A cardiac inflammatory myofibroblastic tumor (IMT) is an extremely rare tumor. Our patient was admitted to the hospital due to syncope and subsequently diagnosed with cardiac IMT. He has multiple cerebral infarctions during the disease but recovered well after undergoing twice cardiac surgeries during 4 years of follow-up. Syncope and cerebral infarctions are uncommon in IMT and easily misdiagnosed.

Introduction: Chronic renal failure (CRF) is a progressive loss of renal function that lead to reduced sodium filtration and inappropriate suppression of tubular reabsorption that ultimately leads to volume expansion. To improve treatment outcomes, the aim of this study was to evaluate the possible renoprotective effect of tadalafil and furosemide, individually and in combination, in both conventional and nanoforms in adenine-induced CRF rat-model. Methods: Addition of 0.75% adenine to the diet of rats for 4 weeks gained general acceptance as a model to study kidney damage as this intervention mimicked most of the structural and functional changes seen in human chronic kidney disease Urine analysis, histopathological changes and immunohistochemical expression of caspase-3 and interleukin-1β (IL-1β) in renal tissues were performed. Results: Our results showed that the combination of tadalafil and furosemide using conventional and nanoparticle formulations revealed a beneficial therapeutic effect in the treatment of CRF. This was demonstrated by improvement of urinary, serum and renal tissue markers as indicative of organ damage. This was also reflected on the reduction of tubular expression of KIM-1 and NGAL. Immunohistochemical studies showed that significant increase in the number of apoptotic tubular cells indicated by increased expression of caspase-3 in CRF. These deteriorated renal cellular changes were improved by the treatment of rats with the investigated drugs. Results from ELISA showed that IL-1β was reduced by such treatment in kidney tissue. Conclusion: Tadalafil and furosemide improved the biochemical, histopathological and immunohistochemistry changes in adenine-induced CRF which strongly support the renopreventive effects of investigated drugs in particular the nanoparticle forms.

Background: Placebos being prescribed with full honesty and disclosure (i.e., open-label placebo = OLP) have been shown to reduce symptom burden in a variety of conditions. With regard to allergic rhinits, previous research provided inconclusive evidence for the effects of OLP, possibly related to a separate focus on either symptom severity or symptom frequency. Overcoming this limitation of previous research, the present study aimed to examine the effects of OLP on both the severity and frequency of allergic symptoms. Methods: In a randomized-controlled trial, patients with allergic rhinits ( N=74) were randomized to OLP or treatment as usual (TAU). Due to the COVID-19 pandemic, OLP was administered remotely in a virtual clinical encounter. Participants took placebo tablets for 14 days. The primary outcomes were the severity and frequency of allergic symptoms. The secondary endpoint was allergy-related impairment. Results: OLP did not significantly improve symptom severity over TAU, F(1, 71) = 3.280, p = .074, ɳ² p = .044, but did reduce symptom frequency, F(1, 71) = 7.272, p = .009, ɳ² p = .093, and allergy-related impairment more than TAU, F(1, 71) = 6.445, p = .013, ɳ² p = .083, reflecting medium to large effects. The use of other anti-allergic medication did not influence the results. Conclusions: While OLP was able to lower the frequency of allergic symptoms and allergy-related impairment substantially, its effects on symptom severity were weaker. The remote provision of OLP suggests that physical contact between patients and providers might not be necessary for OLP to work.

Chimeric antigen receptor (CAR) T-cell therapy is growing clinically and commercially as a powerful new approach to treat cancer. Understanding how key culture conditions such as pH and dissolved oxygen (DO) affect CAR T-cell generation and function is important in developing better CAR-T manufacturing processes and CAR T-cell therapies for patients. We used the automated mini-bioreactor (AMBR) 15 platform to assess how differences in pH and DO affect CAR T-cell transduction, proliferation, and differentiation. We found that higher pH can significantly improve CAR T-cell transduction and proliferation, and also biases CAR T-cells away from an effector memory and towards a more central memory phenotype. Both high and low DO negatively affect CAR T-cell generation, with both hypoxic and hyperoxic conditions reducing T-cell transduction into CAR T-cells. Collectively, this data underscores how pH and DO can significantly affect CAR T-cell expansion and differentiation, and provides insight into the optimal culture conditions to enhance CAR T-cell yield and phenotype in clinical and commercial processes.

