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Chien Tai Hong,1,2 Han-Hwa Hu,1,2 Lung Chan,1,2,* Chyi-Huey Bai3,4,* 1Department of Neurology, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; 2Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan; 3School of Public Health, College of Public Health, Taipei Medical University, Taipei City, Taiwan; 4Department of Public Health, College of Medicine, Taipei Medical University, Taipei City, Taiwan *These authors contributed equally to this work Background: People with Parkinson’s disease (PwP) are speculated to be at a low risk of cerebrovascular and cardiovascular disease (CVD) because they have fewer vascular risk factors and lower smoking rate. However, emerging evidence suggests that PwP are at higher risk of CVD, which introduces controversy to the notion that there is no association between Parkinson’s disease (PD) and CVD. Hence, we conducted a meta-analysis to analyze the risk of CVD in PwP.Methods: Electronic databases were searched using terms related to PD and CVD. Articles were included in the meta-analysis only if they employed clear diagnostic criteria for PD and CVD. The reference lists of the relevant articles were reviewed to identify eligible studies not found during the keyword search.Results: The enrolled studies were categorized into case–control and cohort studies, and the former was further divided into postmortem (three) and clinical (four) studies. In the clinical case–control studies group, PD was more associated with CVD (OR: 2.89, 95% CI: 1.36–6.13). Three studies were enrolled in the cohort studies group, and the merged results demonstrated that PwP were at higher risk of CVD during the follow-up period (HR: 1.84, 95% CI: 1.34–2.54).Conclusion: PD is associated with CVD, which may be due to the shared pathogeneses between the two diseases or PD-related effects. PwP should be more aware of the risk of CVD despite having fewer traditional vascular risk factors. Keywords: Parkinson’s disease, cerebrovascular disease, cardiovascular disease, meta-analysis, case-control, cohort, cerebral multimorbidity

Po-Ya Chang,1 Li-Nien Chien,2 Chyi-Huey Bai,1 Yuh-Feng Lin,3 Hung-Yi Chiou1 1School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan; 2School of Health Care Administration, Taipei Medical University, Taipei, Taiwan; 3Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei, Taiwan Purpose: Effective management for type 2 diabetes mellitus (DM) can slow the progression of kidney outcomes and reduce hospital admissions. Better continuity of care (COC) was found to improve patients’ adherence and self-management. This study examined the associations between COC, hospitalization, and end-stage renal disease (ESRD) in DM patients.Patients and methods: In the cohort study, data from 1996 to 2012 were retrieved from the Longitudinal Health Insurance Database, using inverse probability weighted analysis. A total of 26,063 patients with newly diagnosed type 2 DM who had been treated with antihyperglycemic agents were included. COC is to assess the extent to which a DM patient visited the same physician during the study period. This study categorized COC into 3 groups – low, intermediate, and high, – according to the distribution of scores in our sample.Results: The number of ESRD patients in the high, intermediate, and low COC groups were 92 (22.33%), 130 (31.55%), and 190 (46.12%), respectively, and the mean follow-up periods for the 3 groups were 7.13, 7.12, and 7.27 years, respectively. After using inverse probability weighting, the intermediate and low COC groups were significantly associated with an increased risk of ESRD compared with the high COC group (adjusted hazard ratio (aHR) 1.36 [95% CI, 1.03–1.80] and aHR 1.76 [95% CI, 1.35–2.30], respectively). The intermediate and low COC groups were also significantly associated with the subsequent hospitalization compared with the high COC group (aHR 1.15 [95% CI, 0.99–1.33] and aHR 1.72 [95% CI, 1.50–1.97], respectively).Conclusion: COC is related to ESRD onset and subsequent hospitalization among patients with DM. This study suggested that when DM patients keep visiting the same physician for managing their diseases, the progression of renal disease can be prevented. Keywords: continuity of care, end-stage renal disease, hospitalization, diabetes mellitus

Aviation aircraft will be subjected to a large number of complex random vibration loads during service， and its structure is prone to vibration fatigue，which leads to damage or even failure，which can cause serious losses. The stress intensity factor（SIF）solution method for cracked beams under random vibration loading is investigated，and a time-domain method based on Hudson's theory is proposed to estimate the vibration fatigue crack growth life by combining with the Paris formula. The theoretical analysis and vibration fatigue test are conducted on a typical cantilever beam as an object. The results show that the life prediction results of the proposed time-domain method based on the Hudson's theory is better than that of the experimental estimation results，which can verify that the method can effectively describe the random vibration crack growth behavior.

The damage effect of the explosion shock wave generated by the explosion of the air to air missile warhead on the aircraft skin structure is influenced by various factors，and the function mechanism is relatively com plex，so that a large number of experimental and computational samples are required to evaluate the damage of shock waves to aircraft skin structures accurately. The static explosion experiments of aluminum alloy reinforced plates with fixed supports are performed，and their dynamic response and deformation patterns under shock wave loading are analyzed. The finite element analysis software LS-DYNA is used to simulate the structural response under explosive impact，and the simulation model is validated by comparing with the experimental results. The results show that the target plate is prone to tensile failure with tearing at the fixed boundary when the hole area ratio of the reinforced plate exceeds 1‰，and increasing the hole diameter or the number of holes enhances the risk of perforation damage between holes. The target deformation increases with the incident angle of explosion，and the target deflection can increase by more than 30% when the angle increases from 30° to 60° at a constant explosion distance.

BackgroundThe mental health problems of employees in administrative organs and public institutions are highly valued. However， there is a lack of understanding regarding the mental health status of employees in provincial and municipal administrative organs and public institutions in Qinghai region.ObjectiveTo analyze the anxiety and depression of employees in provincial and municipal administrative organs and public institutions in Qinghai region， so as to provide references for promoting their mental health and intervening in psychological problems.MethodsFrom October 23 to 28， 2022， a total of 3 096 employees in provincial and municipal administrative organs and public institutions in Qinghai region were enrolled using stratified cluster sampling technique， and were assessed using Self-rating Anxiety Scale （SAS） and Self-rating Depression Scale （SDS）.ResultsA total of 1797 （58.04%） employees in municipal and above administrative organs and public institutions in Qinghai region completed a valid questionnaire survey. Depressive symptoms were noted in 579 （32.22%）. SDS scores yielded statistical difference among the selected employees of different ethnicities， types of job positions and educational levels （F=9.074， 101.488， 4.477， P

The use of weak passwords is a significant vulnerability in computer information system security, and this issue is also present in the digital applications of grain storage information systems. Simple hashing algorithms have obvious limitations when dealing with weak passwords. Based on the actual application of grain storage software systems, this paper proposed a method to enhance weak password protection by using a hashing algorithm as the foundation, combined with the introduction of salt values and high-order reflections for strengthening, along with multiple rehashing operations. Validation and analysis showed that this method increased the hashing strength of weak passwords, and effectively prevented dictionary attacks or rainbow table attacks, which could achieve the effective protection for the transmission and storage of weak passwords. Additionally, it had low complexity, and was easy to implement. It also had an average computational latency of approximately 2.5 ms, which was imperceptible to users. This method is suitable for the construction and management of digital grain storage information systems, providing robust security protection.

Square-hexagonal kink chains, also known as hexagonal kink chains or simply kink chains, are structural configurations used in engineering for various purposes, including material science, nano-technology and mechanics. The square hexagonal kink chain likely describes a chain-like structure where the individual units have square and hexagon-like shapes and are arranged with symmetry. Additionally, there are likely points in the chain where the linear arrangement deviates or kinks, possibly due to some structural irregularity. A nonterminal hexagon is regarded as a kink if it contains two neighbouring vertices of degree 2 , while a nonterminal square is considered a kink if and only if it has a vertex of degree 2 . The kinks from these two types of arrangements are called kinks of type T 1 and T 2 , respectively. Our objective is to discover three possible arrangements of kinks of type T 2 further, depending on the process of how different polygons are attached at different places, holding the condition to make a kink at each step. In this work, we have calculated forgotten, geometric-arithmetic, sum-connectivity and atom bond-connectivity indices for the kink chains. A comparison between these topological descriptor is given by computing their numerical values for each kink chain.

