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Objective: To compare the short-term and long-term outcomes between robotic gastrectomy (RG) and laparoscopic gastrectomy (LG) for gastric cancer. Background: The clinical outcomes of RG over LG have not yet been effectively demonstrated. Methods: This retrospective cohort study included 3599 patients with gastric cancer who underwent radical gastrectomy at eight high-volume hospitals in China from January 2015 to June 2019. Propensity score matching was performed between patients who received RG and LG. The primary end point was 3-year disease-free survival (DFS). Results: After 1:1 propensity score matching, 1034 pairs of patients were enrolled in a balanced cohort for further analysis. The 3-year DFS in the RG and LG was 83.7% and 83.1% (P=0.745), respectively, and the 3-year overall survival was 85.2% and 84.4%, respectively (P= 0.647). During 3 years of follow-up, 154 patients in the RG and LG groups relapsed (cumulative incidence of recurrence: 15.0% vs 15.0%, P= 0.988). There was no significant difference in the recurrence sites between the 2 groups (all P>0.05). Sensitivity analysis showed that RG had comparable 3-year DFS (77.4% vs 76.7%, P= 0.745) and overall survival (79.7% vs 78.4%, P= 0.577) to LG in patients with advanced (pathologic T2-4a) disease, and the recurrence pattern within 3 years was also similar between the 2 groups (all P>0.05). RG had less intraoperative blood loss, lower conversion rate, and shorter hospital stays than LG (all P> 0.05). Conclusions: For resectable gastric cancer, including advanced cases, RG is a safe approach with comparable 3-year oncological outcomes to LG when performed by experienced surgeons. [ABSTRACT FROM AUTHOR]

Objective: To describe the characteristics of a consultation-liaison psychiatry (CLP) service at a general hospital in China, compare the literature on CLP in other hospitals in China and abroad, and identify reasons for the differences. Methods: The medical records of all inpatients who received liaison consultations in the first year of the establishment of Xi'an International Medical Center Hospital were reviewed. Demographic data, specific department, number of consultations, reasons for consultation, outcome of consultation, and follow-up information on patients was collected. Results: A total of 630 patients were enrolled during the first year of the hospital's opening, of which 45.2% were male and 54.8% were female. A total of 89.2% of non-psychiatric departments requested a psychosomatic consultation. The percentage of middle-aged and elderly patients was 75.6%, of whom 61.6% were aged 45 to 74 years. The internal medicine department requested the highest number of consultations (48.2%), including those from respiratory medicine (12.1%), neurology (12.1%), gastroenterology (12.1%), and cardiology (12.1%). Among surgical patients, orthopedic patients (6.5%) comprised the majority of consults. The main reasons for requesting a psychosomatic consultation were depressive symptoms (139 cases, 22.8%), anxiety symptoms (137 cases, 22.5%), sleep problems (111 cases, 18.2%), and hallucinations, delusions, or behavioral problems (68 cases, 11.2%), accounting for a total of 74.6% of consultations (455/630). Conclusion: A significant gap exists between the level of CLP services in China and developed regions in Europe and the United States, mainly due to low psychiatric consultation rates and poor quality CLP services. [ABSTRACT FROM AUTHOR]

To explore the status of irrational drug use in a hospital between the pre-intervention (2018 to 2019) and postintervention (2020 to 2021) in Beijing and evaluate the effects of relevant interventions. Prescriptions were evaluated manually with reference to the management rules of the china prescription administrative policy, standard management of hospital prescription comments, standards for prescription examination in medical institutions, regulations on pharmaceutical administration in medical institutions and the administrative measures for the clinical application of antibiotics. There were 5,584 irrational outpatient electronic prescriptions, with 1,681, 1,554, 1,234 and 1,115 made annually from 2018 to 2021, respectively. Among the all irrational prescriptions, high proportions were filled by patients aged 15 to 34 years (55.62%), female patients (50.90%), patients with complications (77.42%) or chronic diseases (65.45%). The top-three types of irrational electronic prescriptions were incomplete prescription postscript (24.05%), excessive dosage (19.75%) and inappropriate medication frequency (16.42%). Among all the physicians who prescribed, the most common was physicians aged from 25 to 30 years (45.61%) and with a junior title (64.83%). Although irrational drug use interventions could significantly improve the prescribing of irrational electronic prescriptions, the situation of irrational prescribing still exists. Related interventions should be taken in future clinical work. [ABSTRACT FROM AUTHOR]

