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PurposeThe purpose of the study is to clarify the quality of home delivery logistics services from the perspectives of customers and provide insight to aid the prioritization of service quality improvements and guide managerial strategic planning.Design/methodology/approachThe study used a three-dimensional model that integrated Kano model, goal difficulty (GD) and importance–performance analysis (IPA) for investigating service quality aspects emphasized by customers and determine which attributes should be prioritized according to an enterprise's resource and capability constraints. Data were collected through questionnaires administered to the customers and managers of five primary home delivery logistics service enterprises and six small to medium-sized enterprises in Taiwan. Improving the quality of home delivery logistics services has become of increased interest for enterprises.FindingsThe three most important attributes, ranked in order of priority for improvement, were the protection of customers' personal information, delivery of products without damage and reasonable compensation standards for product damage. The study concludes that enterprises should prioritize the improvement of these attributes. Implications, detailed explanations and directions for further investigations are also proposed.Originality/valueThe study discusses the importance and relevant satisfaction levels of service quality attributes from the perspective of customers while also considering the limitations of companies' resources and capabilities. The results indicate that the method can be used to identify service quality attributes of home delivery logistics and formulate strategies for enhancing customer satisfaction.

Despite rural hospitals' central role in their communities, they are increasingly in financial distress and may merge with other hospitals or health systems, potentially reducing service lines that are less profitable or duplicative of services that the acquirer also offers. Using hospital discharge data from thirty-two Healthcare Cost and Utilization Project State Inpatient Databases from the period 2007-18, we examined the influence of rural hospital mergers on changes to inpatient service lines at hospitals and within their catchment areas. We found that merged hospitals were more likely than independent hospitals to eliminate maternal/neonatal and surgical care. Whereas the number of mental/substance use disorder-related stays decreased or remained stable at merged hospitals and within their catchment areas, it increased for unaffiliated hospitals and their catchment areas, indicating a potential unmet need in the communities of rural hospitals postmerger. Although a merger could salvage a hospital's sustainability, it also could reduce service lines and responsiveness to community needs.

Aim: To explore the role of urine cell-free DNA (ucfDNA) concentration and integrity indexes as potential biomarkers for lung cancer diagnosis. Materials & methods: Quantitative real-time PCR targeting Arthrobacter luteus ( ALU) repeats at three size fragments ( ALU-60, 115 and 247 bp) was performed in 55 lung cancer patients and 35 healthy individuals. Results: ucfDNA concentration and integrity indexes were significantly higher in lung cancer patients than in healthy controls. The area under the receiver operating characteristic curve for differentiating patients with stage I/II from healthy controls by ALU fragments concentration were 0.856, 0.909 and 0.932, respectively. In addition, the ucfDNA integrity indexes in patients with lymph node metastasis were significantly higher than in patients with non-metastatic. Conclusion: ucfDNA concentration and integrity indexes could serve as promising biomarkers for lung cancer diagnosis.

Background and Aims: This study was designed to analyze the effects of age and clinicopathological characteristics on prognosis of Chinese patients with hepatocellular carcinoma (HCC). Methods: The clinical data of 2032 HCC patients who were first diagnosed with HCC and underwent curative hepatectomy in our hospital between January 2006 and January 2011 were retrospectively analyzed. Results: Younger HCC patients (age

Background Individuals with co-occurring hyperactivity disorder/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) can have complex presentations that may complicate diagnosis and treatment. There are established guidelines with regard to the identification and treatment of ADHD and ASD as independent conditions. However, ADHD and ASD were not formally recognised diagnostically as co-occurring conditions until the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM-5) was published in 2013. Hence, awareness and understanding of both conditions when they co-occur is less established and there is little guidance in the clinical literature. This has led to uncertainty among healthcare practitioners when working with children, young people and adults who present with co-existing ADHD and ASD. The United Kingdom ADHD Partnership (UKAP) therefore convened a meeting of professional experts that aimed to address this gap and reach expert consensus on the topic that will aid healthcare practitioners and allied professionals when working with this complex and vulnerable population. Method UK experts from multiple disciplines in the fields of ADHD and ASD convened in London in December 2017. The meeting provided the opportunity to address the complexities of ADHD and ASD as a co-occurring presentation from different perspectives and included presentations, discussion and group work. The authors considered the clinical challenges of working with this complex group of individuals, producing a consensus for a unified approach when working with male and female, children, adolescents and adults with co-occurring ADHD and ASD. This was written up, circulated and endorsed by all authors. Results The authors reached a consensus of practical recommendations for working across the lifespan with males and females with ADHD and ASD. Consensus was reached on topics of (1) identification and assessment using rating scales, clinical diagnostic interviews and objective supporting assessments; outcomes of assessment, including standards of clinical reporting; (2) non-pharmacological interventions and care management, including psychoeducation, carer interventions/carer training, behavioural/environmental and Cognitive Behavioural Therapy (CBT) approaches; and multi-agency liaison, including educational interventions, career advice, occupational skills and training, and (3) pharmacological treatments. Conclusions The guidance and practice recommendations (Tables 1, 4, 5, 7, 8 and 10) will support healthcare practitioners and allied professionals to meet the needs of this complex group from a multidisciplinary perspective. Further research is needed to enhance our understanding of the diagnosis, treatment and management of individuals presenting with comorbid ADHD and ASD.

Strong non-radiative surface recombination in GaAs nanowires heavily blocks their applications as nanoscale optoelectronic devices. Pressure can effectively affect the surface recombination behaviors through tuning interactions between the surface of nanomaterials and the medium environment. Here, we report the pressure-induced light emission enhancement in GaAs nanowires via in situ high pressure photoluminescence measurements with nitrogen as the pressure transmitting medium. In the pressure range from 0 to 2.2 GPa, the photoluminescence intensity dramatically increases with increasing pressure. Above 2.2 GPa, the band gap transition from direct to indirect results in a sudden decrease in the photoluminescence intensity. Photoluminescence enhancement in GaAs nanowires also shows the pressure-dependent reversibility. The pressure-enhanced charge transfer effect between nitrogen molecules and the GaAs nanowire surface has been revealed according to first-principles calculations, which results in the reduction of surface states and the light-emission enhancement in GaAs NWs. Our study can provide a potential route for optimizing nanoscale functional devices.