Introduction Although shisha smoking is banned in Senegal, it has become increasingly popular, especially among youth. Despite the health risks associated with shisha smoking, there are few studies on shisha smoking in West Africa and none in Senegal. Our study assessed the prevalence and factors associated with shisha smoking among students aged 13–15 years in Senegal. Methods We used the 2020 Global Youth Tobacco Survey (GYTS) Senegal data from 2524 students aged 13–15 years. We calculated the weighted prevalence of ever and current (past 30 days) shisha smoking. Multivariable logistic regression analyses identified factors associated with ever and current shisha smoking among students. Results The prevalences of ever and current shisha smoking were 9.8% (95% CI: 7.7–12.3) and 2.2% (95% CI: 1.5–3.1), respectively. Ever shisha smoking was significantly associated with being male (AOR=1.97; 95% CI: 1.33–2.92), current cigarette smoking (AOR=7.54; 95% CI: 2.95–19.29), higher class grade (AOR=2.27; 95% CI:1.10–4.67), more weekly pocket money (AOR=3.29; 95% CI:1.36–7.95), current use of smokeless tobacco (AOR=11.53; 95% CI: 4.98– 26.72), and exposure to secondhand cigarette smoke in public (AOR=1.55; 95% CI: 1.00–2.41). Current shisha smoking was significantly associated with current cigarette smoking (AOR=21.75; 95% CI: 6.08–77.78), more weekly pocket money (AOR=8.91; 95% CI: 1.75–45.40), current use of smokeless tobacco (AOR=8.26; 95% CI: 2.07–33.04), and fathers’ smoking (AOR=3.34; 95% CI: 1.24–8.96). Conclusions One in 10 students aged 13–15 years have ever smoked shisha and 2.2% were currently smoking it, suggesting that shisha smoking is a public health concern in Senegal. Senegal might consider offering students more education on the harms of shisha, both in schools and through comprehensive media campaigns that address all tobacco products.

In order to clarify the controlling effect of different packaging materials on common storage pests, the penetration and survival of 7 kinds of high density polyethylene films with different concentrations of deltamethrin by the larvae of 3 common species of stored grain pests (Tribolium castaneum (Herbst), Tribolium confusum Duval and Lasioderma serricorne (Fabricius)) were investigated after being treated by two penetration methods for different times at 27~29 ℃ and 70%~80% RH. The results showed that all the tested new insect-proof films had certain insect resistance capabilities, which were different based on species of stored grain insects. In addition, the insect resistance capability of the 6 kinds of new films containing chemicals was higher than that of the control films after 9 days of treatment, and the anti-penetration rate of 1% A (HDPE particle containing 5% deltamethrin by mass) film, 3% A film, 1% B (HDPE particle containing 5% deltamethrin and 2% isoethers by mass) film and 3% B film was 100% under two penetration modes. The survival rate of all three species larvae decreased with increasing treatment time. After 9 days of parallel penetration treatment, the survival rate of three species of larvae on 3%B film was significantly lower than that of other films, and the survival rate of L. serricorne larvae reduced to 10% at the lowest. According to the penetration resistance and larvae survival rate of the test insects on the films, 3% B film had the best insect control effectiveness.

Abstract Chemical graph theory has made a significant contribution to understand the chemical compound properties in the modern era of chemical science. At present, calculation of the topological indices is one of most important area of research in the field of chemical graph theory. Cyclodecane is a cyclic hydrocarbon with the chemical formula $$C_{10}H_{20}$$ C 10 H 20 . It consists of a ring of ten carbon atoms bonded together in a cyclical structure. Cyclodecane chains can be part of larger molecules or polymers, where multiple cyclodecane rings are connected together. These molecules can have various applications in chemistry, materials science, and pharmaceuticals. This article aims to determine expected values of some connectivity based topological indices of random cyclodecane chains, containing saturated hydrocarbons with at least two rings. It also compares these descriptors using explicit formulae, numerical tables and present graphical profiles of these comparisons.

The ground vibration test of full-scale aircraft has the characteristics of multiple coordination units, complex system, long implementation time and high risk. Facing the need of efficient development of advance aircraft, it is necessary to improve the capability of the test by introducing the digital means. In this paper, the flow of ground vibration test in traditional mode is summarized, the elements of digital test are analyzed, and the digital test programme is constructed preliminarily. It is pointed that the current digital collaboration model has significant benefits in reducing experimental risks and improving experimental efficiency. In the future, it is necessary to further promote the integration of digital and real simulation and application platform development to promote the mature implementation of digitalization.

Objectives Six million children were under-vaccinated in 2022. Our study aimed to 1) quantify the magnitude of under-vaccination variation between health facilities, 2) assess to which extent individual and health center level factors contributed to the variation, 3) identify individual and health facility factors associated with under-vaccination, and 4), explore rural vs. urban health facility variations. Methods We used data from 61,839 children from The Gambia national routine vaccination register. We cross tabulated under-vaccination status across study variables and fitted two-level random intercept multilevel logistic regression models to measure variance, contribution to the variance, and factors associated with the variance and under-vaccination. Results We found that 7% of the prevalence of under-vaccination was due to variation between health facilities. Thirty-seven percent of the variation was explained by individual and health center variables. The variables explained 36% of the variance in urban and 19% in rural areas. Children who were not vaccinated at 4 months or with delayed history, due for vaccination in the rainy season, and health facilities with very small or large population to health worker ratios had higher under-vaccination odds. Conclusion Our study indicates that one of the pathways to improving vaccination coverage is addressing factors driving under-vaccination inequities between health facilities through urban-rural differentiated strategies.

The cubic intuitionistic fuzzy set is an expansion of the cubic fuzzy set that displays massive information to demonstrate interval-valued intuitionistic fuzzy sets and intuitionistic fuzzy sets. This increment informs limitations essential in existing frameworks, primarily focusing on the significance of embracing our access for more accurate decisions in compound and unresolved structures. The Schweizer and Sklar (SS) operations are engaged in promoting strong aggregation operators for cubic intuitionistic fuzzy sets through this research. Operators such as cubic intuitionistic fuzzy Schweizer and Sklar power weighted average (CIFSSPWA) and cubic intuitionistic fuzzy Schweizer and Sklar power weighted geometric (CIFSSPWG) are offered that enhance the workability of data aggregation within the cubic intuitionistic fuzzy (CIF) environment when compared to surviving methods. The proposed operators may assist in patient treatment and handling by upgrading decision-making in medical sectors like diabetes care. Moreover, to determine the stability and reliance of the outcomes, sensitivity and comparison studies are richly absorbed by this approach.

