficacy and safety of transcutaneous electrical acupoint stimulation for the management of primary dysmenorrhoea: Protocol for a randomised controlled trial in China

INTRODUCTION: Primary dysmenorrhoea (PD) is a common menstrual concern with significant physical and psychosocial impacts. The effectiveness and safety of transcutaneous electrical acupoint stimulation (TEAS) in alleviating PD symptoms remain uncertain due to insufficient evidence. This single-centre, parallel, randomised controlled study intends to evaluate the efficacy and safety of TEAS for PD management. METHODS AND ANALYSIS: 60 participants aged 18-40 years diagnosed with moderate to severe PD will be recruited from Tai\u27an Hospital of Traditional Chinese Medicine (TCM) and randomly assigned to either a TEAS group or a TEAS-sham group (1:1). The TEAS group will undergo 12 sessions of TEAS treatment over two menstrual cycles, with 30 min per session, three sessions weekly. Participants in the TEAS-sham group will receive TEAS stimulation using identical devices and protocols but without current output. The primary outcome is the Visual Analogue Scale (VAS) for pain assessment. Secondary outcomes are Short-Form McGill Pain Questionnaire, total effective rate, uterine artery haemodynamics, prostaglandin and β-endorphin level, mental well-being and quality of life. Adverse events and their potential reasons and the use of analgesics will also be recorded. ETHICS AND DISSEMINATION: This study was approved by the Medical Ethics Committee of Tai\u27an Hospital of TCM. Written informed consent will be obtained from each participant. The results will be submitted for publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: ChiCTR2300071686

Efficacy and safety of bevacizumab in patients with malignant melanoma: a systematic review and PRISMA-compliant meta-analysis of randomized controlled trials and non-comparative clinical studies

Background: Malignant melanoma is a highly aggressive cancer that spreads and metastasizes quickly. In recent years, the antiangiogenic drug bevacizumab has been trialed to treat malignant melanoma. We conducted the first meta-analysis to examine the efficacy and safety of bevacizumab combined with other drugs in malignant melanoma.Methods: We searched for randomized controlled trials (RCTs) and non-comparative clinical studies of bevacizumab combined with chemotherapy, targeted medicine, and interferon to treat malignant melanoma in PubMed, Embase, the Cochrane Library, and Web of Science. Meta-analysis of RCT was performed using Review Manager (version 5.4), and non-comparative meta-analysis was performed using R (version 4.0.3). The primary outcome was the objective response rate. Depending on the heterogeneity of the included studies, the pooled outcomes and 95% CI were calculated using either random-effects or fixed-effect models. Subgroup outcomes were calculated with possible relevant variables. Sensitivity analyses were carried out by excluding each study from the highly heterogeneous pooled results in turn. Funnel plot and Begg’s test were used to test the included studies' potential publication bias. The level of significance was set at p < 0.05.Results: This meta-analysis included 20 trials: five RCTs and 15 non-comparative clinical studies with a total of 23 bevacizumab intervention arms. In 14 treatment arms, bevacizumab was combined with chemotherapy drugs such as fotemustine, dacarbazine, carboplatin/paclitaxel, and temozolomide. In six treatment arms, bevacizumab was combined with targeted medicines such as imatinib, everolimus, sorafenib, erlotinib, and temsirolimus. There were also six treatment arms that used bevacizumab in combination with interferon. The pooled objective response rate was 15.8% (95% CI, 11.4%–20.2%). Bevacizumab plus carboplatin/paclitaxel significantly increased the overall survival compared to carboplatin/paclitaxel (HR = 0.64, 95% CI, 0.49-0.85, p < 0.01). Fatigue, nausea, leukopenia, thrombocytopenia, and neutropenia were the most common adverse events. The pooled incidence of hypertension of all bevacizumab arms in malignant melanoma was 32.4% (95% CI, 24.5%–40.3%).Conclusion: This study showed that bevacizumab combined with chemotherapy might be effective and well-tolerated in patients with stage III or IV unresectable malignant melanoma.Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=304625], identifier [CRD42022304625]

Exploring autistic adults' psychosocial experiences affecting beginnings, continuity and change in camouflaging over time: A qualitative study in Singapore