Key Points Question Are mergers and acquisitions associated with the quality of care at rural hospitals? Findings This case-control study including 172 merged hospitals and 266 comparison hospitals that remained independent compared premerger to postmerger changes in in-hospital mortality for common conditions and complications for elective procedures. Adjusted for patient, hospital, and community characteristics, decreases in mortality among stays for acute myocardial infarction, heart failure, stroke, and pneumonia postmerger were greater at merged hospitals than at comparison hospitals. Meaning These findings suggest that rural hospital mergers were associated with better mortality outcomes for certain conditions., This case-control study examines changes in quality of care at rural hospitals that merged with or were acquired by other hospitals compared with hospitals that remained independent., Importance Rural hospitals are increasingly merging with other hospitals. The associations of hospital mergers with quality of care need further investigation. Objectives To examine changes in quality of care for patients at rural hospitals that merged compared with those that remained independent. Design, Setting, and Participants In this case-control study, mergers at community nonrehabilitation hospitals in Federal Office of Rural Health Policy–eligible zip codes during 2009 to 2016 in 32 states were identified from Irving Levin Associates and the American Hospital Association Annual Survey. Outcomes for inpatient stays for select conditions and elective procedures were derived from the Healthcare Cost and Utilization Project State Inpatient Databases. Difference-in-differences linear probability models were used to assess premerger to postmerger changes in outcomes for patients discharged from merged vs comparison hospitals that remained independent. Data were analyzed from February to December 2020. Exposures Hospital mergers. Main Outcomes and Measures The main outcome was in-hospital mortality among patients admitted for acute myocardial infarction (AMI), heart failure, stroke, gastrointestinal hemorrhage, hip fracture, or pneumonia, as well as complications during stays for elective surgeries. Results A total of 172 merged hospitals and 266 comparison hospitals were analyzed. After matching, baseline patient characteristics were similar for 303 747 medical stays and 175 970 surgical stays at merged hospitals and 461 092 medical stays and 278 070 surgical stays at comparison hospitals. In-hospital mortality among AMI stays decreased from premerger to postmerger at merged hospitals (9.4% to 5.0%) and comparison hospitals (7.9% to 6.3%). Adjusting for patient, hospital, and community characteristics, the decrease in in-hospital mortality among AMI stays 1 year postmerger was 1.755 (95% CI, −2.825 to −0.685) percentage points greater at merged hospitals than at comparison hospitals (P

The study of light propagation in turbid media is of great importance for tissue imaging, component measurement and laser therapy. A geometric model for simulating Gaussian laser beam has been presented and proved by Monte Carlo method and experiment with sample of turbid suspension. The beam expansion ratio (BER) and total power attenuation have been used to evaluate the scattering and absorption characteristics of the samples. BER is a useful indicator to distinguish scattering medium and absorbing medium, and is sensitive to the position of focus plane. The power attenuation is sensitive to different suspensions and independent to focus position. The transmission measurement need be combined with method of reflection or refraction, which can give more information of the contribution of each optical parameter to power attenuation and beam expansion.

Osteoporosis (OP) is a highly prevalent orthopedic condition in postmenopausal women and the elderly. Currently, OP treatments mainly include bisphosphonates, receptor activator of nuclear factor kappa-B ligand (RANKL) antibody therapy, selective estrogen receptor modulators, teriparatide (PTH1-34), and menopausal hormone therapy. However, increasing evidence has indicated these treatments may exert serious side effects. In recent years, Traditional Chinese Medicine (TCM) has become popular for treating orthopedic disorders. Erxian Decoction (EXD) is widely used for the clinical treatment of OP, but its underlying molecular mechanisms are unclear thanks to its multiple components and multiple target features. In this research, we designed a network pharmacology method, which used a novel node importance calculation model to identify critical response networks (CRNs) and effective proteins. Based on these proteins, a target coverage contribution (TCC) model was designed to infer a core active component group (CACG). This approach decoded the mechanisms underpinning EXD’s role in OP therapy. Our data indicated that the drug response network mediated by the CACG effectively retained information of the component-target (C-T) network of pathogenic genes. Functional pathway enrichment analysis showed that EXD exerted therapeutic effects toward OP by targeting PI3K-Akt signaling (hsa04151), calcium signaling (hsa04020), apoptosis (hsa04210), estrogen signaling (hsa04915), and osteoclast differentiation (hsa04380) via JNK, AKT, and ERK. Our method furnishes a feasible methodological strategy for formula optimization and mechanism analysis and also supplies a reference scheme for the secondary development of the TCM formula.

Diabetes is one of the most prevalent and costly health conditions in the U.S. (1), and diet plays a fundamental role in managing the condition effectively. Yet prior research raises concerns about the “food security” of people with diabetes (i.e., whether they have access to healthy, affordable food) (2,3). It is unknown, however, how widespread food insecurity is among people with diabetes across different insurance types and, moreover, whether food assistance is adequately addressing the problem (4). This study helps to fill this gap by providing national estimates of the prevalence of food insecurity among Americans with diabetes by insurance status and receipt of Supplemental Nutrition Assistance Program (SNAP) benefits. We used a new source of data on food security from the Medical Expenditure Panel Survey (MEPS), a nationally representative survey sponsored by the Agency for Healthcare Research and Quality. In 2016 and 2017, the MEPS included an interview module designed to assess food security based on a validated instrument developed by the U.S. Department of Agriculture (5). These data, together with data from the MEPS questionnaire on diabetes care, provide a unique resource for investigating the …

Patients with subcutaneous panniculitis-like T-cell lymphoma (SPTCL) are prone to the development of hemophagocytic lymphohistiocytosis (HLH). It is not known whether small infections in SPTCL patients can trigger the development of HLH. The clinical data were collected from 21 SPTCL patients admitted to our hospital from January 2006 to October 2019. Among 21 cases of SPTCL, six cases had HLH as the first manifestation (SPTCL/HLH), seven cases had intrathoracic infection (ITI), five cases were SPTCL/HLH, 13 cases had no ITI or HLH (SPTCL/no HLH). Two patients with SPTCL/noHLH healed spontaneously. We found that 28.6% of the SPTCL patients had HLH as the first presentation. ITI may cooperate with SPTCL to trigger HLH and a small number of SPTCL/noHLH can fully recover without treatment.

