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Objective This paper analyzes Tianjin residents’ satisfaction with TCM medical services and its influencing factors, in order to provide reference for giving full play to social and economic benefits of TCM. Methods Using both stratified and random sampling method, Six hospitals from Heping, Jinghai and Beichen were selected, and 260 residents conducted questionnaires. Result Residents’ satisfaction rate of TCM medical service was 22.2 %. TCM knowledge propaganda and TCM price satisfaction score were the highest ( 3.5 ), and TCM curative effect score was the lowest ( 2.3 ).Logistic regression showed that gender, TCM knowledge propaganda, medical equipment, medical distance, medical convenience and reimbursement ratio had significant effects on residents’ satisfaction(P < 0.05).Conclusion Tianjin residents have low satisfaction with TCM medical services, so it is suggested to accelerate the innovation of TCM technology, improve the effect of TCM treatment, rationally allocate TCM medical resources, and improve the satisfaction of residents.

The aim of this study was to investigate the changes of Helper T cells 17 (Th17 cells), Regulatory T cells (Treg cells), Treg/Th17, Interleukin-17 (IL-17) and Interleukin-10 (IL-10) in patients with type 2 diabetes mellitus (T2DM).Four electronic resource databases were searched from their inception to 1 August 2021. Case-control studies about changes of Th17 cells, Treg cells, Treg/Th17, IL-17 and IL-10 in patients with T2DM were retrieved. We performed this meta-analysis via RevMan V.5.3 and Stata14.20 studies with 1242 individuals were included in the meta-analysis. Compared with the controls, the patients with T2DM had significantly increased levels of percentage of Th17 cells (SMD, 1.74; 95% CI, 0.47-3.01; p 0.001), IL-17 (SMD, 2.17; 95% CI, 0.06-4.28; p 0.001), IL-10 (SMD, 1.20; 95% CI, 0.81-1.59; p = 0.003), but decreased levels of percentage of Treg cells (SMD, -1.17; 95% CI, -2.22 to -0.13; p 0.001) and Treg/Th17 ratio (SMD, -4.43; 95% CI, -7.07 to -1.78; p 0.001). Subgroup analysis showed that percentage of CD4Adaptive immune system indeed plays an essential role in the process of T2DM. Imbalance between Th17 and Treg triggers pro-inflammatory environment in patients with T2DM.

Since the 2010s, foreign direct investment in real estate (FDIRE) by Mainland Chinese firms has emerged as a major force within global real estate markets, challenging Western investors’ traditional dominance. It is unclear, however, whether Mainland Chinese FDIRE is fueled by the same motivations as those of investors from advanced economies, which to date have represented both the primary investors and main objects of study. One major difference may be that Mainland Chinese investment originates in an institutional environment comprised of strong state intervention and social networks important for fostering business and ethnic ties. To uncover the potentially unique determinants and heterogeneity of Mainland Chinese corporate real estate investors, we build and analyze a state-level panel dataset of Mainland Chinese FDIRE by state-owned enterprises and private enterprises in the U.S. from 2010 to 2017. Our empirical results reveal the importance of Chinese migrants in promoting Mainland Chinese real estate investment, especially by private enterprises. Our findings also demonstrate that at the state level, Mainland Chinese FDIRE exhibits few agglomerative tendencies.

Smoothed particle hydrodynamics (SPH) method is a Lagrangian particle method that has been widely used for solving complex mechanics problems. To reduce the SPH computational cost, the adaptive SPH (ASPH) with time-varying particle distribution has been proposed using the particle splitting and merging techniques. However, the particle splitting in the adaptive SPH results in a decreased time step due to the reduced particle spacing and thus requires an increased amount of computing time. In the present work, an explicit Runge-Kutta Chebyshev time stepping scheme is implemented within the adaptive SPH, by including the stabilizing substeps into the Runge-Kutta integration method with the use of the Chebyshev polynomials. The number of stabilizing substeps in a single SPH time step can be adaptive after particle splitting while the Runge-Kutta integration time step remains the same. Therefore, the proposed SPH algorithm is adaptive in both time and space domains. Representative example problems are simulated using the developed time-space adaptive SPH method. It is demonstrated that, as compared to the standard SPH and the conventional adaptive SPH with varying particle distribution only, the presented time-space ASPH method exhibits much higher efficiency without compromising accuracy and the superiority in terms of stability.

