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Background: Although cutaneous melanoma diagnoses are rising, morbidity and mortality can be reduced through early detection. This investigation seeks to improve melanoma identification accuracy, attitudes, and intentions among a lay population by comparing the effectiveness of different melanoma identification training strategies and the effect of real-time decisional feedback on a melanoma identification task. We developed an innovative, game-based approach and hypothesize differences among frequently used melanoma identification training modalities (i.e, the Asymmetry/Border/Color/Diameter [ABCD] rule, the Ugly Duckling Rule [UDS], and a modality that combines them both, ABCDF (where the F stands for 'funny looking"), and investigate differences in types of immediate feedback on a melanoma identification task., Methods: We conducted a national online randomized experiment to test a 4 (melanoma training strategies: ABCD, UDS, ABCD-F, control) × 3 (feedback: Dermatological, Dermatological + Motivational, control) factorial design on melanoma identification, skin cancer beliefs (perceived susceptibility, severity, response efficacy, self-efficacy), attitudes, and prevention intentions., Results: ABCD training (p < .001) and UDS training (p = .05) resulted in significantly higher melanoma identification than the control. All training types resulted in significantly higher self-efficacy than the control (p = .02). Both Dermatological (p = .02) and Dermatological + Motivational feedback (p = .01) elicited significantly lower melanoma identification than the control condition, although this effect may be due to differences observed among participants who received UDS training. There was a significant main effect of feedback on self-efficacy (p = .002), where both Dermatological and Dermatological + Motivational feedback elicited higher levels of self-efficacy than the control., Conclusions: Our results suggest that game-based ABCD and UDS training strategies could increase melanoma identification accuracy. Real-time feedback reduced accuracy, but was associated with increased self-efficacy related to melanoma detection outcomes., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Nanomaterials-based gas sensors have great potential for substance detection. This paper first outlines the research of gas sensors composed of various dimensional nanomaterials. Secondly, nanomaterials may become the development direction of a new generation of gas sensors due to their high sensing efficiency, good detection capability and high sensitivity. Through their excellent characteristics, gas sensors also show high responsiveness and sensing ability, which also plays an increasingly important role in the field of electronic skin. We also reviewed the physical sensors formed from nanomaterials in terms of the methods used, the characteristics of each type of sensor, and the advantages and contributions of each study. According to the different kinds of signals they sense, we especially reviewed research on gas sensors composed of different nanomaterials. We also reviewed the different mechanisms, research processes, and advantages of the different ways of constituting gas sensors after sensing signals. According to the techniques used in each study, we reviewed the differences and advantages between traditional and modern methods in detail. We compared and analyzed the main characteristics of gas sensors with various dimensions of nanomaterials. Finally, we summarized and proposed the development direction of gas sensors based on various dimensions of nanomaterials.

Joking is an important communication behavior that helps people cope with colorectal cancer and colonoscopy screening. However, whether joking serves a beneficial or maladaptive function in the context of colorectal cancer screening remains unknown. The lack of a valid scale impedes our understanding of how joking influences colonoscopy uptake. This study aims to develop and validate the Colonoscopy Joking Scale, a scale of joking behaviors in colonoscopy screening. A sample of Mturk participants aged 50-75 ( N = 105) who were not compliant with colonoscopy screening recommendations was recruited to rate items for three joking factors and a measure of colonoscopy screening intentions. Two joking factors (i.e., screening-related and sexual connotation) related to colonoscopy screening and one related to general health were identified in the analysis. The psychometric analysis demonstrated strong convergent, predictive, and discriminant validity. The Colonoscopy Joking Scale will be helpful to understand what joking factor is associated with specific barriers to colonoscopy for different patients so that effective educational and interventional programs can be implemented.