Limited availability of fossil energy and serious environmental pollution have caused the emergence of bio-oil, which can serve as an alternative and promising green energy source. However, bio-oil generated from the rapid pyrolysis of biomass cannot be utilized immediately owing to its corrosivity, instability, and low heating value. Herein, the electrocatalytic hydrogenation (ECH) process towards bio-oil upgrading is reviewed. Specifically, the ECH integrates the advantages of mild operating conditions, no petrochemically derived hydrogen and good controllability. The influence of different factors on the conversion of bio-oil components and product selectivity in the ECH process are presented comprehensively. In addition, various reaction mechanisms are discussed in the designed ECH systems. Finally, some challenges need to be further overcome for real bio-oil reduction in the ECH process: exploration of efficient multifunctional electrocatalysts for specific bio-oil components and determination of the dominant steps in the complicated reaction path network.

Coronavirus disease 2019 (COVID‐19) has spread worldwide. To date, no specific drug for COVID‐19 has been developed. Thus we performed this randomized, open‐label, controlled clinical trial (ChiCTR2000029853) in China. A total of 20 mild and common COVID‐19 patients were enrolled and randomly assigned to receive azvudine and symptomatic treatment (FNC group), or standard antiviral and symptomatic treatments (control group). The mean times of the first nucleic acid negative conversion (NANC) of 10 patients in the FNC group and 10 patients in the control group were 2.60 (SD 0.97; range 1–4) days and 5.60 (SD 3.06; range 2–13) days, respectively (p = 0.08). The mean times of the first NANC of 4 newly diagnosed subjects in the FNC group and 10 subjects in the control group were 2.50 (SD 1.00; range 2–4) days and 9.80 (SD 4.73; range 3–19) days, respectively (starting from the initial treatment) (p = 0.01). No adverse events occurred in the FNC group, while 3 adverse events occurred in the control group (p = 0.06). The preliminary results showed that FNC treatment in the mild and common COVID‐19 may shorten the NANC time versus standard antiviral treatment. Therefore, clinical trials of FNC treating COVID‐19 with larger sample size are warranted.

Although many studies have recently investigated how the product quality impacts on economic and environment performance under remanufacturing, all of them assume that remanufacturing operations are undertaken by the original equipment manufacturers (OEMs) or independent remanufacturers (IRs). However, many OEMs such as Lexmark, Canon, and Epson filed lawsuits with those IRs without licensing, but outsourced the remanufacturing operations to several contracted remanufacturers (CRs). We therefore extend the prior research to investigate the economic and environmental implications of OEMs&rsquo, strategic desired quality level choices under remanufacturing outsourcing. That is, we develop two models corresponding to two scenarios where OEMs (1) undertake remanufacturing in-house or (2) outsource it to a CR. Our results show that, to create a less intense cannibalization problem for new products sales, OEMs would be likely to choose a lower product quality when outsourcing remanufacturing to a CR. More importantly, from the economic perspective, we find that outsourcing remanufacturing to a CR hurts the OEM and the industry. However, from the environmental angle, our results reveal that there is a ratio threshold for environmental impact for different life cycle phases, above which remanufacturing in-house is definitely beneficial for OEM in economics and environment, but for the rest, outsourcing is equally or more environmental-friendly, despite cutting down the profit.

Effects of parameters including temperature, time and coal ratio on the reduction behaviour of preheated iron-bearing converter sludge pellets in a simulated rotary kiln are studied through orthogonal tests. ANOVA analyses show that reduction time and temperature have remarkable influence on the metallisation degree, occupying 55.02 and 30.08% of the total contribution, while temperature is the most significant factor affecting the compressive strength, with 90.98% contribution. The metallisation degree increases with the increasing time from 1.5 to 2.5 h, and first increases and then decreases with the increasing temperature from 1000 to 1100°C. The compressive strength increases with the increasing temperature. Under the optimal condition of temperature 1050°C, time 2.5 h, coal ratio 1.3, the metallisation degree is 72.92%, and the compressive strength is 1310 N/p, which satisfies the requirement of iron burden for blast furnace.

The real-time computing method of big data index based on stream processing is composed of logs collection, message management, coordination management, real-time processing, and other parts. This paper presents the discussion of the technical framework, implementation method and path of the real-time computing method of big data index based on Storm, and provides the algorithm verification process and result analysis.

