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Abstract Laying long horizontal borehole (LHB) in mining‐induced strata fractures for coal‐bed gas drainage in the goaf is a pivotal method for eliminating safety hazards, preventing atmospheric pollution, and realizing gas utilization. A crucial premise of this method is to determine the effective drainage range of the borehole, a key parameter directly affecting boreholes spacing and drainage efficiency. In this study, a model of gas seepage during LHB drainage within a circular equipotential boundary was presented, and the complex variable function theory and the mirror principle were adopted for deriving the complex potential function of gas flow under the condition of LHB drainage and the drainage volume function of a single center borehole. Besides, the main indicator to determinate the effective drainage range of LHB was given. Specifically, the indicator refers to the distance between the turning point (the point at which the change rate of the gas flow velocity is −0.002 around the borehole) and the center of the borehole. Subsequently, numerical simulation was conducted to obtain the effective drainage range of LHB within mining‐induced fractures of overlying strata, that is, 4 m

Abstract The gases released by underground coal mining pose a threat to mine safety, lead to resource wastage, and contribute to environmental pollution. Employing long horizontal boreholes (LHB) for gas extraction proves to be an effective solution. However, accurately determining the LHB's position within the overlying rock strata is challenging due to complex mining and geological conditions. This study introduces a novel “zone‐position” method for identifying the optimal LHB placement, utilizing both physical simulation tests and theoretical analysis. The approach comprises two steps. Initially, it identifies the appropriate LHB layout zone within the overlying strata. It delineates four subzones within the fractured zone, among which the stable fractured subzone (SFSZ) is identified as the most favorable for LHB placement. The boundaries of the SFSZ are also defined. Subsequently, the method focuses on pinpointing the LHB's precise location within the SFSZ, proposing a criterion that considers gas accumulation, strata permeability, and LHB stability. Application of this method in engineering projects demonstrates that the gas extracted by LHBs accounts for about 60% of the total gas emission. Furthermore, the volume of gas extracted at the optimal LHB location reaches up to 5.52 m3 min−1, triple that of other locations.

ABSTRACT Background Clear cell renal cell carcinoma (ccRCC), the predominate histological type of renal cell carcinoma (RCC), has been extensively studied, with poor prognosis as the stage increases. Research findings consistently indicated that the PI3K‐Akt pathway is commonly dysregulated across various cancer types, including ccRCC. Targeting the PI3K‐Akt pathway held promise as a potential therapeutic approach for treating ccRCC. Development and validation of PI3K‐Akt pathway‐related genes related biomarkers can enhance healthcare management of patients with ccRCC. Purpose This study aimed to identify the key genes in the PI3K‐Akt pathway associated with the diagnosis and prognosis of CCRCC using data mining from the Cancer Genome Atlas (TCGA) and Gene Expression Synthesis (GEO) datasets. Methods The purpose of this study is to use bioinformatics methods to screen data sets and clinicopathological characteristics associated with ccRCC patients. The exhibited significantly differential expressed genes (DEGs) associated with the PI3K‐Akt pathway were examined by KEGG. In addition, Kaplan–Meier (KM) analysis used to estimate the survival function of the differential genes by using the UALCAN database and graphPad Prism 9.0. And exploring the association between the expression levels of the selected genes and the survival status and time of patients with ccRCC based on SPSS22.0. Finally, a multigene prognostic model was constructed to assess the prognostic risk of ccRCC patients. Results A total of 911 genes with common highly expressed were selected based on the GEO and TCGA databases. According to the KEGG pathway analysis, there were 42 genes enriched in PI3K‐Akt signalling pathway. And seven of highly expressed genes were linked to a poor prognosis in ccRCC. And a multigene prognostic model was established based on IL2RG, EFNA3, and MTCP1 synergistic expression might be utilized to predict the survival of ccRCC patients. Conclusions Three PI3K‐Akt pathway‐related genes may be helpful to identify the prognosis and molecular characteristics of ccRCC patients and to improve therapeutic regimens, and these risk characteristics might be further applied in the clinic.