Based on the theoretical framework of agency effect, this study examined the role of affect in influencing the effects of chatbot versus human brand representatives in the context of health marketing communication about HPV vaccines. We conducted a 2 (perceived agency: chatbot vs. human) × 3 (affect elicitation: embarrassment, anger, neutral) between-subject lab experiment with 142 participants, who were randomly assigned to interact with either a perceived chatbot or a human representative. Key findings from self-reported and behavioral data highlight the complexity of consumer-chatbot communication. Specifically, participants reported lower interaction satisfaction with the chatbot than with the human representative when anger was evoked. However, participants were more likely to disclose concerns of HPV risks and provide more elaborate answers to the perceived human representative when embarrassment was elicited. Overall, the chatbot performed comparably to the human representative in terms of perceived usefulness and influence over participants' compliance intention in all emotional contexts. The findings complement the Computers as Social Actors paradigm and offer strategic guidelines to capitalize on the relative advantages of chatbot versus human representatives., (© 2021 Wiley Periodicals LLC.)

To study the leaching characteristics of a cement-stabilized macadam base with fly ash, a calcium leaching test, using varying cement and fly ash dosages in an ammonium chloride solution, was designed to obtain the rate of calcium ion leaching, porosity, and permeability coefficient of cement-stabilized macadam with leaching time. The results showed that the number of leached calcium ions increased with the cement dosage in the leaching of cement-stabilized macadam. With an increase in the cement dosage, the leaching rate of calcium ions decreased, and the leaching process of the material was delayed. The incorporation of fly ash could effectively slow down the degree of calcium ion leaching. The permeability coefficient increased gradually with the extension of leaching time, and the increase in fly ash content had a more significant effect on the improvement of the permeability coefficient than the increase in cement dosage did.

Accurate determination of the biomedical properties of connective tissue such as tendons and ligaments is dependent on the accurate measurement of their cross-sectional area (CSA). To date, techniques for determining cross-sectional areas of ligaments and tendons have been less than ideal due to their complex geometries and their deformations under external load. A novel non-destructive technique has been developed for determining the cross-sectional area of tendon by locating the tendon rupture, in which aqueous rapid curing alginate dental molding materials, digital photography and computerized image analysis are utilized. This technique marks tendons and alginate molds at 1 cm interval and then tendons are taken out for tensile test. Real-time video is recorded to locate the position of tendon rupture. The corresponding alginate slice is found and then analysis through computer image processing software to obtain a more accurate CSA at tendon rupture, which can be used to calculate the stress and young's modulus of tendon. The accuracy of this technique has been investigated and comparisons have been made with the alginate un-localization molding technique and ellipse estimation technique. Results show this technique can provide accurate CSA values (within 2%) and great reproducibility (coefficient of variation = 0.8%). The technique is non-destructive, can obtain morphological information of soft tissue and can detect cavities.

There are concerns that recent climate change is altering the frequency and magnitude of river floods in an unprecedented way 1 . Historical studies have identified flood-rich periods in the past half millennium in various regions of Europe 2 . However, because of the low temporal resolution of existing datasets and the relatively low number of series, it has remained unclear whether Europe is currently in a flood-rich period from a long-term perspective. Here we analyse how recent decades compare with the flood history of Europe, using a new database composed of more than 100 high-resolution (sub-annual) historical flood series based on documentary evidence covering all major regions of Europe. We show that the past three decades were among the most flood-rich periods in Europe in the past 500 years, and that this period differs from other flood-rich periods in terms of its extent, air temperatures and flood seasonality. We identified nine flood-rich periods and associated regions. Among the periods richest in floods are 1560-1580 (western and central Europe), 1760-1800 (most of Europe), 1840-1870 (western and southern Europe) and 1990-2016 (western and central Europe). In most parts of Europe, previous flood-rich periods occurred during cooler-than-usual phases, but the current flood-rich period has been much warmer. Flood seasonality is also more pronounced in the recent period. For example, during previous flood and interflood periods, 41 per cent and 42 per cent of central European floods occurred in summer, respectively, compared with 55 per cent of floods in the recent period. The exceptional nature of the present-day flood-rich period calls for process-based tools for flood-risk assessment that capture the physical mechanisms involved, and management strategies that can incorporate the recent changes in risk.