Introduction: Data from acute ischemic stroke patients throughout 2021 from one district of an archipelago city of China were collected and analyzed retrospectively to determine the management difference due to time lags from onset of symptoms to the arrival at the stroke center (FMCT) of two regions: main island (MI) and outer islets (OIs). Methods: All patients information from 1 January to 31 December 2021 was retrieved through the electronic medical records system of the only stroke center in MI. After screening and exclusion, each patient’s medical record was reviewed by two neurologists separately. Before OI patients were allocated to a group, their residential addresses at onset of the stroke were confirmed by telephone. Comparisons were analyzed between the two regions for gender, age, pre-stroke risk factors and peri-admission management parameters. Results: A total of 326 patients met the inclusion criteria: 300 from the MI group and 26 for the OI group. Intergroup comparisons for gender, age and most of the risk factors showed no significant difference. FMCT were shown to be significantly distinct (p<0.001). Hospitalization expenses also showed significant difference. The odds ratio of the definite treatment IV thrombolysis was 0.131 (OI group to MI group range: 0.017–0.987, p=0.021). Conclusion: The diagnosis and treatment of acute ischemic stroke patients from OIs was significantly postponed compared to those from MI. Therefore, new effective and efficient solutions are urgently needed. [ABSTRACT FROM AUTHOR]

Compared with CAD/CAM, fused deposition modeling (FDM) 3D printing technology is simple and safe to operate and has a low cost and high material utilization rate; thus, it is widely used. The present investigation aimed to evaluate the mechanical properties and fit of polyetheretherketone (PEEK) removable partial dentures (RPDs) constructed by FDM. We analyzed mechanical properties of PEEK samples prepared by FDM, milling, or injection molding. RPDs were designed and finite element analysis models was constructed to evaluate maximum stress and strain in the RPDs, cortical bone and mucosa. Geomagic Qualify software was used to analyze gaps between the model and the tissue surface of the framework. The results showed that the compressive strength of the 3D-printed PRDs was greater than that of the injection-molded samples. Finite element analysis demonstrated that the maximum stress on the PRDs was less than the yield strength of the material. Overall, the mechanical properties and fit of the PEEK RPD fabricated by FDM technology essentially fulfilled clinical requirements. [ABSTRACT FROM AUTHOR]

Purpose: Prior research has shown that concordance with the guideline-endorsed recommendation to re-resect patients diagnosed with primary T1 bladder cancer (BC) is suboptimal. Therefore, the aim of this population-based study was to identify factors associated with re-resection in T1 BC. Materials and Methods: We linked province-wide BC pathology reports (January 2001 to December 2015) with health administrative data sources to derive an incident cohort of patients diagnosed with T1 BC in the province of Ontario, Canada. Re-resection was ascertained by a billing claim for transurethral resection within 2 to 8 weeks after the initial resection, accounting for systemrelated wait times. Multivariable logistic regression analysis accounting for the clustered nature of the data was used to identify various patient-level and surgeon-level factors associated with re-resection. P values <0.05 were considered statistically significant (2-sided). Results: We identified 7,373 patients who fulfilled the inclusion criteria. Overall, 1,678 patients (23%) underwent re-resection. Patients with a more aggressive tumor profile and individuals without sufficiently sampled muscularis propria as well as younger, healthier and socioeconomically advantaged patients were more likely to receive re-resection (all p <0.05). In addition, more senior, lower volume and male surgeons were less likely to perform re-resection for their patients (all p <0.05). Conclusions: Only a minority of all patients received re-resection within 2 to 8 weeks after initial resection. To improve the access to care for potentially underserved patients, we suggest specific knowledge translation/exchange interventions that also include equity aspects besides further promotion of evidence-based instead of eminence-based medicine. [ABSTRACT FROM AUTHOR]

