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3D seismic and well log dataset were used jointly to build a structural model of the Late Cretaceous to Pliocene sedimentary sequence in the Maui Gas Field, to predict structural mechanics in the Taranaki Basin with geostatistics. Three phases of tectonic movements affected by faulting in this field were identified by this structural model: Late Cretaceous to Palaeocene rifting phase, Late Eocene to Miocene compressive faulting phase, and Plio-Pleistocene differential (compressive faulting in Maui South, normal fault activity in Maui North) faulting phase. Different phases of tectonic movements resulted in different structural patterns, Early Oligocene formations have abundant normal faults with slight slip and higher dip angles (40°-70°), and lower dip angle in the north (10°-15°) than in the south (15°-20°); Mid-Oligocene to Late Miocene formations contain low angle reverse faults (20°-40°), showing the structures in this period were affected by compressive stress on the whole; structural inversion occurred during mid-Oligocene to Pliocene, indicating the structural stress was contraction first and extension later in this period. Key words: Taranaki Basin, Maui Gas Field, 3D seismic, fault framework, extensional structure, inversion structure, variogram analysis, structure modeling

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Copyright of Tunnel Construction / Suidao Jianshe (Zhong-Yingwen Ban) is the property of Tunnel Construction Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Fishery Modernization is the property of Fishery Modernization Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Laser Biology / Acta Laser Biology Sinica is the property of Acta Laser Biology Sinica Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Advanced Textile Technology is the property of Zhejiang Sci-Tech University Magazines and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Tissue Engineering Research / Zhongguo Zuzhi Gongcheng Yanjiu is the property of Chinese Journal of Tissue Engineering Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Wool Textile Journal is the property of National Wool Textile Science & Technology Information Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Practical Oncology Journal is the property of Journal of Practical Oncology Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The flight control system of helicopter is difficult to control for their performance of high-order unstable, nonlinear, and multiple-inputs multiple-outputs (MIMO) system. The behavior of two degree-of-freedom (2-DOF) helicopter has significant cross-coupling between pitch and yaw directional motions. This study presents a control system for a 2-DOF helicopter plant which more specific presented as twin-rotor MIMO system by using fuzzy logic technique. Fuzzy logic controller (FLC) is designed by using MATLAB to improve the performance of flight control system. Thus, the designed pitch and yaw controller are tuned by adjusting the range of membership function of input variable and the number of fuzzy rules used. The designed FLC are implemented and the results of the simulation are compared with LQR controller. The proposed pitch fuzzy controller shows improvement in rise time from 0.607sec to 0.458s, settling time from 7.188s to 1.866s, and percent overshoot from 38.1% to 0% over the existing pitch LQR controller. Meanwhile, the proposed yaw fuzzy controller shows improvement in rise time from 1.361s to 0.828s, settling time from 9.120sec to 2.517 s, and percent overshoot from 23.51% to 2.86% over the existing yaw LQR controller. Hence, the simulation results show that FLC has great potential than LQR controller for the flight control system. [ABSTRACT FROM AUTHOR]

To analyze the changes in lactate dehydrogenase, creatine kinase, creatine kinase isoenzyme, high-sensitivity troponin T, N-terminal B-type natriuretic peptide precursor, homocysteine, and novel inflammatory indices (neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, systemic immune-inflammation index) before and after competitions in amateur marathon runners, and to assess the effects of myocardial injury due to acute exercise and the value of novel inflammatory indices in marathon exercise monitoring. This paper is an analytical study. Amateur athletes recruited by Beijing Hospital to participate in the 2022 Beijing Marathon and the 2023 Tianjin Marathon, and those who underwent health checkups at the Beijing Hospital Medical Checkup Center from January to June 2023 were selected as the study subjects, and 65 amateur marathon runners (41 males and 24 females) and 130 healthy controls (82 males and 48 females) were enrolled in the study according to the inclusion criteria. Peripheral blood was collected one week before, immediately after, and one week after running, and routine blood tests, cardiac enzymes, infarction markers, N-terminal B-type natriuretic peptide precursor, and homocysteine were performed to calculate the values of novel inflammatory indexes. Wilcoxon signed-rank test and Spearman's rank correlation analysis were used to compare the differences in the levels of each index between the amateur marathon population and the health checkup population, and to compare the changes and correlations of each index at the three time points in the amateur marathoners.The results showed that the neutrophil-lymphocyte ratios of the healthy physical examination population and 65 amateur marathoners 1 week before running were 1.73 (1.33, 2.16) and 1.67 (1.21, 2.16), the platelet-lymphocyte ratios were 122.75 (96.69, 155.89) and 120.86 (100.74, 154.63), and the systemic immune inflammation index was 398.62 (274.50, 538.69) and 338.41 (258.62, 485.38), etc.; on 1 week before running, immediately after running and 1 week after running, lactate dehydrogenase of 65 amateur marathon runners was 173.00(159.00, 196.50)U/L,284.00(237.50, 310.50)U/L, 183.00(165.50, 206.50)U/L, creatine kinase was 131.00(94.30, 188.20)U/L,318.00(212.00, 573.15)U/L,139.00(90.55, 202.40)U/L, creatine kinase isoenzyme was 2.50(1.76, 3.43)μg/L,6.24(4.87, 10.30)μg/L,2.73(1.57, 4.40)μg/L.In 65 amateur marathon runners, lactate dehydrogenase, creatine kinase, creatine kinase isoenzyme, high sensitivity troponin T, N-terminal B-type natriuretic peptide precursor, homocysteine, and novel inflammation markers were significantly elevated in the immediate post-run period compared with 1 week before the run, and the differences were statistically significant ( Z =-7.009, Z =-6.813, Z =-6.885, Z =-7.009, Z =-7.009, Z =-6.656; P <0.05 for the above indicators).Neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and systemic immune-inflammatory index all showed significant positive correlation with the pre-and post-run rates of change of high-sensitivity troponin T ( ρ =0.28, P =0.03; ρ =0.31, P =0.01; ρ =0.27, P =0.03); these 3 markers were also significantly and positively correlated with the pre-and post-run rates of change in a collection of myocardial-related markers such as lactate dehydrogenase, creatine kinase, creatine kinase isozymes, high-sensitivity troponin T, N-terminal B-type natriuretic peptide precursor, and homocysteine, respectively( r =0.446, P =0.039; r =0.452, P =0.033; r =0.449, P =0.036).In addition, the platelet-lymphocyte ratio was positively correlated with the pre-and post-run rates of change in creatine kinase and creatine kinase isoenzymes( ρ =0.27, P =0.03; ρ =0.28, P =0.02).In conclusion, acute myocardial injury may be triggered during marathon exercise. Changes in novel inflammatory markers were significantly associated with changes in myocardial enzymes, infarction markers, N-terminal B-type natriuretic peptide precursors, and homocysteine, which may be of value for the prediction of myocardial injury during exercise.