This article considers the problem of finite-time command filtered control for switched nonlinear systems with input quantization and output constraints. The unmeasurable state is estimated by designing a switched state observer. During the design process, to overcome the chattering problem effectively, the hysteresis quantization is designed as two bounded nonlinear functions. Furthermore, in order to restrict the output to an expected range, the barrier Lyapunov function (BLF) approach is introduced. The “explosion of complexity” (EOC) and the error compensation problems in the backstepping design are solved by using a finite-time command filtered (FTCF) approach. A first-order Levant differentiator (FLD) is used instead of the general command filter in this paper, which cannot only filter the intermediate signals accurately to get the differential signals, but also ensure the finite-time stability of the filter. Stability of the closed-loop system in the sense of semi-global practical finite-time stability (SGPFS) is proved by exploring a multiple Lyapunov functions approach. Finally, a simulation example is provided to verify the validity of the presented control method.

In this paper, reduced-order models are developed for the rotating thermal shallow water equation (RTSWE) in the non-canonical Hamiltonian form with the state-dependent Poisson matrix. The high fidelity full solutions are obtained by discretizing the RTSWE in space with skew-symmetric finite-differences, that preserve the Hamiltonian. The resulting skew-gradient system with the skew-symmetric Poisson matrix is integrated in time by the energy preserving average vector field (AVF) method. The reduced-order model (ROM) is constructed in the same way as the full-order model (FOM), preserving the reduced skew-symmetric structure and integrating in time with the AVF method. Applying proper orthogonal decomposition (POD) with the Galerkin projection, an energy preserving ROM is constructed. The nonlinearities in the ROM are computed by applying the discrete empirical interpolation (DEIM) method to reduce the computational cost. The computation of the reduced-order solutions is accelerated further by the use of tensor techniques. The overall procedure yields a clear separation of the offline and online computational cost of the reduced solutions. The accuracy and computational efficiency of the ROMs are demonstrated for a numerical test problem. Preservation of the energy (Hamiltonian), and other conserved quantities, i.e., mass, buoyancy, and total vorticity show that the reduced-order solutions ensure the long-term stability of the solutions while exhibiting several orders of magnitude computational speedup over the FOM.

There is regular non-response in sample surveys which creates bias in estimates of population parameters. The present study develops some techniques to estimate a finite population using second-order raw moments of an auxiliary variable in the presence of non-response in a sample survey. Two estimators of the ratio type and the difference type have been proposed in the two traditional situations of non-response. The bias and mean square errors have been calculated under large sample approximation in both situations: situation-I and situation-II. The performance of the proposed estimators in terms of Percent Relative Efficiency (PRE) is shown in conjunction with other existing estimators discussed in this article using theoretical and empirical studies using real data sets. Concerning the famous Hansen and Hurwitz (1947) method of proposed estimators, the percent relative efficiency is always greater than the percent relative efficiency of the other discussed estimators. The results show that the proposed estimators performed better than the other discussed estimators. The results are interpreted, and appropriate recommendations are made to the survey practitioners.

In this article, a new analysis method for the failure probability of bridge girder is presented. Firstly, considering the correlation among multiple monitored variables, the optimal regular vine model is established based on the monitored extreme strain data; secondly, the optimal regular vine model about the multiple performance functions corresponding to the failure modes of the multiple monitored points, is given, further, through combining the proposed optimal regular vine model with bivariate Pair-Copula model and first order second moment method, the bridge girder failure probability considering the correlation of the performance functions, is analyzed; finally, the monitored extreme strain data of an existing bridge is provided to illustrate the feasibility and application of the proposed model and method.

Background There are sparse data on long-term and late effects of hematopoietic cell transplantation (HCT) for sickle cell disease (SCD) Objectives To establish an international registry of long-term outcomes post-HCT for SCD and demonstrate the feasibility of recruitment at a single site in the US. Methods The STELLAR registry is designed to enroll SCD patients ≥ 1-year post-HCT, their siblings without SCD, and non-transplanted SCD controls to collect participant self-report of health status and practices using the BMT survivor study surveys, HRQOL using PROMIS 25 or 29, cGVHD using the symptom scale survey, daily pain using an electronic pain diary, economic impact of HCT using the financial hardship survey, and sexual function using PROMIS SexFSv2.0. We also piloted retrieval of clinical data previously submitted to CIBMTR, recorded demographics, height, weight, BP, hip and waist circumference, timed-up-and-go, and handgrip test, and obtained blood for metabolic screening, gonadal function, fertility potential, and biorepository of plasma, serum, RNA, and DNA. Results Among 100 eligible post-HCT patients, we enrolled 72 participants 9-38 (median 17) years age. We also enrolled 19 siblings 5-32 (median10)years age and 28 non-transplanted SCD controls 4-46 (median 22) years age. Of 119 participants, 73 completed 85 sets of surveys and 41 contributed samples to the biorepository. We successfully piloted retrieval of data submitted to CIBMTR and expanded recruitment to seven US, Canada, UK, and Nigeria sites. Conclusions It is feasible to recruit subjects and conduct study procedures for the STELLAR registry of long-term and late effects of HCT for SCD.