Abstract Objective To evaluate whether quantification of lung GGN shape is useful in predicting pathological categorization of lung adenocarcinoma and guiding the clinic. Methods 98 patients with primary lung adenocarcinoma were pathologically confirmed and CT was performed preoperatively, and all lesions were pathologically ≤ 30 mm in size. On CT images, we measured the maximum area of the lesion’s cross-section (MA). The longest diameter of the tumor (LD) was marked with points A and B, and the perpendicular diameter (PD) was marked with points C and D, which was the longest diameter perpendicular to AB. and D, which was the longest diameter perpendicular to AB. We took angles A and B as big angle A (BiA) and small angle A (SmA). We measured the MA, LD, and PD, and for analysis we derived the LD/PD ratio and the BiA/SmA ratio. The data were analysed using the chi-square test, t-test, ROC analysis, and binary logistic regression analysis. Results Precursor glandular lesions (PGL) and microinvasive adenocarcinoma (MIA) were distinguished from invasive adenocarcinoma (IAC) by the BiA/SmA ratio and LD, two independent factors (p = 0.007, p = 0.018). Lung adenocarcinoma pathological categorization was indicated by the BiA/SmA ratio of 1.35 and the LD of 11.56 mm with sensitivity of 81.36% and 71.79%, respectively; specificity of 71.79% and 74.36%, respectively; and AUC of 0.8357 (95% CI: 0.7558–0.9157, p

Abstract Traditional cemented paste backfilling continues to face the shortcomings such as paste leakage, poor adaptability to geological structures and insufficient roof-contact. To solve the limitations, a novel L-shaped cemented paste backfilling (LCPB) technology was proposed in this study. It is to set L-shaped filling zones and partition zones in the goaf to perform interval and multiple filling. A mechanical model was established to calculate backfilling body strength, widths of L-shaped filling zones and partition zones and backfilled ratio and etc. The results of a case study showed that: (1) The LCPB mining has a high backfilled ratio, without prominent ground pressure. The maximum values of roof-to-floor convergence of the working face and roadway were 58 mm and 259 mm, respectively. It could effectively control the deformation of surrounding rock and achieve roadway retention. (2) When the floor strata were intact, the maximum floor damage depth was less than 4 m, and the floor near the fault was 10–12 m. The secondary lift height of the confined water was about 5 m near the fault. The LCPB mining allows for safety mining above a confined aquifer. (3) The maximum surface inclination and curvature were 1.75 mm/m and 0.06 mm/m2, respectively. The draw angle was 11.3°, and the subsidence factor was 0.085. The ground surface deformation was reduced to be less than that allowed in the first level of the building damage (inclination and curvature of 3 mm/m and 0.2 mm/m2, respectively).

Autonomous vehicles require more precise and reliable braking control, and electro-hydraulic braking (EHB) systems are better adapted to the development of autonomous driving. However, EHB systems inevitably suffer from unilateral dead zone nonlinearity, which adversely affects the position tracking control. Therefore, a finite-time adaptive control strategy was designed for unilateral dead zone nonlinearity. Initially, the unilateral dead zone nonlinearity was reformulated into a matched disturbance term and an unmatched disturbance term to reduce the adverse effects of disturbances, thereby enhancing system controllability. Then, the “complexity explosion” in the design of the control strategy was avoided by command filtering, and the design process of the controller was simplified. Furthermore, the finite-time control theory was employed to boost the system’s convergence speed, thereby enhancing control performance. In order to ensure the stability of the system under the dead zone disturbance, the unknown disturbance terms were estimated. The stability of the control strategy was validated through the finite-time stability theorem and the Lyapunov function. Eventually, simulations and hardware-in-the-loop (HIL) experiments validated the feasibility and availability of the finite-time adaptive control strategy.