Objective: To explore the clinical characteristics of intermittent exotropia (IXT) patients with different visual perception and oculomotor control. Methods: A cross-sectional study was conducted. Minor IXT patients between March 2021 and May 2023 at Beijing Tongren Hospital were enrolled. Demographic characteristics were recorded, and visual perception and oculomotor control were evaluated. The patients were divided into simultaneous vision disappearing and existing groups, fusion disappearing and existing groups, distant stereoscopic vision disappearing and normal groups, and near stereoscopic vision injury and normal groups. Statistical description was performed by using M ( Q 1 , Q 3 ). Rank sum test was used to compare the Revised Newcastle Control Score (RNCS), near and far strabismus degree, duration of disease, and age of onset among different groups. The correlation between visual perception and oculomotor control and the correlation of duration of disease and age of onset with visual perception and oculomotor control were analyzed by Pearson correlation analysis. Results: A total of 381 patients were enrolled, including 189 males and 192 females, with a median age of 7 (6, 9) years. The incidence of normal visual perception was 19.4% (74/381). Compared with simultaneous vision and fusion existing groups and distant and near stereoscopic vision normal groups, the RNCS [7 (5, 9) vs 4 (3, 6), 6 (5, 8) vs 4 (3, 6), 5 (4, 7) vs 3 (3, 5), and 5 (3, 6) vs 4 (3, 6)], near strabismus degree [65 Δ (60 Δ , 80 Δ ) vs 40 Δ (30 Δ , 50 Δ ), 60 Δ (45 Δ , 65 Δ ) vs 40 Δ (30 Δ , 50 Δ ), 50 Δ (40 Δ , 60 Δ ) vs 35 Δ (30 Δ , 45 Δ ), and 45 Δ (30 Δ , 60 Δ ) vs 40 Δ (30 Δ , 50 Δ )] and far strabismus degree [60 Δ (50 Δ , 75 Δ ) vs 35 Δ (25 Δ , 50 Δ ), 55 Δ (41 Δ , 65 Δ ) vs 35 Δ (25 Δ , 45 Δ ), 45 Δ (30 Δ , 60 Δ ) vs 35 Δ (25 Δ , 45 Δ ), and 40 Δ (30 Δ , 60 Δ ) vs 35 Δ (25 Δ , 45 Δ )] increased significantly in disappearing simultaneous vision, fusion, and distant stereoscopic vision groups and injury near stereoscopic vision group (all P <0.05). Compared with simultaneous vision and fusion existing groups and distant stereoscopic vision normal group, duration of disease was significant longer in disappearing simultaneous vision, fusion, and distant stereoscopic vision groups [3 (1, 5) years vs 2 (1, 3) years, 2 (1, 4) years vs 1 (1, 3) years, 2 (1, 4) years vs 1 (1, 3) years, all P <0.05]. The age of onset in disappearing distant stereoscopic vision group was significantly lower than normal distant stereoscopic vision group [5 (3, 7) years vs 6 (4, 8) years, P =0.005]. Pearson correlation analysis showed that subjective angle and random dot stereogram (RDS) stereoacuity were positive correlation with RNCS, and the near and far strabismus degree ( r =0.414, 0.516, and 0.559, all P <0.001; r =0.153, 0.142, and 0.173, all P <0.05). Subjective angle, RNCS, and the near and far strabismus degree were positive correlation with duration of disease ( r =0.238, 0.195, 0.236, 0.239, all P <0.001) and negative correlation with age of onset ( r =-0.184, -0.279, -0.112, -0.147, all P <0.05). Conclusions: Nearly 20% of IXT patients have normal visual perception. With the longer duration of disease or lower age of onset, the incidence of abnormal visual perception is higher and injury of visual perception and oculomotor control is more serious.

Objective: To investigate the effect of zirconia personalized gingival structure on peri-implant soft and hard tissue stability after single-tooth implant restorations in patients with thin gingival biotypes in the anterior region, with a view to provide a clinical guideline. Methods: This retrospective study included 20 patients with thin gingival biotype and implant restorations in the anterior region. These patients included 9 males and 11 females, and the age was (35.2± 10.3) years. The patients were from the Department of Periodontal Implantology, Stomatology Hospital, Southern Medical University from January 2018 to December 2022. Computer-aided design/computer-aided manufacturing (CAD/CAM) techniques were used to fabricate a titanium base zirconia personalized gingival structure to maintain the soft-tissue perforated gingival contour of the anterior esthetic zone. This structure consists of two modalities: titanium base + zirconia outer crown or titanium base personalized zirconia abutment + zirconia outer crown. Clinical outcomes were recorded immediately and after delivery of the final restorations. Implant retention was recorded, esthetic scoring was performed using the pink esthetic index, the amount of bone resorption at the implant margins was measured based on digitized apical radiographs, and periodontal health was evaluated using the modified plaque index and the modified bleeding index. Results: The survival rate of the 20 implants was 100% after 3 years of wearing the final restorations, with a pink aesthetic score of 9.3±0.9. Bone resorption at the proximal and distal mesial margins of the implants was 0.09 (-0.21, 0.20) mm, 0.17 (-0.12, 0.27) mm after 3 years, respectively, and the difference was not statistically significant when compared to bone resorption immediately after placement of the final restoration [0(0, 0) mm] ( Z =-1.03, P =0.394; Z =-2.05, P =0.065). Conclusions: Zirconia personalized gingival structure maintains the stability of peri-implant hard and soft tissues of thin gingival biotypes in the anterior region.

Coumarins are natural products with benzopyran ring as the parent nucleus. Numerous coumarin derivatives exhibit a variety of pharmacological activities, including antibacterial, anti-inflammatory, antitumor, anti-coagulant, anti-osteoporotic, and insecticidal activities. Therefore, they play an important role in both medicine and agriculture. The development and utilization of coumarin derivatives have attracted increasing attention. The advancement of gene sequencing technology and the rapid progress in synthetic bio-logy have led to significant advancement in the biosynthesis of coumarin derivatives, and has received increasing attention from global researchers. This paper presents a comprehensive overview of the key biosynthesis-related enzymes of coumarin derivatives, such as cytochrome P450 enzyme(CYP450), prenyltransferase(PT), UDP-glucosyltransferase(UGT). Additionally, the pharmacological activities of these enzymes, including anti-tumor, anti-inflammatory, antioxidant, and antibacterial activities, are systematically summarized. This review aims to provide a valuable reference for the biosynthesis of coumarin derivatives and further exploration of their medicinal potential.

Objective: To investigate the effect and mechanism of SIRT7 in epithelial mesenchymal transformation (EMT) of pancreatic cancer cells. Methods: The pancreatic cancer cells were divided into siControl, siSIRT7, over-expression SIRT7, siSIRT7+siCOL4A1, and siSIRT7+siSLUG groups using siRNA or plasmid transfection. The proliferation, migration and invasion of pancreatic cancer cells were detected by EdU, wound healing assay and Transwell experiments, respectively. The expression of EMT and cancer stem cell (CSC) markers were detected by quantitative real-time reverse transcription polymerase chain reaction assay (qRT-PCR) and western blot. RNA sequencing (RNA-seq) in SIRT7 knockdown PANC-1 cells was performed to explore the signaling pathways and target genes regulated by SIRT7. Then the target genes directly regulated by SIRT7 were identified with quantitative chromatin immunoprecipitation experiment (q-ChIP) and chromatin immunoprecipitation polymerase chain reaction (ChIP-PCR). The expressions of SIRT7 and target genes were detected by immunohistochemical (IHC) in pancreatic cancer tissues, and the correlation between SIRT7 and target gene expression was analyzed using TCGA dataset. The correlation between expression of SIRT7 or target genes and survival was analyzed on KM-plotter website. Finally, GeneMANIA, STRING and ENCORI were used to predict SIRT7-related proteins and miRNAs. Results: EdU assay showed that the cell proliferation rates in SIRT7-overexpressed PANC-1 [(19.33±0.35)%] and BxPC-3 cells [(17.00±1.89)%] were lower than those in the control group [(31.60±1.37)% and (24.33±0.78)%, respectively, P ＜0.05]. The proliferation rates of SIRT7-knockdown PANC-1 [(23.94±1.00)% and (27.08±0.97)%] and BxPC-3 cells [(22.00±1.86)% and (25.96±1.61)%] were higher than those of the siControl group [(11.80±1.86)% and (13.42±1.39)%, respectively, P ＜0.05]. In PANC-1 cells, the wound healing assay showed that the relative migration rate of SIRT7-overexpression cells [(76.67±2.74)%] was lower than that of control cells [(100.00±2.13)%, P ＜0.05]; the relative migration rate of cells with SIRT7 knockdown [(134.22±4.08)% and (199.82±9.20)%, respectively] was higher than that of siControl group [(102.24±3.13)%, P ＜0.05]. Compared with the control group, SIRT7 overexpression decreased the number of migrated BxPC-3 cells (45.66±1.69 vs 28.33±2.62, P ＜0.05); while SIRT7 knockdown increased these numbers (65.66±2.86 and 82.00±2.94 versus 33.00±0.81, P ＜0.01). Transwell experiment revealed that the number of invaded cells in SIRT7 overexpression groups (16.33±2.05 and 34.66±1.69) was lower than that control groups (54.33±4.64 and 58.66±5.90, P ＜0.05); with SIRT7 knockdown, the numbers of invaded PANC-1 (63.66±2.49 and 69.33±3.29) and BxPC-3 cells (134.33±3.09 and 181.66±4.02) were higher than those in control groups (35.33±2.49 and 42.00±0.81, P ˂0.05). Also, SIRT7 knockdown decreased the expressions of epithelial markers and increased the expressions of mesenchymal and CSC markers. RNA-seq analysis showed that SIRT7 was involved in regulating a variety of cancer-related signaling pathways, including the pancreatic cancer pathway and the EMT pathway. Furthermore, SIRT7 could directly bind to the promoter regions of target genes, such as COL4A1 and SLUG. SIRT7 was negatively correlated with the expression and function of COL4A1 and SLUG in pancreatic cancer cells. The expressions of SIRT7, COL4A1, SLUG and SOX2 were verified in pancreatic cancer tissues by IHC. Finally, SIRT7 was predicted to be associated with many proteins and miRNAs based on GeneMANIA, STRING, and ENCORI online tools. Conclusions: SIRT7 can inhibit the EMT of pancreatic cancer cells through transcriptionally inhibiting the expression of target genes, such as COL4A1 and SLUG. Thus, SIRT7 may serve as a potential tumor suppressor gene in pancreatic cancer.

