OBJECTIVES: Accurate identification of risk factors for precocious puberty is essential for clinical diagnosis and management, yet the performance of natural language processing methods applied to unstructured electronic medical record (EMR) data remains to be fully evaluated. This study aims to assess the performance of a prompt engineering method for extracting individual risk factors of precocious puberty from EMRs. METHODS: Based on the capacity and role-insight-statement-personality-experiment (CRISPE) prompt framework, both simple and optimized prompts were designed to guide the large language model GLM-4-9B in extracting 10 types of risk factors for precocious puberty from 653 EMRs. Accuracy, precision, recall, and F1-score were used as evaluation metrics for the information extraction task. RESULTS: Under simple and optimized prompt conditions, the overall accuracy, precision, recall, and F1-score of the model were 84.18%, 98.09%, 81.99%, and 89.32% versus 97.15%, 98.31%, 98.16%, and 98.23%, respectively. The optimized prompts achieved more stable performance across age (<9 years vs ≥9 years) and visit-time (<2023 vs ≥2023) subgroups compared with simple prompts. The accuracy range for extracting each risk factor was 60.03%-97.24%, while with optimized prompts, the range improved to 92.19%-99.85%. The largest performance improvement occurred for "beverage intake" (60.03% vs 92.19%), and the smallest for "maternal age of menarche" (97.24% vs 99.23%). In comparing distributions among simple prompts, optimized prompts, and ground truth, statistically significant differences were observed for snack intake, beverage intake, soy milk intake, honey intake, supplement use, tonic use, sleep quality, and sleeping with the light on (all P<0.001), while exercise (P=0.966) and maternal menarche age (P=0.952) showed no significant differences. CONCLUSIONS Compared with simple prompts, optimized prompts substantially improved the extraction performance of individual risk factors for precocious puberty from EMRs, underscoring the critical role of prompt engineering in enhancing large language model performance.
Humans ; Puberty, Precocious/epidemiology* ; Risk Factors ; Electronic Health Records ; Female ; Child ; Natural Language Processing

Objective This study aimed to explore the underlying mechanisms between parental neglect and depression of adolescents.Methods This study utilized data from the 2020 China Family Panel Studies(CFPS)and included 1902 adolescents aged 10～15.Correlation analysis,multivariable logistic regression,structural equation modeling,and the bootstrap method were employed to examine the relationships between parental neglect,social trust,and depressive symptoms in adolescents.Results This study found that the prevalence of depressive symptoms among adolescents was 10.9%.Parental neglect was associated with an increased risk of depressive symptoms(OR:1.772,95%CI:1.310～2.636),and social trust acted as a mediator between parental neglect and depressive symptoms(mediating effect:17.20%,P<0.001).Additionally,gender moderated the latter half of the mediation model(β:0.127,95%CI:0.016～0.236,P<0.001).Conclusion The experiences of parental neglect are closely related to higher levels of depressive symptoms among adolescents,with social trust serving as a mediating factor.This mediating effect of social trust is particularly significant among females.It is crucial to cultivate a supportive environment and develop a harmonious family atmosphere.

Objective:To explore the effect of different swallowing tasks on cortex activation and functional connectivity in stroke survivors with dysphagia using functional near-infrared spectroscopy (fNIRS).Methods:Thirty stroke survivors with dysphagia performed three different swallowing tasks: swallowing action observation (SO), swallowing action execution (SE), and swallowing action imagination (SI). During each task, fNIRS was used to document the brain concentrations of oxyhemoglobin and deoxyhemoglobin. Cortex activation (β value) and brain functional connectivity were assessed.Results:Compared with the resting state, the areas activated during the SO task included the left primary sensory cortex and the right prefrontal cortex. During the SE and SI tasks the left prefrontal cortex and the left motor cortex were activated as well. Compared with hemorrhagic stroke survivors, ischemic stroke survivors showed significantly greater activation of the right primary sensory cortex, the right motor cortex, and the left primary sensory cortex during the SE task. Functional connectivity during the SO, SE and SI tasks was significantly greater than in the resting state, with the average connectivity values during the SE task significantly higher than during the SI task.Conclusions:Stroke survivors with dysphagia exhibit increased activation in the prefrontal cortex and primary sensory cortex during different swallowing tasks. Such tasks can improve their brain functional connectivity.