Over their lifetimes, many autistic people learn to camouflage (hide or mask) their autism-related differences to forge relationships, find work and live independently in largely non-autistic societies. Autistic adults have described camouflaging as a 'lifetime of conditioning . . . to act normal' involving 'years of effort', suggesting that camouflaging develops over an autistic person's lifetime and may start early on, in childhood or adolescence. Yet, we know very little about why and how autistic people start to camouflage, or why and how their camouflaging behaviours continue or change over time. We interviewed 11 Singaporean autistic adults (9 male, 2 female, 22-45 years old) who shared their camouflaging experiences. We found that autistic adults' earliest motivations to camouflage were largely related to the desire to fit in and connect with others. They also camouflaged to avoid difficult social experiences (such as being teased or bullied). Autistic adults shared that their camouflaging behaviours became more complex and that, for some, camouflaging became a part of their self-identity over time. Our findings suggest that society should not pathologise autistic differences, but instead accept and include autistic people, to reduce the pressure on autistic people to hide who they truly are

A unique case of subcutaneous panniculitis-like T-cell lymphoma presenting as an abscess following an arthropod bite

Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare form of low-grade cutaneous lymphoma that usually presents with multifocal non-tender subcutaneous nodules over the trunk and extremities. We present an exceptional case of SPTCL masquerading as a solitary abscess which developed following an antecedent arthropod bite. Unique histological features encountered include foci of neutrophilic aggregation and admixed eosinophils within the neoplastic lymphomatous subcuticular infiltrate. As SPTCL rarely presents as an abscess, the authors wish to highlight this diagnostic pitfall and suggest excluding SPTCL as a cause of pseudo-pyoderma in patients who are afebrile with a discordant inflammatory marker profile. In addition, this condition should be suspected in non-diabetic patients who experience a rapid clinical course with suppuration and demonstrate a poor response to appropriate antibiotics. As such, we recommend sending tissue for histopathological examination for patients with atypical presentations

Fine Texture Detection Based on a Solid–Liquid Composite Flexible Tactile Sensor Array

Surface texture information plays an important role in the cognition and manipulation of an object. Vision and touch are the two main methods for extracting an object’s surface texture information. However, vision is often limited since the viewing angle is uncertain during manipulation. In this article, we propose a fine surface texture detection method based on a stochastic resonance algorithm through a novel solid–liquid composite flexible tactile sensor array. A thin flexible layer and solid–liquid composite conduction structure on the sensor effectively reduce the attenuation of the contact force and enhance the sensitivity of the sensor. A series of ridge texture samples with different heights (0.9, 4, 10 μm), different widths (0.3, 0.5, 0.7, 1 mm), but the same spatial period (2 mm) of ridges were used in the experiment. The experimental results prove that the stochastic resonance algorithm can significantly improve the signal characteristic of the output signal of the sensor. The sensor has the capability to detect fine ridge texture information. The mean relative error of the estimation for the spatial period was 1.085%, and the ridge width and ridge height, respectively, have a monotonic mapping relationship with the corresponding model output parameters. The sensing capability to sense a fine texture of tactile senor surpasses the limit of human fingers

Eucalyptus Plantation Area Extraction Based on SLPSO-RFE Feature Selection and Multi-Temporal Sentinel-1/2 Data

An accurate and efficient estimation of eucalyptus plantation areas is of paramount significance for forestry resource management and ecological environment monitoring. Currently, combining multidimensional optical and SAR images with machine learning has become an important method for eucalyptus plantation classification, but there are still some challenges in feature selection. This study proposes a feature selection method that combines multi-temporal Sentinel-1 and Sentinel-2 data with SLPSO (social learning particle swarm optimization) and RFE (Recursive Feature Elimination), which reduces the impact of information redundancy and improves classification accuracy. Specifically, this paper first fuses multi-temporal Sentinel-1 and Sentinel-2 data, and then carries out feature selection by combining SLPSO and RFE to mitigate the effects of information redundancy. Next, based on features such as the spectrum, red-edge indices, texture characteristics, vegetation indices, and backscatter coefficients, the study employs the Simple Non-Iterative Clustering (SNIC) object-oriented method and three different types of machine-learning models: Random Forest (RF), Classification and Regression Trees (CART), and Support Vector Machines (SVM) for the extraction of eucalyptus plantation areas. Each model uses a supervised-learning method, with labeled training data guiding the classification of eucalyptus plantation regions. Lastly, to validate the efficacy of selecting multi-temporal data and the performance of the SLPSO–RFE model in classification, a comparative analysis is undertaken against the classification results derived from single-temporal data and the ReliefF–RFE feature selection scheme. The findings reveal that employing SLPSO–RFE for feature selection significantly elevates the classification precision of eucalyptus plantations across all three classifiers. The overall accuracy rates were noted at 95.48% for SVM, 96% for CART, and 97.97% for RF. When contrasted with classification outcomes from multi-temporal data and ReliefF–RFE, the overall accuracy for the trio of models saw an increase of 10%, 8%, and 8.54%, respectively. The accuracy enhancement was even more pronounced when juxtaposed with results from single-temporal data and ReliefF-RFE, at increments of 15.25%, 13.58%, and 14.54% respectively. The insights from this research carry profound theoretical implications and practical applications, particularly in identifying and extracting eucalyptus plantations leveraging multi-temporal data and feature selection