The pressure-relief gas drainage in longwall mining goaf is an important part of the simultaneous extraction of coal and gas in the green mining technology system. The horizontal-directional long boreholes arranged in overlying strata for pressure-relief gas drainage have been widely used in recent years. The boreholes in mining overburden are different from the high drainage roadway and ordinary high-level boreholes. When the pressure-relief gas is extracted from the overburden of goaf, the boreholes response and sensitivity to the mining overburden damage and gas migration have some significant particularities. Through theoretical analysis, numerical simulation and engineering example verification, the position characteristics and pressure-relief gas drainage mechanism of horizontal-directional long boreholes in mining overburden were studied. The technical principle of extracting pressure-relief gas by horizontal-directional long boreholes was described. Combined with laboratory tests and numerical simulation, three position characteristics of hori-zontal-directional long boreholes were analyzed. The gas accumulation degree at the borehole area is high, which provides the concentration conditions for borehole gas drainage. The fractures at the borehole area are relatively developed, which provides gas source guarantee for borehole drainage. The stratum at the borehole area is less affected by mining, which provides stability conditions for the borehole. On this basis, the drainage mechanism of horizontal-directional long boreholes was revealed from three aspects: the degree of gas accumulation in mining fractures, the permeability of mining strata and the stability of mining boreholes. The theoretical criteria for determining the position of horizontal-directional long boreholes was proposed, and the method for determining the position of the boreholes drainage was given, which were verified by numerical simulation and engineering examples. The research results show that according to the borehole position criteria, the maximum pure volume of gas drainage of the borehole arranged is 2.59 m3/min, which is 2.56 times that of other comparative boreholes. Affected by horizontal-directional long boreholes drainage, the maximum gas volume fraction in return airway is 0.11%−0.72%, and the gas volume is 0.69−2.79 m3/min, which verifies the reasonability of pressure-relief gas drainage based on the position determination method of horizontal-directional long boreholes. The research results can provide a technical basis for the layout of horizontal-directional long boreholes to extract the pressure-relief gas in goaf, thereby improving the pres-sure-relief gas extraction rate and promoting the development of green mining technology of the mine.

Failure of any of the drive systems in a Four-Wheel Independent Drive (4WID) electric vehicle may affect the control performance and driving safety of the whole vehicle. Therefore, in this paper, a fault-tolerant controller (FTC) for 4WID electric vehicles considering drive actuator failures is proposed. First, a comprehensive characterization of multiple fault types is achieved by establishing a generalized fault model and designing a comprehensive fault factor. Second, based on the comprehensive fault factor, an LPV model with faults is constructed. Further, a fault-tolerant controller based on LPV/H∞ output feedback is designed by combining the weighting function. Finally, the effectiveness of the FTC in this paper is verified by simulation and hardware-in-the-loop (HIL) experiments. The experimental results show that the FTC designed in this paper can improve the stability of the vehicle traveling while ensuring tracking accuracy when the drive system fails.

ObjectiveTemporal lobe epilepsy (TLE) is the most common cause of drug-resistant epilepsy and can be treated surgically to control seizures. In this study, we analyzed the relevant research literature in the field of temporal lobe epilepsy (TLE) treatment to understand the background, hotspots, and trends in TLE treatment research.MethodsWe discussed the trend, frontier, and hotspot of scientific output in TLE treatment research in the world in the last 20 years by searching the core collection of the Web of Science database. Excel and CiteSpace software were used to analyze the basic data of the literature.ResultWe identified a total of 2,051 publications on TLE treatment from 75 countries between 2003 and 2023. We found that the publication rate was generally increasing. The United States was the most publishing country; among the research institutions on TLE treatment, the University of California system published the most relevant literature and collaborated the most with other institutions. The co-citation of literature, keyword co-occurrence, and its clustering analysis showed that the early studies focused on open surgical treatment, mainly by lobectomy. In recent years, the attention given to stereotactic, microsurgery, and other surgical techniques has gradually increased, and the burst analysis indicated that new research hotspots may appear in the future in the areas of improved surgical procedures and mechanism research.

