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Purpose: This paper aims to survey the status quo of the student pressure and the relationship between their daily time management and their learning outcomes in three different types of higher secondary schools at Shenyang, the capital city of Liaoning Province in mainland China. Design/methodology/approach: An investigation was carried out in 14 higher secondary schools (HSS) located in five districts of Shenyang. Both qualitative and quantitative approaches were used, such as interviews and questionnaires. Findings: The important findings include: the students pressure sources in three different types of higher secondary schools, the strongest pressure felt by the HSS students in China was the pressure from national college entrance examinations (NCEE), the rank orders of other pressures were pressures from parents, from society, from others, from schools, from teachers. The findings also include the relationship between student time management (time for sleep, time for getting up, time spent at schools, time for doing homework) and the students learning, the tests frequency in different types of HSS, the relationship between the tests frequency and student learning outcomes, etc. Originality/value: To survey the HSS students' pressure causes, to explore the relationship between their time management and learning outcomes, to find out the effective learning factors and strategies will benefit students, teachers and schools worldwide. (Contains 6 figures.)

Background: Erector spinae plane block (ESPB) improves postoperative analgesia and significantly enhances the quality of recovery (QoR) after video-assisted thoracoscopic lobectomy surgery (VATLS). However, it is not known whether the use of dexmedetomidine (Dex) as an adjunct for ropivacaine to ESPB affects the QoR after VATLS. The purpose of this study was to explore the effects of different Dex dosages as an adjunct for ropivacaine in combination with ultrasound-guided ESPB on the quality of postoperative recovery in patients with VATLS. Methods: In this single-center, double-blind, randomized study, 120 patients between the ages of 18 and 65 who were scheduled for VATLS from december 2021 and october 2022 in our hospital under general anesthesia were randomly divided into three groups: ultrasound-guided ESPB with 30 mL of 0.5% ropivacaine (Group R), ultrasound-guided ESPB 0.5% ropivacaine plus 0.5 µg/kg Dex (Group RD1), and ultrasound-guided ESPB 0.5% ropivacaine plus 1.0 µg/kg Dex (Group RD2), ultrasound-guided ESPB was administrated at the T5 vertebral level before surgery. The primary outcome was the QoR-15 score 24 h after the surgery. The secondary outcomes included the QoR-15 scores at 12 h, 48 h, and 72 h after the operation, visual analogue scale (VAS) scores at 8 h, 12 h, 24 h, and 48 h after surgery, cumulative flurbiprofen consumption, postoperative nausea and vomiting (PONV), postoperative bradycardia, and hypotension. Results: The QoR-15 scores were higher in group RD2 than the R and RD1 groups on postoperative day 1 (P < 0.05), in addition, no significant difference was found in the QoR-15 scores between groups R and RD1 on postoperative day 1. The VAS scores were significantly lower in group RD2 than in groups RD1 and group R 12–24 h after surgery (P < 0.05). No significant differences were observed in the QoR-15 and VAS scores at 48 and 72 h after surgery between the three groups. The cumulative flurbiprofen consumption was markedly reduced during the 72 h after surgery in the RD2 group (P < 0.05). The incidence of postoperative nausea and vomiting was lower in the RD2 group (P < 0.05). Conclusions: The combination of 1 µg/kg dexmedetomidine as an adjunct with 0.5% ropivacaine 30 ml for erector spinae plane block significantly improved the postoperative quality of recovery and provided better postoperative analgesia on postoperative day 1 in patients undergoing Video-assisted thoracoscopic lobectomy surgery. However, dexmedetomidine (1 µg/kg) as an adjunct for ropivacaine combined with erector spinae plane block did not enhance the postoperative quality of recovery at 48 and 72 h postoperatively. Trial registry number: The number of this clinical trial registry is ChiCTR2100053230, date of registration: 16/11/ 2021) [ABSTRACT FROM AUTHOR]

Based on CT and MRI images acquired from normal pressure hydrocephalus (NPH) patients, using machine learning methods, we aim to establish a multimodal and high-performance automatic ventricle segmentation method to achieve an efficient and accurate automatic measurement of the ventricular volume. First, we extract the brain CT and MRI images of 143 definite NPH patients. Second, we manually label the ventricular volume (VV) and intracranial volume (ICV). Then, we use the machine learning method to extract features and establish automatic ventricle segmentation model. Finally, we verify the reliability of the model and achieved automatic measurement of VV and ICV. In CT images, the Dice similarity coefficient (DSC), intraclass correlation coefficient (ICC), Pearson correlation, and Bland–Altman analysis of the automatic and manual segmentation result of the VV were 0.95, 0.99, 0.99, and 4.2 ± 2.6, respectively. The results of ICV were 0.96, 0.99, 0.99, and 6.0 ± 3.8, respectively. The whole process takes 3.4 ± 0.3 s. In MRI images, the DSC, ICC, Pearson correlation, and Bland–Altman analysis of the automatic and manual segmentation result of the VV were 0.94, 0.99, 0.99, and 2.0 ± 0.6, respectively. The results of ICV were 0.93, 0.99, 0.99, and 7.9 ± 3.8, respectively. The whole process took 1.9 ± 0.1 s. We have established a multimodal and high-performance automatic ventricle segmentation method to achieve efficient and accurate automatic measurement of the ventricular volume of NPH patients. This can help clinicians quickly and accurately understand the situation of NPH patient's ventricles. [ABSTRACT FROM AUTHOR]