Over the last two decades, China's outward foreign direct investment (OFDI) has expanded rapidly. The country is now the world's second‐largest source of OFDI. China is often viewed as a monolithic investor, however, without sufficient attention to the differences between investments by state‐owned enterprises (SOEs) and private enterprises (PEs). To shed light on the internal complexity and heterogeneity of Chinese OFDI, we construct a panel dataset of investments in the U.S. across the 50 states and Washington, D.C. from 2005 to 2017, which we analyze using a spatial autoregressive model. We find clear evidence that the ownership structure of Chinese firms affects investment strategy and entry mode. Statistical analysis indicates that SOEs are more likely to pursue greenfield investment motivated by market‐seeking and resource‐seeking objectives, while PEs pursue mergers and acquisitions in order to obtain strategic assets. We also detect a positive and significant relationship between the presence of Chinese overseas communities and OFDI, with the strength of the correlation depending on ownership structure. Finally, we find that Chinese OFDI is spatially dependent, meaning that investments flow to states where they are already concentrated nearby.

Although the environmental and health risks of chlorinated organophosphate esters (OPEs-Cl) have drawn much attention, its environmental behaviors have been insufficiently characterized. As a notable sink of this emerging contaminant, non-sanitary landfills, which may decompose/accumulate OPEs-Cl, is of particular concern. In the present study, the dynamic processes of the typical OPEs-Cl, tris(2-chloroethyl) phosphate (TCEP), in non-sanitary landfill soils were analyzed under anaerobic condition, and the microbial taxa involved in these processes were explored. Our results showed that TCEP could be simultaneously reduced by abiotic and biotic processes, as it was reduced by 73.9% and 65.5% over the 120-day experiment in landfill humus and subsoil, respectively. Notably, the degradation of TCEP was significantly (p 0.05) enhanced under the stress of a high TCEP concentration (10 μg g

Purpose The purpose of this paper is to develop parallel algorithms for moving boundary simulations by local remeshing and compose them to a fully parallel simulation cycle for the solution of problems with engineering interests. Design/methodology/approach The moving boundary problems are solved by unsteady flow computations coupled with six-degrees-of-freedom equations of rigid body motion. Parallel algorithms are developed for both computational fluid dynamics (CFD) solution and grid deformation steps. Meanwhile, a novel approach is developed for the parallelization of the local remeshing step. It inputs a distributed mesh after deformation, then marks low-quality elements to be deleted on the respective processors. After that, a parallel domain decomposition approach is used to repartition the hole mesh and then to redistribute the resulting sub-meshes onto all available processors. Then remesh individual sub-holes in parallel. Finally, the element redistribution is rebalanced. Findings If the CFD solver is parallelized while the remaining steps are executed in sequential, the performance bottleneck of such a simulation cycle is observed when the simulation of large-scale problem is executed. The developed parallel simulation cycle, in which all of time-consuming steps have been efficiently parallelized, could overcome these bottlenecks, in terms of both memory consumption and computing efficiency. Originality/value A fully parallel approach for moving boundary simulations by local remeshing is developed to solve large-scale problems. In the algorithm level, a novel parallel local remeshing algorithm is present. It repartitions distributed hole elements evenly onto all available processors and ensures the generation of a well-shaped inter-hole boundary always. Therefore, the subsequent remeshing step can fix the inter-hole boundary involves no communications.

Nonlocal elastoplasticity and/or damage models in terms of gradient or integral of strain or internal state variables have been proposed to regularize softening with localization in model-based simulation of failure evolution. For transient problems, the numerical oscillations due to semi-discretization in space make the evaluation of higher order terms a difficult task in avoiding numerical failure such as premature cracking. In this preliminary study, an integrated MPM (material point method) and SPH (smoothed particle hydrodynamics) numerical scheme is proposed to implement a nonlocal model via the gradient of plastic strain, with an application to a one-dimensional bar under impact. The MPM is used to discretize the continuum region without the need for master/slave nodes at the contact surface, while the smoothing operator and particle approximation based on the SPH are adopted on the material points to reduce the unphysical oscillations and facilitate the evaluation of strain gradient. A parametric investigation is performed to illustrate the effects of controlling parameters on the evolution of localized softening. It is demonstrated that integrating nonlocal constitutive modeling with spatial discretization might yield an effective procedure for predicting and evaluating failure evolution.