Objective To assess the preparedness of public health care facilities to provide essential newborn care across India Design Mixed methods study analysing the collected cross sectional observational data across five districts of India. Setting India, across districts of Thiruvallur, Cuttack, Allahabad, Vadodara and Jaipur Sample 56 healthcare facilities comprising of Medical colleges, District/Sub-district hospitals, and Community Health Centres/First Referral Units and Primary Healthcare units. 1479 women undergoing vaginal delivery and qualitative data on attitude and barriers faced while following mandated guidelines of essential newborn care were collected from 125 healthcare providers. Method Descriptive analysis for the quantitative data and inductive and deductive analysis for the qualitative data Main outcome measure Preparedness of different facilities was considered as a composite of four dimensions- Clean delivery, Clean cord care, Optimal thermal care and Early exclusive breastfeeding. Results Provision of hygienic delivery (50.8%) and optimal thermal care (26.1%) was observed to be highest among the women availing services in Medical Colleges and clean cord care was highest in PHCs (52.9%). Nearly 77% of cases in CHCs/FRUs experienced exclusive breast feeding. Pre-lacteal feeding, immediate cord clamping and application of traditional dressing on cord stump were prevalent undesirable neonatal care practices. Conclusion Deviations from the mandated essential newborn care protocols by a noteworthy proportion of healthcare professionals including at teaching Medical colleges was observed. Unavailability of sufficient medical supplies for safe and hygienic newborn care in addition to the need for training for essential newborn care was observed.

ABSTRACT Background Labour pain ranks consistently among the most severe types of pain that a woman will experience during her lifetime and leads harmful effects on both mother and baby. As a complementary method, auricular acupressure has been used in the pain management for many diseases and many RCTs showed it has a pain-reliving effect in labour. However, no meta-analysis has been conducted to provide systematic evidence for pain relief in labour. Objectives To perform a systematic review to assess the efficacy of auricular acupressure for labor pain. Search Strategy PubMed, Cochrane Library, Embase, Web of Science databases, SinoMed, CNKI, WanFang Data and VIP were searched for studies using keywords “auricular acupressure” combined with “labor” and “RCTs.” Selection Criteria: Eligible criteria included RCTs, full-text studies, English, and Chinese literature, whereas exclusion criteria included incomplete information, duplicated publications, and studies combined with other analgesic methods. Data Extraction and Analysis: The selection of eligible items and assessment of methodological quality were performed independently by two researchers. A meta-analysis was performed to analyze the treatment effects on pain intensity reduction, maternal satisfaction and safety. Main Results: 17 RCTs were included in this review involving a total of 2574 parturients. Auricular acupressure showed significant efficacy in the reduction of pain intensity and improvement of maternal satisfaction. Conclusions: Auricular acupressure showed a pain-relieving effect compared with the routine care. Although the evidence is limited and high quality studies are needed.

This paper reports a systematic study for evaluating the growth and enzyme kinetics of Candida antarctica MTCC 2706 for the first time. A hybrid machine learning (ML) aided experimental approach is proposed here to evaluate the microbial growth kinetics in which different ML models were built with a smaller set of experimental samples to predict the growth curve at different substrate concentrations and their performance was compared. Gradient boosting regression model was found to predict the growth curves effectively. Further, growth kinetics was evaluated and the data was found to be fitted well with Monod’s model. In addition, the activity of lipase produced in this study was evaluated, and the resulting enzyme kinetics were studied. Further, the statistical significance of models developed was quantified using average absolute deviation percentage (AAD %) and R2 parameters, and robustness of the model parameters is ensured through sensitivity analysis. The results of the proposed ML-based approach were found to be in good agreement with that of the conventional method while successfully reducing the experimental efforts, time and resources by nearly 50%. Also, the application of the proposed method can be extended to any other microbial process.