Objective: To explore the correlation between periodontitis (PD) and chronic kidney disease (CKD) in adults, as well as the potential mechanisms involved. Methods: Data on PD and CKD from the National Health and Nutrition Examination Survey (NHANES) database between 1999 and 2014 were downloaded. Weighted univariate and multivariate logistic regression analyses were conducted to investigate the risk factors associated with PD and CKD, considering demographic and clinical indicators. Using publicly available genome-wide association study (GWAS) summary datasets for CKD and PD as outcome variables, as well as 731 immune cell phenotypes and 91 inflammatory proteins as exposure factors from the OPEN GWAS database, a two-sample Mendelian randomization (TSMR) analysis was performed using the inverse-variance weighted (IVW) method. Results: Seven demographic indicators including gender, age, race, education level, marital status, income, and health are related to the incidence of CKD and PD. Among them, the elderly (≥60 years old), poverty (poverty-income ratio <1.3), divorce or widowhood, and male ratio in the comorbidity group of CKD and PD [67.12% (833/1 241), 36.83% (457/1 241), 34.41% (427/1 241), and 57.78% (717/1 241) respectively] were significantly higher than those in the control group [23.71% (4 179/17 623), 29.17% (5 141/17 623), 18.16% (3 200/17 623), and 48.73% (8 587/17 623) respectively] (all P< 0.001). Those with high educational level (university and above) and self-rated excellent health accounted for a relatively small proportion in the comorbidity group [14.10% (175/1 241) and 8.22% (102/1 241) respectively]. The prevalence of PD increased among individuals with abnormal renal function indices, including glomerular filtration rate, urine protein/creatinine ratio, serum creatinine, serum uric acid, and blood urea nitrogen. Univariate logistic regression analysis showed a positive correlation between the incidence of PD and CKD ( OR= 2.14, 95 %CI : 1.90-2.42, P< 0.001). Multivariate logistic regression analysis also indicated that PD and CKD were potential risk factors for each other (PD for CKD: OR= 1.22, 95 %CI : 1.07-1.40, P= 0.004; CKD for PD: OR= 1.19, 95 %CI : 1.04-1.37, P= 0.012). Furthermore, after adjusting the model based on demographic indicators, there was still a significant correlation between PD and CKD ( P= 0.010). Mechanistically, the results of the TSMR analysis support the existence of a common risk factor mediated by immune cells between CKD and PD, namely the expression of CD64 on multiple innate immune cells mediates the occurrence of CKD and PD. The absolute count of CD64 + monocytes is associated with an increased risk for both CKD ( HR =1.11) and PD ( HR =1.07), while same tendency showed in the absolute count of CD64 + neutrophils for CKD ( HR =1.22) and PD ( HR =1.23). Conclusions: There is a positive correlation between CKD and PD, particularly moderate to severe PD, and the shared pathogenesis involves CD64 + monocytes in the circulatory system. Targeted interventions focusing on CD64 molecules or monocyte subsets may be beneficial.

We studied the population characteristics of Caragana microphylla and related soil factors across diffe-rent stages of shrub encroachment ( i.e ., light, moderate, and severe) on the Xilingol Grassland of Inner Mongolia. The results showed that the density and height of C. microphylla gradually increased during the process of grassland shrub-encroachment from light to moderate to severe. The density and height were increased by 196.0% and 34.5% from light to moderate stage of shrub encroachment, and were increased by 25.4% and 17.6% from moderate to severe stage. Crown size, basal diameter, tiller number per clump, and aboveground productivity of C. microphylla tented to decrease first and then increase, while the proportion of aboveground biomass allocation to leaves decreased across the stages of shrub encroachment. The competition between C. microphylla and herbaceous species was strongest in the moderate encroachment stage. C. microphylla reduced its lateral growth (such as crown size, basal diameter, and tiller number per clump) and increased density and height to get competitive advantage. Limi-ting soil factors for C. microphylla varied significantly at different stages of shrub encroachment. In the light encroachment stage, soil factors had little effect on the growth of C. microphylla . In the moderate encroachment stage, soil moisture in the deep layer (20-50 cm) and soil pH were the key factors limiting shrub density. In the severe encroachment stage, soil moisture in the deep layer and pH limited the vertical growth of C. microphylla , while soil moisture of shallow layer (0-20 cm) and nutrients were the limiting factors for the lateral expansion of shrubs.

Background: Thirst is a common symptom among patients with endotracheal intubation in the intensive care unit (ICU), with an estimated prevalence of 88%., Purpose: This study was designed to compare the effectiveness of cold saline spray and cold water spray in alleviating thirst, and to explore the maintenance and sustained effects of both groups in relieving thirst among patients with endotracheal intubation in the ICU., Methods: Patients with indwelling tracheal tubes in the medical ICU were recruited from one medical center in northern Taiwan and randomly assigned to either the cold saline (n = 18) or cold water (n = 18) group. The cold saline group received three rounds of cold saline spray at a temperature of 2°C - 8°C. Each round consisted of 10 sprays directed toward each of the four surfaces of the oral cavity followed by a 5-minute wait period. This process was repeated three times, with 30-minute intervals between interventions. The cold water group received the same intervention steps using a cold water spray at 2°C - 8°C. Thirst intensity was measured using a numeric rating scale before and after each of the three interventions in both groups. Demographic and relevant physiological data were collected on the participants by reviewing their medical records., Results: Both of the interventions were found to effectively alleviate thirst intensity, with no significant difference between the two groups in terms of thirst intensity reduction after each intervention detected. Only the cold water spray had a maintenance effect, while the two groups had a continuous sustained effect in alleviating thirst intensity., Conclusions: Both of the interventions effectively alleviated thirst, and the cold water spray had both maintenance and sustained effects in alleviating thirst intensity. Based on the results, the cold water spray method may be considered as the priority treatment for thirst alleviation by healthcare providers in the clinical management of patients with tracheal intubation.

Background: Colorectal cancer (CRC) is a primary cause of cancer-related mortality, and, after treatment, cancer survivors often worry that disease recurrence may worsen their health. Nevertheless, limited research on fear of cancer recurrence (FCR) and treatment-related symptoms has been conducted on survivors of CRC., Purpose: This study was designed to explore (1) symptom distress severity and post-treatment FCR in CRC survivors and (2) the predictors of FCR., Methods: A cross-sectional correlational research design and convenience sampling approach were used to recruit patients at the colorectal surgery outpatient department of a medical center in central Taiwan. Basic demographic data, the Symptom Distress Scale - Chinese Modified Form, and Fear of Progression Questionnaire - Short Form were used as monitoring tools. Pearson's product-moment correlation analysis, independent t-tests, one-way ANOVA, and stepwise linear regression analysis were used for statistical analysis., Results: One hundred fourteen survivors of CRC with an average age of 63.44 were enrolled as participants. The top five symptoms of distress were numbness, bowel patterns, fatigue, insomnia, and dry mouth, and the average FCR score was 18.09. Gender, educational level, monthly disposable income, and symptom distress were identified as significant predictors of FCR, with an overall explanatory power of 41.4%., Conclusions: Level of post-treatment FCR in survivors of CRC is influenced by symptom distress severity. Early intervention by healthcare providers to control or alleviate physical symptoms can help prevent the emergence of negative emotions and improve quality of life in this patient group.

Here, we reported the diagnosis and treatment of a case of HIV infected person complicated by an extremely rare infection with Mycobacterium celatum . Due to the similarity of homologous sequence regions between Mycobacterium celatum and Mycobacterium tuberculosis complex, the identification of conventional Mycobacterium species was incorrect, which was corrected after first-generation 16S rRNA sequencing. This report aimed to improve the clinical understanding of Mycobacterium celatum infection and the level of differential diagnosis between non-tuberculous mycobacterial disease and tuberculosis.