Objective This study aimed to explore the underlying mechanisms between parental neglect and depression of adolescents.Methods This study utilized data from the 2020 China Family Panel Studies(CFPS)and included 1902 adolescents aged 10～15.Correlation analysis,multivariable logistic regression,structural equation modeling,and the bootstrap method were employed to examine the relationships between parental neglect,social trust,and depressive symptoms in adolescents.Results This study found that the prevalence of depressive symptoms among adolescents was 10.9%.Parental neglect was associated with an increased risk of depressive symptoms(OR:1.772,95%CI:1.310～2.636),and social trust acted as a mediator between parental neglect and depressive symptoms(mediating effect:17.20%,P<0.001).Additionally,gender moderated the latter half of the mediation model(β:0.127,95%CI:0.016～0.236,P<0.001).Conclusion The experiences of parental neglect are closely related to higher levels of depressive symptoms among adolescents,with social trust serving as a mediating factor.This mediating effect of social trust is particularly significant among females.It is crucial to cultivate a supportive environment and develop a harmonious family atmosphere.

Objective:To explore the effect of different swallowing tasks on cortex activation and functional connectivity in stroke survivors with dysphagia using functional near-infrared spectroscopy (fNIRS).Methods:Thirty stroke survivors with dysphagia performed three different swallowing tasks: swallowing action observation (SO), swallowing action execution (SE), and swallowing action imagination (SI). During each task, fNIRS was used to document the brain concentrations of oxyhemoglobin and deoxyhemoglobin. Cortex activation (β value) and brain functional connectivity were assessed.Results:Compared with the resting state, the areas activated during the SO task included the left primary sensory cortex and the right prefrontal cortex. During the SE and SI tasks the left prefrontal cortex and the left motor cortex were activated as well. Compared with hemorrhagic stroke survivors, ischemic stroke survivors showed significantly greater activation of the right primary sensory cortex, the right motor cortex, and the left primary sensory cortex during the SE task. Functional connectivity during the SO, SE and SI tasks was significantly greater than in the resting state, with the average connectivity values during the SE task significantly higher than during the SI task.Conclusions:Stroke survivors with dysphagia exhibit increased activation in the prefrontal cortex and primary sensory cortex during different swallowing tasks. Such tasks can improve their brain functional connectivity.

Objective To evaluate the validity of the Patient Health Questionnaire(PHQ-9)and the Generalized Anxiety Disorder Scale(GAD-7)in measuring depression and anxiety among employees.Methods A stratified random sample of 1117 employees from various departments of an enterprise was included in the study.The item analysis was performed using the Grade Response Model in IRT to assess the dimensionality,discrimination,difficulty coefficient and average information of each item.The model fit and differential item functioning were also assessed.Results The study population consisted of 661(59.2%)employees under the age of 45 and 456(40.8%)employees aged 45 and above;802(71.8%)were male and 315(28.2%)were female.The Cronbach's α coefficients for the PHQ-9 and GAD-7 were 0.923 and 0.951,and the split-half reliability coefficients were 0.863 and 0.940.The ratio of the first characteristic root to the second characteristic root of both the PHQ-9 and GAD-7 scales was＞3,in line with the hypothesis of unidimensionality.The discrimination of the PHQ-9 items ranged from 2.362 to 3.618,the difficulty coefficient from-0.949 to 2.639,and the average information from 0.772 to 1.935.The discrimination of the GAD-7 items ranged from 3.631 to 5.580,the difficulty coefficient from-0.469 to 2.044,and the average information from 1.880 to 3.547.Differential item functioning indicated that age and gender did not influence the screening of the two scales.Conclusion The PHQ-9 and GAD-7 scales can be used as psychometric tools to assess depression and generalized anxiety disorder in corporate employees.