Mandatory and voluntary information disclosure and the effects on financial analysts: evidence from China

Purpose – This paper aims to make a comparison, different from existing literature solely focusing on voluntary earnings forecasts and ex post earnings surprise, between the effects of mandatory earnings surprise warnings and voluntary information disclosure issued by management teams on financial analysts in terms of the number of followings and the accuracy of earnings forecasts. Design/methodology/approach – This paper uses panel data analysis with fixed effects on data collected from Chinese public firms between 2006 and 2010. It uses an exogenous regulation enforcement to minimise the endogeneity problem. Findings – This paper finds that financial analysts are less likely to follow firms which mandatorily issue earnings surprise warnings ex ante than those voluntarily issue earnings forecasts. Moreover, ex post, they issue less accurate and more dispersed forecasts on former firms. The results support Brown et al.’s (2009) finding in the USA and suggest that the earnings surprise warnings affect information asymmetries. Practical implications – This paper justifies the mandatory earnings surprise warnings policy issued by Chinese Securities Regulatory Commission in 2006. Originality/value – Mandatory earnings surprise is a unique practical regulation for publicly listed firms in China. This paper, for the first time, provides empirical evaluation on the effectiveness of a mandatory information disclosure policy in China. Consistent with existing literature on information disclosure by public firms in other countries, this paper finds that, in China, voluntary information disclosure captures more private information than mandatory information disclosure on corporate earnings ability

Suppressive effect of CORM-2 on LPS-induced platelet activation by glycoprotein mediated HS1 phosphorylation interference.

In recent years, it has been discovered that septic patients display coagulation abnormalities. Platelets play a major role in the coagulation system. Studies have confirmed that carbon monoxide (CO) has important cytoprotective and anti-inflammatory function. However, whether CO could alter abnormal activation of platelets and coagulation and thereby reduce the incidence of mortality during sepsis has not been defined. In this report, we have used CO-releasing molecules (CORM-2) to determine whether CO inhibits LPS-induced abnormal activation of platelets and have explored the potential mechanisms. LPS was used to induce activation of platelets in vitro, which were purified from the peripheral venous blood of healthy adult donors. CORM-2 was applied as a potential therapeutic agent. CORM-2 preconditioning and delayed treatment were also studied. We found that in the LPS groups, the function of platelets such as spreading, aggregation, and release were enhanced abnormally. By contrast, the platelets in the CORM-2 group were gently activated. Further studies showed that the expression of platelet membrane glycoproteins increased in the LPS group. Coincidently, both hematopoietic lineage cell-specific protein 1 and its phosphorylated form also increased dramatically. These phenomena were less dramatically seen in the CORM-2 groups. Taken together, we conclude that during LPS stimulation, platelets were abnormally activated, and this functional state may be associated with the signal that is transmitted between membrane glycoproteins and HS1. CORM-released CO suppresses the abnormal activation of platelets by interfering with glycoprotein-mediated HS1 phosphorylation

System Position and Divergent Time of Based on ITS Sequence <i>Humulus scandens</i>

Angkor, Cambodia: RootsTa Prohm was built c. 1186 during the reign of Jayavarman VII. Strangler fig and silk-cotton trees have grown around the temple.Ta Prohm Temple, Angkor, Cambodia. (2013). Asian Historic Architecture. Retrieved from http://www.orientalarchitecture.com/cambodia/angkor/taprohm.phpGrayscaleForman Safety Negatives, Box