Objective: The fully automatic segmentation of glioma and its subregions is fundamental for computer-aided clinical diagnosis of tumors. In the segmentation process of brain magnetic resonance imaging (MRI), convolutional neural networks with small convolutional kernels can only capture local features and are ineffective at integrating global features, which narrows the receptive field and leads to insufficient segmentation accuracy. This study aims to use dilated convolution to address the problem of inadequate global feature extraction in 3D-UNet., Methods: 1) Algorithm construction: A 3D-UNet model with three pathways for more global contextual feature extraction, or 3DGE-UNet, was proposed in the paper. By using publicly available datasets from the Brain Tumor Segmentation Challenge (BraTS) of 2019 (335 patient cases), a global contextual feature extraction (GE) module was designed. This module was integrated at the first, second, and third skip connections of the 3D UNet network. The module was utilized to fully extract global features at different scales from the images. The global features thus extracted were then overlaid with the upsampled feature maps to expand the model's receptive field and achieve deep fusion of features at different scales, thereby facilitating end-to-end automatic segmentation of brain tumors. 2) Algorithm validation: The image data were sourced from the BraTs 2019 dataset, which included the preoperative MRI images of 335 patients across four modalities (T1, T1ce, T2, and FLAIR) and a tumor image with annotations made by physicians. The dataset was divided into the training, the validation, and the testing sets at an 8∶1∶1 ratio. Physician-labelled tumor images were used as the gold standard. Then, the algorithm's segmentation performance on the whole tumor (WT), tumor core (TC), and enhancing tumor (ET) was evaluated in the test set using the Dice coefficient (for overall effectiveness evaluation), sensitivity (detection rate of lesion areas), and 95% Hausdorff distance (segmentation accuracy of tumor boundaries). The performance was tested using both the 3D-UNet model without the GE module and the 3DGE-UNet model with the GE module to internally validate the effectiveness of the GE module setup. Additionally, the performance indicators were evaluated using the 3DGE-UNet model, ResUNet, UNet++, nnUNet, and UNETR, and the convergence of these five algorithm models was compared to externally validate the effectiveness of the 3DGE-UNet model., Results: 1) In internal validation, the enhanced 3DGE-UNet model achieved Dice mean values of 91.47%, 87.14%, and 83.35% for segmenting the WT, TC, and ET regions in the test set, respectively, producing the optimal values for comprehensive evaluation. These scores were superior to the corresponding scores of the traditional 3D-UNet model, which were 89.79%, 85.13%, and 80.90%, indicating a significant improvement in segmentation accuracy across all three regions ( P <0.05). Compared with the 3D-UNet model, the 3DGE-UNet model demonstrated higher sensitivity for ET (86.46% vs. 80.77%) ( P <0.05) , demonstrating better performance in the detection of all the lesion areas. When dealing with lesion areas, the 3DGE-UNet model tended to correctly identify and capture the positive areas in a more comprehensive way, thereby effectively reducing the likelihood of missed diagnoses. The 3DGE-UNet model also exhibited exceptional performance in segmenting the edges of WT, producing a mean 95% Hausdorff distance superior to that of the 3D-UNet model (8.17 mm vs. 13.61 mm, P <0.05). However, its performance for TC (8.73 mm vs. 7.47 mm) and ET (6.21 mm vs. 5.45 mm) was similar to that of the 3D-UNet model. 2) In the external validation, the other four algorithms outperformed the 3DGE-UNet model only in the mean Dice for TC (87.25%), the mean sensitivity for WT (94.59%), the mean sensitivity for TC (86.98%), and the mean 95% Hausdorff distance for ET (5.37 mm). Nonetheless, these differences were not statistically significant ( P >0.05). The 3DGE-UNet model demonstrated rapid convergence during the training phase, outpacing the other external models., Conclusion: The 3DGE-UNet model can effectively extract and fuse feature information on different scales, improving the accuracy of brain tumor segmentation., Competing Interests: 利益冲突　所有作者均声明不存在利益冲突, (© 2024《四川大学学报（医学版）》编辑部 版权所有Copyright ©2024 Editorial Board of Journal of Sichuan University (Medical Sciences).)

Coal mining is the world's primary means of coping with an increasing energy demand. However, with the mining of coal, the regional ecosystem has been damaged to varying degrees, resulting in a decrease in the "carbon sink" capacity. Vegetation restoration is the basis for the restoration of degraded ecosystems and carbon sequestration functions in mining areas. However, no systematic studies have been conducted on the effects of vegetation restoration on soil organic carbon in coal mining areas on a global scale. Therefore, it is not possible to accurately predict the response of the global SOC pool to vegetation restoration. In this study, soil physicochemical properties of vegetation restoration were collected from 112 peer-reviewed articles to assess the effects of vegetation restoration type, soil depth, restoration year, mean annual temperature, annual precipitation, and elevation on soil organic carbon in coal mining areas and to identify relevant key drivers. The results showed that the damaged coal mine area could significantly improve the physicochemical properties of the soil through vegetation restoration. The restored soils had 39.02% higher SOC reserves compared to that in unrestored or naturally restored soils. When environmental factors were not considered, the vegetation restoration types that were favorable for SOC stock accumulation were cropland > woodland > grassland > shrubland. All four types of vegetation restoration significantly increased the SOC storage in the surface layer (0-20 cm). Grassland and shrubs significantly increased SOC storage at depth (>40 cm), whereas SOC storage at depth under woodland and farmland types was not significantly different from SOC storage after unrestored or natural restoration. The increasing trend of SOC storage after vegetation restoration decreased with increasing soil depth. The specific vegetation restoration strategy should select the appropriate vegetation type according to the climatic conditions. The types of vegetation restoration with higher carbon sequestration effects in damaged coal mining areas with mean annual temperature <0℃ and mean annual precipitation <500 mm were grassland or shrubland. In contrast, woodland and cropland restoration types could better increase SOC storage in environments with mean annual temperature >15℃ and annual precipitation >800 mm. TN, BD, AN, and AK were the main factors influencing the ability to affect soil carbon sequestration. This study can provide a theoretical reference for quantifying the carbon sequestration effects of different vegetation restoration measures in damaged coal mining areas and the restoration and reconstruction of degraded ecosystems.

Carbon, nitrogen, phosphorus, and potassium in the soil are the necessary nutrient elements for plant growth, and their contents and ecological stoichiometry can reflect the status of soil quality and nutrient limitation. The Huayuankou Yellow River Floating Bridge Wetland in the lower Yellow River was selected as the research object. The methods of ANOVA, redundancy analysis, and linear regression fitting were used to study the contents of organic carbon (SOC), total nitrogen (TN), total phosphorus (TP), total potassium (TK), alkaline nitrogen (AN), available phosphorus (AP), available potassium (AK), and their ecological stoichiometric ratios as well as the limiting elements of soil nutrients, and the key physicochemical properties that affect soil nutrients and their ecological stoichiometry in the wetland were revealed. The results showed that the mean values of ω (SOC), ω (TN), ω (TP), ω (TK), ω (AN), ω (AP), and ω (AK) in wetland soil were 5.46 g·kg -1 , 0.60 g·kg -1 , 0.28 g·kg -1 , 17.06 g·kg -1 , 13.75 mg·kg -1 , 6.54 mg·kg -1 , and 158.56 mg·kg -1 , respectively, which showed an increasing trend from the river bank to the shoaly land and were generally higher at the high vegetation coverage areas than at the low vegetation coverage areas. There were significant correlations among SOC, TN, TP, and TK. Soil C/P, C/K, N/P, and N/K showed a consistent trend with soil nutrients, whereas C/N showed the opposite. The coefficients of variation of SOC, TN, AN, N/P, and N/K in the soil exceeded 50.00%, with significant spatial differences. The average value of C/N in wetland soil was 11.882, which was close to the average level of soils in China, whereas the average values of C/P and N/P were 49.119 and 4.516, respectively, both of which were lower than the average level of soils in China, and the N/P of soil was far less than 14, which indicated that N was limited in the soil. The proportion of clay and electrical conductivity combined to explain 61.4% and 43.9% of the variation in the soil nutrients and their ecological stoichiometry, respectively, which were the dominant soil physicochemical properties affecting the soil nutrients and their ecological stoichiometry of Huayuankou Yellow River Floating Bridge Wetland. The research results are helpful to improve our knowledge of nutrients and their influencing factors in the wetland soil of the lower Yellow River and provide an important scientific basis for the ecological restoration and management of the wetland in the lower Yellow River.

Empowerment not only benefits patients but also provides support and assistance to their family members, especially in cases when patients are subject to custodial protection sentences. The positive effects of empowerment on patients' family members may be summarized into three main aspects, including: enhancing their engagement in healthcare, alleviating their anxiety, and enhancing their caregiving skills. With regard to enhancing engagement in healthcare, family members receive health education that provides an overview of the illness, treatment options, prognosis, and key nursing points and allows them to better understand the patient's condition and actively participate in decision-making. With regard to alleviating anxiety, patients under custodial protection sentences are involved in legal problems, which results in higher levels of stress for family members compared to their peers caring for general patients. Through emotional support and active listening, nurses provide opportunities for family members to express their concerns and offer comfort and encouragement, helping them cope with difficulties and pressures. With regard to enhancing caregiving skills, the purpose of custodial protection sentences is to prevent recidivism, and family members bear significant responsibility for caregiving after discharge. Nurses can share similar caregiving experiences from their ward, educate family members about observing symptoms, and provide guidance, thereby strengthening their caregiving capabilities. In addition, with regard to the disposition of patients, nurses assist family members to understand the medical process and provide necessary guidance, ensuring family members have a clear understanding and are respected during the preparations for discharge. Based on related theoretical frameworks and practical experiences, this research highlights the positive role of empowerment in enhancing the caregiving abilities and satisfaction of the family members of patients, particularly those subject to custodial protection sentences.