Diabetes is a common, complex, chronic metabolic disease. A randomized, double-blind, placebo-parallel controlled clinical study has shown that Gegen Qinlian Decoction (GQD) can reduce glycosylated hemoglobin in type 2 diabetes mellitus (T2DM) intestinal damp-heat syndrome patients in a dose-dependent manner.To explore the pathogenesis of T2DM intestinal damp-heat syndrome and the therapeutic effect of GQD from the perspective of exosomal microRNA (miRNA).Eligible patients were selected and treated with GQD for 3 months to evaluate their clinical efficacy. Effective cases were matched with healthy volunteers, and saliva samples were collected. Exosomal miRNA was extracted from saliva and analyzed by chip sequencing. Subsequently, the function of the differential gene and the signal transduction pathway were analyzed using bioinformatics technology. Finally, three target miRNAs were randomly selected from the T2DM group/healthy group, and two target miRNAs in the T2DM before treatment/after treatment group were randomly selected for qPCR verification. Finally, we conducted a correlation analysis of the miRNAs and clinical indicators. The registration number for this research is ChiCTR-IOR-15006626.(1) The expression of exosomal miRNA chips showed that there were 14 differentially expressed miRNAs in the T2DM group/healthy group, and 26 differentially expressed miRNAs in the T2DM before treatment/after treatment group. (2) Enrichment results showed that in the T2DM group/healthy group, it was primarily related to cell development, body metabolism, TGF-β, and ErbB signaling pathways. In the T2DM before treatment/after treatment group, it was mainly related to cellular metabolic regulation processes, and insulin, Wnt, and AMPK signaling pathways. (3) The qPCR verification showed that the expressions of hsa-miR-9-5p, hsa-miR-150-5p, and hsa-miR-216b-5p in the T2DM group was higher (P0.05). Following GQD treatment, hsa-miR-342-3p and hsa-miR-221-3p were significantly downregulated (P0.05). (4) hsa-miR-9-5p was positively correlated with BMI (P0.05), and hsa-miR-150-5p was positively correlated with total cholesterol and triglycerides (P0.05). The GQD efficacy-related gene hsa-miR-342-3p was positively correlated with the patient's initial blood glucose level (P0.05), and hsa-miR-221-3p was positively correlated with total cholesterol and triglycerides (P0.05).The exosomal miRNA expression profile and signaling pathways related to T2DM intestinal damp-heat syndrome and the efficacy of GQD were established, which provides an alternative strategy for precision traditional Chinese medicine treatment.

The smoothed material point method (SMPM) is being developed for better simulating impact problems, based on the respective strengths of the original material point method (MPM) and the smoothed particle hydrodynamics (SPH). The field variables of each material point (including velocity and stress) are re-calculated by one smoothed reconstruction procedure, while the rest of the solution steps are the same as those in the original MPM algorithm. In this preliminary study, the numerical performances of the original MPM, SPH and the SMPM are examined and compared using one-dimensional transient problems including impact. It is demonstrated that the numerical oscillations can be effectively reduced by the proposed reconstruction, showing the superiority of the SMPM over the original MPM and SPH in terms of solution accuracy and stability. As compared with the SPH, the SMPM exhibits significantly higher efficiency. Numerical results also illustrate that the proposed SMPM possesses the advantages of both the MPM and the SPH, which warrants the further development of the SMPM for general applications.

Background With the rapid development of modern society, people's dietary structure has been changing accordingly. Diets high in salt, fat, and sugar have led to an increase in the incidence of diabetes year by year, posing a great threat to human health. More than 90% of diabetic patients have type 2 diabetes mellitus (T2DM). It is currently believed that the onset of T2DM is mainly related to factors such as genetics, insulin resistance, impaired insulin cell function, and obesity. The main mechanisms are as follows:The dominant flora of normal intestinal tract is mainly anaerobic bacteria which are beneficial to the human body. Under certain conditions, when intestinal flora is maladjusted, harmful bacteria and opportunistic bacteria become the dominant intestinal bacteria, resulting in metabolic disorders. Ingestion of probiotics can correct the imbalance of intestinal flora, and then, have a therapeutic effect on T2DM. Therefore, we designed this study to evaluate the effects of probiotics on blood glucose control and intestinal dominant flora in patients with T2DM. Methods The retrieval period of meta-analysis literature is set from January 1, 1990 to September 2020. We will mainly search five English electronic databases, including Cochrane Library, Pubmed, Excerpt Medical Database (EMBASE), Science Direct and Web of Science, and search the following four Chinese databases: China Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), China Science Journal Database (VIP), Wanfang Database, and so on. At the same time, the two reviewers will independently conduct research selection, data extraction and deviation risk assessment, and use Review Manager 5.3 software provided by the Cochrane Collaboration for meta-analysis and heterogeneity assessment. Results This study will demonstrate an evidence-based review of probiotics on glycemic control and intestinal dominant flora in patients with type 2 diabetes mellitus. Conclusion This study can be used to evaluate the efficacy and safety of probiotics on glycemic control and intestinal dominant flora in patients with T2DM. REGISTRATION NUMBER:: is INPLASY202090104.

