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Abstract Aims The utility of growth differentiation factor‐15 (GDF‐15) in predicting long‐term adverse outcomes in heart failure (HF) patients is not well established. This study explored the relationship between GDF‐15 levels and adverse outcomes in HF patients across various ejection fraction (EF) phenotypes associated with coronary heart disease (CHD) and evaluated the added prognostic value of incorporating GDF‐15 into the Meta‐Analysis Global Group in Chronic Heart Failure (MAGGIC) risk score‐based model. Methods and results This single‐centre cohort study included 823 HF patients, categorized into 230 (27.9%) reduced EF (HFrEF), 271 (32.9%) mid‐range EF (HFmrEF), and 322 (39.1%) preserved EF (HFpEF) groups. The median age was 68.0 years (range: 56.0–77.0), and 245 (29.8%) were females. Compared with the HFrEF and HFmrEF groups, the HFpEF group had a higher GDF‐15 concentration (P = 0.002) and a higher MAGGIC risk score (P

【Background and Objective】 The arid and semi-arid regions in Northwest Liaoning Province are characterized by low precipitation and high evaporation, leading to desertification, soil erosion and degradation. This paper presents the results of an experimental study on variation and determinants of saturated hydraulic conductivity of soils in these regions. 【Method】 This study was conducted in grasslands exhibiting various levels of desertification. We measured the saturated hydraulic conductivity of soils at different depths, along with various influencing factors across different regions. 【Result】 The impact of desertification on soil hydraulic conductivity varied with soil depth. In the top 0-30 cm soil, the saturated hydraulic conductivity of soil in non-deserted, slightly deserted, moderately deserted, and severely deserted regions was 2.46 mm/min, 5.57 mm/min, 8.72 mm/min and 9.04 mm/min, respectively. The impact of desertification on hydraulic conductivity of soil in the 30-70 cm layer is similar, with the saturated soil hydraulic conductivity in the non-deserted regions being 30% of that in the severely deserted region. In the 70-100 cm layer, the saturated soil hydraulic conductivity in different regions was ranked in the order of non-deserted < slightly deserted < severely deserted < moderately deserted, with the saturated soil hydraulic conductivity in the non-deserted region being 40% of that in the moderately deserted region. Saturated soil hydraulic conductivity was negatively correlated with soil phosphatase and positively correlated with sand content, bulk density, and porosity of non-capillary pores. Soil saturated hydraulic conductivity linearly decreases with soil desertification in y=13.13x-31.80, which could explain 98.70% of the variation in the hydraulic conductivity. It was also found that, regardless of the level of desertification, soil hydraulic conductivity tended to increase with soil depth and vegetation coverage. 【Conclusions】 The saturated hydraulic conductivity of soils in the grasslands in the northern Liaoning Province varies with both soil depth and the degree of desertification. Key factors influencing this variation include sand content, phosphatase content, bulk soil density, and presence of large non-capillary pores.

[Objective] Jiaojia-type gold deposit is a new type of gold mine discovered by Shandong geologists in northwestern Jiaodong in the 1960s, and its output is controlled by regional tectonic fracture zones. Pyrite sericitized alteration generally occurred during the ore-forming period, which is characterized by a large scale, distinct alteration zones, concentration of mineralization, simple morphology of the ore body, relatively uniform grade, and simple mineral combinations. The deposit has gone through 12 years of exploration and scientific research, from discovery to establishment. [Methods] This new type of gold deposit has been rapidly promoted since its establishment and has achieved fruitful prospecting results in China. Deep exploration achievements of the Jiaojia-type gold deposit have been coming up in the Jiaodong area since the 21st century. [Results] The accumulated gold resource reserves submitted have been 3617.12 tons by 2020, which has helped the Jiaodong area become the third largest gold cluster in the world, and gold reserves of China have risen to the second rink in the world. Research on the Jiaojia-style gold mine has also made considerable progress, with the age of mineralization accurately limited to 126~120 Ma and formation occurring under a strong regional extension background. The source of mineralization material has multiple origins, with the Archean tholeiite being the initial source rock of gold-bearing minerals. The ore-forming process is divided into four stages, and the “thermo-extension”metallogenic theory and the step metallogenic model are proposed. The metallogenic depth is about 5~10 km, and the post-metallogenic denudation thickness is 5.2±1.2 km, with the deposits well preserved. [Conclusion] The metallogenic prediction study concluded that the total gold resources in the three major metallogenic zones of Sanshandao, Jiaojia, and Zhaoping in the northwestern Jiaozhou area were 7258~10150 tons of metal at a depth of 5000 m, which demonstrates the immense potential of the deeper part of the Jiaojia-type gold deposits for exploration. A set of key exploration techniques was summarized for different exploration stages, from shallow to deep. [Significance] These studies enriched the metallogenic theory of the Jiaojia-type gold deposit, making the metallogenic prediction results highly accurate, reliable, and effective in guiding the gold exploration in the Jiaodong peninsula.

Guangjie Wang,1,&ast; Puhui Liu,2,&ast; Hui Xie,2 Chuanzhen Niu,2 Jie Lyu,1 Youzhong An,1 Huiying Zhao1 1Department of Critical Care Medicine, Peking University People’s Hospital, Beijing, People’s Republic of China; 2Department of Critical Care Medicine, Yantai Qishan Hospital, Yantai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Huiying Zhao, Department of Critical Care Medicine, Peking University People’s Hospital, No. 11, Southern Xizhimen Road, Beijing, 100044, People’s Republic of China, Tel +86 13811088270, Email zhaohuiying@pkuph.edu.cnPurpose: The high mortality rate associated with the critical stages of severe fever with thrombocytopenia syndrome (SFTS) does not have effective treatment. We aimed to evaluate the 28-day mortality and potential impact of glucocorticoid therapy in these patients.Patients and Methods: This retrospective observational study included participants from the intensive care unit between July 2019 and April 2023. The participants were categorized into glucocorticoid (GC) and non-GC groups. Propensity score matching (PSM) was employed to ensure comparability between groups. We used Cox proportional hazard models to examine mortality risk associated with GC use, Kaplan–Meier survival analyses for overall survival, stratified Cox proportional hazard models for subgroup analyses, and likelihood ratio tests to examine interactions between subgroups.Results: Of 218 patients with SFTS (median age, 71 years; male, 49.1%), 61.9% required mechanical ventilation, 58.3% received GC treatment, and the 28-day mortality rate was 61.5%. After PSM, there were 58 patients in each group; post-PSM analysis revealed improved 28-day mortality rates with GC treatment, particularly for patients with Glasgow coma scale (GCS) score < 13 (hazard ratio [HR], 95% confidence interval [CI] for GCS score: 9– 12: 0.39, 0.17– 0.88, p=0.024 and for GCS score: 3– 8: 0.09, 0.02– 0.35, p=0.001); lactate levels > 2 mmol/L (0.35, 0.15– 0.83, p=0.017); and norepinephrine usage (0.26, 0.13– 0.49, p< 0.001). Combining antiviral (0.41, 0.22– 0.78, p=0.006) or immunoglobulin therapy (0.22, 0.1– 0.51, p< 0.001) with GC treatment significantly decreased the 28-day mortality rates, compared with GC monotherapy.Conclusion: Using GCs reduced the high 28-day mortality rate in the patients, especially with low GCS score, high lactate levels, norepinephrine intake, and on antiviral or immunoglobulin therapy.Keywords: glucocorticoids, mortality, severe fever with thrombocytopenia syndrome, intensive care unit, virus infection

Objective In order to ensure that FAO (fully automatic operation system) can effectively guarantee the safe evacuation of passengers in case of emergency and quickly resume operations after evacuation completion, it is proposed to study the evacuation solution for FAO system based on central remote supervision and command. Method Based on the line conditions (such as evacuation platform, trackbed, etc.) and vehicle conditions (providing side door and end door two evacuation modes) that affect the safety of passenger evacuation, and targeting the safety risks that may be encountered during the passenger evacuation process (such as passengers falling, train collision, transition switch injury, third rail electric shock, etc.), the evacuation activation, evacuation recovery, as well as the FAO multi-system linkage mechanism and protection method for coupling train evacuation are designed in detail from two different application scenarios of platform evacuation and interval evacuation. Result & Conclusion Line and vehicle conditions required for the realization of FAO system evacuation function are proposed. During the evacuation process, the central dispatcher can remotely monitor and direct the evacuation of passengers through CCTV (video surveillance system), PA (broadcast system), emergency intercom and other devices. At the same time, through the ATS (automatic train supervision) system, the central dispatcher can realize the linkage control of multiple systems, such as CC (car controller), ZC (zone controller), and CI (computer interlocking), in order to ensure the safety protection and evacuation recovery of passengers when evacuating through the side/end doors of trains with different marshalling on platforms or intervals. This solution significantly improves the safety level and efficiency of evacuation.