Objectives: To explore the effects of the combination of he -sea and front- mu points on the feeding compliance rate, the intra-abdominal pressure, the enteral nutrition tolerance score, the score of acute physiological and chronic health evaluation (APACHE)-Ⅱ and gastrointestinal function impairment grade in the patients with enteral nutrition feeding intolerance (ENFI) of critical illness and evaluate clinical effect on ENFI after acupuncture at the he- sea and front- mu points., Methods: Seventy patients of ENFI were randomized into a control group and an observation group, 35 cases in each one. In the control group, the patients were treated with routine regimen combined with intestinal nutrition support. In the observation group, on the basis of the treatment as the control group, acupuncture was applied to Shangwan (CV13), Zhongwan (CV12), Xiawan (CV10), Qihai (CV6) and Guanyuan (CV4), as well as bila-teral Neiguan (PC6), Zusanli (ST36), Xiajuxu (ST39), Shangjuxu (ST37), Tianshu (ST25) and Daheng (SP15). Of those acupoints, ST25 and SP15 on the same side were attached to one pair of electrodes (20 Hz/100 Hz). Acupuncture was delivered once daily, 30 min each time and for consecutive 7 days. During treatment, the numbers of the cases up to the feeding standard were observed everyday to calculate the feeding compliance rate. The score of enteral nutrition tolerance, the intra-abdominal pressure, the score of APACHE-Ⅱ and the level of acute gastriointestinal injury(AGI) grading were recorded., Results: After treatment, the enteral feeding compliance rate was increased in comparison with that before treatment in the two groups, and the rate in the observation group was higher than that of the control group ( P< 0.05) except that on the 2 nd day. The score of the enteral nutrition tolerance, the intra-abdominal pressure, the score of APACHE-Ⅱ and the level of AGI were all reduced ( P< 0.05, P< 0.01) when compared with those before treatment in the two groups, and these indicators in the observation group were lower ( P< 0.05) than those of the control group., Conclusions: Acupuncture at the he -sea and front- mu points relieves the conditions of ENFI, improves the feeding and the recovery of gastrointestinal function, and benefits the prognosis through increasing the amount of enteral nutrition in ENFI patients.

Objective: To explore the effects of the immune responses mediated by topological structures of three-dimensional bioprinted scaffolds on hair follicle cycle in mice. Methods: The study was an experimental research. The alginate-gelatin composite hydrogels were printed into scaffolds using a three-dimensional bioprinter and named T45 scaffolds, T60 scaffolds, and T90 scaffolds according to the 3 topological structures of the scaffolds (the rotation angles of the printhead during printing were 45°, 60°, and 90°, respectively), and the morphology of the three scaffolds was observed after cross-linking by naked eyes. Nine 8-week-old female C57BL/6J mice were divided into T45 group, T60 group, and T90 group, according to the random number table, with three mice in each group, and the T45, T60, and T90 scaffolds were subcutaneously implanted on the back of mice, respectively. On post implantation day (PID) 7, the hair growth in the dorsal depilated area of mice was observed, the thickness of the fiber capsule around the scaffolds was observed by hematoxylin-eosin staining, and the expression levels of CD68, bone morphogenetic protein-2 (BMP-2), and tumor necrosis factor (TNF) protein in the tissue surrounding the scaffolds were observed by immunofluorescence staining. The samples of the above experiments were all 3. Results: The topological structures of the three scaffolds were all clear with high fidelity after cross-linking. On PID 7, the hair growth was obvious in the dorsal depilated area of mice in T45 group and T90 group, while hair growth was slow in the scaffold implantation area of mice in T60 group, which was significantly different from that of the unimplanted area. On PID 7, compared with (18±4) μm in T90 group, the thickness of both the fiber capsule around the scaffolds ((39±4) and (55±8) μm) of mice in T45 group and T60 group was significantly increased ( P <0.05); the thickness of the fiber capsule around the scaffolds of mice in T60 group was also significantly increased compared with that in T45 group ( P <0.05). On PID 7, the expression level of CD68 protein in the tissue surrounding the scaffolds of mice in T60 group was significantly higher than the levels in T45 group and T90 group (with both P values <0.05). The expression level of BMP-2 protein in the tissue surrounding the scaffolds of mice in T60 group was significantly higher than the levels in T45 group and T90 group (with both P values <0.05), and the expression level of BMP-2 protein in the tissue surrounding the scaffolds of mice in T45 group was significantly higher than that in T90 group ( P <0.05). The expression level of TNF protein in the tissue surrounding the scaffolds of mice in T60 group was significantly lower than the levels in T45 group and T90 group (with both P values <0.05). Conclusions: Three-dimensional bioprinted scaffolds with different topological structures mediate different degrees of immune responses after being implanted in mice. A moderate immune response promotes hair growth in depilated area of mice, while an excessive immune response results inhibits the hair follicle entering into the anagen phase.

Objective: To compare and evaluate the difference in maxillary dentition position using an anatomical facebow and jaw movement analyzer. Methods: From March to May 2023, 15 medical interns from Yantai Stomatological Hospital were recruited, including 9 males and 6 females, aged 20-25 years. Digital models and plaster models of maxillary dentition were obtained from the 15 medical interns. The anatomical facebow group (AFB) and jaw movement analyzer group (JMA) were used to transfer the position of the maxillary dentition to the virtual articulator. The virtual occlusal articulator module of exocad denture design software was used to measure the inclination angle of the occlusal plane of the two groups, the distance between the mesio-incisal angle of the left maxillary central incisor and the lateral center point of the lateral condylar sphere of the virtual occlusal articulator, the distance between the mesial buccal cusp of the maxillary first molar and the lateral center point of the lateral condyle sphere of the virtual articulator. The same marks (mesial incisor point of left maxillary central incisor and mesial buccal cusp point of both maxillary first molars) were measured in two groups of maxillary dentition, and the root-mean-square error between 3 points was calculated. Results: The occlusal plane inclination angle in AFB group (9.11°±3.85°) was significantly larger than that in JMA group (4.94°±2.69°) ( t =10.45, P <0.001). There were significant differences between AFB and JMA groups. The distances from the mesial cusp of the left first molar to the lateral center of the left condylar, from the mesial cusp of the left maxillary central incisor to the lateral center of the left condylar[(91.75±3.05), (129.09±4.60) mm]were significantly smaller than those in the JMA group[(95.68±5.45), (132.41±5.64) mm]( t =-4.48, P =0.001; t =-4.21, P =0.001). In both groups of models, the distance of the mesial cusp of the left maxillary central incisor was (8.81±2.56) mm, and the distance between mesial buccal cusp of maxillary left first molar was (7.56±2.49) mm, the distance between mesial buccal cusp of maxillary right first molar was (7.13±2.77) mm; the root mean square error was (7.93± 2.94) mm. Compared with 0, the difference was statistically significant ( t =10.45, P <0.001). Conclusions: There were differences between the two methods (anatomical facebow and the jaw movement analyzer) for transferring the maxillary dentition position to the three-dimensional space position of the virtual articulator.

Microplastic pollution is not only an environmental problem but also a social problem. Many studies have been conducted on the sources, abundance, and distribution of microplastics in the environment, but an understanding of human exposure levels and potential health risks remains very limited. Based on the bibliometric methods, the present review systematically summarized the exposure pathways of microplastics in humans, and then the characteristics and potential adverse impacts on human health were expounded upon. Available literature showed that microplastics in human bodies were mainly concentrated on sizes smaller than 50 μm, and polyethylene (PE), polypropylene (PP), and polyethylene terephthalate (PET) were the main polymers. Microplastics in environments entered human bodies mainly through food and respiratory pathways, then accumulated in lung and gastrointestinal tissues. Most importantly, small-sized microplastics could distribute in tissues and organs via the circulatory system. The results from lab-based toxicological experiments showed that microplastics not only posed threats to cell membrane integrity, immune stress, gut microbiota, and energy metabolism but also had potentially adverse impacts on the reproductive system. To further understand the health risks of microplastic pollution, it is necessary to promote research on the toxicological effects of microplastics as well as the inner mechanisms and also to establish risk assessment frameworks for evaluating microplastic pollution. These works are crucial to preventing the risks of microplastic pollution with scientific evidence.