This paper proposes a method from Scan statistics for identifying flood-rich and flood-poor periods (i.e., anomalies) in flood discharge records. Exceedances of quantiles with 2-, 5-, and 10-year return periods are used to identify periods with unusually many (or few) threshold exceedances with respect to the reference condition of independent and identically distributed random variables. For the case of flood-rich periods, multiple window lengths are used in the identification process. The method is applied to 2,201 annual flood peak series in Europe between 1960 and 2010. Results indicate evidence for the existence of flood-rich and flood-poor periods, as about 2 to 3 times more anomalies are detected than what would be expected by chance. The frequency of the anomalies tends to decrease with an increasing threshold return period which is consistent with previous studies, but this may be partly related to the method and the record length of about 50 years. In the northwest of Europe, the frequency of stations with flood-rich periods tends to increase over time and the frequency of stations with flood-poor periods tends to decrease. In the east and south of Europe, the opposite is the case. There appears to exist a turning point around 1970 when the frequencies of anomalies start to change most clearly. This turning point occurs at the same time as a turning point of the North Atlantic Oscillation index. The method is also suitable for peak-over-threshold series and can be generalized to higher dimensions, such as space and space-time., (©2020. The Authors.)

Perceived social norms are routinely observed as positive predictors of indoor tanning. Past research has suggested that messaging interventions target normative perceptions to reduce indoor tanning behavior. Despite this call, little empirical research has investigated the utility of taking a social norms approach in behavioral interventions. The present study addresses this gap by conducting a quasi-experiment ( N = 206) assessing the effect of an intervention message correcting normative misperceptions on indoor tanning intentions at different levels of tanning frequency. Results suggest that tailored normative intervention messages can successfully reduce tanning intentions among high-frequency tanners, those who scored at the 75th and 90th percentile of tanning frequency ( f 2 for interaction = .015). These results provide preliminary empirical evidence to support previous theorizing on the efficacy of social norms interventions among high-frequency indoor tanners.

Climate change has led to concerns about increasing river floods resulting from the greater water-holding capacity of a warmer atmosphere 1 . These concerns are reinforced by evidence of increasing economic losses associated with flooding in many parts of the world, including Europe 2 . Any changes in river floods would have lasting implications for the design of flood protection measures and flood risk zoning. However, existing studies have been unable to identify a consistent continental-scale climatic-change signal in flood discharge observations in Europe 3 , because of the limited spatial coverage and number of hydrometric stations. Here we demonstrate clear regional patterns of both increases and decreases in observed river flood discharges in the past five decades in Europe, which are manifestations of a changing climate. Our results-arising from the most complete database of European flooding so far-suggest that: increasing autumn and winter rainfall has resulted in increasing floods in northwestern Europe; decreasing precipitation and increasing evaporation have led to decreasing floods in medium and large catchments in southern Europe; and decreasing snow cover and snowmelt, resulting from warmer temperatures, have led to decreasing floods in eastern Europe. Regional flood discharge trends in Europe range from an increase of about 11 per cent per decade to a decrease of 23 per cent. Notwithstanding the spatial and temporal heterogeneity of the observational record, the flood changes identified here are broadly consistent with climate model projections for the next century 4,5 , suggesting that climate-driven changes are already happening and supporting calls for the consideration of climate change in flood risk management.

A wide variety of processes controls the time of occurrence, duration, extent, and severity of river floods. Classifying flood events by their causative processes may assist in enhancing the accuracy of local and regional flood frequency estimates and support the detection and interpretation of any changes in flood occurrence and magnitudes. This paper provides a critical review of existing causative classifications of instrumental and preinstrumental series of flood events, discusses their validity and applications, and identifies opportunities for moving toward more comprehensive approaches. So far no unified definition of causative mechanisms of flood events exists. Existing frameworks for classification of instrumental and preinstrumental series of flood events adopt different perspectives: hydroclimatic (large-scale circulation patterns and atmospheric state at the time of the event), hydrological (catchment scale precipitation patterns and antecedent catchment state), and hydrograph-based (indirectly considering generating mechanisms through their effects on hydrograph characteristics). All of these approaches intend to capture the flood generating mechanisms and are useful for characterizing the flood processes at various spatial and temporal scales. However, uncertainty analyses with respect to indicators, classification methods, and data to assess the robustness of the classification are rarely performed which limits the transferability across different geographic regions. It is argued that more rigorous testing is needed. There are opportunities for extending classification methods to include indicators of space-time dynamics of rainfall, antecedent wetness, and routing effects, which will make the classification schemes even more useful for understanding and estimating floods. This article is categorized under:Science of Water > Water ExtremesScience of Water > Hydrological ProcessesScience of Water > Methods., Competing Interests: The authors have declared no conflicts of interest for this article.