Objective In order to solve the stop mark exceeding/failing problem of Qingdao Metro Line 13, it is necessary to deeply analyze the control principle of ATO (automatic train operation) parking and the factors affecting its accuracy, and formulate effective control measures accordingly. Method The principle of ATO parking accuracy control for Qingdao Metro Line 13 trains is briefly described. The causes of train stop mark exceeding/failing are analyzed from the aspects of signal system factors and vehicle system factors respectively. Optimization control measures for accurate parking are proposed. Result & Conclusion ① Signal system factors: by optimizing the speed measurement logic, balise layout and ATO algorithm, the train positioning and parking accuracy are improved; ② Vehicle system factors: through fine-tuning the braking conversion timing to match the signal system requirements, the train accurate parking is achieved. These optimization measures jointly improve the train parking accuracy and significantly enhance the operational efficiency.

Between 1958 and 1999, notable lithic localities recorded prehistoric activities in Xiqiao Town of Nanhai District, Foshan City, Guangdong Province, from which double-shouldered and microlith-stone artefacts were uncovered. Currently, the "Xiqiaoshan site" is recognized as a substantial Neolithic quarry and processing location, dating back to 4‒7 ka B P. Subsequently, from 2011 to 2022, we conducted multiple geological environmental surveys and analyses on Xiqiaoshan Mountain. A well-preserved Quaternary stratigraphic profile was discovered north of Fuxian village in the southeast foothills of Xiqiaoshan Mountain. The sedimentological, geochemical, and geochronological results indicate the presence of two primary sedimentary strata in the Fuxian locality. The upper unit comprises the Holocene swamp facies, with a calibrated AMS14C dating range from 5052‒5409 a B P; whereas, the lower unit comprises the late Pleistocene alluvial-diluvial strata, with a calibrated AMS14C dating range from 38420‒40502 a B P, and an optically stimulated luminescence (OSL) dating range of 41.977‒43.796 ka B P. Late Pleistocene strata yielded two sand-gravel layers containing Paleolithic artefacts, which are marked as layers A1 and A2. The predominant artefacts in lower layer A1 include larger scrapers, pointed tools, tongue-shaped edged tools, and small flake tools, such as various scrapers, denticulates, notches, knives, utilized flakes, and cores, including tanged axe-shaped knives. In the upper layer A2, backed or tanged knives appear more frequently. The other small flake tools from this layer (A2) were not significantly different from those in lower layer A1. One bifacially prepared core for producing small elongated flakes is of particular interest for this artefact. Based on the average deposition rate, the computational age of the A1 layer was 46.511‒47.325 ka B P, whereas that of the A2 layer was 41.977‒42.167 ka B P. Although the number of artefacts within the Holocene sediments (>5 ka B P) overlying the late Pleistocene strata is limited, the characteristics of inheritance and development are still evident in the types of artefacts. The discovery presented in this study has completely updated and extended the connotation of Xiqiaoshan National Geopark and "Xiqiaoshan culture,"breaking through the late Pleistocene Paleolithic remains records with exact dating in the Pearl River Delta region for the first time. Therefore, a ground-breaking discovery can accurately trace the footsteps of modern humans in the coastal areas of South China from 40‒50 ka. It also reveals the rich features of lithic industry and the developmental characteristics and evolution of its cultural connotations during this period. The present study shows that during the relatively warm and humid conditions of marine isotope stages 3 (MIS3) interglacial period and the subsequent cold and arid stage of MIS2, human population in the Fuxian locality encountered environmental challenges and adopted new subsistence strategy, which is of great significance for understanding modern human responses and adaptations to global and regional environmental and climate change.

Yi Li,1– 3,&ast; Yixuan Lu,1,2,&ast; Youdan Zhao,1 Zhi Lyu1,2 1Department of Senior Cadres Ward, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, People’s Republic of China; 2The School of Clinical Medicine, Fujian Medical University, Fuzhou, People’s Republic of China; 3Department of General Medicine, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zhi Lyu, Department of Senior Cadres Ward, Zhongshan Hospital of Xiamen University, No. 201-209 hubin South Road, Siming District, Xiamen, 361000, People’s Republic of China, Tel +86-13779950606, Email lyuzhi@xmu.edu.cnBackground: Central obesity, as measured by examination instruments, has been shown to be associated with both OSA and short sleep duration. However, objective measurement tools like CT, MRI, and DXA are expensive, cause radiation exposure, and have limited availability, especially in resource-limited settings. Thus, this study aimed to demonstrate the relevance of Body Mass Index (BMI) and Waist-to-Height Ratio (WHtR) as surrogate indicators of visceral obesity in the assessment of OSA and short sleep duration. We also intend to evaluate whether WHtR, in combination with BMI, can be a suitable surrogate marker for visceral adiposity.Methods: We recruited 333 adults with complete polysomnographic (PSG) records retrospectively. Logistic regression helped to assess the association of BMI and WHtR as surrogates for central adiposity with OSA and short sleep duration. Moreover, ROC curve analysis was conducted to evaluate the predictive ability of BMI and WHtR.Results: Following the relevant adjustments, logistic regression analysis results showed that the combination of WHtR and BMI acting as central obesity surrogates was significantly associated with OSA and short sleep duration (p< 0.05). According to univariate regression analysis, sleep latency and wake after sleep onset were independent predictors of the risk of central obesity in patients with short sleep duration and OSA. Additionally, ROC curve analysis demonstrated that the combination of BMI and WHtR provided a better assessment of central adiposity in patients with OSA and short sleep duration, compared to each measure alone.Conclusion: BMI and WHtR are significantly associated with OSA and short sleep duration, and might serve as a potential surrogate marker for central obesity. Sleep latency and wake after sleep onset can independently predict the risk of central obesity in patients with short sleep time and OSA. Thus, larger prospective studies are needed to verify our findings.Keywords: body mass index, central obesity, obstructive sleep apnea, short sleep duration, waist-to-height ratio

AIM: To study the degree of astigmatism, axial distribution and axial symmetry pattern of binocular astigmatism in primary and secondary school students aged 7-18 years with myopia.METHODS:A total of 239 cases(478 eyes)of primary and secondary school students aged 7-18 years who underwent keratoplasty for myopia correction at the Fifth Affiliated Hospital of Zhengzhou University from 2020 to 2022 were randomly selected, and optometry was performed under ciliary muscle paralysis and was statistically analyzed.RESULTS:Astigmatism degree: 0.25 to 1.00 D accounted for 78.5%, 1.25 to 2.00 D accounted for 17.1%, and >2.00 D accounted for 4.4%. The axial distribution of astigmatism: 86.6% was astigmatism with the rule, 5.9% was astigmatism against the rule, and 7.5% was oblique astigmatism; both genders and different astigmatism degrees were dominated by astigmatism with the rule, and there were differences with the other two axes(both P

AIM:To explore the effect of the peripheral defocus spectacle lenses and orthokeratology(OK)on the control of myopia progression and the impact on vision related quality of life in children and adolescents.METHODS:Prospective study. A total of 237 children initially diagnosed with myopia in the ophthalmology department of Huzhou Central Hospital from January 2021 to January 2022 were selected and divided into two groups according to different correction methods: peripheral defocus spectacle lenses group(105 cases, 105 eyes)and OK lens group(132 cases, 132 eyes). The Vision Related Quality of Life Questionnaire for Primary and Secondary School Students was used to follow up the both groups of myopic children, and the best corrected visual acuity(BCVA), spherical equivalent(SE), and axial length(AL)were recorded at the first visit and 1 a of follow-up.RESULTS:After wearing lenses for 1 a, both the peripheral defocus spectacle lenses group and OK lens group showed an increase in SE and AL, but there was no statistical difference between two groups(P>0.05). The changes in SE and AL in the peripheral defocus spectacle lenses group were greater than those in the OK lens group(all P=0.001). After 1 a of follow-up, in the emotional dimension scores, the peripheral defocus spectacle lenses group of children's vision-related quality of life scales scored higher than in the OK lens group(P