Bioaerosols in healthcare facilities are closely related to the health of medical staff and patients. Inhalation of microbial aerosol particles can lead to both infectious and non-infectious diseases. However, a systematic summary of bioaerosol types, sources, impact factors and health risk analysis is lacking.This article condutcted a literature review to understand the distribution characteristics, sources, influencing factors and health risks of bioaerosols in healthcare facilities, both domestically and internationally. The goal is to increase awareness of the distribution characteristics of bioaerosols in healthcare facilities and health risk of bioaerosols in medical institutions. This article also provides a reference for prevention and control of bioaerosols.

Aromatherapy is a natural therapy that utilizes essential oils that enter the body through the skin, inhalation, or ingestion to promote health. Clinical aromatherapy refers to the incorporation of essential oils as a complementary therapy within the medical field and is conducted in accordance with medical safety, ethical, and regulatory requirements. Healthcare professionals must have a comprehensive understanding of clinical aromatherapy management and enhance their knowledge of aromatherapy. Based on a meta-analysis of the related literature, clinical aromatherapy management procedures and the various applications of aromatherapy for anxiety, depression, sleep disorders, and pain are introduced. The goal is to help appropriately integrate aromatherapy into the healthcare system to enhance quality of care and improve well-being in patients and healthcare providers.

Objective: To investigate the effect of image quality, degree of stenosis, calcification, and their first-order interactions on diagnostic performance of coronary computed tomography (CT) angiography-derived fractional flow reserve (CT-FFR). Methods: This is a reanalysis of data from a multi-center retrospective cross-sectional study of CT-FFR in China. A total of 522 patients with suspected or known coronary heart disease [mean age: 61.6 (34.0-83.0) years, 71.8% (354/493) were male] from 11 medical centers including the General Hospital of Eastern Theater Command from May 2015 to October 2019 were enrolled. All patients underwent coronary CT angiography (CCTA), CT-FFR, and invasive FFR examination. Subjective image quality scores of target vessels were recorded on CCTA images, and stenosis was visually assessed at the lesion level. Calcification arc and calcification remodeling index (CRI) were recorded for each lesion. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were compared. Two-way analysis of variance was used to analyze the first-order interaction effects of image quality, degree of stenosis, and calcification. Results: A total of 493 patients with 629 lesions with invasive FFR as a reference were included in the study. The overall sensitivity, specificity, and accuracy of CT-FFR were 80.4%, 93.8%, and 88.6%, respectively. The specificity (95.0% vs. 87.3%, χ 2 =4.11, P =0.043); accuracy (90.1% vs. 81.9%, χ 2 =6.22, P =0.013); and NPV (89.7% vs. 80.9%, χ 2 =4.25, P =0.039) of the group with image quality ≥3 was higher than the group with image quality <3. The degree of stenosis affected the sensitivity, PPV, and NPV of CT-FFR and the calcification arc affected the specificity of CT-FFR (all P >0.05). The specificity (95.8% vs. 90.5%, χ 2 =4.23, P =0.040); accuracy (91.0% vs. 86.1%, χ 2 =4.01, P =0.045); and NPV (91.1% vs. 83.8%, χ 2 =5.10, P =0.024) of the group with CRI<1 were higher than that of the group with CRI≥1. In the subgroup of mild and severe stenosis, no calcification, and CRI<1, the accuracy of CT-FFR with image quality ≥3 points were higher than that with image quality <3 points. The accuracy of CT-FFR in the moderate stenosis group was mainly affected by CRI; the accuracy of CT-FFR in the group with CRI<1 was higher than that in the group with CRI≥1 (after Bonferroni correction, P values between groups were statistically significant). Conclusion: Subjective image quality, degree of stenosis, calcification of lesions, and their first-order interactions can all negatively affect the diagnostic performance of CT-FFR.

Background: The application of palliative care is limited and challenging in intensive care units (ICUs) because of complex factors such as time constraints and unpredictable disease progression. Although research results and international consensus stress the early use of palliative care, utilization remains low, resulting in increased risks of ineffective medical care and poor quality of death. Improving this situation requires a comprehensive understanding of the palliative condition in ICUs., Purpose: This study was designed to investigate the utilization of hospice resources in adult ICUs and to compare this utilization between users and non-users., Methods: This retrospective correlation study recruited cases from the adult ICU database of a medical center in northern Taiwan between June and July 2022. Descriptive statistics, independent t-test and chi-square were used to analyze the data., Results: A total of 1,181 records were analyzed, including 458 (38.8%) females and 723 (61.2%) males. Two hundred and seventeen cases (18.4%) used hospice resources. Although 124 (10.4%) of the 1181 cases were identified as "in urgent need of hospice resources" (i.e., died within 30 days of ICU admission), 25 (20.2%) did not use these resources. Significant differences between the urgent-need cases who did and did not use hospice resources were found in terms of age, disease type, degree of frailty, cardiac arrest, infection, state of consciousness, intubation and tracheostomy status, inotropic and vasopressor medication, renal replacement, ECMO placement, delirium, and Acute Physiology and Chronic Health Evaluation III and Sequential Organ Failure Assessment Scores., Conclusions / Implications for Practice: The roughly 20% of ICU patients in urgent needs of palliative care who did not utilize palliative care resources highlight the needs for continued discussion to better assist patients on palliative care decision-making. The findings show multifaceted differences between those who did and did not access palliative care. Future studies should design and test strategies to facilitate the identification of palliative care needs and ensure the effective allocation of palliative care resources in ICUs.

In 2022, the American Diabetes Association and the European Association for the Study of Diabetes emphasized that type 2 diabetes care is a person-centered holistic care concept. This article summarizes the concepts of holistic care for individuals with type 2 diabetes and proposes a complete model of the six-layer whole-person care circle for individuals with type 2 diabetes. This model treats individuals with type 2 diabetes as the core of care and adopts their specific needs, preferences, and values to design individualized care plans. The overall goal of care is to maintain quality of life and to avoid or delay complications. Management methods must be holistic. Based on people and comprehensive considerations, six circles of care are listed. The first layer is caregivers, taking into account the influence of the family and the community on the individual. The second layer is multi-professional and multi-disciplinary team care, which provides support to individuals with diabetes. The third layer emphasizes the need for the following thirteen principles in diabetes care: monitoring and screening for complications, behavior modification for healthy habits, monitoring and continuous assessment, reducing the risk of hypoglycemia, effective implementation and care organization, considering underlying physiological conditions, avoiding therapeutic inertia, considering social determinants of health, psychological factors, structured diabetes education, language proficiency, shared decision-making, and considering regional healthcare institutions and related resources. The fourth layer is the decision cycle of care, which applies the principles of care and conducts continuous and dynamic case management based on the decision cycle. The fifth layer is the healthcare network through which health providers provide hospital, long-term care, and primary clinics/ primary network care referrals based on the needs of individual with diabetes. The sixth layer leverages the chronic care model to construct a supportive healthcare system comprising organizational support, clinical information systems, delivery system design, decision support, self-management support, and community resources. This proposed model may provide a reference for constructing healthcare systems to care for patients with type 2 diabetes.

Objective: To identify tooth number abnormalities on pediatric panoramic radiographs based on deep learning. Methods: Eight hundred panoramic radiographs of children aged 4 to 11 years meeting the inclusion and exclusion criteria were selected and randomly assigned by writing programs in Python (version 3.9) to the training set (480 images), verification set (160 images) and internal test set (160 images), taken in Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology between November 2012 to August 2020. And all panoramic radiographs of children aged 4 to 11 years taken in the First Outpatient Department of Peking University School and Hospital of Stomatology from June 2022 to December 2022 were collected as the external test set (907 images). All of the 1 707 images were obtained by operators to determine the outline and to label the tooth position of each deciduous tooth, permanent tooth, permanent tooth germ and additional tooth. The deep learning model with ResNet-50 as the backbone network was trained on the training set, validated on the verification set, tested on the internal test set and external test set. The images of test sets were divided into two categories according to whether there was abnormality of tooth number, to calculate sensitivity, specificity, positive predictive value and negative predictive value, and then divided into four types of extra teeth and missing permanent teeth both existed, extra teeth existed only, missing permanent teeth existed only, and normal teeth number, to calculate Kappa values. Results: The sensitivity, specificity, positive predictive value and negative predictive value were 98.0%, 98.3%, 99.0% and 96.7% in the internal test set, and 97.1%, 98.4%, 91.9% and 99.5% in the external test set respectively, according to whether there was abnormality of tooth number. While images were divided into four types, the Kappa value obtained in the internal test set was 0.886, and that in the external test set was 0.912. Conclusions: In this study, a deep learning-based model for identifying abnormal tooth number of children was developed, which could identify the position of additional teeth and output the position of missing permanent teeth on the basis of identifying normal deciduous and permanent teeth and permanent tooth germs on panoramic radiographs, so as to assist in diagnosing tooth number abnormalities.