Background Cardiovascular complications, especially myocardial infarctions (MIs), are the leading mortality cause in diabetic patients. The transplantation of stem cells into damaged hearts has had considerable success as a treatment for MI, although whether antidiabetic drugs affect the therapeutic efficacy of stem cell transplantation is still unknown. This study aims to understand whether and how metformin, one of the first-line drugs used to treat type 2 diabetes mellitus (T2DM), induces mesenchymal stromal cell (MSC) apoptosis and dampens their cardioprotective effect after transplantation into infarcted hearts. Methods A mouse MI model was generated via permanent ligation of the left anterior descending (LAD) coronary artery. MSCs with or without metformin treatment were transplanted after MI in diabetic mice. Echocardiography was used to assess cardiac function and determine cardiac remodeling, and TTC staining was performed to evaluate infarction size. A mouse gavage model was performed to evaluate bone marrow MSCs for flow cytometry assay. Results Metformin dampened MSC therapeutic efficacy, which increased infarct size and restricted functional cardiac recovery. Specifically, metformin induced the activation of AMP-activated protein kinase (AMPK)-mediated apoptosis through the inhibition of S6K1-Bad-Bcl-xL cell survival signaling, resulting in the upregulated expression of apoptosis-associated proteins and increased MSC apoptosis. Accordingly, counteracting AMPK attenuated metformin-induced apoptosis in MSCs and partially restored their cardioprotective effects in diabetic mice with MI. Furthermore, a decrease in peripheral blood MSCs was found in patients with T2DM who had a metformin medication history. Conclusions Our results highlight an unexpected adverse effect of metformin-induced MSC apoptosis through AMPK-mediated mTOR suppression, which is attenuated by an AMPK inhibitor. Moreover, AMPK inhibition may be a novel strategy for enhancing the effectiveness of stem cell therapy after MI in diabetes. Electronic supplementary material The online version of this article (10.1186/s13287-018-1057-0) contains supplementary material, which is available to authorized users.

In this paper, hyperspectral imaging and spectral matching classification technology are used to identify poppy and distinguish it from other leaves in the surrounding environment, which solves the problem of identification of poppy plantation. In this application, spectral classification chooses waveform and spectral absorption index as classification features, takes the size of the spectral angle between pixels as a similarity measure to make classification judgment, takes minimum error criterion as a classification criterion, and uses spectral angle matching method as classification algorithm to carry out spectral matching classification. Experiments show that this spectral matching classification technology has strong classification ability and good effect, and can be applied to detect illicit poppy cultivation.

Background: Experts have recommended the adoption of health literacy universal precautions, whereby health care providers make all health information easier to understand, confirm everyone's comprehension, and reduce the difficulty of health-related tasks. The U.S. Department of Health and Human Services selected three health literate practices to track progress in the adoption of health literacy universal precautions. Objectives: This study sought to examine whether there has been an increase in the delivery of health literate care and whether recommendations for health literacy universal precautions are being followed. Methods: This study used trend and multiple regression analyses of data from 2011 to 2014 from the Medical Expenditure Panel Survey, a national household survey. Key Results: The proportion of adults in the U.S. who reported receiving health literate care increased from 2011 to 2014, but fell far short of health literacy universal precautions recommendations of delivering health literate care to everyone. In 2014, 70% of the population reported their providers always gave them instructions that were easy to understand, but only 29% were asked to Teach-Back the instructions and only 17% were offered help with forms. Older, less educated, and racial and ethnic minority group members were more likely to report receiving health literate care than more advantaged groups. People who perceived their health and mental health as fair or poor were less likely to report receiving health literate care. Conclusions: Failure to adopt health literacy universal precautions in the face of the high prevalence of limited health literacy in the general population may perpetuate adverse health outcomes that are costly to society. Greater efforts should be made to increase providers' health literacy skills, particularly those who serve populations that are more likely to have limited health literacy, including those with poor health. [ Health Literacy Research and Practice . 2017;1(4):e216–e230.] Plain Language Summary: This study shows that some health care providers did not always check that their instructions were clear enough for patients to understand. Even fewer providers always offered help in filling out forms. People who were older, less educated, or members of racial or ethnic minority groups were more likely to be asked to confirm their understanding or be offered help with forms. More patients said that their provider was easy to understand, checked their understanding, or offered help with forms in 2014 than in 2011.

Chronic severe hepatitis B (CSHB) is a critical clinical syndrome with a high mortality rate in China. The prognostic value of neutrophil to lymphocyte ratio (NLR) which is simple, low-cost, and useful inflammatory marker for hepatitis B virus (HBV)-infected patients is largely overlooked and without further exploration. This study assesses the association of NLR with prognosis of chronic hepatitis B (CHB) and CSHB patients. Two hundred and eighty subjects, including 79 with chronic hepatitis B (CHB) and 67 with chronic severe hepatitis B (CSHB), and 134 healthy individuals were retrospectively recruited into this study. Blood samples were collected to conduct liver function, prothrombin time activity (PTA), international normalized ratio (INR), HBV DNA measurement, and routine hematological testing. All patients were followed up for at least 3 months. NLR values in patients with CSHB (4.984 ± 3.608) and CHB (2.020 ± 1.182) were significantly higher than those in healthy control (1.638 ± 0.601) and patients with CSHB had the highest NLR values than CHB and healthy control. Increased NLR values were clinically associated with severe liver disease and higher mortality rate. NLR was found to be an independent predictor of mortality in multivariable Cox Regression models (HR = 3.912, 95%CI: 1.587-9.640, P = 0.003). NLR values are significantly increased in CHB and CSHB patients with the severity of liver disease. Moreover, NLR value is an independent predicting factor for the mortality rate in HBV-infected patients.

With the popularization of computer technology and application and popularization, the network technology has been widely used, the resulting network security issues are also increasingly prominent, to the network itself and the information system based on network constitutes the great potential safety hazard. This paper expounds the concept of intrusion detection and data mining, the commonly used invasion detection technology and models, and analyzes the application of data mining technology in intrusion detection system, to provide reference for the optimization and perfection of the network intrusion detection system and using for reference.

The acceleration and force sensors are taken as the measurement parameter,vibration power flow analysis is conducted to the data collected using MATLAB software,the results show that validity of engine suspension vibration is intuitively judged using the power flow,it is a evaluation index,moreover,it is not only convenient measurement,but also the influence of phase difference between the measured parameters to vibration isolation effect is not needed consider.