ObjectiveThe relevant literatures in the field of pulmonary neuroendocrine tumor were analyzed to understand the lineage, hot spots and development trends of research in this tumor.MethodThe Web of Science core collection was searched for English-language literature about neuroendocrine tumors of the lung published between 2000 and 2022. CiteSpace software was imported for visualization analysis of countries, institutions, co-cited authors and co-cited journals and sorting of high-frequency keywords, as well as co-cited references and keyword co-occurrence, clustering and bursting display.ResultsA total of 594 publications on neuroendocrine tumours of the lung were available, from 2000 to 2022, with an overall upward trend of annual publications in the literature. Authors or institutions from the United States, Italy, Japan and China were more active in this field, but there was little cooperation among the major countries. Co-cited references and keyword co-occurrence and cluster analysis showed that research on diagnostic instruments, pathogenesis, ectopic ACTH signs, staging and prognosis and treatment was a current research hotspot. The keyword bursts suggested that therapeutic approaches might be a key focus of future research into the field for pulmonary neuroendocrine tumors.ConclusionOver these 20 years, research related to neuroendocrine tumors of the lung has increased in fervour, with research on diagnostic instruments, pathogenesis, ectopic ACTH signs, staging and prognosis, and treatment being the main focus of research. Therapeutic treatments may be the future research trend in this field.

With the development of safety technologies for intelligent commercial vehicles, electronic pneumatic braking systems (EBSs) have been widely used. However, EBS actuators may fail during vehicle operation and thus create safety problems. For this reason, we propose a path-tracking fault-tolerant control strategy under EBS actuator failure in intelligent commercial vehicles. First, in order to be able to characterize different types of brake actuator faults during the EBS differential braking process of a vehicle, a comprehensive fault coefficient for calculating the degree of fault is designed, and a BES generalized fault model is established. Second, the faults are introduced into the fault-tolerant controller through the comprehensive fault coefficients for braking torque calculation and braking pressure allocation. Thus, a vehicle path model with the complete fault coefficients as variable parameters is established. Then, based on the LPV system gain scheduling, a path-tracking LPV/H∞ fault-tolerant controller under EBS actuator faults in commercial vehicles is designed, which is used to solve the safety problem arising from sudden EBS actuator faults. Finally, we conducted experimental validation through hardware-in-the-loop tests. The results demonstrate that the control strategy designed in this paper redistributes the braking torque and synergizes with the steering system to enhance vehicle stability, thereby improving vehicle safety in the EBS failure mode.

Rapid urbanization has profoundly changed ability of ecosystem to supply welfare and resulted a series of environmental issues, in turn, such results not only affected the economic growth, but also the quality of sustainable development. Therefore, deeply understanding the interaction between ecosystem service (ES) supply and urbanization is of great significance. As a case study of northern China, we attempt to build an effective framework to evaluate past and future states of the interaction between ES supply and urbanization from quantification spatiotemporal pattern of coupling coordination degree (CD), decoupling path exploration, driving factor analysis to grey prediction model construction. It tries to better improve the interaction between ES supply and urbanization, as well as provide some effective policies for local condition. Results showed that the synthesis coefficient of urbanization (URSC) and CD has been significantly improved from 1995 to 2020 at province scale, while the synthesis coefficient of ES supply (ESSC) and decoupling index score are fluctuating. All of indicators revealing differences between the west and east regions. The east region has the highest levels of ESSC, URSC, CD and decoupling index score during the last twenty-five years. The driving factors including annual precipitation (Precipitation), normalized difference vegetation index (NDVI), cropland area (Cropland), grassland area (Grassland), unused land area (Unused land) all have a spatiotemporal impact on the CD with divergent significances, among which the effect of NDVI is the most significant. Finally, the grey prediction model was applied to predict the ESSC, URSC, CD and decoupling index in the future. The findings reveal a growing state for ESSC and CD in province scale, while a decline state of URSC. Based on the aforementioned results, some scientific policies were proposed for different regions to improve sustainable development.