Background: The most effective method for improving the prognosis of lung cancer is the application of low-dose computed tomography (LDCT) for pulmonary nodule screening in populations at high risk. Timely diagnosis and treatment of early-stage lung cancer can contribute to higher long-term survival rates. However, it remains difficult to differentiate malignant from benign pulmonary nodules measuring 8–15 mm, and avoid overtreatment on the one hand and delayed diagnosis on the other hand. In this consensus paper, we aimed to clarify the definition of “high-risk indeterminate pulmonary nodules (IPNs)” and discuss appropriate evaluation and management to facilitate timely diagnosis of lung cancer to improve lung cancer outcome. Direction for future research was discussed. Methods: A multi-disciplinary panel of doctors and IT experts from Asia, Canada and the U.S. were invited to participate. Published evidence and consensus guidelines were used to develop this consensus was clarified. Their evaluation and management were discussed. Findings: The experts believed that the prevalence of pulmonary nodules was very high, and it that was difficult to diagnose early-stage lung cancer due to the small size of the nodules, often leading to delayed diagnosis or overtreatment. To address this issue and to improve long-term outcome, the panel considered important to revise the classification of high-risk IPNs, (1) as pulmonary nodules that cannot be clearly diagnosed with non-surgical biopsy procedures, but is highly suspicious for early-stage lung cancer. The panel also recommends the most responsible should arrange imaging evaluations and follow-ups, taking new technologies into account. Artificial intelligence (AI) assessment based on the Medical Internet of Things (MIoT) can be combined with expert opinion to form a human–computer multidisciplinary team (MDT) that can fully implement the three core procedures of the MIoT, namely, comprehensive perception, reliable transmission, and intelligent processing. This will help to upgrade the non-standard diagnosis and treatment, the so-called “handicraft workshop model”, to a modern assembly-line model that meets international standards. The MIoT technology, which has the potential to realize “simplification of complex problems, digitalization of simple problems, programming of digital problems, and systematization of programming problems”, can promote the homogeneous evaluation of pulmonary nodules by enhancing both the sensitivity and the specificity of detecting early-stage lung cancer, in order to avoid delayed diagnosis and overtreatment. Conclusion: To optimize the evaluation of early-stage lung cancer, and to avoid delayed diagnosis and overtreatment, it is necessary to propose and promote the concept of “high-risk IPNs”. The application of current technologies, AI, and a human–computer MDT, will facilitate improvement in nodule evaluation, transforming the current diagnosis and treatment model, which is akin to production in handicraft workshops, into a modern assembly-line model that meets international standards, and will ultimately result in better prognosis.

Stored grain is extremely vulnerable to the storage insects during storage and processing. At present, chemical control is still the main method for controlling stored grain insects. However, the increasing resistance of insects caused by long-term use of chemical control raises unprecedented challenges. Insect-repellent packaging, as a traditional and emerging physical insect prevention method, has increasingly attracted widespread attention among people. The types and characteristics of food packaging materials, the types and application of insect-repellent packaging, the research and evaluating methods of insect-repellent packaging at home and abroad, and the problems existing in the practical application of insect-repellent packaging were reviewed, and the development trend of insect-repellent packaging was prospected, so as to provide reference information for the scientific and efficient use of insect-repellent packaging, development of new insect-repellent packaging to control stored grain insects in the future.

【Objective】 Selenium is a vital nutrient but deficient in many soils. Sodium selenium can be used as a selenium fertilizer. This paper investigates the impact of its application on photosynthesis and activity of antioxidant enzymes of Tartary buckwheat. 【Method】 The experiment was conducted in pots using the variety Xiyang as the model plant. There were 5 treatments by mixing the sodium selenite with soil at a ratio (weight /weight) ranging from 0 (control) to 40 mg/kg. In each treatment, we measured the height, fresh and dried weight, photosynthetic parameters, and antioxidant enzyme activities of the crop. 【Result】 ①Applying sodium selenite can significantly increase biomass and height of the crop, compared to the control, but only when application ratio did not exceed 10 mg/kg. ② Compared to the control, applying sodium selenite increased net photosynthetic rate, transpiration rate, stomatal conductance, and chlorophyll by 7.57%, 32.70%, 28.12% and 6.96% respectively, while reduced the intercellular CO2 concentration by 13.95%. It was found that applying 5 mg/kg of sodium selenite increased CO2 assimilation capacity. The effect of sodium selenite in improving the photosynthesis was most effective during the full flowering stage. ③Compared to the control, applying 5 mg/kg of sodium selenite increased activity of catalase by 3.29%; however, increasing the application to 10 mg/kg enhanced the activity of superoxide dismutase and peroxidase by 261.74% and 88.63%, respectively. ④The growth and development of Tartary buckwheat were inhibited when the concentrations of disodium selenite were 20 mg/kg and 40 mg/kg. 【Conclusion】 Our results show that applying sodium selenite to soil can improve photosynthesis and antioxidant enzyme activities of Tartary buckwheat, especially at the flowering stage, but only when the application ratio did not exceed 10 mg/kg.

The use of self-sharpening cutters can increase crop survival and regrowth by reducing the extent of stem damage incurred during the mowing stage and reducing the healing time at the harvest site. In this study, a self-sharpening cutter was prepared using a two-stage rare earth catalytic carbon–nitrogen–boron co-infiltration process, and the self-sharpening and wear-resistant properties of the cutter were verified by using metallographic organization testing, hardness testing, friction and wear performance testing, and the homemade tool wear test bench, and the low-damage cutting characteristics of the cutter were examined through field tests on alfalfa. The results show that the thickness of the penetration layer on the back face of a self-sharpening cutter made of gradient material is about 800 μm, with a maximum hardness of 1,800 HV. The coefficient of friction of the gradient material self-sharpening cutter is 67% lower than that of the commercially available 65Mn cutter. Gradient material self-sharpening cutter wear resistance is 2.15 times more than that of commercially available 65Mn cutter. The gradient material self-sharpening cutter reduces cutting damage by 11.42% compared to the commercially available 65Mn cutter. The application and promotion of self-sharpening cutting blades with gradient materials reduce alfalfa cutting damage, thereby improving reproductive yield.

This article proposes a flexible surgical robot featuring strong magnetic steering achieved by a hemispherical magnet array actuation, and high‐accuracy ultrasonic position sensing achieved by a beacon total focusing method (b‐TFM). The hemispherical magnet array with magnetic focusing is described and its array parameters are optimized through finite element analysis to increase the magnetic field for actuation. The magnetic field strength at 100 mm for the array with the same mass as the cylindrical magnet is about 1.8 times higher than that of the cylindrical magnet. Using the magnet array actuation, the flexible robot exhibits the capability of agile steering to navigate along a predefined trajectory. In addition, a 1 mm × 1 mm lead zirconate titanate (PZT) patch is embedded into the tip of the flexible robot as a beacon for b‐TFM ultrasonic imaging to detect the position of the robot. Therefore, the entire navigation process can be executed under the supervision of the ultrasonic position sensing system, and the maximum error is 0.8 mm when the steering radius is 100 mm.

Objective To investigate the incidence of COVID-19 in patients with tumor during the pandemic of Omicron variant strains. Methods From December 25, 2022 to January 25, 2023, through the questionnaire star platform in the form of electronic questionnaire, we collected information about COVID-19 vaccine, COVID-19 infection and clinical symptoms, and post-infection anti-tumor therapy of patients with malignant tumors (including patients who previously visited the oncology department of Peking Union Medical College Hospital and the oncology department of the local hospital where the trainee doctors of the oncology department of Peking Union Medical College Hospital are located) during the survey period (from December 9, 2022 to the time of questionnaire survey) and performed statistical analysis. Results A total of 270 questionnaires were sent out, of which 265 valid questionnaires were recovered (the effective questionnaire rate was 98.1%). Among the 265 patients with malignant tumors, 170(64.2%) patients received COVID-19 vaccine, 158(59.6%) patients were alive with tumor, and 216 patients (81.5%) were receiving antitumor therapy at the time of COVID-19 infection or during the investigation. In 210 cases (79.2%), patients were infected with COVID-19. Among them, 9 cases (4.3%) developed COVID-19 pneumonia and 3 cases (1.4%) were hospitalized due to COVID-19, and there were no severe or fatal cases. Among the infected patients, 205(97.6%) patients showed symptoms related to the COVID-19, among which fever was the most common (72.9%) symptom, and cough (64.8%) and sputum (50.5%) were the main respiratory symptoms. There were no significant differences in gender, age, tumor type, whether they had underlying diseases, whether they were vaccinated against COVID-19, and whether they were treated with anti-tumor therapy between COVID-19 infected and uninfected patients (all P > 0.05). Among the infected patients, the incidence of pneumonia in those who received ≥3 doses of vaccine was significantly lower than that in those who did not receive vaccine (1.1% vs. 9.9%, P=0.025). At the time of questionnaire survey, 88 patients started antitumor therapy after COVID-19 infection. Compared to infection before COVID-19, 12 patients(13.6%) had more serious adverse anti-tumor reactions after COVID-19 infection, 63 patients (72.7%) had similar symptoms, and 12 patients (13.6%) had milder symptoms. There was no significant correlation between the adverse reactions of anti-tumor therapy before and after infection and the timing of initiation of anti-tumor therapy after infection(P=0.938), but there was a certain correlation with anti-tumor therapy after infection(P=0.003). Conclusions During the pandemic period of Omicron variant, tumor patients were generally susceptible to COVID-19. Almost all infected patients showed related clinical symptoms, but very few patients developed pneumonia. Vaccination with≥3 doses of vaccine may be protective against pneumonia. The adverse reactions of anti-tumor therapy in most cancer patients after infection with COVID-19 were not significantly worse than those before infection.