// Yan-Rong Liu 1, * , Lan Liang 3, * , Jian Min Zhao 4, * , Yang Zhang 5, * , Min Zhang 1, 2 , Wei-Long Zhong 1, 2 , Qiang Zhang 1, 2 , Jun-Jie Wei 1, 2 , Meng Li 1, 2 , Jie Yuan 1, 2 , Shuang Chen 1 , Shu-Min Zong 1, 2 , Hui-Juan Liu 1 , Jing Meng 1, 2 , Yuan Qin 1, 2 , Bo Sun 1 , Lan Yang 1 , Hong-Gang Zhou 1, 2 , Tao Sun 1, 2 and Cheng Yang 1, 2 1 Tianjin Key Laboratory of Molecular Drug Research, Tianjin International Joint Academy of Biomedicine, Tianjin, China 2 State Key Laboratory of Medicinal Chemical Biology and College of Pharmacy, Nankai University, Tianjin, China 3 Tianjin GoalGen Biotechnology Co., Ltd., Tianjin, China 4 Pathology Department, Shun Yi District Hospital, Beijing, China 5 Department of Anesthesiology, Tianjin 4th Center Hospital, Tianjin, China * These authors have contributed equally to this work Correspondence to: Cheng Yang, email: cheng.yang@nankai.edu.cn Tao Sun, email: sunrockmia@hotmail.com Keywords: Twist1, multidrug resistance, colon cancer, ABCB1, ABCC1 Received: December 29, 2016 Accepted: March 30, 2017 Published: May 02, 2017 ABSTRACT Multidrug resistance is a major problem in colon cancer treatment. However, its molecular mechanisms remain unclear. Recently, the epithelial-mesenchymal transition (EMT) in anticancer drug resistance has attracted increasing attention. This study investigated whether vincristine treatment induces EMT and promotes multidrug resistance in colon cancer. The result showed that vincristine treatment increases the expression of several ATP-binding cassette transporters in invasive human colon adenocarcinoma cell line (HCT-8). Vincristine-resistant HCT-8 cells (HCT-8/V) acquire a mesenchymal phenotype, and thus its migratory and invasive ability are increased both in vitro and in vivo . The master transcriptional factors of EMT, especially Twist1, were significantly increased in the HCT-8/V cell line. Moreover, the ectopic expression of Twist1 increased the chemoresistance of HCT-8 cells to vincristine and increased the expression levels and promoter activities of ABCB1 and ABCC1. Furthermore, Twist1 silencing reverses the EMT phenotype, enhances the chemosensitivity of HCT-8/ V cells to anticancer agents in vitro and in vivo , and downregulates the expression of ABCB1 and ABCC1. Twist1-mediated promotion of ABCB1 and ABCC1 expression levels plays an important role in the drug resistance of colon cancer cells.

We investigate the structural phase transitions and electronic properties of GaAs nanowires under high pressure by using synchrotron x-ray diffraction and infrared reflectance spectroscopy methods up to 26.2 GPa at room temperature. The zinc-blende to orthorhombic phase transition was observed at around 20.0 GPa. In the same pressure range, pressure-induced metallization of GaAs nanowires was confirmed by infrared reflectance spectra. The metallization originates from the zinc-blende to orthorhombic phase transition. Decompression results demonstrated that the phase transition from zinc-blende to orthorhombic and the pressure-induced metallization are reversible. Compared to bulk materials, GaAs nanowires show larger bulk modulus and enhanced transition pressure due to the size effects and high surface energy.

The damping effect of 485 diesel engine is taken as research object, on the same conditions, bench test is conducted respectively to self-developed MR fluid damper and traditional rubber damper, comparative analysis of domain and spectrum are conducted to collected test data using MATLAB, the results show that damping effect of MR fluid damper to engine is significantly superior to effect of traditional rubber damper.

Blast furnace tapping is one of the most important aspects of BF iron-making, a process during which the ideal state is for the molten iron to remain the invariant and the level of liquid to remain stable. However, due to the viscosity of molten iron, the liquid level will tilt to one side near the tap-hole, causing the iron flow field during blast furnace tapping to change with time. This research simulated two cases of horizontal and inclined molten iron liquid levels in the process of blast furnace tapping. This study also discusses different hearth erosion situations and explains the rationality of blast furnace large-scale trends from the perspective of molten iron liquid level stability.

The nonlinear and hysteresis characteristics showed by magneto-rheological (MR) mount make it seem very difficult to establish a precise mathematical model. Based on the testing of MR mount dynamics, RBF neural network model can train and forecast the collected data. Analysis of comparing the predicting result of the RBF neural network model with the testing result shows that the trained RBF neural network model can exactly predict the dynamics of MR mount, and it provides some new ideas to implement the better intelligent control of the engine MR mount.

Since the spectral imaging technology emerged, it has gained a lot of application achievements in the military field, precision agriculture and biomedical science. When the fluorescence spectrum imaging first applied to the detection of the feature resource of Chinese herbal medicine, the characteristics of holistic and ambiguity made it a new approach to the traditional Chinese medicine testing. In this paper, we applied this method to study the Chinese medicine north and south isatis root granules by comparing their fluorescence spectra. Using cluster analysis, the results showed that the north and south Banlangen can not be divided by ascription. And these indicate that there is a large difference in the quality of Banlangen granules on the market, and fluorescence spectrum imaging method can be used in monitoring the quality of radix isatidis granules.