Background: The multiple symptoms of Sjögren's syndrome lead patients affected by this disease to seek medical advice from different medical disciplines and specialists. Diagnoses are often made many years after initial onset, resulting in mental and physical exhaustion and misunderstandings., Purpose: This study was designed to explore the health-seeking experiences of patients with Sjögren's syndrome., Methods: Qualitative research methods and purposive sampling were used. Fourteen patients with Sjögren's syndrome were interviewed by the first author, and the collected data were analyzed using content analysis., Results: Four themes were revealed from the data, including: (1) distressing symptoms; (2) difficulty in diagnosis; (3) concerns about drug side effects; and (4) facing the disease. The participants initially sought medical attention when they began experiencing early onset symptoms that caused discomfort or annoyance. Their doctors' failure to provide proper diagnoses during the long health-seeking process caused a great deal of suffering to the participants. Although related medications should be taken for life, the participants reported taking lower-than-prescribed dosages out of fear of side-effects. The participants explored their process of coping with the disease, which began with denial and ended with acceptance. By learning from their health-seeking process, participants realized that they needed to take proper care of themselves, adapt to life with their disease, and control related symptoms., Conclusions / Implications for Practice: To facilitate the early diagnosis of Sjögren's syndrome, healthcare professionals should improve their awareness of this condition and refer patients with related symptoms to rheumatologists and immunologists. Effective early diagnosis and treatment can help these patients reduce the time and effort involved in unproductive doctor's visits, allowing them to better continue as productive members of society and to maintain a good quality of life.

Simulating the change of ecosystem service values (ESV) caused by land use/cover change (LUCC) in the eastern coastal cities of Zhejiang Province is of great significance for regional sustainable development and ecological security. Based on remote sensing images of land use and Statistics Yearbook of 2000, 2010, and 2020, we analyzed the influence of LUCC on ESV in the study area during 2000-2020. We used the PLUS model to simulate land use change under three scenarios, including inertial development, ecological protection, and urban development in 2030, analyzed the spatial distribution and concentration degree of ESVs based on grid scale, and clarified the sensitivity characteristics of ESVs. The results showed that the construction land area showed an increasing trend during 2000-2020. The area of forest, cultivated land and water decreased significantly, resulting in a continuous downward trend of ESVs, which decreased by 160×10 8 yuan. Under the simulation of three scenarios of inertial development, ecological development, and urban development, the construction land area would increase by 93624, 54927, and 111966 hm 2 , respectively. The eastern plain would become the agglomeration area of construction land expansion. The ESVs of those three scenarios was 1693×10 8 , 1729×10 8 , and 1688×10 8 yuan, respectively, which were all lower than the ESVs of the study area in 2020. The decline rate of ESV in the ecological protection scenario slowed down. The spatial distribution of ESVs in the study area was high in the west and low in the east. Hot spots and cold spots of ESVs were distributed in a large range with strong agglomeration. Hot spots were mainly concentrated in the west, while cold spots were mainly distributed in the east and north.

To explore the effects of long-term balanced fertilization and straw mulching on soil nutrients and stoichiometric ratios in purple soil sloping cropland, nine plots (length 7 m×width 3 m) were established in Dianjiang County as the research sample area of long-term farmland nitrogen and phosphorus loss monitoring. The following three treatments were set up:conventional mode (CK), balanced fertilization mode (M1), and balanced fertilization+straw mulching mode (M2), with three replications for each treatment to compare the contents of carbon (C), nitrogen (N), phosphorus (P), and potassium (K) and their stoichiometric changes under different treatments from 2018 to 2020. The results showed:K contents showed significant differences among the three treatments in 2018, in the order of CK>M2>M1. NO 3 - -N and NH 4 + -N contents showed significant differences among the three treatments in 2019, both in the order of M1>M2>CK. Other nutrient contents showed no significant difference among different treatments each year. Soil C and N contents showed non-significant differences among different years. The total K contents of CK, M1, and M2 in 2018 were significantly higher than that in other years and were 78.26% and 98.79%, 19.13% and 35.4%, and 54.49% and 41.76% higher than that in 2019 and 2020, respectively. The total P content in the CK and M2 treatments decreased with years, and that of CK and M2 in 2018 was 20.29% and 10.67% and 39.68% and 17.33% higher than that in 2019 and 2020, respectively. The available potassium (AK) content of the three treatments showed non-significant differences among different years, whereas the contents of nitrate nitrogen (NO 3 - -N), ammonium nitrogen (NH 4 + -N), and available phosphorus (AP) showed significant differences among the different treatments, with all being the highest in 2020. Soil C:P, C:K, N:P, N:K, and P:K ratios of each treatment showed significant differences among different years ( P <0.05). Soil C:K, N:K, and AN:AP ratios all showed significant differences among different fertilization modes in 2018 and 2019, respectively ( P <0.05). There was a significantly linearly positive relationship between soil C and N concentration and soil P and K concentration. There were very significant linear positive correlations between soil C:K and C:P, N:K, N:P, and P:K; N:K with C:P, P:K, and N:P; and N:P with C:P, N:P, and C:P. Soil P concentration was highly significantly linearly negatively correlated with C:K and N:K ratios. There were significant positive correlations between soil NO 3 - -N, NH 4 + -N, AN:AP, and AN:AK; NH 4 + -N, AN:AP, and AN:AK; and AN:AP and AN:AK. The results suggested that balanced fertilization and straw mulching was a more suitable management mode for purple soil sloping cropland.

Background: Approximately 30% of patients experience postoperative complications after surgery for early-stage lung cancer. However, the relationships among meridian energy during lung cancer surgery, changes in quality of life, and prognosis have not been investigated., Purpose: This study was designed to explore the associations among meridian energy, changes in quality of life, and prognosis in patients with newly diagnosed lung cancer undergoing surgery., Methods: A longitudinal, repeated-measures design was used. Basic data forms, meridian energy measurements, and a concise 12-item health status questionnaire were administered to the participants at the time of diagnosis, 2 weeks post-surgery, and 12 weeks post-surgery. During this period, changes were analyzed, and their association with postoperative risks was explored., Results: Forty-eight cases were investigated. Both meridian energy and quality of life were found to be significantly decreased 2 weeks after surgery. The high/low ratio of meridian energy, the physical component score of the Short Form 12-Item Health Survey Questionnaire, gender, cancer stage, and body mass index were identified as significantly associated with prognosis., Conclusions / Implications for Practice: Conclusion/Implications for Practice: The declining trends in meridian energy and quality of life during the 2 weeks after surgery in patients with lung cancer are associated with poor postoperative prognoses. Nurses may use the findings of this study to identify patients at high risk of postoperative complications and develop appropriate strategies to provide comprehensive care.

Background: Most children with complex congenital heart disease (CHD) require open-heart surgery within one year of birth to survive. Thus, new mothers of infants with CHD are faced with making unexpected and difficult decisions., Purpose: This study was designed to explore the essence of the maternal uncertain experience prior to infants with CHD undergoing open-heart surgery., Methods: In this study, a phenomenological approach was used and data were collected using open-ended interview guidelines structured around the Uncertainty in Illness Theory. Nine mothers of infants with CHD who had received open-heart surgery were interviewed in a hospital interview room within two weeks the operation. Colaizzi's (1978) data processing procedure was applied in the post-interview analysis., Results: Five themes emerged: (1) Hit bottom and felt helpless; (2) Hit the road - An overwhelming sense of emergency; (3) The crunch - Do your best to accept destiny (4) Disease brought the unknown; (5) Hope in uncertainty., Conclusions / Implications for Practice: The high-risk nature of and their unfamiliarity with the surgery made the participants experience illness uncertainty. The medical system should develop more-structured CHD information and provide emotional support in a timely manner to alleviate illness uncertainty in mothers of infants with CHD.

Over the past few decades, complementary and alternative treatments have become increasingly popular worldwide. The purported therapeutic characteristics of natural products have come under increased scrutiny both in vitro and in vivo as part of efforts to legitimize their usage. One such product is tea tree oil (TTO), a volatile essential oil primarily obtained from the native Australian plant, Melaleuca alternifolia , which has diverse traditional and industrial applications such as topical preparations for the treatment of skin infections. Its anti-inflammatory-linked immunomodulatory actions have also been reported. This systematic review focuses on the anti-inflammatory effects of TTO and its main components that have shown strong immunomodulatory potential. An extensive literature search was performed electronically for data curation on worldwide accepted scientific databases, such as Web of Science, Google Scholar, PubMed, ScienceDirect, Scopus, and esteemed publishers such as Elsevier, Springer, Frontiers, and Taylor & Francis. Considering that the majority of pharmacological studies were conducted on crude oils only, the extracted data were critically analyzed to gain further insight into the prospects of TTO being used as a neuroprotective agent by drug formulation or dietary supplement. In addition, the active constituents contributing to the activity of TTO have not been well justified, and the core mechanisms need to be unveiled especially for anti-inflammatory and immunomodulatory effects leading to neuroprotection. Therefore, this review attempts to correlate the anti-inflammatory and immunomodulatory activity of TTO with its neuroprotective mechanisms.