Background: Coagulation abnormalities are universal in patients with septic shock and likely play a key role in multiple organ dysfunction syndrome. Early diagnosis and management of sepsis-induced coagulopathy can influence the outcome. Thromboelastography (TEG) can effectively distinguish hypercoagulability and hypocoagulability in patients with septic shock. TEG may be a useful tool to objectively evaluate the degree and risk of sepsis. Methods: A total of 76 adult patients with septic shock were enrolled and divided into four groups: patients with hypotension requiring vasopressor and serum lactate level >2 mmol/L (group A), patients with hypotension requiring vasopressor and serum lactate level ≤2 mmol/L (group B), patients with mean arterial pressure ≥65 mmHg and serum lactate level >2 mmol/L (group C), and patients with mean arterial pressure ≥65 mmHg and serum lactate level ≤2 mmol/L (group D) after adequate fluid resuscitation. TEG values were obtained at the emergency room and after 6 hours of adequate fluid resuscitation. Data on fibrinogen (FIB) levels, international normalized ratio (INR), activated partial thromboplastin time (aPTT), blood gas, platelet count, and D-dimers were also collected. Results: The length of stay in the intensive care unit was 9.11 ± 5.36 days. Mortality rate was 6.58%. The values of reaction time, kinetics time, maximum amplitude, alpha angle, aPTT, INR, serum creatinine, FIB, and sepsis-related organ failure assessment (SOFA) score showed a significant differences. The results of the routine coagulation tests, blood gas volume, platelet count, procalcitonin level, d-dimer level, white blood cell count, creatinine level, disseminated intravascular coagulation score, SOFA score, and TEG values after adequate fluid resuscitation were significantly different between groups A and B, groups A and C, groups A and D, groups B and D, and groups C and D. Conclusion: TEG is helpful in predicting the severity of sepsis and outcome of patients. [ABSTRACT FROM AUTHOR]

The Longtan Formation of the Upper Permian in the southwestern Guizhou Province is widely exposed in the area. From the northwest to the southeast, there are terrestrial, sea-continental and marine sediments with thicknesses ranging from 0 to 543 m. The mudstone intervals are thicker. Good shale gas reservoir conditions. Through the reservoir characteristics of the Upper Permian Longtan Formation shale in the southwestern Guizhou and the kerogen (soul group and vitrinite, chitin group, inertin group), organic carbon content (TOC) and organic maturity (Ro) and other analytical studies. The results show that the organic matter types of the shale in the Longtan Formation are mainly type II2, and II1 and III are present. The organic carbon content is 4.54% on average and the organic carbon content is very good. The maturity of organic matter averaged 2.03%, and the degree of evolution was generally higher. The Longtan Formation mud shale has low porosity and low permeability, and the water medium has a certain softening effect on rock strength. The favorable area is mainly located in the east of the Shuicheng- Pu'an-Xingyi line. [ABSTRACT FROM AUTHOR]

From the five aspects of marine resource endowment, marine ecological environment, marine economic development, marine culture construction and marine system management, 29 specific indicators were selected to establish a marine ecological civilization evaluation index system for coastal cities. Through the construction of BP neural network model to measure the level of marine ecological civilization construction in 53 prefecture-level cities in China's coastal areas in 2016.According to the evaluation value, it is divided into five levels: high level, high level, medium level, low level and low level, and its spatial differentiation is analyzed. The results show that the construction of marine ecological civilization in China's coastal cities is generally moderate, but the differences between cities at various levels are obvious. The level of marine ecological civilization construction in Qingdao is the highest, and the level of marine ecological civilization construction in Tangshan is the lowest. According to the provincial distribution, Shanghai and Hainan have the highest construction level, Tianjin and Shandong provinces have higher levels, Guangdong and Fujian provinces have medium levels, and Hebei and Jiangsu provinces have the lowest construction level. The level of urban marine ecological civilization construction in the Yellow Sea is significantly higher than other sea areas. The endowment of marine resources and the quality of marine ecological environment are the basic factors affecting the construction of marine ecological civilization. Marine economic development is a key factor affecting the construction of marine ecological civilization. Marine culture and marine system are the factors that affect the level of marine ecological civilization construction. [ABSTRACT FROM AUTHOR]