Considering the lack of a general multi-carrier signal dataset in urban multipath channels, and the challenge of recognizing the modulation types of distorted signals at low signal-to-noise ratio (SNR), a differentiable architecture search-based (DARTS) automatic modulation recognition algorithm for multi-carrier signals was proposed. Firstly, the received signal datasets of commonly used multi-carrier signals, i.e., orthogonal frequency division multiplexing, filter bank multi-carrier, and orthogonal time frequency space, were generated over typical urban multipath channels. The time-frequency images, which were insensitive to modulation parameters, were selected as feature vectors to train the neural network. Secondly, DARTS was employed to automatically search the optimal network architecture. Finally, a joint attention mechanism was introduced into the feature learning process. This mechanism spatially transforming distorted signal features to mitigate the impact of multipath interference, while also calculating and sorting the information weights for each channel of the feature maps to improve the recognition performance of the relevant feature map channels. Simulation results demonstrate that the proposed algorithm improves accuracy in urban multipath channels, especially at low SNR, while simultaneously providing better robustness to modulation parameter variations and small-sample scenarios.

Generative artificial intelligence (GAI) refers to AI technology capable of generating new content such as text, images, or audio from training data. GAI tools not only demonstrate rapid and efficient potential in literature screening, data extraction, and literature appraisal in systematic reviews, but can also be used for guideline evaluation and dissemination, enhancing the readability and promotion efficiency of guidelines. However, the accuracy of content generated by GAI tools, the rationality of cited evidence, the level of evidence, and the reliability of data still need verification. Additionally, data privacy protection and ethical issues are challenges that need to be addressed. This article aims to overview the current status of GAI tools in the formulation, evaluation, dissemination, and implementation of guidelines, explore the feasibility and new models of GAI tools in the field of guidelines, and improve the efficiency and quality of guideline formulation to better serve guideline developers and users.

ObjectiveTo analyze the cost changes of cervical cancer inpatients after the implementationof diagnosis related group (DRG) payment in public grade-A tertiary hospitals, and to provide reference for public hospitals to improve management strategies and optimize the utilization of medical insurance funds.MethodsCase data of cervical cancer patients discharged from a public grade-A tertiary hospital in Shandong Province from April to December 2021 (before the implementation of DRG) and from April to December 2022 (after the implementation of DRG) were retrospectively collected. Patients with medical insurance were treated as the policy group and patients with full self-payment were treated as the control group. The changes in the relevant indicators such as total hospitalization costs, drug costs and consumable costs of cervical cancer patients before and after the implementation of the DRG policy were analyzed using the double difference-in-difference (DID) method.ResultsA total of 10 383 hospitalized patients with cervical cancer were enrolled in this study, including 9711 cases in the policy group (including 5418 cases before the implementation of DRG and 4293 cases after the implementation of DRG) and 672 cases in the control group (including 426 cases before the implementation of DRG and 246 cases after the implementation of DRG). Compared with the pre-DRG policy implementation, there were no significant changes in the complication rate, mortality rate, unplanned rehospitalization rate within 30 days, and length of hospital stay between the patients in the policy group and the control group after the DRG policy implementation. However, the total cost of the policy group decreased from ￥11 453.49 to ￥8780.94 (a decrease of 23.33%), in which the cost of medicines decreased by ￥617.37 (a decrease of 25.17%), and the cost of consumables decreased by ￥28.93(a decrease of 28.49%). The results of the double DID mode showed that the total cost of hospitalization in the policy group decreased by 14.40%(R2=0.616, P < 0.05), the cost of medicines decreased by 13.80%(R2=0.364, P < 0.01), and the cost of consumables decreased by 15.40%(R2=0.565, P < 0.01) compared to the control group after the implementation of the DRG policy.ConclusionsThe implementation of DRG policy can reasonably reduce the cost of disease groups and achieve more effective utilization of medical resources on the basis of ensuring accurate clinical diagnosis and high treatment standards.

ObjectiveTo evaluate the impact of diagnosis-related group(DRG) payment reform on medical resource utilization and healthcare quality among hospitalized lung cancer patients, so as to provide critical insights into China's healthcare payment reform and enhance medical efficiency and quality.MethodsA retrospective analysis was conducted using medical records from a tertiary oncology hospital in Shandong province, with a focus on patients diagnosed with malignant lung tumors between January 28, 2021 and April 16, 2024. A self-paired design was implemented, with October 26, 2021 serving as the intervention point. Data from the same patients were collected for two periods: pre-DRG payment (January 28, 2021-October 25, 2021) and post-DRG payment (October 26, 2021-April 16, 2024). An interrupted time series(ITS) regression model was employed to compare the changes in medical resource utilization indicators (e.g., length of stay, total hospital expenses, reimbursement expenses, out-of-pocket expenses, number of chemotherapy/radiotherapy sessions, number of targeted/immunotherapy sessions, and number of nursing examinations) and healthcare quality indicators, including the incidence of major complications or comorbidities (MCC), complications or comorbidities (CC), and 30-day readmission rates.ResultsA total of 944 patients were included in the analysis, with 49.4% male and 50.6% female; 67.1% were under 65 years of age, while 32.9% were 65 years or older. After the DRG payment, there was a significant reduction in length of stay (β2=-3.235, P < 0.001), total hospital expenses (β2=-5155.900, P < 0.001), reimbursement expenses (β2=-2120.350, P=0.020), and out-of-pocket expenses (β2=-3035.555, P < 0.001). However, the number of chemotherapy/radiotherapy sessions, targeted/immunotherapy sessions, and nursing examinations did not exhibit significant changes. The incidence of MCC/CC significantly increased (β2=3.011, P < 0.001), whereas the 30-day readmission rate remained unchanged.ConclusionsThe DRG payment reform effectively reduces medical costs and shortens hospitalization duration, thereby enhancing hospital management efficiency. However, it may also lead to an increased incidence of complications, which could potentially affect healthcare quality. Therefore, the possible implications of DRG reform on healthcare quality should be carefully monitored and addressed.

【Objective】 This paper is to propose a method to optimize ecological space zoning and develop scientific management strategies for watersheds. The focus is on clarifying the synergies and trade-offs among mountains, waters, forests, farmlands, lakes, and grasslands. 【Method】 The study takes the Hongfeng Lake watershed as a case study. It is a typical watershed consisting of mountains, water, forests, fields, lakes and grasses. Quantitative and qualitative methods were used to calculates synergies and trade-offs between these sub-ecosystems at both basin scale and local scale. The ecological zoning in the watershed was analyzed by considering the synergistic relationships between mountains, waters, forests, farmlands, lakes and grasslands. 【Result】 The study revealed significant spatial variation in ecological zones within the studied areas. It identified contrasting spatial relationships in the distribution of synergies and trade-offs, particularly between water and other subsystems, as defined by the water intersection line. Key findings include differentiated ecological protection roles of forests and grasslands, high pollution risks facing lakes, and the reliance on rainfall for agriculture outside regions where lakes effectively manage water storage. The watershed was classified into nine ecological control zones, including urban water source protection zones and ecological agricultural zones along the lake and its tributaries. Additionally, mountain areas were designated as ecological industrial development and conservation zones, water source conservation zones, and geo-hazard risk zones. 【Conclusion】 By analyzing the coordination and trade-offs among various ecological components, this study ensures the maximization of ecological diversity within each zoning type. The findings highlight the need for tailored management strategies across different zones to address their unique ecological needs and challenges.

With technological advancements and cost reduction， the centralized integration of grid-forming energy storage system has significantly expanded. This integration notably impacts the short-circuit currents of power system， an effect that warrants careful consideration. This paper utilizes an electromechanical transient simulation model for grid-forming energy storage system to examine the amplitude and phase characteristics of short-circuit currents under various limiting strategies. Case simulations are conducted to assess changes in short-circuit currents at nearby buses under different scales of energy storage system integration， overcurrent capabilities， grid voltage levels， and operating conditions. This comprehensive analysis reveals the influence of energy storage integration system on the bus short-circuit currents and quantifies the contribution of grid-forming energy storage system to the short-circuit currents. Based on these findings， the paper offers recommendations for capacity allocation and placement of grid-forming energy storage system， taking into account their impact on short-circuit current levels.