"Adversity" is one primary element that impacts the pharmacology components of authentic Chinese herbal medicine. Knowledge about "adversity" is a precondition of yield estimation, quality monitoring, location selection and the geo-herbalism protection. Used 3S(GIS, RS and GPS) technology to combine multi-source key ecological factors of "Anling", and used parasitic relationships between organisms to extracting its suitable region for the first time. Results showed that the "Anling" were mainly distributed in Dabie coteau. Suitable area amount to 36.8 km², Yuexi, Shucheng, Jinzhai and Qianshan which account for about 93.55% of whole congenial region. The first three accounts for about 80.82%. It was Yuexi that account for 1/3 above especially. Field investigation verify accuracy of extraction about 91.67%, which has confirmed it is feasible that using the relationship between parasitic host and parasitic to extract native environment of parasitic traditional medicine based on 3S technology., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

Objective: To observe the efficacy of the circumferential decompression with posterior transpedicular osteotomy and segmental instrumentation with interbody fusion for thoracic ossification of posterior Iongitudinal ligament (T-OPLL)., Methods: From May 2012 to June 2015, 16 consecutive patients underwent posterior transpedicular osteotomy and segmental instrumentation with interbody fusion.Osteotomy range was depended by length and types of OPLL.Patient's data included level, clinical presentation, blood loss, length of surgery, complications, VAS, JOA, and Frankel grading system before and after the surgery. All data were collected, retrospectively., Results: The follow-up period was (30±19) months (range from 12 to 50 months). The operation time was (261.6±51.3) min (range from 190 to 310 min). The blood loss was (980.3±370.5) ml (range from 600 to 2 100 ml). All patients were well treated with posterior compression and segmental instrumentation with interbody fusion.The VAS score was (4.2±0.2) in all patients at a week, improving to (2.7±0.1) points at 3 months, (2.4±0.2) at 1 year, and (2.0±0.1) at last fellow-up.The statistical analysis of the results showed a significant improvement of pain at 3 months (P<0.05) when compared to the preoperative status.The preoperative JOA score was (4.2±1.7) in all patients, improving to (7.8±2.5) points at 3 months, (8.5±2.7) at 1 year, and (9.0±1.0) at last fellow-up.The mean recovery rate for the total JOA score was (72%±8%). Differences in the overall JOA Scores showed significant postoperative improvement.Frankel grade improved by either 1 or 2 grades in 16 patients at the last follow-up.None of the patients showed any signs of instrument migration or failure during follow-up., Conclusion: The results suggested that the procedure achieved a total resection of the ossified posterior longitudinal ligament.The treatment method with posterior transpedicular osteotomy and circumferential decompression was found to be safe, effective, reliable, and technically feasible.

Objective: To evaluate the treatment outcomes of mini-invasive transforaminal lumbar interbody fusion by Quadrant system for upper lumbar disc herniation., Methods: Between February 2008 and June 2011, 21 patients with upper lumbar disc herniation underwent mini-invasive transforaminal lumbar interbody fusion under Quadrant system at our institution. The relevant patient data included visual analogue scale (VAS) and Oswestry disability index (ODI) scores before and after operation 1 week, 3 months and last follow-up. And all data were collected retrospectively., Results: No operation-related complications occurred. The mean operative duration was 2.8 (2.5-3) hours. The average blood loss volume was 430 (350-500) ml. Preoperative VAS was 7.3 ± 0.8 and 2.1 ± 0.9, 1.3 ± 0.6, 0.6 ± 0.5 after operation 1 week, 3 months and last follow-up respectively. Statistically significant differences were demonstrated between each group. Preoperative ODI was 43.7 ± 12.9 and 22.5 ± 10.4, 16.2 ± 8.5, 11.3 ± 7.2 after operation 1 week, 3 months and last follow up. Significant differences existed in preoperative and postoperative ODI scores respectively., Conclusion: Mini-invasive transforaminal lumbar interbody fusion using Quadrant system and special osteotome is safe and efficacious for upper lumbar disc herniation.