Slope stability analysis is of great significance in geotechnical engineering, for which there are various research approaches as limit equilibrium analysis, numerical analysis, neural network based analysis, etc. Being one of the modern approaches, slope stability analysis based on GIS rises and develops swiftly. Authors give a brief introduction of the theory, research procedures, new developments and try to make it clear the new trend in slope stability analysis. Finally, the slope stability system which was developed based on GIS is introduced. The system which can analyze slope stability based on data mining including fuzzy clustering analysis, regression analysis, extension evaluation etc has provided with more powerful slope stability functions and is easy to be integrated

OBJECTIVE:Examine the rate of screening for adolescent overweight and obesity by pediatric health care professionals and the provision of advice on healthy eating and physical activity.METHODS:Our sample contains adolescents 11 to 17 years old (6911 girls and 6970 boys) from the 2001–2007 Medical Expenditure Panel Survey who reported having at least 1 health provider visit in the previous 12 months. Using logistic regression, we investigated factors associated with whether parents reported that their children were weighed and measured and whether they or their children received counseling on their eating habits and physical activity. All models were estimated separately by gender.RESULTS:Forty-seven percent of girls and 44% of boys who visited a health provider were advised to eat healthy, and 36% of boys and girls were advised to exercise more. Obese boys and girls were both more likely to be advised to eat healthy (odds ratio [OR] = 2.10, P < .001 and OR = 1.70, P < .001) and exercise more (OR = 2.37, P < .001 and OR = 1.90, P < .001) than adolescents who have normal weight. However, overweight boys and girls were counseled at a much lower rate than those who were obese. Adolescents who were more likely to receive such advice lived in the northeast, were from higher-income households, had parents with at least some college education, and had a usual source of medical care.CONCLUSIONS:Greater efforts should be made to incorporate guidelines on childhood obesity screening and counseling into clinical practice.

The advantages of hybrid HCR have not been fully displayed because recently planning and scheduling of hot strip mill seldom consider how to avoid slabs with extremely different temperatures charging into the same reheating furnace. In this paper, the method base on specific reheating furnaces is proposed and both ant colony algorithm and simulation method are designed to solve the problem. Production data from one steel company is used for model validation.

Focusing on the disadvantages of recent researches for roll planning that seldom consider the warm-up part and solution efficiency is low, in this paper, a parallel planning model and an improved ant colony algorithm were proposed to solve the problem. Firstly, the model considering constraints of both warm-up part and staple one was designed; Secondly, the improved ant colony algorithm was proposed where the slab cluster was used to decrease the searching scope and the local optimization to improve the efficiency of pheromone accumulation. Finally, with production data from hot strip mill, we proof the method can get the best results by comparing with other two ant colony algorithms.

Research related to the effect of product diversification on firm performance (PD- P, hereafter) in China has not yet paid attention to the heterogeneity of sub- national institutions in various re...

The objective of this work was to develop a model to evaluate the performance of process safety management systems of paint manufacturing facilities. The model was constructed based on a three-level multi-attribute value model (MAVT) approach. The first level consisted of Deming's PDCA cycle, labeled as Plan, Do, Control, and Act Factors. The 20 attributes of the second level and 101 elements of the third levels were significant attributes derived from the literature search. The Analytical Hierarchy Process (AHP) and factor analysis were used to assign their weights. Using this model, a Safety Index (SI) of a paint manufacturing facility could be calculated based on the independent evaluation of safety auditors. Safety audits on four paint manufacturing facilities were conducted by three auditors chosen from government inspectors, safety consulting engineers and paint industry professionals. The results showed that the two OHSAS 18001 certified facilities with zero Disabling Severity Rate (SR) and Disabling Frequency Rate (FR) statistics in 2006 scored much higher than those without OHSAS 18001 certification and with high SR/FR. The result of a two-way ANOVA and the low standard deviations indicated that the bias among different auditors was minimal. The framework developed in this work will be modified, generalized, and applied to other industry sectors in the future.

We projected future prevalence and BMI distribution based on national survey data (National Health and Nutrition Examination Study) collected between 1970s and 2004. Future obesity-related health-care costs for adults were estimated using projected prevalence, Census population projections, and published national estimates of per capita excess health-care costs of obesity/overweight. The objective was to illustrate potential burden of obesity prevalence and health-care costs of obesity and overweight in the United States that would occur if current trends continue. Overweight and obesity prevalence have increased steadily among all US population groups, but with notable differences between groups in annual increase rates. The increase (percentage points) in obesity and overweight in adults was faster than in children (0.77 vs. 0.46-0.49), and in women than in men (0.91 vs. 0.65). If these trends continue, by 2030, 86.3% adults will be overweight or obese; and 51.1%, obese. Black women (96.9%) and Mexican-American men (91.1%) would be the most affected. By 2048, all American adults would become overweight or obese, while black women will reach that state by 2034. In children, the prevalence of overweight (BMI >/= 95th percentile, 30%) will nearly double by 2030. Total health-care costs attributable to obesity/overweight would double every decade to 860.7-956.9 billion US dollars by 2030, accounting for 16-18% of total US health-care costs. We continue to move away from the Healthy People 2010 objectives. Timely, dramatic, and effective development and implementation of corrective programs/policies are needed to avoid the otherwise inevitable health and societal consequences implied by our projections .

Aims Little is known about smoking during the transition to college. The current study examined trajectories of smoking among college freshmen, how trajectories predicted later smoking and the social context of smoking. Design Weekly assessments of daily smoking were collected via the web during the first year of college for a large cohort with a previous history of smoking. Participants and setting A total of 193 college freshmen from a large public university with a previous history of smoking who smoked frequently enough to be included in trajectory analysis.Measurements Measuresincludedweeklyreportsof dailysmoking,familysmoking,perceivedpeerattitudes and smoking, social norms and social smoking environment. Findings Seven trajectories were identified: one of low-level sporadic smoking, one of low-level smoking with a small increase during the year, two classes with a substantial decrease during the year, two classes with relatively small decreases and one class with a substantial increase in smoking. Trajectories of smoking in the freshman year predicted levels of sophomore year smoking, and some social context variables tended to change as smoking increased or decreased for a given trajectory class. Conclusions The transition into college is marked by changes in smoking, with smoking escalating for some students andcontinuingintothesophomoreyear.Shiftsinsocialcontextthatsupportsmokingwereassociatedwithtrajectories of smoking. Despite the focus of developmental models on smoking in early adolescence, the transition into college warrants further investigation as a dynamic period for smoking.