In order to improve the orderly control and flexible adjustment capabilities of large-scale distributed power sources connected to the distribution network, it is currently an effective method to reasonably divide the distributed power sources into clusters and use the cluster as the basic unit for regulation. To this end, a distributed power cluster partitioning method that considers the adjustable capacity and response speed of flexible resources is proposed. Firstly, the modularity index and the active power balance index are proposed to characterize the structural and power balance capability of clusters. Secondly, based on the analysis of the cluster's flexible response capability, and in view of the problem that it is difficult to quantify the impact of the flexible resource response capacity and response speed on the adjustment capability, it is proposed to take the cumulative area of deviation between the response curve of cluster output and the net load curve as the indicator of the flexible response capability of clusters, and the influence of the allocation of energy storage capacity on the delineation of clusters is also taken into account. Then, a cluster division objective function that comprehensively considers the modularity index, active power balance index, cluster flexible response capability index and energy storage unit allocation index is proposed, and this function is solved using an improved adaptive genetic algorithm. Finally, the proposed method is verified in the improved IEEE 33-node system and IEEE 69-node system. The results show that the cluster partitioning method based on the proposed comprehensive performance index can improve the cluster flexible response capability by more than 20% on the basis of ensuring the structural strength of the cluster, which verifies the effectiveness and superiority of the cluster partitioning method proposed in this paper.

This study aimed to investigate the long-term clinical outcomes and toxicities of induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CCRT) vs. CCRT alone in patients with non-operable esophageal squamous cell carcinoma (ESCC).

Ru Yan,1,2 Songqing Jin,3 Chen Ji,1 Cindy Feng,2 Huan Wang,2 Jiayang Lyu,1,2 Scott Rozelle2,4 1China Academy for Rural Development, School of Public Affairs, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China; 2Stanford Center on China’s Economy and Institutions (SCCEI), Freeman Spogli Institute for International Studies, Stanford University, Palo Alto, California, USA; 3Department of Agricultural, Food and Resource Economics, Michigan State University, East Lansing, Michigan, USA; 4Tsingshan Institute for Advanced Business Studies, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of ChinaCorrespondence: Songqing Jin, Department of Agric, Food and Resource Economics, Michigan State University, East Lansing, MI, 48823, USA, Email jins@msu.eduPurpose: Depression is a growing public health concern around the world. For adolescents, depression not only impedes healthy development, but is negatively associated with academic performance. The purpose of this paper is to examine the prevalence of adolescent depressive symptoms in a sample of rural primary and junior high school students. Additionally, we examine various factors to identify subgroups within the sample that may be more vulnerable to depression. Finally, we explore the extent to which depression correlates with academic performance and conduct a series of heterogeneity analyses.Patients and Methods: We utilize cross-sectional data derived from 30 schools in underdeveloped regions of rural China encompassing primary and junior high school students (n = 1,609).Results: We find a high prevalence of depression, with 23% and 9% of students experiencing general depression (depression score ≥ 14) and severe depression (depression score ≥ 21), respectively. Female gender, elevated stress and anxiety levels, boarding at school, exposure to bullying, and having depressed caregiver(s) are positively correlated with depressive symptoms, while high social support exhibits a negative association. Importantly, our analyses consistently show a significantly negative link between depression and academic performance, which is measured using standardized math tests. For instance, transitioning from a non-depressed state to a state of general depression (depression score ≥ 14) is linked to a decline of 0.348– 0.406 standard deviations in math scores (p < 0.01). Heterogeneity analyses reveal that this adverse relationship is more pronounced for male students, boarding students, those with lower social support, individuals with more educated mothers, and those with lower family assets.Conclusion: Our findings underscore the high prevalence of depression in rural schools and the detrimental impact on academic performance. We advocate for the implementation of policies aimed at reducing student depression, particularly within vulnerable populations and subgroups.Keywords: adolescent health, academic performance, rural China, developing countries

Qiu-Xia Jiang,1 Li-Jing Shi,1 Xiu-Yang Hong,2 Yu-Qin Zhu,3 Qiu-Ling Guo,1 Wen Xie,1 Guo-Rong Lyu4 1Department of Ultrasound, Quan-Zhou Women’s and Children’s Hospital, Quanzhou, 362000, People’s Republic of China; 2Department of Women Health Care, Quan-Zhou Women’s and Children’s Hospital, Quanzhou, 362000, People’s Republic of China; 3Department of Pathology, Quan-Zhou Women’s and Children’s Hospital, Quanzhou, 362000, People’s Republic of China; 4Department of Ultrasound, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, 362000, People’s Republic of ChinaCorrespondence: Guo-Rong Lyu, Email lgr_feus@sina.comAbstract: Primary breast Burkitt lymphoma (PB-BL) is an exceedingly rare form of primary breast lymphoma. Ultrasonography is the preferred modality for diagnosing breast diseases; however, the ultrasonic features of Burkitt lymphoma have rarely been reported. Herein, we report a case of ultrasonically diagnosed bilateral PB-BL in a lactating patient and present a literature review. A 28-year-old female patient experienced bilateral breast engorgement starting more than a month after childbirth. At three months postpartum, the patient experienced extreme bilateral breast engorgement, with the skin appearing dark purple and jaundiced. Based on the imaging diagnosis, pathological, immunohistochemical, and molecular biological findings, she was diagnosed with Burkitt lymphoma involves bilateral breasts, right adrenal glands, uterus, and multiple bones. After 4 cycles of combination chemotherapy, the tumor basically disappeared, and then after autologous stem cell transplantation and one cycle of combination chemotherapy, the patient is generally in good condition and is under follow-up. We found that the ultrasonic characteristics of PB-BL are different from those of common breast cancer or lactation mastitis. PB-BL lesions are often multiple, large masses, and even involve the whole breast. The characteristic reticular structures are common in lesions, and irregular hyperechoic masses can be seen around it. The mass has abundant peripheral and internal blood flow signals, but internal calcification and attenuated posterior echoes of masses are rarely observed. Thus, the ultrasonic features of breast Burkitt lymphoma are somewhat specific and understanding these features is conducive to its early identification.Keywords: Burkitt lymphoma, ultrasonography, case report

Linyu Xu, Jianxia Lyu, Xutong Zheng, Aiping Wang Department of Public Service, The First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of ChinaCorrespondence: Aiping Wang, Department of Public Service, The First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China, Email jianghaoran88@hotmail.comBackground: Gastric cancer is a significant contributor to the global cancer burden. Risk prediction models aim to estimate future risk based on current and past information, and can be utilized for risk stratification in population screening programs for gastric cancer. This review aims to explore the research design of existing models, as well as the methods, variables, and performance of model construction.Methods: Six databases were searched through to November 4, 2023 to identify appropriate studies. PRISMA extension for scoping reviews and the Arksey and O’Malley framework were followed. Data sources included PubMed, Embase, Web of Science, CNKI, Wanfang, and VIP, focusing on gastric cancer risk prediction model studies.Results: A total of 29 articles met the inclusion criteria, from which 28 original risk prediction models were identified that met the analysis criteria. The risk prediction model is screened, and the data extracted includes research characteristics, prediction variables selection, model construction methods and evaluation indicators. The area under the curve (AUC) of the models ranged from 0.560 to 0.989, while the C-statistics varied between 0.684 and 0.940. The number of predictor variables is mainly concentrated between 5 to 11. The top 5 most frequently included variables were age, helicobacter pylori (Hp), precancerous lesion, pepsinogen (PG), sex, and smoking. Age and Hp were the most consistently included variables.Conclusion: This review enhances understanding of current gastric cancer risk prediction research and its future directions. The findings provide a strong scientific basis and technical support for developing more accurate gastric cancer risk models. We expect that these conclusions will point the way for future research and clinical practice in this area to assist in the early prevention and treatment of gastric cancer.Keywords: stomach neoplasms, risk prediction, primary prevention, scoping review