Objective:To construct the evaluation index system of the core competence of neonatal specialist nurses, so as to provide reference for clinical training of neonatal specialist nurses.Methods:From January 2020, through literature review, theoretical analysis, interview, Delphi method and superiority chart, the evaluation index and weight of core competence of neonatal specialist nurses were determined.Results:Totally 28 experts in China were invited for 3 rounds of consultation. The effective recovery rate of the questionnaires was 93.33%(28/30) in the first round. The effective recovery rate of the questionnaires was 100.00%(28/28) in the second and third rounds. The authority coefficient of the experts was 0.85 in the third round. The Kendall′s coefficients of concordance of the first-level indexes, second-level indexes and third-level indexes were 0.150, 0.221 and 0.161, respectively. The final evaluation index system of the core competence of neonatal specialist nurses included 5 first-level indicators, 17 second-level indicators and 58 third-level indicators.Conclusions:The evaluation index system of the core competence of neonatal specialist nurses constructed in this study has certain scientific, reliable and clinical application value, which is conducive to the training of newborn specialized nurses in China.

Objective:To investigate the efficacy and safety of nasal continuous positive airway pressure (NCPAP) combined with inhalation of pulmonary surfactant (PS) using vibrating mesh nebulizers in the treatment of neonatal respiratory distress syndrome (RDS).Methods:A prospective study was performed on premature infants with RDS admitted to the First Affiliated Hospital of Bengbu Medical College between December 2020 and June 2021. They were randomly assigned into vibrating mesh atomization technology group and intubation-surfactant-extubation (INSURE) technology group. The two groups were treated with NCPAP combined with PS. PS in the vibrating mesh atomization technology group was inhaled into the lungs by the new vibrating mesh atomization technology, while PS in the INSURE group was injected into the lungs by endotracheal tube. The pH value, arterial partial pressure of carbon dioxide (PaCO 2), oxygenation index (PaO 2/FiO 2), mechanical ventilation via endotracheal tube (MVET) demand rate, duration of respiratory support, secondary use of PS, complications, and hospital mortality were compared between the two groups. The occurrences of adverse events in the two groups were recorded. Results:A total of 42 preterm infants were finally enrolled, including 20 cases in the vibrating mesh atomization technology group and 22 cases in the INSURE technology group. There were no significant differences in blood gas analysis and PaO 2/FiO 2 before PS administration between the two groups. One hour after PS administration, blood gas analysis and PaO 2/FiO 2 were significantly improved in both groups. Compared with the INSURE technology group, the improvement of PaO 2/FiO 2 was more obvious in the vibrating mesh atomization technology group [mmHg (1 mmHg≈0.133 kPa): 198±34 vs. 173±39, P < 0.05], but no significant difference in pH value or PaCO 2 was found between the two groups. The duration of respiratory support in the vibrating mesh atomization technology group was significantly shorter than that in the INSURE technology group (hours: 96±13 vs. 120±18, P < 0.01), but there was no statistical difference in MVET demand rate [5.0% (1/20) vs. 13.6% (3/22), P > 0.05]. The incidence of periventricular-intraventricular hemorrhage (PVH-IVH) in the vibrating mesh atomization technology group was less than that in the INSURE technology group [0% (0/20) vs. 18.2% (4/22)], but no statistical difference was found ( P > 0.05). No significant differences in the secondary use rate of PS and incidence of bronchopulmonary dysplasia (BPD) or other complications were found between the vibrating mesh atomization technology group and the INSURE technology group [5.0% (1/20) vs. 9.1% (2/22), 5.0% (1/20) vs. 4.5% (1/22), both P > 0.05]. There were no deaths or serious adverse events such as pneumothorax, pulmonary hemorrhage, periventricular leukomalacia (PVL), retinopathy of prematurity (ROP), and necrotizing enterocolitis (NEC) in both groups. Conclusion:Compared with the INSURE technique, NCPAP combined with vibrating mesh atomization technology was also effective and safe in the treatment of RDS, which could significantly improve PaO 2/FiO 2 and shorten the duration of respiratory support. Thus, it was worthy of clinical popularization and application.