Introduction Access to tobacco plays a strong role in smoking initiation among youth. This study aimed to quantify successful purchase of cigarettes and assess the factors associated with cigarette purchase access among students aged 11–17 years in The Gambia. Methods We used the 2017 Global Youth Tobacco Survey (GYTS) of 12585 students, aged 11–17 years from The Gambia. The analysis was restricted to 2951 students aged 11–17 years who bought and/or attempted to buy cigarettes within the past 30 days regardless of smoking status. Our outcome was purchasing access, defined as successfully purchasing cigarettes within the past 30 days. We report a weighted prevalence of successful purchase attempt. Multivariable logistic regression assessed the factors associated with successful purchase of cigarettes and was adjusted for non-response and the complex survey design. Results Most students (59.4%, 95% CI: 55.4–63.3) who attempted to purchase cigarettes were successful, most of whom were boys (61.3%, 95% CI: 57.8–64.6). However, there was no significant difference in successful attempts to purchase cigarettes between boys (59.3%, 95% CI: 54.2–64.2) and girls (59.4%, 95% CI: 55.4– 63.3). Older age (AOR=2.45; 95% CI: 1.25–4.78), higher school grade (AOR=1.53; 95% CI: 1.09–2.16) and current cigarettes smoking (AOR=1.41; 95% CI: 1.08–1.85) were significantly associated with successful attempt to purchase cigarettes. Sex, parents’ smoking status and students’ weekly pocket money were not associated with successful cigarettes purchase attempt. Among students who currently smoke cigarettes, 55.6% (95% CI: 47.7–63.2) bought them from a store, shop, street vendor, or canteen; 12.2% (95% CI: 8.3–17.5) obtained them from someone else, and 6.7% (95% CI: 4.4–10.0) used other means the last time they smoked. Conclusions Students in The Gambia can purchase cigarettes without much hinderance despite the restrictions. Our research findings can guide the implementation of policies, programs, and public health strategies including more efforts toward implementing tobacco control laws and regulations that protect children from exposure and use of all forms of tobacco products.

The abrupt and destructive nature of systemic financial risks underscores the imperative for modern societies to prioritize early detection and prevention over post-crisis management. This paper introduces a dual-perspective early warning indicator system for regional systemic financial risks, encompassing both macro and market dimensions. It further enhances this system by incorporating the ReliefF algorithm into the feature selection phase of a modified random forest model aimed at predicting regional systemic financial risks. The model’s efficacy was assessed using data spanning from 2009 to 2023, enabling dynamic early warning evaluations of regional systemic financial risks. The model was also employed to project the risk landscape for 2024. The results demonstrate superior performance metrics for the random forest model, with an accuracy of 0.9909, precision of 0.9847, recall of 0.9871, and an F1 score of 0.9785—outperforming three comparative models. Notably, during years of significant systemic risk (2008, 2010, and 2013), the model’s predictions exceeded 0.8, while in 2015 and 2020, they surpassed 0.9. For 2024, the model predicts a higher likelihood of maintaining a “normal” state of systemic financial risk in China, with probabilities ranging between 0.3 and 0.5. This study thus offers robust theoretical support for forecasting regional systemic financial risks.

Tourism architecture is an important material guarantee for carrying out tourism activities in scenic spots and is an important part of the tourism system. This paper analyzes the theory and structure of the G-DINA model in detail. To conceptualize the geospatial tourism architecture, form a conceptual cognition, and establish a basic geospatial tourism architecture cognitive model. Then the G-DINA model is brought into the basic cognitive model, and cognitive judgments are made using observation of tourism building features to form a G-DINA-based geospatial cognitive model of tourism buildings for planning and design of scenic tourism buildings. Experimental proof: By comparing the number of tourists in a tourist area for two months, it is obvious that the number of tourists in the second month has increased by 592 compared with the number of tourists in the first month, which is 160% of the number of tourists in the first month, and the comprehensive index of tourism economy has increased from 0.08 to 0.5, with an annual growth of 8.3%, showing a gradual upward trend in general. Accordingly, it can be considered that the attractiveness and competitiveness of tourist areas are significantly improved through the rational planning and design of tourist buildings. This verifies that reasonable design of tourism architecture and scientific planning of tourism areas can strengthen the harmony between tourism architecture and local style and surrounding environment, highlight regional characteristics and let them be inherited, and promote tourism development.

Abstract Introduction The Hepatitis B virus that can cause liver cancer is highly prevalent in the Gambia, with one in ten babies at risk of infection from their mothers. Timely hepatitis B birth dose administration to protect babies is very low in The Gambia. Our study assessed whether 1) a timeliness monitoring intervention resulted in hepatitis B birth dose timeliness improvements overall, and 2) the intervention impacted differentially among health facilities with different pre-intervention performances. Methods We used a controlled interrupted time series design including 16 intervention health facilities and 13 matched controls monitored from February 2019 to December 2020. The intervention comprised a monthly hepatitis B timeliness performance indicator sent to health workers via SMS and subsequent performance plotting on a chart. Analysis was done on the total sample and stratified by pre-intervention performance trend. Results Overall, birth dose timeliness improved in the intervention compared to control health facilities. This intervention impact was, however, dependent on pre-intervention health facility performance, with large impact among poorly performing facilities, and with uncertain moderate and weak impacts among moderately and strongly performing facilities, respectively. Conclusion The implementation of a novel hepatitis B vaccination timeliness monitoring system in health facilities led to overall improvements in both immediate timeliness rate and trend, and was especially helpful in poorly performing health facilities. These findings highlight the overall effectiveness of the intervention in a low-income setting, and also its usefulness to aid facilities in greatest need of improvement.

This article aims to provide a review of the domestic and foreign studies on the quality indicators for evaluating the psychiatric nursing care in recent years. According to Donabedian model， the research progress of quality indicators for evaluating the psychiatric nursing care were described from the three dimensions of structure quality， process quality and outcome quality. This paper summarizes the status of the research， points out the shortcomings of existing research， and provides references for the future research on the quality indicators for evaluating the psychiatric nursing care.