Yang Li,1,&ast; Huihui Fan,2,&ast; Wei Wei,3 Hanyu Zhu,4 Haifeng Wang,4 Dayao Lyu,1 Zengrui Zhang,1 Ying Tan1 1Department of Neurology, Huzhou Central Hospital, The Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou, People’s Republic of China; 2Department of Ultrasound, Huzhou Central Hospital, The Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou, People’s Republic of China; 3Department of Key Laboratory of Basic Research and Clinical Translation, Huzhou Central Hospital, The Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou, People’s Republic of China; 4Department of Neurology, Medical School of Huzhou University, Huzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Ying Tan, Email zzftyzhy@126.comIntroduction: The primary clinical manifestation of venous thrombosis is discomfort in the lower extremities. Some early Parkinson’s disease (PD) patients feel discomfort in the lower limbs. Venous thrombosis can risk lives by causing pulmonary embolism. This study examines the incidence of DVT in early PD patients and its correlation with different clinical and lab features.Methods: A cross-sectional study was conducted on 117 patients with early-stage PD. Ultrasonography was employed to detect the presence of DVT. Factors such as age, gender, body mass index, lifestyle habits (smoking and drinking), medical history (hypertension, diabetes, atrial fibrillation, and tumor), and other lab tests linked to thrombosis were analyzed.Results: In 117 patients, 11 (9.4%) had DVT, while 106 (90.6%) did not. There were no significant differences in gender, BMI, habits, medical history, or other thrombosis-related tests between both groups. However, DVT patients were older with higher d-dimer levels. They also showed an increased right substantia nigra ultrasound echo area, higher HY grades, higher UPDRS 3 scores, less improvement in UPDRS 3 scores and levodopa response.Discussion: The primary risk factors for lower extremity venous thrombosis were found to be age, d-dimer levels, and low-dose levodopa. Therefore, for elderly patients with early-stage PD, it is crucial to conduct d-dimer and lower extremity vascular ultrasound tests. The prevention of venous thrombosis in the lower extremities of early PD patients is of utmost importance.Keywords: deep vein thrombosis, early-stage, Parkinson’s disease, ultrasonography, risk

Objective The maximum slope of the mountain gear rail line can reach 250‰. As the sliding force generated by the component of the gravity is much greater than the maximum friction force between wheel and rail, relying solely on the conventional wheel and rail braking system can not restrain the vehicle sliding when the vehicle runs on the maximum slope of the mountain gear rail line. Special gear rail braking device, which uses the gear rack engagement mode to brake the gear rail wheel directly, is needed to break the friction limit between the steel wheel and rail and provide greater braking force for the mountain gear rail vehicle running on the big slope. Analysis of the new brake performance is helpful to ensure the safety of the gear rail vehicle operation. Method The characteristics of the current special gear rail braking system for gear rail train in China and abroad are analyzed, and the advantages and disadvantages of the existing gear rail braking devices are summarized. According to the space and interface dimensions of the gear rail bogie, combined with the characteristics of the aircraft brake, a special brake for multi-friction disc gear rail on super large slope is designed, and its composition and performance are introduced. Theoretical calculation and finite element simulation are used to analyze the performance and component strength of the new brake, as well as its temperature changes under three worst working conditions. Result & Conclusion The new brake has good braking performance, and its highest temperature is lower than the bearing limit of the brake material in the worst working conditions. It can meet the braking requirements of the gear rail train under different braking conditions at maximum gradient (250‰).

Chaowen Zheng,1,2 Siyuan Li,1 Huanran Lyu,1 Cheng Chen,1 Johannes Mueller,1 Anne Dropmann,3 Seddik Hammad,3,4 Steven Dooley,3 Songqing He,2 Sebastian Mueller1,5 1Center for Alcohol Research, University of Heidelberg, Heidelberg, Germany; 2Division of Hepatobiliary Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China; 3Molecular Hepatology Section, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany; 4Department of Forensic Medicine and Veterinary Toxicology, Faculty of Veterinary Medicine, South Valley University, Quena, Egypt; 5Viscera AG Bauchmedizin, Bern, SwitzerlandCorrespondence: Sebastian Mueller, Center for Alcohol Research, University Hospital Heidelberg Im Neuenheimer Feld 350 69120 Heidelberg, Germany, Tel +49 6221 567121, Email sebastian.mueller@urz.uni-heidelberg.dePurpose: Both hepatic iron accumulation and hemolysis have been identified as independent prognostic factor in alcohol-related liver disease (ALD); however, the mechanisms still remain poorly understood. We here demonstrate that hepatocytes are able to directly ingest aged and ethanol-primed red blood cells (RBCs), a process termed efferocytosis.Methods: Efferocytosis of RBCs was directly studied in vitro and observed by live microscopy for real-time visualization. RBCs pretreated with either CuSO4 or ethanol following co-incubation with Huh7 cells and murine primary hepatocytes. Heme oxygenase-1 (HO-1) and other targets were measured by q-PCR.Results: As shown by live microscopy, oxidized RBCs, but not intact RBCs, are rapidly ingested by both Huh7 cells and murine primary hepatocytes within 10 minutes. In some cases, more than 10 RBCs were seen within hepatocytes, surrounding the nucleus. RBC efferocytosis also rapidly induces HO1, its upstream regulator Nuclear factor erythroid 2-related factor 2 (Nrf2) and ferritin, indicating efficient heme degradation. Preliminary data further suggest that hepatocyte efferocytosis of oxidized RBCs is, at least in part, mediated by scavenging receptors such as ASGPR1. Of note, pretreatment of RBCs with ethanol but also heme and bilirubin also initiated efferocytosis. In a cohort of heavy human drinkers, a significant correlation of hepatic ASGPR1 with the heme degradation pathway was observed.Conclusion: We here demonstrate that hepatocytes can directly ingest and degrade oxidized RBCs through efferocytosis, a process that can be also triggered by ethanol, heme and bilirubin. Our findings are highly suggestive for a novel mechanism of hepatic iron overload in ALD patients.Keywords: alcohol-related liver disease, ASGPR1, efferocytosis, heme oxygenase-1, red blood cells, scavenging receptors, iron metabolism

With the significant changes in people's lifestyles, the prevalence of myopia is escalating globally, which has aroused the close attention of clinicians. Myopia is easy to combine with other serious ophthalmic diseases, especially in patients with high myopia(HM), often combined with primary open angle glaucoma(POAG), and the incidence rate is much higher than that of people with normal refractive status. The condition becomes especially complex when HM co-exists with POAG. In recent years, we have focused on the characteristics of fundus changes in patients in clinical work. Early detection of patients with POAG from HM is the key to in-depth understanding and effective prevention and treatment of these two diseases. In this paper, we review the recent literatures on the relationship between HM and POAG from the aspects of epidemiology, pathogenesis, and clinical features, and summarize the research progress, so as to provide help for early detection, early diagnosis, and early treatment of the disease.

Chinese Space Station (CSS) has been fully deployed by the end of 2022, and the facility has entered into the application and development phase. It has conducted scientific research projects in various fields, such as space life science and biotechnology, space materials science, microgravity fundamental physics, fluid physics, combustion science, space new technologies, and applications. In this review, we introduce the progress of CSS development and provide an overview of the research conducted in Chinese Space Station and the recent scientific findings in several typical research fields. Such compelling findings mainly concern the rapid solidification of ultra-high temperature alloy melts, dynamics of fluid transport in space, gravity scaling law of boiling heat transfer, vibration fluidization phenomenon of particulate matter, cold atom interferometer technology under high microgravity and related equivalence principle testing, the full life cycle of rice under microgravity and so forth. Furthermore, the planned scientific research and corresponding prospects of Chinese space station in the next few years are presented.

Under the “dual carbon” strategy aimed at further reducing carbon emissions and improving wind and PV power consumption， this study proposes a low-carbon optimal scheduling strategy for hybrid wind/PV/storage microgrids considering green electricity certificate （GEC） trading and carbon emission constraints. With the goal of minimizing the overall operational costs of the microgrid systems， the GEC trading scenario is considered along with constraints of microgrid operation. Moreover， the cost of carbon emissions is introduced. A low-carbon optimal scheduling model for hybrid wind/PV/storage microgrids considering GEC trading and carbon emission constraints is established. The model is simulated and solved using the YALMIP toolbox in MATLAB and the Gurobi optimizer respectively. The simulation results demonstrate that the model effectively minimizes both the economic costs and carbon emissions of the system， while taking into account environmental benefits. This provides an efficient approach for the low-carbon scheduling of microgrids.