Background A large number of clinical studies have confirmed that after treatment with traditional Chinese medicine components such as sinomenine (SIN), the matrix -metalloproteinase3 (MMP-3) level of patients with rheumatoid arthritis (RA) shows a significant decrease, whereas MMP-3 can be involved in degrading bone matrix in humans, so in the progression of bone and joint injury in patients with RA, serum MMP-3 can be used as an important biochemical marker. The traditional Chinese medicine components commonly used in clinical practice include total glucosides of paeony (TGP), SIN, and tripterygium glycosides, which have the characteristics of disease-modifyinganti-rheumatic drugs and non-steroidal anti-inflammatory drugs, while they can reduce the toxic side effects of methotrexate (MTX), and their combination with other drugs such as MTX and leflunomide (HWA486) has become an important regimen for the treatment of RA in clinical practice. Therefore, we designed this study protocol to evaluate the adjuvant effect of commonly used traditional Chinese medicine components combined with MTX in the treatment of osteoarticular injury in RA. Methods The search time was set from January 2000 to September 2020 in this study. EMBASE database, Cochrane Library, PubMed, Web of Science, Science Direct, Chinese National Knowledge Infrastructure, China Biology Medicine disc (CBM), Chinese Scientifific Journals Database (VIP), and Wanfang Database were used as search sources to select the traditional Chinese medicine components that reduce MMP-3 and use MTX in the treatment of RA. Clinical randomized controlled trials were used, and inclusion criteria and exclusion criteria were set for screening. In this study, MMP-3, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), cyclic peptide containing citrulline (CCP) and rheumatoid factor (RF) were used as the main outcomes, and the improvement of Disease Activity Score 28 (DAS28), joint bone mineral density, Clinical Disease Activity Index (CDAI), and other clinically relevant symptoms was selected as the secondary outcomes. Revman software version 5.3 was used for statistical analysis of data and risk assessment of deviation in this meta-analysis. In this study, one researcher performed study direction selection, literature inquiry, and literature download, and 2 independent reviewers performed literature data extraction and literature quality assessment. Dichotomized data are expressed as relative risk, continuous data are expressed as mean difference or standard mean difference, and finally fixed-effect model or random-effect model is used for synthesis according to the heterogeneity of data. Results To evaluate the effect of downregulation of MMP-3 level by traditional Chinese medicine components combined with MTX on the progression of bone injury in patients with RA by serum MMP-3, ESR, CRP, CCP, and RF. Conclusion This study protocol can be used to evaluate the efficacy and safety of traditional Chinese medicine components combined with MTX in the treatment of bone injury in patients with RA. Ethics and dissemination This study is a secondary study based on the published clinical research; therefore, approval from an ethics committee is not required for this study. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol (PRISMA-P), the results of this study will be published in peer-reviewed scientific journals and conference papers. REGISTRATION NUMBER:: is INPLASY202090064.

Augmented Reality (AR) has been demonstrated to be an efficient way to overcome the negative effect of time delays in teleoperation, because AR can superimpose the virtual simulation results on real working conditions in real-time. This paper proposes a general framework of Augmented Reality Aided Teleoperation Guidance (ARATG), which can support not only 3D predictive information but also operation guidance. Our general framework employs three individual but cooperative modules called tracking, image acquisition and interaction. Tracking module estimates the pose of virtual objects. Image acquisition module decides the type and content of virtual objects. And interaction module manages the multiform interactive information. A prototype system is implemented based on this ARATG framework, the experimental results show that our framework is both powerful and easy-to-use.

The material point method (MPM) and the smoothed particle hydrodynamics (SPH) are two commonly used particle-based methods for solving large-deformation problems. Especially, the SPH has been widely applied to fluid dynamics problems, while the MPM performance in fluid dynamics simulations has rarely been investigated. In this study, the capabilities of the MPM and the SPH in simulating fluid dynamics problems have been quantitatively examined and compared through three example problems, i.e., Poiseuille and Couette flows and water dam break flows. Both numerical methods could yield the results in good agreements with the theoretical and experimental results. Without requiring neighbour search and additional boundary particles, the MPM exhibits significantly higher computational efficiency as compared with the SPH. The comparisons also demonstrate that the MPM has higher accuracy and faster convergence than the SPH. It is shown that the MPM could be a promising alternative to the SPH for the fluid dynamics simulations. Future work for the improvement of the MPM in fluid dynamics modelling is discussed.