Purpose – The supercritical design of tail rotor drive shaft has attracted more attention in helicopter design due to its high power–weight ratio and low maintenance cost. However, there exists excessive vibration when the shaft passes through the critical frequency. Dry friction damper is the equipment applied to the drive shaft to suppress the excessive vibration. In order to figure out the damping mechanism of the dry friction damper and improve the damping efficiency, the dynamic model of the shaft/damper system is established based on the Jeffcott rotor model. Design/methodology/approach – The typical frequency response of the system is studied through bifurcation diagrams, amplitude-frequency characteristic curves and waterfall frequency response spectrum. The typical transient responses under frequency sweeps are also obtained. Findings – The results show that the response of the system changes from periodic no-rub motion to quasi-periodic rub-impact motion, and then to synchronous full annular rub-impact, and finally, back to periodic no-rub motion. The slip of the rub-impact ring improves the stability of the system. Besides, the effects of the system parameters including critical dry friction force, rub-impact friction coefficient, initial clearance on the stability and the vibration damping capacity are studied. It is observed that the stability changes significantly varying the three parameters respectively. The vibration damping capacity is mainly affected by the critical dry friction force and the initial clearance. Originality/value – Presented results provide guidance for the design of the dry friction damper.

准确获得飞机结构及机载设备的振动环境至关重要, 传统的振动环境预计方法预计准确度低, 可能会导致后期振动环境试验过试验或欠试验的问题。创新性地提出了一种基于扩展工况传递路径分析(OPAX)的振动环境预计方法, 采用实测数据搭建振动环境预计模型, 再利用该模型对新工况下的振动环境进行预计。试验室环境下, 搭建了某型飞机典型设备舱振动测试系统, 基于OPAX方法搭建了机载设备的振动环境预计模型, 并对其预计准确度进行了验证。对比预计结果与试验结果, 得到: ①新工况下模型预计均方根值与试验测试均方根值相比, 误差保持在20%以内; ②在预计频段范围内, 新工况下模型预计的变化趋势与试验测试基本一致, 个别频率处差异较大。综合新工况下预计结果, 这种基于OPAX的振动环境预计方法预计精度较高, 且搭建模型所需数据量较少, 搭建方便, 具有可操作性和工程实用价值。

Objective To analyze the clinical, imaging and pathological features of patients with epithelial-myoepithelial carcinoma(EMC). Methods The data of a patient with primary EMC of the thymus in Peking Union Medical College Hospital was retrospectively analyzed, and the relevant literature was reviewed. Results The patient was a middle-aged male diagnosed with primary EMC of the thymus, and he was the first case currently reported at home and abroad. Even though the patient received comprehensive treatments including surgery, chemotherapy, radiotherapy and molecular targeted therapy, he still experienced disease progression, with a survival time of 22 months after surgery. Conclusions Primary EMC of the thymus is extremely rare and has atypical clinical manifestations. The diagnosis mainly depends on histopathological examination. Surgery is currently the major treatment and multidisciplinary treatment is very important to prolong the survival time of EMC patients.

Abstract To investigate the diagnostic value of ultra‐small superparamagnetic Fe3O4 nanoparticles as dual modal contrast agent in rabbit orthotopic liver tumor. Twenty‐four New Zealand rabbits with orthotopic liver tumor were randomly divided into experimental group and control group. The experimental group contained 12 rabbits which intravenously injected with Fe3O4 nanoparticles and the control group contained 12 rabbits which intravenously injected with Gd‐DTPA. After injection, the cross‐sectional T1 and T2‐weighted scan images of experimental group and cross‐sectional T1‐weighted scan images of control group were obtained at the different timepoints (including 0, 5, 15, 20, 30, 45, 60, 75, 90, 120, 180, and 240 min) with a clinical 3.0 T MRI scanner. The SNR value of the tumor site and the normal liver site at different time points were calculated, respectively, and then the signal change value (CNR) of the tumor relative to the normal liver tissue was obtained. The r1 value of Fe3O4 nanoparticles was significantly higher than Gd‐DTPA (6.97 mM−1 s−1 for Fe3O4 nanoparticles and 4.75 mM−1 s−1 for Gd‐DTPA and only Fe3O4 nanoparticles exhibited the r2 relaxation rate which was 22.53 mM−1 s−1). In addition, the r2/r1 ratio of Fe3O4 was 3.23 which also demonstrated the strong MR relaxation characteristics of Fe3O4 nanoparticles. Compare with clinical used MRI contrast agent (Gd‐DTPA), the ultra‐small magnetic Fe3O4 nanoparticles not only showed the better T1 contrast enhancement but also exhibited the T1/T2 dual‐modal enhanced contrast ability, which could improve the accuracy and sensitivity of MRI diagnosis and realize the early diagnosis of diseases in prospect.

BackgroundAlthough the pathology and bacterial status of the “normal” bone stump after operation of diabetic foot osteomyelitis (DFO) are of great significance for the prognosis of foot wounds, there are only a few studies on this topic; hence, it is clinically relevant and urgent to study this topic.MethodsThe data of 57 inpatients with DFO from June 2021 to April 2022 were collected, all of whom had DFO in the forefoot and underwent conservative surgery. After the surgical removal of necrotic bone, bone biopsies were taken from the necrotic phalangeal bone and the reserved “normal” metatarsal stump. They were cultured, after which antibiotic susceptibility test and pathological screening were carried out. According to clinical judgment, inpatients’ wounds were divided into metatarsal affected group and metatarsal unaffected group. We then compared and analyzed the pathological and bacterial characteristics of preserved “normal” bone stump and its effect on wound healing and prognosis.ResultsThe poor concordance rate between deep soft tissue culture and infected phalange culture was only 19.3%. The deep soft tissue (72.6%), infected phalange (70.7%), and metatarsal stump (71.4%) were mainly infected with gram-negative Bacillus. The proportion of Enterococcus spp. increased significantly in bone tissue. Acinetobacter baumannii had the highest drug resistance (88%, 22/25). There was no significant difference in several clinical characteristics and wound healing regardless of whether their metatarsal stumps were affected. Most reserved “normal” metatarsal stumps (84.2%, 48/57) were positive by pathological diagnosis and bacterial culture testing; only 15.7% (9/57) samples were truly sterile. Only 8.3% (4/48) of the former patients healed within 6 months; whereas, all the latter (9/9) patients healed within 6 months. However, the majority (89.6%, 43/48) could heal. There was no difference in operations, skin grafting, negative pressure wound therapy, and mortality between the two groups.ConclusionThe most reserved “normal” metatarsal stumps have been invaded by bacteria. However, the majority stumps can be preserved, and the wound will eventually be healed according to the pathological and bacterial culture results.

The heat and mass exchange of CO2 in a vertical U-tube under supercritical pressure was simulated. The effects of the geometry of the bend area, The center arc radius of the bend area and the different bend orientations on the flow heat transfer of supercritical CO2 in the U-tube were analyzed. The results show that in the bend area, the flow is affected by the combined action of centrifugal force and gravity, as well as the pipe structure, so the flow mixing is intense, and the heat transfer capacity is significantly enhanced. When the direction of the bend changes, the interaction between centrifugal force and gravity will affect the heat transfer at pipe bending. When the central arc radius r of the bend area increases from 0.5D to 3D, the heat transfer at the bend can be strengthened, but will weaken the heat transfer at the bend outlet area.

ObjectiveTo summarize the current research of traditional physical and mental exercise in elderly patients with mild cognitive impairment （MCI） by means of a scoping review， so as to provide references for exercise intervention in elderly patients with MCI.MethodsRelevant literatures related to the application of traditional physical and mental exercise in elderly MCI patients were searched from CNKI， Wanfang， VIP database， PubMed， Web of Science and Embase， and the retrieval time was set up until June 2021. Basic information， traditional physical and mental exercise methods and application effects were extracted from the selected literatures. The application of traditional physical and mental exercise in elderly MCI patients were summarized.ResultsA total of 22 literatures were involved in the final review， and the intervention methods were as follows， combined intervention of various traditional physical and mental exercise（2）， Baduanjin（9）， Tai Chi（9）， Liuzijue（1） and Qigong（1）. The intervention plan lasted from 2 to 18 months in total， 2 to 5 sessions per week， and each session was 40 to 90 minutes. Traditional physical and mental exercise had an overall positive effect on cognitive function， sleep quality， memory and reaction time of elderly patients with MCI， but its effect on daily living ability and depression was controversial.ConclusionTraditional physical and mental exercise can improve cognitive function and physical function of elderly patients with MCI， which may be a safe and effective treatment.