Vigorously developing new energy sources is an important approach to achieving the carbon peaking and carbon neutrality goals. However, the randomness, volatility, and intermittency of new energy pose severe challenges to the supply-demand balance and stability of the electric power system. Therefore, there is an urgent need to develop diversified flexible resources to guarantee the system’s safe and stable operation. This study summarizes the electricity demand and the power structure development pathways in China under the carbon neutrality goal. Based on this, it analyzes the different flexibility demands of electric power systems with different proportions of wind and solar power generation capacities and elaborates on the characteristics of various types of flexible resources needed for power generation, transmission, load, and storage from four aspects: peak capacity (adequacy), ramping flexibility, stability, and inertia. Drawing from the international experience regarding flexible resource development, we propose the principles for flexible resource development: supply security guarantee, low-carbon development, and economic optimization. Considering the existing problems in the flexible resource development in China, we propose a flexible resource development pathway that aligns with the emission reduction goal of the power sector and the medium- to long-term development trend of the electric power structure of China. Furthermore, key initiatives to ensure the development of flexible resources are proposed from five aspects: power source, power grid, load, energy storage, and market mechanism.

During the normal operation of cooling towers in nuclear power plants, water vapor with a certain temperature is discharged through the outlet of the cooling tower, which mixes with the surrounding air. A portion of this vapor condenses and forms visible plumes. This paper uses Computational fluid dynamics (CFD) numerical simulation software to simulate six nuclear power units and their supporting cooling towers at a nuclear power plant site, and studies the impact of plumes emitted from the six cooling towers under different wind directions on the radioactive diffusion of the nuclear power plant discharge. The research results indicate that when the arrangement direction of the cooling towers is consistent with the wind direction，the influence of the cooling towers on the environmental flow field extends to a distance of approximately 1 500 m in the downwind direction. When the cooling towers are located in the downwind direction of the reactor unit, the emission from the cooling towers increases the pollution diffusion factor within a 1 000 m range of the chimney. As the environmental wind speed increases, the impact of the cooling tower emissions on the diffusion of pollutants from the chimney decreases.

To improve the proton conductivity of the sulfonated polyether ether ketone/ionic liquid （SPEEK/IL） membrane and reduce the loss rate of IL in the membrane， Cd@Co-MOF-74/Phosphate-4-phenylimidazole ionic liquid （［IM2］［H2PO4］）/SPEEK ternary composite membranes were prepared by the solution casting method. Results show that due to the formation of hydrogen bonds between the imidazole ring in ionic liquids and the —OH or carboxylic acid groups in MOF， imidazole molecules are anchored on the pore walls of MOF. The proton conductivity of the ternary composite membrane at 120 ℃ is the highest， reaching 26.93 mS·cm-1， when the mass fraction of the Cd@Co-MOF-74 doping is 1.5%. The IL loss rate of bimetallic MOF/IL/SPEEK ternary composite membranes with different contents is generally between 20% and 25%. Doping bimetallic MOFs in SPEEK/IL membranes ensures high proton conductivity while reducing the swelling rate of SPEEK/IL composite membranes， thereby increasing their service life.

Abstract The surge in interest regarding the next generation of optical fiber transmission has stimulated the development of digital signal processing (DSP) schemes that are highly cost-effective with both high performance and low complexity. As benchmarks for nonlinear compensation methods, however, traditional DSP designed with block-by-block modules for linear compensations, could exhibit residual linear effects after compensation, limiting the nonlinear compensation performance. Here we propose a high-efficient design thought for DSP based on the learnable perspectivity, called learnable DSP (LDSP). LDSP reuses the traditional DSP modules, regarding the whole DSP as a deep learning framework and optimizing the DSP parameters adaptively based on backpropagation algorithm from a global scale. This method not only establishes new standards in linear DSP performance but also serves as a critical benchmark for nonlinear DSP designs. In comparison to traditional DSP with hyperparameter optimization, a notable enhancement of approximately 1.21 dB in the Q factor for 400 Gb/s signal after 1600 km fiber transmission is experimentally demonstrated by combining LDSP and perturbation-based nonlinear compensation algorithm. Benefiting from the learnable model, LDSP can learn the best configuration adaptively with low complexity, reducing dependence on initial parameters. The proposed approach implements a symbol-rate DSP with a small bit error rate (BER) cost in exchange for a 48% complexity reduction compared to the conventional 2 samples/symbol processing. We believe that LDSP represents a new and highly efficient paradigm for DSP design, which is poised to attract considerable attention across various domains of optical communications.

Jiangpei Shi,1,&ast; Rongguang Zhang,1,&ast; Yu Wang,1 Yingwei Sun,1 Xiaoyan Gu,1 Yu An,1 Xinyu Chai,1 Xiaoyu Wang,2 Zhi Wang,1 Yaqi Lyu,1 Teng Guo,1 Nianping Feng,1 Ying Liu1 1School of Pharmacy, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People’s Republic of China; 2Experiment Center for Science and Technology, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Nianping Feng; Ying Liu, Email npfeng@shutcm.edu.cn; debbyly@shutcm.edu.cnBackground: Metastasis is a complex process involving multiple factors and stages, in which tumor cells and the tumor microenvironment (TME) play significant roles. A combination of orally bioavailable therapeutic agents that target both tumor cells and TME is conducive to prevent or impede the progression of metastasis, especially when undetectable. However, sequentially overcoming intestinal barriers, ensuring biodistribution in tumors and metastatic tissues, and enhancing therapeutic effects required for efficient therapy remain challenging.Methods: Inspired by the unique chemical features of natural herbs, we propose an oral herb–nanoparticle hybrid system (HNS) formed through the self-binding of Platycodon grandiflorum–Curcuma zedoaria (HG), a herb pair/group used in clinical practice to treat breast cancer metastasis, to lipid–polymer nanoparticles (LPNs) loaded with silibinin. The molecular structure responsible for HG association with LPNs was assessed using surface-enhanced Raman spectroscopy for HNS surface chemistry characterization. Moreover, the molecular class of HG was identified using UPLC–Orbitrap–MS/MS to further confirm the surface binding. Mucus diffusion and in vivo biodistribution were evaluated using in vitro multiple-particle tracking and environment-responsive fluorescence probe in 4T1 tumor-bearing mice, respectively. The alleviation of breast cancer metastasis was assessed in 4T1 tumor-bearing mice, and the underlying mechanism was investigated.Results: The HNS reduced particle–mucus interactions by altering hydrophilicity and surface characteristics compared to LPNs. The epithelium transportation of HNS and absorption through Peyer’s patch in mice were improved, promoting their biodistribution in the lung and tumor tissues. Furthermore, the HNS alleviated lung metastasis by inducing cell apoptosis and regulating the expression of MMP-9 and TGF-β 1, which altered the TME in 4T1 tumor-bearing mice.Conclusion: HNS provides an appealing system with multi-component binding of herbal medicine to facilitate both oral nanoparticle delivery efficiency and the alleviation of lung metastasis. This strategy may potentially help improve treatment for patients with breast cancer.Keywords: herb–nanoparticle hybrid system, intestinal biological barrier, tumor microenvironment, breast cancer lung metastasis

This paper presents a method of equipment demonstration AoA method considering RMS factors. It puts forward the equipment demonstration AoA framework, and elaborates equipment demonstration AoA measure system. It analyses the RMS and cost factors, and establishes their quantitative models. An AoA model based on Data Envelopment Analysis (DEA) and an application example are given to illustrate the feasibility and effectiveness of the method.

Angiogenesis is a key step involving physiological and pathological processes, and pro/antiangiogenic factors are involved in angiogenesis throughout. Melatonin is a product synthesized by the pineal gland of the human brain and acts in various systems of the body. This article briefly describes the wide range of biological roles and physiological functions of melatonin, and summarizes that melatonin regulates pro-/anti-angiogenic factors(e.g., vascular endothelial growth factor/matrix metalloproteinase)under different conditions and is involved in angiogenesis in fundus diseases(e.g., age-related macular degeneration, diabetic retinopathy, and central serous choroioretinopathy); in addition, it also summarizes that melatonin regulates various cytokines, inflammatory factors and signaling pathways to produce anti-inflammatory, antioxidant and immune responses in fundus diseases, and thus obtaining the application and potential treatment of melatonin in fundus vascular diseases, with a view to providing new ideas and therapeutic targets for the treatment of fundus diseases.