Objectives: We estimate for young children the annual excess health service use, healthcare expenditures, and disability bed days for respiratory conditions associated with exposure to smoking in the home in the United States. Methods: Health service use, healthcare expenditures and disability bed days data come from the 1999 and 2001 Medical Expenditure Panel Survey (MEPS). Reported smoking in the home comes from the linked National Health Interview Survey, from which the MEPS sample is drawn. Multivariate statistical analysis controls for potential confounding factors. The sample is 2759 children aged 0–4. Results: Smoking in the home is associated with an increase in the probability of emergency department visits for respiratory conditions by five percentage points and the probability of inpatient use for these conditions by three percentage points. There is no relation between indoor smoking by adults and either ambulatory visits or prescription drug expenditures. Overall, indoor smoking is associated with $117 in additional healthcare expenditures for respiratory conditions for each exposed child aged 0–4. Indoor smoking is also associated with an eight percentage point increase in the probability of having a bed day because of respiratory illness for children aged 1–4. Conclusions: Despite the significant progress made in tobacco control, many children are still exposed to secondhand smoke in their home. Reducing exposure to smoking in the home would probably reduce healthcare expenditures for respiratory conditions and improve children’s health.

We present a novel scheme for embedding secret data into a binary image without introducing noticeable artifacts. Unlike some block-based methods, the proposed scheme encodes the secret bits directly into boundary pixels by checking each pixel of the cover image in a pseudo-random order for embedding eligibility. A set of rules ensures correct identification of data-carrying pixels in blind extraction. The proposed scheme does not generate isolated dots, and can incorporate various coding methods such as matrix encoding to further improve the embedding performance. It is shown that up to one fourth of the boundary pixels may be used to carry secret data. Experimental results indicate that the method can achieve good visual quality with fairly large data capacity.

Objective Examine association between adult patients’ and health care providers’ (HCPs) gender or race/ethnicity concordance and patients’ reported receiving weight-related advice from HCP’s in USA. Methods Using Medical Expenditure Panel Survey (MEPS) 2004–2007 data, studied prevalence of weight-related advice (on exercise and diet) given to patients and its association with patients/HCPs concordance in gender (n = 9,686) and race/ethnicity (n = 8,825). Results Overall, 46% of patients received HCP advice on diet and 49% on exercise. Overweight females seeing female HCPs were more likely to receive exercise advice than those seeing male HCPs (OR = 1.44 [95% CI: 1.10–1.89]). Race/ethnicity concordance was associated with lower odds of advice-receiving in certain populations (OR = 0.80 [0.67–0.97] for exercise and OR = 0.42 [0.19–0.91] for diet among white patients, OR = 0.47 [0.23–0.98] for exercise among Hispanic overweight patients). Conclusions Patient/HCP gender or race/ethnicity concordance was not positively associated with HCPs providing weight-related advice. Patients with female HCPs or with racial/ethnic discordant HCPs (especially black or Asian HCPs) were more likely to receive advice. Practice implications Health care providers need be empowered, particularly white and male HCPs, to improve delivery of weight-related advice. It may reflect better of receiving weight-related advice based on patients’ recall.

This study used data from a national sample of bar owners or managers and employees at these establishments to look at the following issues. To what extent does the imposition of liability affect employees’ incentive to take care? Do various liability rules affect employees’ serving practices? And does how the employees were paid make a difference? Employees received higher pay when they engaged in serving practices that may lead to driving under the influence of alcohol (DUI), but pay did not increase when they engaged in behavior that may decrease DUI. Employees were less likely to engage in irresponsible behaviors when the perceived threat of a lawsuit by the owner/manager was relatively high. However, tort liability only affected some forms of precautionary behaviors. Based on our analysis, administrative and criminal law overall appears to be ineffective deterrents. The deterrent effects of lawsuits may also diminish when alcohol servers are mostly paid through tips.

Youth smoking continues to be an important public health problem. Many policy tools designed to reduce youth smoking are based on economic principles. This paper describes the economic and policy context of tobacco use aiming at reducing youth smoking and explains the economic rationale for tobacco control tools such as excise tax and price, clean indoor air laws, youth access laws and the broad provision of health information to the public. An overview of economic models of addiction provides the framework for empirical analysis of the impact of these policies. This is followed by a summary of the empirical evidence of the effectiveness of various tobacco control tools that are primarily economic in nature. The most consistent finding in this literature is that higher cigarette prices discourage youth smoking. Compared to the effects of cigarette taxation and price on youth smoking, the evidence on the effectiveness of the youth access laws and clean indoor air laws are still mixed and inconclusive. More research is needed to address issues such as: (1) the effects of gender, age, race and socio-economic status on the relationship between tobacco control policies and youth smoking; (2) better measurement of the outcome variables to account for the multi-dimensional nature of dependence; and (3) the effects of excise taxes and other tobacco control policies with regard to a host of dimensions of smoking such as initiation, cessation, and more generally the trajectories of tobacco use that would include patterns of progression, maintenance, regression, cessation, and relapse. More frequently collected longitudinal data than those currently available are needed to address the above issues. Understanding smoking behavior cannot be achieved without incorporating familial and other social contexts.

Objectives: Data from the 1992, 1993, and 1994 Monitoring the Future Surveys were used to investigate the differential effects of cigarette price on the intensity of youth cigarette smoking. Methods: Respondents are classified into nonsmokers; individuals who smoked less than one cigarette per day; individuals who smoked one to five cigarettes per day; individuals who smoked one-half pack a day; and individuals who smoked one pack or more a day. A Threshold of Change Model was estimated with information on cigarette prices as the main explanatory variables. Results: Dummy variables indicating medium and high prices were found to have varying effects on different levels of smoking intensity, even though higher prices were associated with lower smoking in all cases. The differences are more striking in the high price case. The effects of higher prices are largest at the heaviest smoking levels. Conclusion: Cigarette prices an effective tool to discourage youth smoking. The differential effects of cigarette price on smoking intensity warrant further investigation.