We detected the expressions of hsa_circRNA_000121 and hsa_circRNA_ 004183 in papillary thyroid microcarcinoma (PTMC) and explored their relationship with the invasiveness of PTMC. PTMC patients with (n = 30; metastasis group) and without lymph node metastasis (n = 30; nonmetastasis group) were included. The levels of hsa_circRNA_000121, hsa_circRNA_004183, hsa-miR-4763, hsa-miR-6775, sarcoma gene (SRC), and MMP-14 were detected with real-time polymerase chain reaction. Receiver-operating characteristic (ROC) analyzed the diagnostic value of hsa_circRNA_000121 and hsa_circRNA_004183. Binary logistic regression analysis evaluated the relationship of gene expression with PTMC invasiveness. In PTMC tissue samples, compared with the metastasis group, the expression of hsa_circRNA_000121, hsa_circRNA_004183, SRC, and MMP-14 in the nonmetastasis group decreased, while the expression of hsa-miR-4763 and hsa-miR-6775 increased. In peripheral blood, compared with the metastasis group, the expression of hsa_circ_000121 and hsa_circRNA_004183 in the nonmetastasis group decreased. Both hsa_circRNA_000121 and hsa_circRNA_004183 had good sensitivity and specificity for diagnosing PTMC lymph node metastasis, with a cut-off value of 0.796 and 0.938, respectively. However, the gene expressions were not significantly associated with PTMC lymph node metastasis. Hsa_circRNA_000121 may upregulate SRC expression through hsa-miR-4763, while hsa_circRNA 000121 may upregulate MMP-14 expression through hsa-miR-6775, thereby promoting the aggressiveness of PTMC and ultimately leading to cervical lymph node metastasis. hsa_circRNA_000121 and hsa_circRNA_004183 may become potential biomarkers of PTMC aggressiveness.

IntroductionUnderstanding the modulations of the medial prefrontal cortex (mPFC) in the valence of the stimulus from rewarding and aversive status to neutral status is crucial for the development of novel treatments for drug addiction. This study addressed this issue and examined whether optogenetic ChR2 photostimulation in the cingulate, prelimbic, and infralimbic cortices of the mPFC regulated the valence of saccharin solution consumption from the rewarding property, the aversive property induced by morphine’s conditioning, and the neutral states via saccharin extinction processes after morphine’s conditioning.MethodsAll rats received virus infection, buried optical fiber, optical stimulation, water deprivation, and saccharin solution consumption phases. In Experiment 1, rats were given ChR2 virus infection into the cingulate cortex (Cg1), prelimbic cortex (PrL), and infralimbic cortex (IL) to influence the rewarding saccharin solution consumption under photostimulation. In Experiment 2, rats were given ChR2 or EYFP virus infection into the Cg1, PrL, and IL to alter the saccharin solution consumption in the morphine-induced aversively conditioned taste aversion (CTA) and the saccharin solution consumption in the neutral state following the extinction process under photostimulation. Later, the immunohistochemical staining with c-Fos protein was performed for the Cg1, IL, PrL, nucleus accumbens core, nucleus accumbens shell, central amygdala, basolateral amygdala, ventral tegmental area, and dentate gyrus.ResultsThe results showed that optogenetic PrL stimulation decreased the rewarding valence of saccharin solution consumption and increased the morphine-induced, aversive valence of saccharin solution consumption. PrL stimulation decreased the neutral valence of saccharin solution consumption via the extinction process. Cg1 optogenetic stimulation increased the rewarding valence of saccharin solution consumption and the aversive valence of saccharin solution consumption induced by morphine in conditioning. Optogenetic IL stimulation increased the aversive valence of saccharin solution consumption induced by morphine via conditioning.ConclusionAltogether, optogenetic stimulation in the subareas of the mPFC modulated the reward, aversion, and neutral valences of the stimulus and altered neuronal activity in the mPFC, amygdala, nucleus accumbens, and hippocampus. Notably, the change of valence was temporary alternation during light-on related to the light-off periods. However, the findings may provide insights in the development of novel treatments for addictive symptoms.

Surface electromyography (sEMG) control interface is a common method for human-centered robotics. Researchers have frequently improved the recognition accuracy of sEMG through multichannel or high-precision signal acquisition devices. However, this increases the cost and complexity of the control system. Therefore, this study developed a control interface based on the sEMG enveloped signal for a collaborative wearable robot to improve the accuracy of sEMG recognition based on the time-domain (TD) features. Specifically, an acquisition device is developed to obtain the sEMG envelope signal, and 11 types of TD features are extracted from the sEMG envelope signal acquired from the upper limb. Furthermore, a dimension reduction method based on the correlation coefficient is proposed, transforming the 11-dimensional feature into a five-dimensional envelope feature set without decreasing the accuracy. Moreover, a recognition algorithm based on a neural network has also been proposed for gesture classification. Finally, the recognition accuracy of the proposed method, principal component analysis (PCA) feature set, and Hudgins TD feature set is compared, with their accuracy at 84.39%, 72.44%, and 70.89%, respectively. Therefore, the results indicate that the envelope feature set performs better than the common gesture recognition method based on signal channel sEMG envelope signal.

Objective To design a safety management system for antitumor drugs, which can intercept or warn the overdose of medical orders from the prescription source, and ensure the safety of clinical application of antitumor drugs. Methods The threshold of interception and warning strategy of 88 kinds of antitumor drugs were developed, and the safety management system of antitumor drugs was established to intercept or warn the overdose orders. The interception and warning data from January 2021 to June 2021 in the safety management system of antitumor drugs were extracted and analyzed. Results A total of 665 medical orders were intercepted or warned by the safety management system of antitumor drugs, and the majority of the intercepted or warned drugs were oral tablets(74.29%). The intercepted orders were 642 (96.54%), and the warned orders were 23(3.46%). Among the intercepted medical orders, frequency error (64.22%) has the highest proportion, followed by route error (11.73%) and dose error (9.92%). A total of 564 medical orders were intercepted, involving 28 kinds of antitumor drugs. Methotrexate tablets ranked first in overdose quantity, with an average of seven times. Pemetrexed ranked first in overdose multiples, with an average overdose of 1000 times. 78 medical orders were intercepted for over pathway, involving 5 kinds of antitumor drugs. Conclusion The safety management system of antitumor drugs can eliminate the error of overdose in prescription and guarantee the safety of antitumor drugs.

Due to the immunosuppressive microenvironment as well as the lack of medicine that targets the driver gene alterations, the prognosis of patients with pancreatic ductal adenocarcinoma(PDAC)is worse than that of other malignant tumors.At present, chemotherapy is still the main stay of treatment for most patients with advanced PDAC. In recent years, with the continuous development of anti-cancer drugs and the wide application of next-generation sequencing technology, increasing number of studies have shown that genetic alteration could guide the selection of chemotherapy regimen and molecular targeted therapy for some patients with advanced PDAC.Guidelines of the National Comprehensive Cancer Network and Chinese Society of Clinical Oncology recommend that all patients with advanced PDAC should undergo somatic and germline genetic profiling to help determining the optimal treatment strategy and to prolong patients' survival. Therapy targeting KRAS mutation, cancer vaccines and therapy of anti-tumor metabolism are still in clinical research. This article will review current status and progress of medical treatment for advanced PDAC.