Nonmissile penetrating brain injuries are exceedingly uncommon among civilian population and are most often associated with inflicted injury. They show specific characteristics different from that of missile wounds. In this article, we describe a rare case of a 22-month-old child who experienced accidental penetrating head trauma caused by a crossbow. We document neuroimaging studies and review the management concerning this pathology. To our knowledge, this is the youngest survived case of penetrating brain injury by a crossbow with such radiological findings reported in the literature.

A 1.8-million-member D-octapeptide combinatorial library was constructed in which each member comprised a diversity-containing N-terminal pentapeptide and a C-terminal amidated triarginine motif. The C-terminal motif concentrated the library members at the fungal cell surface. A primary screen for inhibitors of Saccharomyces cerevisiae and Candida albicans growth, together with an in vitro secondary screen with the S. cerevisiae plasma membrane ATPase (Pma1p) as a target, identified the antifungal D-octapeptide BM0 (D-NH(2)-RFWWFRRR-CONH(2)). Optimization of BM0 led to the construction of BM2 (D-NH(2)-RRRFWWFRRR-CONH(2)), which had broad-spectrum fungicidal activity against S. cerevisiae, Candida species, and Cryptococcus neoformans; bound strongly to the surfaces of fungal cells; inhibited the physiological activity of Pma1p; and appeared to target Pma1p, with 50% inhibitory concentrations in the range of 0.5 to 2.5 microM. At sub-MICs (<5 microM), BM2 chemosensitized to fluconazole (FLC) S. cerevisiae strains functionally hyperexpressing fungal lanosterol 14alpha-demethylase and resistance-conferring transporters of azole drugs. BM2 chemosensitized to FLC some FLC-resistant clinical isolates of C. albicans and C. dubliniensis and chemosensitized to itraconazole clinical isolates of C. krusei that are intrinsically resistant to FLC. The growth-inhibitory concentrations of BM2 did not cause fungal cell permeabilization, significant hemolysis of red blood cells, or the death of cultured HEp-2 epithelial cells. BM2 represents a novel class of broad-spectrum, surface-active, Pma1p-targeting fungicides which increases the potencies of azole drugs and circumvents azole resistance.

When performing dynamic studies using emission tomography the tracer distribution changes during acquisition of a single set of projections. This is particularly true for some positron emission tomography (PET) systems which, like single photon emission computed tomography (SPECT), acquire data over a limited angle at any time, with full projections obtained by rotation of the detectors. In this paper, an approach is proposed for processing data from these systems, applicable to either PET or SPECT. A method of interpolation, based on overlapped parabolas, is used to obtain an estimate of the total counts in each pixel of the projections for each required frame-interval, which is the total time to acquire a single complete set of projections necessary for reconstruction. The resultant projections are reconstructed using traditional filtered backprojection (FBP) and tracer kinetic parameters are estimated using a method which relies on counts integrated over the frame-interval rather than instantaneous values. Simulated data were used to illustrate the technique's capabilities with noise levels typical of those encountered in either PET or SPECT. Dynamic datasets were constructed, based on kinetic parameters for fluoro-deoxy-glucose (FDG) and use of either a full ring detector or rotating detector acquisition. For the rotating detector, use of the interpolation scheme provided reconstructed dynamic images with reduced artefacts compared to unprocessed data or use of linear interpolation. Estimates for the metabolic rate of glucose had similar bias to those obtained from a full ring detector.