An effective algorithm for the detection of dim-small moving target in the infrared (IR) image sequence is described in this paper, which is based on the idea of Track-Before-Detect (TBD). To deal with the low signal to noise ratio (SNR) and high false alarm rate of the IR target detection in the sky scene, two of the Track-Before-Detect (TBD) methods are introduced: dynamic programming (DP) for the SNR enhancement by energy accumulation, and multistage hypothesis testing (MSHT) to lower the false alarm rate by threshold judgment. Furthermore, constraints as the stabilization of the energy and the continuity of the movement of IR dim-small target are applied to avoid the energy scatter. And based on MSHT, most of the false trajectories are eliminated to reduce the calculated amount and save the storage space. Simulation shows good results for the detection of IR dim-small moving target based on the algorithm we proposed.

Infrared (IR) target detection is a key part of airborne infrared weapon system, especially the detection of poor dim moving IR target embedded in complex context. This paper presents an improved Dynamic Programming (DP) algorithm in allusion to low Signal to Noise Ratio (SNR) infrared dim moving targets under cluttered context. The algorithm brings the dim target to prominence by accumulating the energy of pixels in the image sequence, after suppressing the background noise with a mathematical morphology preprocessor. As considering the continuity and stabilization of target's energy and forward direction, this algorithm has well solved the energy scattering problem that exists in the original DP algorithm. An effective energy segmentation threshold is given by a Contrast-Limited Adaptive Histogram Equalization (CLAHE) filter with a regional peak extraction algorithm. Simulation results show that the improved DP tracking algorithm performs well in detecting poor dim targets.

Anonymity can be of great importance in distributed agent applications such as e-commerce & auctions. This paper proposes and analyzes a new approach for organized anonymity of agents based on the use of pseudonyms. A novel naming scheme is presented that can be used by agent platforms to provide automatic anonymity for all agents on its platform, or, alternatively, to provide anonymity on demand. The paper also introduces a new technique, based on the use of handles, that can be fully integrated in an agent platform. Performance measures for an anonymity service implemented for the AgentScape platform provides some insight in the overhead involved.

In this paper, we present a novel joint signature protocol suited to applications run on UMTS and heterogeneous networks. The protocol enables a mobile user to securely delegate his/her signing power to an assisted server so that the assisted server can perform signature generation and verification on behalf of the user. By shifting computational expensive cryptographic operations to a third party, i.e. the assisted server, the protocol is able to eliminate public key operations for the mobile end, while providing message origin authentication, integrity, and non-repudiation services to both delegated (i.e. the mobile user) and delegating (i.e. the third party) entities. The protocol is suited to m-commerce applications, in which a mobile user with a resource restrictive device wishes to access Internet-based security-sensitive services. The security of the proposed protocol is analyzed and its performance against other related work is evaluated.

Sweet corn (Zea mays var. rugosa L.) seed with the endosperm mutant shrunken-2 (sh2) often exhibit low seed vigor and poor field emergence. Seed respiration and carbohydrate metabolism during germination of supersweet 'Jubilee' (sh2) and sugary sweet 'Jubilee' (Sh2) were studied. There were no significant vigor differences expressed by isolated embryos from sh2 and sugary (Sh2) seeds, indicating similar embryo physiology. Respiration rates were higher in the sh2 genotype during early stages of germination (24 hours) while they declined later. The available sucrose orig- inating from the endosperm reserves was depleted by day 4. This insufficiency of a sustained energy source due to rapid consumption and minimal stored reserves may limit subsequent seedling growth in the sh2 genotype. sh2 than in other genotypes (Styer et al., 1980). The research we report here focused on the basic carbohydrate metabolism oc- curring during germination of sh2 and su sweet corn seed. The objectives were to 1) clarify whether the low seed vigor of sh2 sweet corn is due to an inferior embryo or endosperm effects, and 2) study respiratory and carbo- hydrate metabolism in the sh2 : Sh2 geno- types during seed germination. For these studies we used four seed lots of supersweet sweet corn (sh2) hybrid 'Ju- bilee' (Sh2), and three seed lots of normal sweet corn (su) hybrid 'Jubilee' as control. Seeds were provided by Rogers Brothers Seed Co., Boise, Idaho. A completely random- ized design was used with four replications for the sh2 genotype and three replications for control. Embryo culture. Embryos were excised from dry kernels, surface sterilized for 3 min with 2% sodium hypochlorite, and rinsed with sterile water before being planted on a Mu- rashige and Skoog (MS) shoot multiplication cell culture medium (Sigma, St Louis). Twenty-five embryos were randomly se- lected from each seed lot and cultured on medium at 27C for 7 days. Shoots and roots were separated and their dry weights deter- mined. An alternative embryo-culture method using moistened Kimpak (Kimberly-Clark, Neenah, Wis.) as the culture medium was