BackgroundEarly identification and intervention of diabetic peripheral neuropathy is beneficial to improve clinical outcome.ObjectiveTo establish a risk prediction model for diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes mellitus (T2DM).MethodsThe derivation cohort was from a meta-analysis. Risk factors and the corresponding risk ratio (RR) were extracted. Only risk factors with statistical significance were included in the model and were scored by their weightings. An external cohort were used to validate this model. The outcome was the occurrence of DPN.ResultsA total of 95,604 patients with T2DM from 18 cohorts were included. Age, smoking, body mass index, duration of diabetes, hemoglobin A1c, low HDL-c, high triglyceride, hypertension, diabetic retinopathy, diabetic kidney disease, and cardiovascular disease were enrolled in the final model. The highest score was 52.0. The median follow-up of validation cohort was 4.29 years. The optimal cut-off point was 17.0, with a sensitivity of 0.846 and a specificity of 0.668, respectively. According to the total scores, patients from the validation cohort were divided into low-, moderate-, high- and very high-risk groups. The risk of developing DPN was significantly increased in moderate- (RR 3.3, 95% CI 1.5–7.2, P = 0.020), high- (RR 15.5, 95% CI 7.6–31.6, P < 0.001), and very high-risk groups (RR 45.0, 95% CI 20.5–98.8, P < 0.001) compared with the low-risk group.ConclusionA risk prediction model for DPN including 11 common clinical indicators were established. It is a simple and reliable tool for early prevention and intervention of DPN in patients with T2DM.

Objective: To assess whether the implementation of a results-based financing (RBF) project in The Gambia resulted in (1) improved national vaccination coverage (2) higher coverage in intervention than non-intervention areas, and (3) improvement in rural–urban coverage inequality. Methods: The study used a difference-in-differences design, based on repeated cross-sectional data from The Gambian Demographic and Health Surveys 2013 (N = 1650) and 2020 (N = 1456). Full vaccination (receipt of one BCG, 3 OPV, 3 DTP, and 1 measles-containing vaccine doses) and rural–urban vaccination inequality were our outcome variables. The intervention, RBF, was implemented in 5 of the 7 health regions. Covariates controlled for included child’s sex, child’s birth order number, socioeconomic status, ethnicity, distance from health facility, maternal education, mother’s age group, mother’s marital status, and mother’s work status. Poisson regression with robust variance was used to estimate whether coverage changed, and difference-in-differences and difference-in-differences-in-differences were used to ‘assess differences in vaccination coverage change and change in inequalities, respectively. Results: Total crude full vaccination coverage in The Gambia was 76% in 2013 and 84.6% in 2020. Overall vaccination significantly increased by 16% (95% CI: 9% to 24%) in 2020 compared to 2013, but with a smaller increase in intervention relative to non-intervention areas [PRR 0.88 (CI: 0.78–0.99)]. Rural-urban inequality in vaccination coverage decreased more – by 13% [0.87 (0.78–0.98)] – in RBF than non-RBF regions. Conclusion: Vaccination coverage improved over the study period though we have no evidence to ascribe the coverage gains to the RBF intervention. However, our study suggests that the RBF project has contributed to reducing rural–urban inequalities in the regions it was implemented.

Objectives To investigate the relationship between cigarette prices and smoking experimentation among children in the Gambia, and thereby expanding the evidence base of the likely impact of excise taxes on cigarette demand in low-income and middle-income countries.Design A survival analysis using the Gambia 2017 Global Youth Tobacco Survey data.Setting The Gambia.Participants The survey sample was 12 585 youths, aged 12–17 years, but our analysis was restricted to 11 030 respondents with information on smoking status.Primary and secondary outcome measures Our outcome variable was smoking experimentation defined as the first time the respondent smoked (at least part of) a cigarette.Results A 1% increase in the price of cigarettes reduces the probability to experiment with smoking by 0.7%. We also found that children are more likely to experiment with smoking if they have at least one smoking parent, friends who smoke and see teachers who smoke. The probability to experiment with cigarette smoking increases with age and is higher among boys than girls.Conclusion There is strong evidence that increasing excise taxes can play an effective role in discouraging children from experimenting with cigarette smoking. Considering the relatively low excise tax burden in the Gambia, the government should consider substantially increasing the excise tax burden.

Abstract Background Serum 25‐hydroxyvitamin D [25(OH)D] level alters in colorectal cancer (CRC) development. Regulatory T (Treg) cells and T‐ helper type 17 (Th17) cells are involved in immune response. Th17‐mediated proinflammatory responses contribute to tumorigenesis, and Treg plays different roles in different periods of CRC. Vitamin D deficiency is associated with significant variations in peripheral immune cells. This study investigated the relationship between Th17 and Treg cells and 25(OH)D level in CRC. Methods Ninety‐five CRC patients were included, as well as 80 healthy controls during the same period at the Affiliated Hospital of Jiangnan University. 25(OH)D level was analyzed through electrochemiluminescence (ECLIA). Th17 and Treg levels were evaluated through flow cytometry. Serum levels of interleukin (IL)‐10, IL‐17, IL‐23, and transforming growth factor‐β (TGF‐β), were analyzed through commercial enzyme‐linked immunoassay (ELISA) kits. Results 25(OH)D levels were downregulated in the serum of CRC patients. Decreased 25(OH)D level contributed to CRC pathogenesis. Decreased 25(OH)D level in CRC correlated with increased Treg and Th17 cell ratios and TGF‐β1, IL‐10, IL‐17, and IL‐23 levels in peripheral blood. Conclusion Decreased 25(OH)D level in the serum of CRC patients had negative correlation with Treg and Th17 ratios and relative cytokines levels.

The objectives of this research were to investigate the effects of Allium mongolicum Regel essential oil on growth performance, nutrient digestibility, rumen fermentation, and bacterial communities in sheep Twenty sheep were randomly divided into two dietary groups with 10 replicates each: (1) a basal diet without AMO as the control group (n = 10) and (2) a basal diet supplemented with 40 mg/kg AMO as the AMO group (n = 10). The average daily gain (ADG) was increased (P < 0.05), and the feed conversion ratio (FCR) was reduced (P < 0.05) in the AMO group compared with the control. The ruminal acetate, propionate, total volatile fatty acids (TVFA), and microbial protein (MCP) were higher (P < 0.05) in the AMO group than in the control. Moreover, ruminal pH and ammonia nitrogen (NH3-N) were lower (P < 0.05) in the AMO group than in the control. The relative abundances of the phylum levels of Firmicutes, Actinobacteriota, and Verrucomicrobiota were higher (P < 0.05) in the AMO group than in the control, and the relative abundances of Bacteroidetes and Spirochaetota were lower (P < 0.05) in the AMO group than in the control. The relative abundance of Prevotella and Prevotellaceae_UCG-003 at the genus level was increased (P < 0.05) in the AMO group compared with the control; however, the relative abundance of Succiniclasticum, Norank_f__F082, Christensenellaceae_R-7_group, and Norank_f__Muribaculaceae was decreased (P < 0.05) in the AMO group compared with the control. The activities of cellulase, α-amylase, and proteinase were higher (P < 0.05) in the AMO group than in the control. The apparent digestibility of dry matter (DM) and crude protein (CP) was increased (P < 0.05) in the AMO group compared with the control. In conclusion, AMO supplementation has the potential to improve growth performance. Moreover, supplementation with AMO improved nutrient digestibility, rumen fermentation, and bacterial communities in the rumen of sheep.