Small incision lenticule extraction(SMILE)is a flapless femtosecond laser-assisted refractive surgery, which is applied in the treatment of refractive errors. Since the earliest publications about SMILE in 2011, the concept of a refractive surgery performed through a small incision without the complications associated with the flap creation, has led to an increased interest in the ophthalmologic field. Lower impact on corneal biomechanical, less dry eye risk and less stromal layer exposure were some benefits this innovative technique had aroused. It is also stable, safe and effective in treating myopia and myopic astigmatism. Despite of the advantages, the implementation of SMILE is challenging, and various postoperative complications can emerge, including dry eye, infectious keratitis, diffuse lamellar keratitis, transient light sensitivity syndrome, corneal ectasia, pressure induced stromal keratitis, epithelial ingrowth, vision-related changes, etc. Early recognition and proper management of these complications are necessary for optimizing refractive outcomes. This article reviews the risk factors, clinical features, management and prevention of various complications focusing on SMILE.

Abstract Background The triglyceride glucose-body mass index (TyG-BMI) is recognized as a reliable surrogate for evaluating insulin resistance and an effective predictor of cardiovascular disease. However, the link between TyG-BMI index and adverse outcomes in heart failure (HF) patients remains unclear. This study examines the correlation of the TyG-BMI index with long-term adverse outcomes in HF patients with coronary heart disease (CHD). Methods This single-center, prospective cohort study included 823 HF patients with CHD. The TyG-BMI index was calculated as follows: ln [fasting triglyceride (mg/dL) × fasting blood glucose (mg/dL)/2] × BMI. To explore the association between the TyG-BMI index and the occurrences of all-cause mortality and HF rehospitalization, we utilized multivariate Cox regression models and restricted cubic splines with threshold analysis. Results Over a follow-up period of 9.4 years, 425 patients died, and 484 were rehospitalized due to HF. Threshold analysis revealed a significant reverse “J”-shaped relationship between the TyG-BMI index and all-cause mortality, indicating a decreased risk of all-cause mortality with higher TyG-BMI index values below 240.0 (adjusted model: HR 0.90, 95% CI 0.86–0.93; Log-likelihood ratio p = 0.003). A distinct “U”-shaped nonlinear relationship was observed with HF rehospitalization, with the inflection point at 228.56 (adjusted model: below: HR 0.95, 95% CI 0.91–0.98; above: HR 1.08, 95% CI 1.03–1.13; Log-likelihood ratio p

Neighborhoods and Cardiovascular Health was drafted by a writing group of experts in cardiology, epidemiology, and preventive medicine and has been published in December 2023 in Circulation: Cardiovascular Quality and Outcomes, the official journal of the American Heart Association (AHA). The American Heart Association provides a roadmap on how to use current knowledge about neighborhoods influence on cardiovascular disease to develop and implement effective interventions to improve cardiovascular health at the population, health system, neighborhoods, and individual levels. Reducing the inequity burden of cardiovascular disease among deprived populations by influencing and improving the neighborhoods environment where possible. Our country is also faced with the problem of imbalance of neighborhoods infrastructure between urban and rural areas as well as between urban and rural areas. The interpretation of this scientific statement may provide new perspectives and ideas for the prevention and control of cardiovascular diseases in China at the community level, which will help to improve the prevention and control of cardiovascular diseases and the cardiovascular health of the public.

Aging is a necessary process for organisms.The antioxidant capacity in the body decreases, which induces the activation of inflammasomes, autophagy dysregulation, protein misfolding in the lens, resulting in lens opacification. With the increase of age, the secretion of melatonin and glutathione(GSH)gradually decreased, and the pro-oxidant/pro-inflammatory factors increased, which created ideal conditions for the formation of age-related cataract(ARC). A series of changes such as oxidative stress, inflammation and autophagy dysregulation accompany the occurrence of aging, which is also the basis of various diseases. Melatonin has antioxidant, anti-inflammatory, regulation of autophagy and circadian rhythm effects, and has shown benefits in age-related macular degeneration(ARMD), diabetic retinopathy(DR), and glaucoma. Although phacoemulsification and lens implantation have developed maturely, they consume a lot of medical resources. This article reviews the research of melatonin in ARC, which may prevent/delay the formation of ARC, thereby reducing the economic burden of patients and reducing the loss of medical resources.

Background Although the number of case reports on pulmonary infarction (PI) secondary to pulmonary embolism (PE) is increasing in recent years, its misdiagnosis remains common, mainly as pneumonia. In patients with intermediate and high-risk pulmonary embolism, delays in diagnosis and timely treatment would lead to poor prognosis. Objective By analyzing the pneumonia-misdiagnosed cases of patients with PI, we summarized their clinical characteristics and related risk factors, and constructed a multivariate joint model to improve the accurate diagnosis rate at early stage. Methods This retrospective study included the hospitalized patients with pulmonary embolism at the First Affiliated Hospital of USTC from January 2017 to December 2023. In the group of pneumonia-misdiagnosed patients with intermediate to high-risk PI, we analyzed the clinical characteristics and compared the differences between the misdiagnosed groups and control group. Furthermore, using a multivariate Logistic regression analysis, we explored the independent predictive factors of the delayed diagnosis, analyze the predictive value of various indicators for the misdiagnosis by ROC curves, and compared the AUC values using Delong test. Results Among 101 cases of PI patients, 70 of them were misdiagnosed as pneumonia. From 2017 to 2023, the misdiagnosis rate gradually decreased in percentages of 100.0%, 83.3%, 74.1%, 71.4%, 63.2%, 66.7%, and 50.0%, respectively (χ2trend=6.672, P=0.010). Based on the results of multivariate Logistic regression analysis, the characteristics of over sixty-years-old age (OR=18.271, 95%CI=4.373-76.339, P

A resource allocation strategy for the low earth orbit (LEO) satellite Internet based on terminal traffic prediction was proposed to address the problems of blind coverage spots in ground network and the low resource utilization of satellite network. An improved LSTM-ARIMA algorithm was proposed with real datasets by the strategy to accurately predict the data traffic generated in the ground area over a certain period of time in the future. Two communication models, differentiated data transmission and task offloading were constructed through Stackelberg games, taking into the data processing latency and energy consumption account. By solving the Nash equilibrium, the optimal ratio for users to transmit data or unload tasks through the LEO satellite Internet, as well as the optimal pricing for satellites to provide network services, were obtained. Extensive simulation results verify that the proposed strategy can increase the revenue by approximately 40% in data transmission services and 50% in task offloading services.

The low carbon target strategy has promoted the rapid growth of distributed energy resources, such as wind power and photovoltaics, and the increase of electric vehicles ownership. Considering the smoothing effect of vehicle to grid (V2G) on the output fluctuation of distributed energy generation, and improving the wind/photovoltaic consumption level, the virtual power plant (VPP) technology was used to achieve unified management of the two, and then the carbon emission of the whole life cycle of electric vehicles and distributed energy generation were combined to establish an optimization model targeting at optimizing the cost of system operation and the cost of carbon emission. The model was solved by particle swarm optimization algorithm. Imental analysis based on example model combined with real vas conducted. The experimental analysis results show that the optimization model can effectively schedule all elements of VPP, and use the charging and discharging of electric vehicles to improve the operation and carbon emission benefits. It may provide a technical reference for the safe and stable operation of the grid system under the background of the low carbon target.

Psoriasis is a disease caused by genetics and immune system dysfunction, affecting the skin and joints. Toll-like receptors (TLRs) play an important role in triggering the innate immune response and controlling adaptive immunity. The role of TLR2 in the progression of psoriasis is not well understood.

ObjectiveTo identify the key issues in emergency response to public health emergencies in the Yangtze River Delta region, and to provide a basis for the formulation of relevant policies.MethodLiterature on emergency response to public health emergencies in the Yangtze River Delta region was systematically reviewed and collected, and 18 main problems were identified after collecting and organizing the problems. A questionnaire survey and cluster analysis were used to identify the key issues.ResultsThe study of 18 major problems revealed that "insufficient reserve of emergency medical supplies", "insufficient financial investment to meet the needs of emergency response", "lack of a sound mechanism for the deployment of supplies, resulting in the untimely deployment of materials", were the key issues of emergency response to public health emergencies in the Yangtze River Delta region.ConclusionFuture development of the emergency response system in the Yangtze River Delta region should focus on accelerating the integration process of the Yangtze River Delta, establishing and improving information systems, optimizing the material storage and deployment network, prioritizing the fund investment and utilization mechanism, and improving the effectiveness of public health emergency response.