To develop more active LTR retrotransposons in Phyllostachys edulis, a Ph. edulis LTR retrotransposon (Ph-LTR2) was identified, and the expression pattern of the transposon under stress was systematically analyzed. Ph-LTR2 transposon is 6 030 bp in length and belongs to the Reina subfamily in the Ty3-Gypsy family. With the similarity of 96.41% of both LTR sequences, the Ph-LTR2 transposon inserted the moso bamboo genome about 61.92 thousand years ago. There are 5 copies identified in the genome. The Ph-LTR2 transposon domain includes GAG (gag protein) protein domain, PR (Proteases) protein domain, RT (Reverse transcriptase) protein domain, RH (Ribonuclease H) protein domain, INT (Integrase) protein domain and CHR (Chromatin organization modifier) protein domain. The expression patterns of INT, RT and RH were detected by real-time quantitative PCR. The three domains were found to have specific expression patterns at different tissues of the bamboo. Under the conditions of low/high temperature, methylation inhibitors treatments, irradiation and high salt stress, transcription levels of the three domains of the Ph-LTR2 transposon increased with different degrees. Specifically, after treatment with low/high temperature and methylation inhibitors, the transcription level was up-regulated; after low dose radiation treatment and low concentration of salt solution treatment, the transcription level was also increased, but the expression level decreased with increasing dose of radiation and concentration of salt solution. These results indicate that the expression pattern of the Ph-LTR2 transposon responds to the changes of the external environment, but the exact mechanism is not yet known. The results of this study laid a certain theoretical foundation for the development of the genetic tool based on Ph-LTR2 transposons.
Genome ; Phylogeny ; Poaceae ; Retroelements

Objective To evaluate the carotid and left ventricular function changes in patients with subclinical atherosclerosis (SA) using echo-tracking (ET) and three-dimensional speckle tracking echocardiography (3D-STE).Methods Eighty patients with SA were divided into low-risk group (27 cases),middle-risk group (26 cases) and high-risk group (27 cases) according to the Framingham risk score (FRS).Each of them was examined by echocardiography and carotid ultrasound to obtain the parameters including carotid intima-media thickness (cIMT),stiffness parameter (β),Pressure-strain elastic modulus (Ep),pulse wave conducting velocity(PWVβ),LV peak systolic global longitudinal strain (GLS),LV peak systolic global circumferential strain (GCS),myocardial wall stress (MWS) and left ventricular ejection fraction(LVEF) for analysis.The study got approval from the Ethics Committee of Tongji Medical College,Huazhong University of Science and Technology (NO:IORG00371).Results Ep,left atrial volume (LAV) and MWS had significantly differences among the three groups (all P ＜0.05).Compared with low-risk group,cIMT,β,PWVβ were higher and GLS was lower in high-risk group (all P ＜0.05).There were no statistical difference in LVEF and GCS among the three groups (all P ＞ 0.05).β was positively correlated with age and FRS,and negatively correlated with GLS (all P ＜ 0.05).LAV was positively correlated with age and E/e (all P ＜0.05).GLS was negatively correlated with FRS and β (all P ＜ 0.05).MWS was positively correlated with β and SBP,and negatively correlated with LVEF (all P ＜0.01).Conclusions ET combined with 3D-STE could be applied to evaluate the carotid and left ventricular function accurately in patients with subclinical atherosclerosis,and provide scientific bases for establishing intervention strategy.