In this study, the novel coaxial-annulus-argon-assisted (CAAA) atmosphere is proposed to enhance the machining capacity of the water-jet-guided laser (WJGL) when dealing with hard-to-process materials, including ceramic matrix composites (CMCs) and chemical-vapor-deposition (CVD) diamond. A theoretical model was developed to describe the two-phase flow of argon and the water jet. Simulations and experiments were conducted to analyze the influence of argon pressure on the working length of the WJGL beam, drainage circle size, and extreme scribing depth on ceramic matrix composite (CMC) substrates. A comparative experiment involving coaxial annulus and helical atmospheres revealed that the coaxial annulus atmosphere disrupts the water jet proactively, while effectively maintaining the core velocity within the confined working length and enhancing the processing capability of the WJGL beam. Single-point percussion drilling experiments were performed on a CMC substrate to evaluate the impact of machining parameters on hole morphology. The maximum depth-to-width ratio of the groove and depth-to-diameter ratio of the hole reached up to 41.2 and 40.7, respectively. The thorough holes produced by the CAAAWJGL demonstrate superior roundness and minimal thermal damage, such as fiber drawing and delamination. The average tensile strength and fatigue life of the CMCs specimens obtained through CAAAWJGL machining reached 212.6 MPa and 89,463.8 s, exhibiting higher machining efficiency and better mechanical properties compared to femtosecond (194.2 MPa; 72,680.2 s) and picosecond laser (198.6 MPa; 80,451.4 s) machining. Moreover, groove arrays with a depth-to-width ratio of 11.5, good perpendicularity, and minimal defects on a CVD diamond were fabricated to highlight the feasibility of the proposed machining technology.

【Objective】 Planting date is an important factor impacting plant growth and ultimate yield. The purpose of this paper is to investigate how sowing date affects growth traits and ultimate yield of different rice varieties cultivated in dryland, aimed to provide guidance for farmers to select optimal agronomic management practices. 【Method】 The experiment was conducted in a field and examined three rice varieties: early-mature japonica, middle-mature japonica and late-mature japonica. For each variety, we compared the impact of five planting dates - 25 and 30 April, 5, 10 and 15 May - on its growth and yield traits. 【Result】 In terms of average yield, the three varieties were ranked in the order of early-mature japonica > late-mature japonica > medium-mature japonica. Delaying the planting date of the early-mature variety to 15 May significantly increased its SPAD at filling stage, while planting the late-mature variety on 30 April increased its SPAD at elongation stage compared to other sowing date. In general, delaying the planting date of the early-mature variety or early planting the late-mature variety can increase the areas of their top three leaves. As the sowing date delayed, dry matter accumulation in all three varieties first decreased followed by an increase. Similar trend was also found for the change of plant height of the early-mature japonica. A right sowing date can benefit the grain filling. The sowing date did not have a noticeable effect on seed-setting rate and 1 000-grain weight but could significantly impact both spike numbers and grain number, with the coefficient of variation of the former reaching 20.9% and that of the latter being as high as 23.7%. 【Conclusion】 Our experimental results showed that under dry cultivation, planting the early-mature japonica between May 10 and May 15, and the late- and the medium-mature japonicas between April 30 and May 5 in central region of Jilin province could increase rice yield when other agronomic managements were the same.

The objective of this study was to investigate the effects of Allium mongolicum Regel (AM) and AM extracts on the growth performance, carcass parameters and meat quality of sheep. Forty sheep were randomly divided into four groups. The groups consisted of CON (basal diet), AM water extract (AWE; basal diet + 3.4 g/sheep/day AWE), AM ethanol extract (AEE; basal diet + 2.8 g/sheep/day AEE) and AM (basal diet + 10 g/sheep/day AM). The average daily gain (ADG) was improved (p

The emergency evacuation of passengers and crew on a civil aircraft is a man-machine-environment multi-system coupling process, which involves complex factors such as human behavior, cabin environment, disaster situation, etc. Cabin layout, personnel attributes, emergency measures all are of significant influence on the process and results of emergency evacuation. As emergency evacuation is directly related to the safety of civil aircraft, the airworthiness standard of transport aircraft requires that civil aircraft with more than 44 seats must perform a full-scale emergency evacuation test for airworthiness demonstration, demanding the evacuation process to be completed within 90 seconds under specified environmental conditions. This paper outlines the airworthiness requirements of civil aircraft for emergency evacuation, summarizes the experimental research methods and numerical simulation methods of emergency evacuation, and prospects the research trend about emergency evacuation combined with the future requirements of civil aircraft safety design and the development of related technologies.

This paper fabricates a flexible tactile sensor for artificial skin. The skin is fabricated with polyurethane rubber to make soft channel which is filled with biocompatible aqueous solution, which can visualize the pressure distribution by electrical impedance imaging technology. This paper establishes a numerical simulation model, uses Tikhonov, Landweber, Radial Basis Function Neural Network (RBFNN) and Convolutional Neural Networks (CNN) methods to verify in noise-free and noisy comparative experiments, and conducts single-target and multi-target experiments on the fabricated flexible tactile sensor. The simulation results show that the Root Mean Square Error (RMSE) of CNN is the smallest and the Image Correlation Coefficient (ICC) of CNN is the largest, and it can accurately display the position and contour of the target. The sensor test results show that the flexible tactile sensor we prepared has a good effect in the four algorithms for pressure image reconstruction. Through CNN algorithm, RMSE can reach less than 0.1 and ICC can reach more than 0.9. Therefore, the flexible tactile sensor can intuitively display the pressure distribution, and has a good application prospect in the skin detection of flexible robot.

Abstract Aim To describe the core competencies of gerontological nurse specialists and investigate the factors that contribute to the development of core competencies. Design A descriptive cross‐sectional study was conducted from August 2015–March 2016. Methods The descriptive study of gerontological nurse specialists’ core competencies used a self‐assessment instrument with three first‐level domains (attitude, skill and knowledge) and 9 s‐level dimensions. A total of 225 gerontological nurse specialists from ten provinces in China were selected by a convenience sampling method. Results The average core competency score of the gerontological nurse specialists was 3.78, in the middle level(3.30–4.17/5.00). Core competency was associated with gerontological nurse specialists’ age (p = .005), professional title (p = .017), hospital level (p = .006) and passion for geriatric nursing (p = .000). The average scores of attitude, skill and knowledge were 4.45, 4.02 and 4.18, respectively. All first‐level domains were related to age (p ≤ .021) and passion for geriatric nursing (p ≤ .008); knowledge and skill were associated with professional title (p ≤ .045) and attitude and skill were associated with hospital level (p ≤ .020).

Impact fatigue problems of materials widely exist in aviation engineering. Launching and landing of carrier-based aircrafts are typical impact fatigue problems. This paper reviews the early development of the concept of impact fatigue, summarizes the main research progress in the field of impact fatigue since 2000, including the main factors affecting the impact fatigue performance of materials, test methods, damage characterization and life prediction of impact fatigue and numerical calculation methods of impact fatigue problems. It is indicated that the microstructure, boundary condition, service environment and impact load type of the material are of significant influence on the impact fatigue performance. This paper summarizes the main challenges of the impact fatigue problems in the aviation engineering, and prospects the future development of the impact fatigue technology in the aviation field based on the requirements of the future engineering structure design.

In order to study the uniaxial compression properties of closed-cell metal foam, three different modeling methods were used in this paper to establish 2D random cell, 3D Kelvin and 3D voronoi metal foam model. Based on the LS-DYNA software, the differences of the compressive mechanical properties of the closed-cell metal foam under three different models were analyzed. The deformation mode and the stress strain response of the metal foam under three models were studied. The results show that 2D random cell model is more suitable for the study of the compression regularity of metal foam, and the 3D model is more suitable for the prediction and optimization of the compression response of metal foam. The 2D random cell model is restricted by its plane geometry, it can only simulate the closed-cell metal foam with low porosity in most cases. The Kelvin model and Voronoi model can simulate the closed- cell metal foam with high porosity. Compared with the Kelvin model and 2D random cell model, the voronoi model is more realistic and reasonable, and it is able to better characterize the compressive mechanical properties of closed-cell metal foam.