ObjectiveTo identify and clarify the key issues faced by tertiary hospitals in responding to public health emergencies.MethodsA literature review index system was constructed, and key issues were identified using hierarchical analysis.ResultsAfter a systematic literature review, 20 types of problems faced by tertiary hospitals in responding to public health emergencies were identified. Three key issues were ultimately identified by prioritizing the issues that needed to be addressed.ConclusionThe key issues of tertiary hospitals in responding to public health emergencies are concentrated in the areas of emergency response capabilities and competencies of medical staff, the number of emergency response personnel, and the standardization and specificity of training and drills. Tertiary hospitals should focus on these issues in developing public health emergency response systems to improve the effectiveness of their emergency response.

With the increasing burden of hypertension in Chinese adults, the detection rate of hypertension among children and adolescents continued to rise, drawing increasing attention to the impact of pubertal timing on blood pressure. In recent years, many scholars have evaluated the association between pubertal development and blood pressure at different stages using various methods of assessing pubertal timing. To understand the correlation between pubertal timing and blood pressure in adolescents, this study reviews the associations between pubertal timing and blood pressure and their underlying mechanisms. The relationship between earlier female pubertal development and the risk of hypertension in adulthood shows positive, negative, and U-shaped correlations, with varying results. Earlier female pubertal development may lead to a higher detection rate of hypertension during adolescence. Most of the studies focus on the correlation between pubertal timing and adult blood pressure, with less research on adolescent blood pressure, indicating a need for further research to reveal underlying patterns.

High-velocity air-fuel spray （HVAF） technology was used to prepare two kinds of Al-based amorphous alloy coatings with high porosity （HP） of 1.36% and low porosity （LP） of 0.86%. The effects of porosities on the corrosion behavior of Al-based amorphous alloy coatings were studied. The porosities and microstructures of the coatings were analyzed by scanning electron microscope （SEM） and X-ray diffraction （XRD） combined with three-dimensional X-ray tomography （3D XRT）. The corrosion properties of the coatings were studied by electrochemical testing system and contact angle measuring instrument. The passive film components of the two coatings were analyzed by X-ray photoelectron spectroscopy （XPS）. The results show that the self-corrosion current density （Icorr） and pitting potential （Epit） of the LP coatings are 3.0×10-6 A/cm2 and -0.40 V， respectively. The Icorr and Epit for HP coatings are 6.0×10－6 A/cm2 and -0.47 V， respectively， signifying that the LP coating has better resistance to the localized corrosion； the charge transfer resistance （Rct） of LP coatings is about twice than that of HP coating； the LP coating has a larger contact angle， which proves that LP coating has better hydrophobicity and stronger corrosion resistance； the contents of RE2O3 in the passive film formed on the LP coating are larger， which further indicates that LP coating has better corrosion resistance.

Purposes In order to improve the detection accuracy of electromagnetic abrasive particles on small particles, the influencing factors of the induced signal of one-excitation, two-in-ductive three-coil electromagnetic abrasive sensor are studied, and structural optimization and signal enhancement measures are proposed. Methods First, the mathematical model of one-excita tion, two-inductance three-coil electromagnetic abrasive sensor is established, and the model is simulated, and verified. Second, different radial positions and different sizes of abrasive grains are experimentally studied, and the relationship between the size and radial position of abrasive grains and the output signal is explored. Finally, the change law of output signal under different structural parameters is studied through finite element analysis, the parameter optimization scheme of the sensor is proposed and verified, and the shielding structure of the sensor is designed. Findings The results show that the strength of the output signal of the optimized sensor is increased by 13.75 times compared with that of the optimization period, and the minimum diameter of the ferromagnetic abrasive particles that can be detected is 82.26 μm, and the minimum diameter of non-ferromagnetic abrasive particles is 294.38 μm. The results are helpful to improve the detection accuracy on electromagnetic abrasive particles of the electromagnetic abrasive sensor.

Qi-Feng Chen,1,&ast; Xiong-Ying Jiang,1,2,&ast; Yue Hu,1,&ast; Song Chen,1 Jun-Zhe Yi,1 Sui-Xing Zhong,1 Jiong-Liang Wang,1 Ning Lyu,1 Ming Zhao1 1Department of Minimally Invasive Interventional Therapy, Liver Cancer Study and Service Group, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, People’s Republic of China; 2Department of Interventional Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510210, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Ming Zhao, Department of Minimally Invasive Interventional Therapy, Liver Cancer Study and Service Group Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong, 510060, People’s Republic of China, Tel +862087343272, Email zhaoming@mail.sysu.edu.cnPurpose: The combination of sorafenib and hepatic arterial infusion chemotherapy (SoHAIC) has shown to enhance overall survival rates in patients with advanced hepatocellular carcinoma and major portal vein tumor thrombosis (HCC-Vp3-4) compared to sorafenib alone. Our objective was to evaluate the cost-effectiveness of SoHAIC versus sorafenib for the treatment of HCC-Vp3-4, taking into account the viewpoint of Chinese healthcare payers.Methods: This pharmacoeconomic study employed a Markov model to assess the cost-effectiveness of treating HCC-Vp3-4 with SoHAIC in comparison to sorafenib. The patient characteristics were drawn from individuals from the trial conducted between June 2017 and November 2019, with cost and health value data sourced from published literature. The primary outcome measure in this research was the incremental cost-effectiveness ratio (ICER), which indicates the additional cost per quality-adjusted life year (QALY). The willingness-to-pay (WTP) threshold per QALY was set at &dollar;30,492.00. Furthermore, 1-way sensitivity and probabilistic sensitivity analyses were carried out to validate the consistency of the results.Results: In the baseline scenario, sorafenib resulted in 0.42 QALY at a cost of &dollar;10,507.89, while SoHAIC generated 1.66 QALY at a cost of &dollar;32,971.56. When comparing SoHAIC to sorafenib, the ICER was &dollar;18,237.20 per QALY, which was below the WTP threshold per QALY. Furthermore, the 1-way sensitivity analysis demonstrated that the ICER remained within the WTP threshold despite fluctuations in variables. In the probabilistic sensitivity analysis, SoHAIC had a 98.8% probability of being cost-effective at the WTP threshold, considering a wide range of parameters.Conclusion: In this cost-effectiveness evaluation, SoHAIC demonstrated cost-effectiveness over sorafenib for HCC with major portal vein tumor thrombosis, as observed from the perspective of a Chinese payer.Keywords: HCC, portal vein tumor thrombosis, sorafenib, HAIC, Cost-effectiveness

The microRNA(miRNA)is a widely present small non-coding RNA(ncRNA), with a length of 20-25 nucleotides. The miRNA in eye tissue plays crucial roles in normal eyes by participating in processes such as cell growth, proliferation, differentiation, and apoptosis. Cataracts are the main cause of blindness worldwide. Research has shown that miRNA is related to the occurrence and development of cataracts, and it has new application prospects as a potential target for the treatment and prevention of cataracts. This article reviews the relationship between miRNA and the occurrence and development of cataracts through several different pathogenesis mechanisms, including oxidative damage, apoptosis, autophagy, and epithelial mesenchymal transition(EMT).

With the continuous development of network technology, the scale of data has shown explosive growth, which leads gradually to replacing traditional single machine databases with distributed databases. Distributed databases solve large-scale data storage problems through collaborative work among nodes, but due to increased communication costs between nodes, its query efficiency is not as good as a standalone database. In a distributed architecture, the data of storage nodes is only used as redundancy for multiple backups, providing data recovery in case of system failure, and it is not utilized to improve query efficiency. In response to the above issues, this article proposes an operator parallel optimization strategy for distributed databases. By splitting key physical operators, the split sub requests are evenly distributed to multiple nodes in the storage layer, which are processed in parallel by multiple nodes, thereby reducing query response time. The above strategy has been applied on distributed database CBase, and experiments have shown that the parallel optimization strategy proposed in this paper can significantly shorten SQL request query time and improve system resource utilization.