The existing building stock faces the challenge of low energy efficiency and requires renovation and upgrading to meet society′s goals of carbon reduction and sustainable development. This study presents an optimization framework utilizing genetic algorithms to develop robust retrofit plans that balance the need for improved energy efficiency, cost-effectiveness considerations for householders, and uncertainties regarding climate conditions. A case study of an aged residential building in a hot and humid region of China is used to demonstrate the proposed method. The optimization results show a potential energy demand reduction of 81.5%. However, due to the relatively long time required to realize economic benefits from high investments, short-term optimization tends to favor solutions with high energy demand and low primary costs. To effectively reduce carbon emissions, it is recommended to consider the long-term economic benefits of retrofits and prioritize solutions with high energy efficiency. However, it is important to acknowledge that the expensive nature of retrofit investments may pose barriers to residents. Society should provide adequate support and guidance to facilitate residential renovation efforts. [ABSTRACT FROM AUTHOR]

Starting from the inheritance and promotion of Chinese life philosophy and traditional Chinese medicine wisdom by Chinese narrative medicine practice, this paper discusses the inheritance and echo relationship between the "close textual reading ability" in Chinese narrative medicine practice and the "four diagnoses" in traditional Chinese medicine wisdom, narrative mediation and the "mind-body holistic philosophy" in traditional Chinese medicine, and narrative wisdom and Dao Sheng in Chinese life philosophy. Meanwhile, by analyzing the stories of contemporary doctors' practice of narrative intelligence, this paper expounds that Chinese narrative medicine is a new model of medical education and clinical practice based on the absorption of Chinese traditional life wisdom and the essence of traditional Chinese medicine culture, and the integration of western narrative medicine concepts. It also advocates Chinese scholars to actively build the discipline of "narrative traditional Chinese medicine," constantly translate the academic achievements to foreign countries, and create a good narrative ecology of traditional Chinese medicine. [ABSTRACT FROM AUTHOR]

In this paper, nine strains of salt-tolerant petroleum-degrading bacteria were applied to an biological aerated filter. Simulating the degradation of high-salinity petroleum wastewater with n-hexadecane and 2,4-ditert-butylphenol as the primary pollutants and analyzing the structure of the biofilm at various salt concentrations. According to the results, when the salinity was 4%, the COD removal efficiency reached 74.34%. Various halotolerant microorganisms have adapted to various salt concentrations. At a salinity of 3%, n-hexadecane exhibited the best degradation effect, with a rate of 83.21%. Shewanella, Acinetobacter, and Marinobacter were the predominant bacterial groups at the time. At 4% salinity, Acinetobacter and Pseudomonas were the predominant bacteria, and the average 2,4-ditert-butylphenol degradation rate was the highest at 63.02%. This study provided an experimental basis for further studying the biological treatment of high-salinity petroleum wastewater. [ABSTRACT FROM AUTHOR]

The adenosine 5ʹ-triphosphate (ATP)-binding cassette (ABC) transporter, IrtAB, plays a vital role in the replication and viability of Mycobacterium tuberculosis (Mtb), where its function is to import iron-loaded siderophores. Unusually, it adopts the canonical type IV exporter fold. Herein, we report the structure of unliganded Mtb IrtAB and its structure in complex with ATP, ADP, or ATP analogue (AMP-PNP) at resolutions ranging from 2.8 to 3.5 Å. The structure of IrtAB bound ATP-Mg2+ shows a "head-to-tail" dimer of nucleotide-binding domains (NBDs), a closed amphipathic cavity within the transmembrane domains (TMDs), and a metal ion liganded to three histidine residues of IrtA in the cavity. Cryo-electron microscopy (Cryo-EM) structures and ATP hydrolysis assays show that the NBD of IrtA has a higher affinity for nucleotides and increased ATPase activity compared with IrtB. Moreover, the metal ion located in the TM region of IrtA is critical for the stabilization of the conformation of IrtAB during the transport cycle. This study provides a structural basis to explain the ATP-driven conformational changes that occur in IrtAB. [ABSTRACT FROM AUTHOR]