This study examines the associations between alcohol policies and motor vehicle fatality rates from 1984 to 1995 in the United States. State policies and state characteristics variables were merged with motor vehicle fatality rates over an 11 year period and analyzed using minimum logit chi-square method and fixed effects to create a quasi time-series analysis. Laws allowing individuals to sue bars for the drunken behavior of their patrons were the policies most strongly associated with lower minor and adult fatality rates. The mandatory first offense fine was associated with lower minor fatality rates but not adult fatality rates, while minor and adult rates fell after administrative per se license suspension and anti-consumption laws for all vehicle occupants. Many other public policies evaluated were not associated with lower fatality rates.

Are state laws, regulatory practices, and allocation of public resources for enforcement reflected in perceptions by bar owners/managers that they will be cited or sued if they fail to exercise care? Among policies, which ones have the greatest impact on risk perceptions and, in turn, on such behaviors? We used data on laws, law enforcement, and regulations in the same areas as the bars to determine risk perceptions of bar owners/managers of threats of being sued or cited if they were to serve minors or obviously intoxicated adults. We found that many of the laws and regulations related systematically to risk perceptions of bar owners/managers. This was particularly true of tort. Precautionary measures were more likely to be taken by owners/managers when the risk was perceived to be high. Copyright 2000 by the University of Chicago.

OBJECTIVE: This article examines the effects of tort liability, criminal law, administrative regulation, price and availability of alcohol, and personal and state characteristics on the decisions to engage in heavy episodic drinking and to drink and drive. METHOD: Individual behavior data from the Behavioral Risk Factor Surveys (1984-95) were used in a logit analysis of the probability that a respondent engaged in heavy episodic drinking (n = 86,273), drinking and driving (n = 87,087) and drinking and driving if also a heavy episodic drinker (n = 22,261). RESULTS: Imposing tort liability on bars reduced self-reported incidents of drunk driving among all drinkers (p = .043) but did not reduce the probability of heavy episodic drinking or drinking and driving among heavy drinkers. In this first national study of the impact of social host liability, we found that such liability lowered the self-reported probability of heavy episodic drinking (p = .0004) and drinking and driving among all drinkers (p = .0005). CONCLUSIONS: Although several criminal and administrative regulations were also effective in reducing heavy episodic drinking and drunk driving, the imposition of tort liability represents a useful addition to the arsenal of alcohol-control policies.

Background Few studies have examined parent-child resemblance in body weight status using nationally representative data for the US. Design We analyzed Body Mass Index (BMI), weight status, and related correlates for 4,846 boys, 4,725 girls, and their parents based on US nationally representative data from the 2006 and 2007 Medical Expenditure Panel Survey (MEPS). Pearson partial correlation coefficients, percent agreement, weighted kappa coefficients, and binary and multinomial logistic regression were used to examine parent-child resemblance, adjusted for complex sampling design. Results Pearson partial correlation coefficients between parent and child’s BMI measures were 0.15 for father-son pairs, 0.17 for father-daughter pairs, 0.20 for mother-son pairs, and 0.23 for mother-daughter pairs. The weighted kappa coefficients between BMI quintiles of parent and child ranged from −0.02 to 0.25. Odds ratio analyses found children were 2.1 (95% confidence interval (CI): 1.6, 2.8) times more likely to be obese if only their father was obese, 1.9 (95% CI: 1.5, 2.4) times more likely if only their mother was obese, and 3.2 (95% CI: 2.5, 4.2) times more likely if both parents were obese. Conclusions Parent-child resemblance in BMI appears weak and may vary across parent-child dyad types in the US population. However, parental obesity status is associated with children’s obesity status. Use of different measures of parent-child resemblance in body weight status can lead to different conclusions.

Objectives. We explored the association between community racial/ethnic composition and obesity risk. Methods. In this cross-sectional study, we used nationally representative data from the Medical Expenditure Panel Survey linked to geographic data from the US Decennial Census and Census Business Pattern data. Results. Living in communities with a high Hispanic concentration (≥ 25%) was associated with a 0.55 and 0.42 increase in body mass index (BMI; defined as weight in kilograms divided by the square of height in meters) and 21% and 23% higher odds for obesity for Hispanics and non-Hispanic Whites, respectively. Living in a community with a high non-Hispanic Asian concentration (≥ 25%) was associated with a 0.68 decrease in BMI and 28% lower odds for obesity for non-Hispanic Whites. We controlled for individual- and community-level social, economic, and demographic variables. Conclusions. Community racial/ethnic composition is an important correlate of obesity risk, but the relationship differs greatly by individual race/ethnicity. To better understand the obesity epidemic and related racial/ethnic disparities, more must be learned about community-level risk factors, especially how built environment and social norms operate within communities and across racial/ethnic groups.

In common with other dysmyelinating mutants, the myelin-deficient rat displays an action tremor and tonic seizures culminating in the death of the animals at approximately 23-26 days. We find that deep lesions of the cerebellar vermis alleviate the manifestations of the myelin deficiency significantly. Such lesions introduced at 20 days or later eliminate both tremor and seizures for periods up to 10 days. Lifespan is prolonged to nearly 30 days, on average, and to 35 days in some cases. Shallow lesions of the vermis or lateral lobe lesions have relatively little effect. Based on these observations we suggest that the cerebellum contributes not only to the action tremor but also to the tonic seizures characteristic of central myelin deficiency. Spontaneous activity originating in myelin-deficient fiber tracts may be carried to the cerebellum and processed there to produce a highly amplified and/or synchronized output to broad areas of the neuraxis. Deep lesions of the vermis presumably interfere with cerebellar output and compromise the cerebellar contribution to the seizures. Tonic seizures and other 'paroxysmal attacks' also occur commonly in human demyelinating diseases including multiple sclerosis [11]. Manipulation of cerebellar output offers a potential approach to the control of such spontaneous activity.