Empirical observations and mathematical models show that climate warming can lead to the northern (or, more generally, poleward) spread of host species ranges and their corresponding diseases. Here, we consider an unexpected possibility whereby climate warming facilitates disease spread in the opposite direction to the directional shift in the host species range. To explore this possibility, we consider two host species, both susceptible to a disease, but spatially isolated due to distinct thermal niches, and where prior to climate warming the disease is endemic in the northern species only. Previous theoretical results show that species’ distributions can lag behind species’ thermal niches when climate warming occurs. As such, we hypothesize that climate warming may increase the overlap between northern and southern host species ranges, due to the northern species lagging behind its thermal tolerance limit. To test our hypothesis, we simulate climate warming as a reaction-diffusion equation model with a Susceptible-Infected (SI) epidemiological structure, for two competing species with distinct temperature-dependent niches. We show that climate warming, by shifting both species’ niches northwards, can facilitate the southward spread of disease, due to increased range overlap between the two populations. As our model is general, our findings may apply to viral, bacterial, and prion diseases that do not have thermal tolerance limits and are inextricably linked to their hosts’ distributions, such as the spread of rabies from arctic to red foxes.

Death or survival are the two outcomes of an infection. Pathogen infections perturb the resource and energy balance of hosts and in response hosts adjust metabolism and resource assimilation. Host resistance against infection relies on the allocation of resources, in particular to mount sufficient immune responses. We hypothesize that interactions between host resources, host immune responses and pathogens determine host homeostasis and result in contrasting infection outcomes. In this study, we mathematically formulate these interactions and find that the temporal dynamics lead to two distinct trajectories of disease progression. The pathogen load responds in a bistable manner by either proliferating or persisting, if not being eliminated, which corresponds to the death or survival of the host. We identified two key negative feedbacks causing bistability: 1) host resources are either directly consumed or indirectly inhibited by pathogens; 2) pathogen elimination by the host immune response. The dynamics is also sensitive to “initial conditions”, such as resource availability, immunocompetence, and pathogen load at the onset of infection. Our result provides a mechanistic intuitive explanation for the bistable outcome of pathogen infection based on resource reallocation. It also provides a quantitative framework to monitor disease trajectories and forecast the physiological tipping point of death and survival.

‎A linear discrete ill-posed problem has a perturbed right-hand side vector and an ill-conditioned‎ ‎coefficient matrix‎. ‎The solution to such a problem is very sensitive to perturbation‎. ‎Replacement of the coefficient matrix by a nearby one that has less condition‎ ‎number is one of the well-known approaches for decreasing the sensitivity of the problem to perturbation. ‎In this paper‎, ‎we suggest some new regularization matrix to the Tikhonov regularization‎. ‎These new ones are based on fractional derivatives such as Grunwald-Letnikov and Caputo and can cause to have more exact solutions‎.

Phytophagous insects are organisms that use any part of a plant as a food resource. Within this group, we focused on the pest insect Anastrepha obliqua, a fly that feeds on fruits of plants of different species and causes economic losses on the American continent. The ability of the larvae of this species to feed on various fruits (polyphagia) has been studied from different perspectives but never at the level of microRNAs. These interfering RNAs can regulate gene expression in tissues and organs of an organism. The objective of this work was to obtain the first micro-transcriptome and to determine its expression levels and possible target mRNAs when the third instar larvae of the species A. obliqua feed on fruits of plants of three different species: Spondias purpurea, Mangifera indica, and Averrhoa star fruit. A total of 116 microRNAs were identified in the study, of which 37 were completely new. 54 microRNAs were expressed in all larvae, regardless of the fruit, while 44 were detected in larvae that fed on a specific fruit. 21 microRNAs showed differential expression, and the annotation of the targets showed that these interfering RNAs have important genes that play roles in the development, feeding and detoxification of the larvae as possible targets. The construction of the first micro-transcriptome and the identification of possible targets for A. obliqua provide new information for understanding the mechanisms that control gene expression in this species of dipteran.

Background: Atrial fibrillation (AF) is one of the most common heart rate disorders, but most relevant studies are mainly focused on Europe and The United States, while information about AF in Chinese population is scarce. The purpose of this study was to provide a systematic review of the literature on atrial fibrillation in China. To the best of our knowledge, this is the first systematic review for China’s burden of AF. Methods: A systematic literature search (Medline 2001-2021) identified studies reporting the prevalence or incidence of ATRIAL fibrillation, risk factors for atrial fibrillation, comorbidities of atrial fibrillation, and use of antithrombotic therapy in China. This report focuses on descriptive analytical data. Results: Studies reported a wide variation in the prevalence of AF, with a range of community-based and hospital-based AF rates (from 0.49% to 8.8% and 4.4-35.7%). Aspirin and warfarin use were found to be particularly low in community-based studies in China, and warfarin and amiodarone use were higher in hospital-based studies than in other countries. Stroke is the most common complication of atrial fibrillation. Conclusions: We need higher quality studies to understand the burden of AF in China and work to improve community delivery and monitoring of antithrombotic therapy after AF. Given the size of China’s population, the impact on healthcare resources could be significant in the future.