Guided by theoretical frameworks in conflict management and intergenerational communication, this study examined the influences of gender and filial obligation on young adults' (N = 182) preference of intergenerational conflict management styles with older adults. Results indicated that young adults preferred the integrating, avoiding, and accommodating styles (the integrating style was rated higher than the accommodating style) more than the competing style in intergenerational conflict. In addition, female participants had higher beliefs of filial obligation than male participants. Furthermore, young adults' beliefs of filial obligation were positively associated with preference of the integrating, accommodating, and avoiding styles, but were not associated with the competing style. Although gender was not associated with any of the conflict styles directly, the indirect effect through filial obligation on the accommodating styles was significant. These major findings are discussed in light of prior literature with respect to intergenerational communication and conflict management styles. [ABSTRACT FROM AUTHOR]

This paper reports the study of the effect of different ions (monovalent, bivalent, and multiple ions) on nanosilica-stabilized carbon dioxide (CO2) foam generation. CO2 foam was generated by coinjecting CO2/5,000 ppm nanosilica dispersion (dispersed in different concentrations of brine) into a sandstone core under 1,500 psi and at different temperatures. A sapphire observation cell was used to determine the foam texture and foam stability. Pressure drop across the core was measured to estimate the foam mobility. The results indicated that more CO2 foam was generated as the sodium chloride (NaCl) concentration increased from 1.0 to 10%. In addition, the foam bubble became smaller and foam stability improved with the increase in NaCl concentration. The CO2-foam mobility decreased from 13.1 to 2.6 md/cp when the NaCl concentration increased from 1 to 10%. For the bivalent ions, the generated CO2-foam mobility decreased from 19.7 to 4.8 md/cp when CaCl2 concentration increased from 0.1 to 1.0%. Synthetic produced water with total dissolved solids (TDS) of 18,583 ppm was prepared to investigate the effect of multiple ions on foam generation. The results showed that stable CO2 foam was generated as the synthetic produced water and nanosilica dispersion/CO2 flowed through a porous medium. The lifetime of the foam was observed to be more than 2 days as the foam stood at room temperature. Mobility of the foam was calculated as 5.2 md/cp. [ABSTRACT FROM AUTHOR]

In the US, for every barrel of oil, approximately 7 bbl of water is produced. Produced water consists of various amounts of organic and inorganic constituents from the source geologic formation and associated hydrocarbons. Produced-water handling has become a major effort for all waterflood operations. Membrane technology has been widely used for produced-water purification because of its economic and portable properties. However, the presence of organic matter in produced water causes serious membrane fouling, which shortens membrane life and increases operation costs. In this study, to reduce organic components in produced water, we fabricated a series of polyethersulfone (PES)/cellulose acetate butyrate (CAB) hybrid hollow-fiber membranes (HFMs) with different polymer-mass ratio for the removal of organic matter (benzene, toluene, octanoic acid, and hexanoic acid) from produced water. The morphology of the hybrid PES/CAB HFMs was characterized by scanning electron microscope (SEM) and atomic force microscope (AFM). The performance of the hybrid PES/CAB HFMs was evaluated in terms of permeate-water flux (PWF), organic-matter-removal efficiency, flux-decline ratio (FDR), and flux-recovery ratio (FRR). The results revealed that the PES/CAB hybrid HFMs comprised open-ended selective layers with homogeneous CAB distribution. Compared with neat PES HFM, the PES/CAB hybrid membranes exhibited 20.3% improvement of PWF. The organics-removal efficiency was higher than 99.8% for all the membranes. With 1.74 wt% of CAB in PES dope solution, the hybrid membranes possessed the lowest FDR and highest FRR, indicating the excellent antifouling ability of the PES/CAB HFMs. Because of these results, a two-stage anti-fouling HFM nanofiltration process was proposed as a follow-up work. The PES/CAB hybrid HFMs could serve as an attractive alternative for removing organic matter from produced water. [ABSTRACT FROM AUTHOR]