To prevent disease spreading during the COVID-19 epidemic, Shenzhen adopted lockdown measures in March of 2022. This provided an opportunity to study the response of changes in anthropogenic volatile organic compounds (AVOCs) in Shenzhen to emission reduction and to evaluate the effectiveness of current emission reduction measures. This study analyzed the variety of AVOCs before, during, and after the epidemic lockdown based on the online observation data of pollutants at Lianhua Station in Shenzhen from March 7, 2022 to March 27, 2022. Additionally, the sensitivity of ozone formation and the assessment of the reduction effect of precursors was conducted by an observation based model(OBM). The results showed that:affected by regional influences and the interference of meteorological conditions, the average value of AVOCs in Shenzhen urban areas did not drop significantly during the lockdown period compared to that before the lockdown. However, the peak of AVOCs at the morning peak time under the influence of "sea and land wind" during the epidemic lockdown period dropped by 46% on average compared with that during the non-lockdown period, and the aromatic hydrocarbon component dropped the most by 59%. Additionally, under the influence of continuous easterly wind, or during the accumulation and increase of AVOCs affected by regional transmission, aromatic components also decreased by an average of 25% and 21%, respectively. During the lockdown period of the epidemic in Shenzhen, the O 3 formation in urban areas was still AVOCs-limited. Increasing the emission reduction ratio of AVOCs was the most effective measure to reduce O 3 in the short term. In order to ensure the effectiveness of emission reduction, it was recommended that the coordinated emission reduction ratio of AVOCs and NO x should be greater than 1:2. It was only possible to enter the downward channel of O 3 if the deep emission reduction was more than 60%. This study revealed that the emission reduction of AVOCs during the morning traffic peak during the epidemic lockdown period was conducive to inhibiting the formation of O 3 , whereas the control of NO x would promote it. Strengthening the control of local aromatic hydrocarbon components during the regional impact process could also significantly reduce O 3 production. At this stage, Shenzhen should strengthen the management and control of industrial solvents, especially to reduce the aromatic hydrocarbon components in the solvent source that have a greater impact on the generation of O 3 . Further, Shenzhen should continue to promote the reform of the energy structure of motor vehicles to reduce the emission of VOCs in fuel combustion.

The deep tissue defects of extremities are prone to cause the exposure of tendons, blood vessels, nerves, and bones, which are commonly repaired with free flaps in clinical practice. However, for special parts such as fingers, toes, posterior ankles, anterior tibias, and dorsum of feet, the appearances are usually bulky after being repaired with free flaps and need lipectomy operations, which bring great physiological, psychological, and economic burden to patients. As the fascia flap is soft and thin with reliable blood supply and strong anti-infection ability, the free fascia flap combined with skin grafting offers some advantages in repairing the above-mentioned wounds. However, its clinical application is severely limited due to the complexity of surgical operation and the difficulty in observing blood supply after operation. In recent years, our team has carried out a lot of work and accumulated rich experience in repairing deep tissue defects of special parts of extremities with free superficial temporal fascia flap/anterolateral femoral fascial flap combined with skin grafting. From the clinical perspective, this paper mainly introduces the anatomy and harvesting method of free superficial temporal fascia flap/anterolateral femoral fascial flap, as well as the advantages, difficulties, and precautions of clinical application, for reference of peers.

Objective: To analyze the epidemic characteristics and drug resistance of pulmonary tuberculosis among the floating population in Beijing and to provide a scientific basis for formulating strategies for the prevention and control of tuberculosis among the floating population. Methods: Data of tuberculosis patients who were positive for Mycobacterium tuberculosis culture was collected from 16 districts and one municipal institution of tuberculosis control and prevention in Beijing in 2019. The strain samples were tested for drug sensitivity by the proportional method. According to household registration location, patients were divided into the floating population and Beijing registration. SPSS 19.0 software analyzed tuberculosis patients' epidemic characteristics and drug resistance in the floating population. Results: In 2019, there were 1 171 culture-positive tuberculosis patients in Beijing, among the floating population, 593 (50.64%) patients were identified, with a male-to-female sex ratio of 2.2∶1 (409∶184). Compared to patients under household registration as Beijing residents, a higher proportion of young adults aged 20-39 years (65.09%,386/593) were noticed, with 55.65% (330/593) reported from the urban areas and 96.80% (574/593) were reported the first time. The differences were statistically significant (all P <0.05). After completing the drug sensitivity test, 37 cases were with multiple drug-resistant tuberculosis, accounting for 6.24% (37/593). The rates of isoniazid resistance (42.11%,8/19) and multidrug resistance (21.05%,4/19) in floating population patients after retreatment were significantly higher than those in newly treated patients (11.67%, 67/574 and 5.75%, 33/574), and the differences were statistically significant (all P <0.05). Conclusions: Most patients with tuberculosis in the floating population in Beijing in 2019 were young males aged 20-39 years. The reporting areas were urban areas and the newly treated patients mainly. The patients with tuberculosis in the re-treated floating population were more likely to suffer from multidrug and drug resistance, which should be taken as the key population for prevention and control.

Background: Improvements in medical science and technology have increased the average number of years that older adults survive with impaired quality of life. Understanding behavioral intentions and related factors affecting advance decision (AD) decision-making can help medical professionals improve the decision-making ability of patients, allowing patients and their family members to make better medical decisions that reduce ineffective medical treatments, improve quality of life, and facilitate a good death., Purpose: This study was developed to explore behavioral intentions and related factors during the process of AD decision-making among community adults., Methods: A cross-sectional study design was used in this study. The knowledge, attitudes, and behavioral intentions regarding AD decisions, spiritual health, and social support were measured in a convenience sample using physical or internet-based questionnaires. Data were analyzed in SPSS 21.0 using descriptive and independent samples t-tests, one-way ANOVA, Pearson correlation, and multiple regression analysis., Results: Three hundred and seventy-seven community adults participated in this research (50.57 years old, SD = 13.39; 58.4% female). The average level of AD-related behavioral intention was found to be high, with high numbers of participants indicating that they would refuse endotracheal intubation (4.13, SD = 0.92), extracorporeal membrane oxygenation (4.09, SD = 0.95), extracorporeal heart massage (4.08, SD = 0.95), and defibrillation (4.08, SD = 0.98) if they were in a permanent vegetative state in the future. The important predictors of AD behavioral intention included gender, written expression of end-of-life medical decision-making, participation in the patient self-rights law and advance decision publicity lectures, having an advance decision attitude, and social support (R2 = 40.1%, p < .001)., Conclusions / Implications for Practice: A high level of AD-related behavioral intention was found in the sample and several important factors that influence related behaviors were identified. These results provide an important reference for related public policymakers to increase the percentage of older patients participating in advance directive decision-making.

Children suffering from critical illness often face significant life changes during hospitalization that can impact their external and internal worlds dramatically. Moreover, invasive treatments and medical procedures may cause physical pain and severe psychological distress. Furthermore, children with long-term hospitalization are often preoccupied with feelings of isolation, anxiety, helplessness, and hopelessness. Because children often have difficulty expressing their experiences and may resort to screaming and crying, it is necessary to help them express and transform their disturbing emotions. The literature supports the efficacy of art psychotherapy (AT) in helping children cope with suffering illness and distressing medical treatment procedures. The process of creation and play in AT helps pediatric patients express emotions non-verbally and experience catharsis in gentle and safe ways. AT can promote a sense of security in these patients by building up courage, mental stability, and the readiness necessary to face upcoming medical treatments and procedures. How AT may be used to care for pediatric patients' bodies and minds during hospitalization is presented in this article using a review of the literature and clinical case presentation, with a particular focus on how AT can effectively reduce anxiety and medical trauma responses (i.e., pediatric medical traumatic stress). In addition, the participation of the family and the medical team in the AT process is important in better understanding and appreciating the physical and mental states of pediatric patients and in realizing and transforming the emotions these patients express through this process. Family and medical team members can form a support system and offer appropriate comfort and care to children during their medical treatment, creating a trauma-informed treatment environment and reducing the risk of patient medical trauma.