High-throughput detection and screening of biological ingredients in a single bulk sample containing a wide range of taxa still have considerable problems. Recently, a new approach named “shotgun metabarcoding” combining shotgun sequencing and multiple barcodes has been proposed. Here, Shenling Baizhu San (SLBZS), a traditional patent medicine composed of ten plant and fungus ingredients was used to test its species detection capability. Mock and pharmaceutical samples of SLBZS were collected, and a total of 39.52 Gb of raw data were obtained via PCR-free shotgun sequencing. All ingredients made for mock samples can be successfully re-detected except Coix lacryma-jobi was failed to be detected in the second mock sample, and the positive control, the roots of Panax quinquefolius, can be re-detected in the second mock sample. For pharmaceutical samples, not only labeled ingredients but also adulterants, e.g. P. quinquefolius, were detected in a sample. The presence of P. quinquefolius was verified using the SNP detection method with a pair of Panax specific primers. In addition, 18 genera of fungal species were detected in both mock and pharmaceutical samples, however, the total number of fungal reads was relatively small. As a result, this study confirmed that shotgun metabarcoding could authenticate all the biological ingredients of SLBZS, has the potential to enable genomic analyses ideally of all species a single bulk sample.

Background and Purpose: Bone metastases are frequent complications of breast cancer, facilitate the development of anarchic vascularization and induce bone destruction. Therefore, anti-angiogenic drugs (AAD) have been tested as a therapeutic strategy for the treatment of breast cancer bone metastasis. However, the kinetics of skeletal vascularization in response to tumor invasion under AAD is still partially understood. Therefore, the aim of this study was to explore the effect of AAD on experimental bone metastasis by analyzing the three-dimensional (3D) bone vasculature during metastatic formation and progression. Experimental Approach: Eight-week-old female mice were treated with AAD (bevacizumab, vatalanib, or a combination of both drugs) or the vehicle (placebo) one day after injection with breast cancer cells. Mice were sacrificed 8 or 22 days after tumor cell inoculation (time points T1 and T2, respectively). Synchrotron radiation microcomputed tomography (SR-μCT) was used to image tibia with a contrast agent. 3D-bone and vascular networks were simultaneously visualized and quantitatively analyzed. Key Results: At T1, the trabecular bone volume was significantly increased in the combined AAD-treatment group, compared to the placebo- and single AAD-treatment groups. At T2, only the bone vasculature was reduced in the combined AAD-treatment group, as judged by measurement of the blood vessel thickness. Conclusion and Implications: We show for the first time that the use of SR-µCT with a contrast agent enables the simultaneous quantitative measurement of 3D bone and vessel microstructures, providing an unbiased method to assess the efficacy of targeted therapies in a mouse model of bone metastasis.

Key points: • When deflated, folds often form in the balloon cuff of a tracheostomy tube resulting in additional friction when inserting the tube. • Furthermore, this potentially increases the risk of cuff rupture, particularly in patients with calcified tracheas and iatrogenic tracheal injury from using excessive physical force when inserting a tracheostomy tube. • The ‘Umbrella Furling’ technique for deflating the cuff of a tracheostomy tube is a simple approach whereby the cuff is slowly deflated with a damp gauze wrapped around it while simultaneously twisting the tracheostomy tube. • This enables the deflated cuff to sit flush to the tube, therefore allowing an easier “reduced-friction” insertion of a cuffed tracheostomy tube and reducing the risk of damage to the cuff. • The same technique can be used to facilitate the insertion of endotracheal tubes through an enclosed laryngoscope.

Aim Colombia is a country that provides a wide supply of nutrients produced in its different regions during the two seasons that make up its climate, being a place of arrival, departure, or transit of migratory species. We wanted to collect the bibliographic information associated with migratory species that transit Colombia and that were reported in scientific documentation. Location The systematic search for information was carried out using virtual platforms from the Pontificia Universidad Javeriana in Bogotá, Colombia. Methods Information about the migratory species of Colombia (MSC) was compiled from two bibliographic databases (Scopus and Web of Science-SciELO Citation Index), combining biological aspects with keywords associated with migration. From both the Scopus and Web of Science databases (SciELO Citation index), the largest number of articles was collected using query strings, which included words associated with the migration of Colombian species (names associates with MSC, class of migration, distribution geographical, migratory orientation, and phylogeny). Results Between 1914 and 2020, we recovered 4286 titles globally, and of these titles, 264 only for Colombia, according to the affiliation reported by the authors in the different publications. Publication trends show that research on migratory species is being conducted mainly in fishes, mammals, and birds. An association between the words and the fields of knowledge related with the migratory animal groups present in Colombia was found, showing that the migratory species have been studied in cooperation with partners of other countries and this visualized with text mining. Main conclusions The data show that Colombian fauna biodiversity is big but the number of studies in MSC is reduced. Keywords Bibliographic review, Biodiversity, Colombia, Information metrics, Migratory species

Backgroud: Postoperative nausea and vomiting (PONV) is a common postoperative complication in the surgical setting. Many agents exist for PONV prophylaxis but rescue options remains a big challenge. Fosaprepitant has been studied in PONV prophylaxis but the data is limited when utilized for rescue. Methods: In this single center retrospecitve chart review, the antiemetic activity of fosaprepitant (selective NK1 receptor antagonist) was investigated as a rescue agent for PONV in patients undergoing orthopedic surgery. Based on the institutional protocol, fosaprepitant was only utilized in patients with an existing history of PONV or when 2 antiemtic agents were exhausted with no success in the postoperative period. The groups evaluated are inferred to be patients with and without emesis relief. Chart reviews, progress notes and clinical interventions were utilized to assess emesis relief. Results: 383 total patients (over a 12 month period) fell into the hospital protocol and approved to receive fosaprepitant as a rescue agent. Out of the 383 patients, 286 had relief with fosaprepitant, and 196 patients did not require further antiemetic therapy. Patient demographs, anesthesia type, additional medications and surgical types were all assessed thoroughly. Three surgical types showed the most prominent significance for fosaprepirtant PONV relief: Sports management and shoulder 76% (p = 0.0012). Adult Reconstruction and Joint Replacement 74% (<0.0001), Spine 61% (p = 0.015), Conclusion: The data shows their may be potential for utilizing fosaprepitant as a rescue agent for PONV in the orthopedic setting. A bigger study with a larger sample size is warranted.

Background: Preoperative inflammatory indicators had been found to correlate with tumor prognosis, contributing to patient stratification and precise treatment. Objectives: The proportion of Platelet-lymphocytes ratio was associated with the progression of laryngeal cancer, however the results were not consistent. Therefore, we used a meta-analysis to evaluate the prediction of preoperative Platelet-lymphocytes ratio （PLR）for laryngeal cancer outcomes. Methods: We searched WOS, Ovid, Pubmed and The Cochrane library for articles on PLR and Overall Survival(OS) and Progression-free survival(PFS) of patients with laryngeal cancer, from January 1, 2000 to May 1, 2021. State 12.0 was used for conbination analysis. Fixed effects model and random effects model were used to calculated HR and 95%CI. Preferred reporting items that follow systematic review and meta-analysis (PRISMA) guidelines. Results: This meta-analysis eventually included 1,711 cases from 7 studies. The merge OS, HR=1.70, 95%CI 1.11-2.61; PFS, HR=1.34, 95%CI 0.47-3.81. Subgroup analysis included sample size, cut-off, treatment, variable and disease stage showed that a poor OS in patients with increased PLR. Conclusion: Higher PLR may be an adverse prognostic factor for laryngeal cancer. PLR could be obtained by regularly preoperative test, it could help surgeons to evaluate the prognosis of patients with laryngeal cancer. Key words: Laryngeal cancer; Platelet-lymphocytes ratio; Meta-analysis; System review.

Different from the construction process of the traditional finite difference method, we derive a large class of high-accuracy methods for approximating derivatives. Since Taylor expansion is avoided, the requirement for function smoothness in the new methods is greatly reduced. We analyze the approximation errors of the proposed methods and compare their approximation effects. As a typical application, we use the proposed methods to solve elliptic, hyperbolic and parabolic problems numerically. For time-dependent problems, a class of new fully implicit difference schemes and the fourth-order Runge-Kutta method are both used for discretization. When using fully implicit difference schemes, the unconditional stability and convergence are proved for hyperbolic and parabolic problems with the periodic boundary conditions. A large number of numerical experiments are provided to demonstrate the theoretical results.