BackgroundTesticular torsion is an acute scrotal disorder requiring immediate emergency treatment. Ischemic injury and reperfusion injury are important causes of oxidative stress and irreversible oxidative damage after testicular torsion. Although a large number of literatures have discussed the causes and treatment of testicular torsion, there is currently a lack of systematic exploration of the historical evolution of testicular torsion and the construction of a knowledge framework.MethodThe Web of Science Core Collection was searched for studies on testicular torsion published between 2000 and 2022. The basic data of the literature were analyzed by using Excel and CiteSpace software.ResultA total of 1,007 publications on testicular torsion published were found in 64 countries between 2000 and 2022, with an increasing annual publication level. Early detection, early diagnosis and early treatment of testicular torsion had always been at the core of clinical practice, and the pathological cascade reaction of ischemic injury and ischemia-reperfusion injury after testicular torsion were also at the core of basic research. Emphasis had been placed on the development of protective drugs for ischemia and reperfusion after testicular torsion in various countries, regions and institutions.ConclusionOver the past 20 years, the research on testicular torsion had been widely concerned. Hot topics in testicular torsion in recent years were ischemia-reperfusion injury, oxidative stress, rat, doppler ultrasonography, diagnosis and orchiectomy. This article may provide a useful resource for clinicians and basic researchers regarding testicular torsion.

IntroductionFitness of plants is affected by their symbiotic interactions with arbuscular mycorrhizal fungi (AMF), and such effects are highly dependent on the environmental context.MethodsIn the current study, we inoculated the nursery shrub species Artemisia ordosica with AMF species Funneliformis mosseae under contrasting levels of soil water and nutrients (diammonium phosphate fertilization), to assess their effects on plant growth, physiology and natural infestation by herbivores.ResultsOverall, plant biomass was synergistically enhanced by increasing soil water and soil nutrient levels. However, plant height was surprisingly repressed by AMF inoculation, but only under low water conditions. Similarly, plant biomass was also reduced by AMF but only under low water and nutrient conditions. Furthermore, AMF significantly reduced leaf phosphorus levels, that were strongly enhanced under high nutrient conditions, but had only minor effects on leaf chlorophyll and proline levels. Under low water and nutrient conditions, specific root length was enhanced, but average root diameter was decreased by AMF inoculation. The negative effects of AMF on plant growth at low water and nutrient levels may indicate that under these conditions AMF inoculation does not strongly contribute to nutrient and water acquisition. On the contrary, the AMF might have suppressed the direct pathway of water and nutrient absorption by the plant roots themselves despite low levels of mycorrhizal colonization. AMF inoculation reduced the abundance of the foliar herbivore Chrysolina aeruginosa on plants that had been grown on the low nutrient soil, but not on high nutrient soil. Fertilization enhanced the abundance of this herbivore but only in plants that had received the high water treatment. The lower abundance of the herbivore on AMF plants could be related to their decreased leaf P content. In conclusion, our results indicate that AMF negatively affect the growth of Artemisia ordosica but makes them less attractive to a dominant herbivore.DiscussionOur study highlights that plant responses to AMF depend not only on the environmental context, but that the direction of the responses can differ for different components of plant performance (growth vs. defense).

A comprehensive understanding of the spatial-temporal evolution and driving forces on ecosystem services (ES) is essential for the agro-pastoral ecotone’s ecological security in northern China. However, the land-use pattern (LULC) agglomeration with spatial differentiation in the pastoral and agricultural areas has been rarely concerned. Taking distinct LULC (1980–2018) in Chifeng as an example, we compared four crucial categories of ESs with InVEST. Using SEM, we further contrasted the effects of several variables on regional ES variations in pastoral-dominated (North) and agriculture-dominated (South) regions, respectively. Results revealed the conversion between forest and grassland oriented the LULC transformation in the North. In contrast, human-activitiy-oriented land tended to occupy environmentally sensitive places in the South. Similar ES variations were supplied with the North outperforming the South when soil conservation was omitted. As for the impacts of regional ES variations, the natural and LULC policies both showed positive effects, whereas the anthropogenic factors showed positive in the North, which was negative in the South. Therefore, the ecologically-maintained-dominant and ecologically-restored-dominant strategies should be separately adopted in the North and South. Our study provided appropriate regional ecological management suggestions for balancing the LULC-driven conflicts between ecological protection and regional development.

As the third most common cancer and the second leading cause of cancer death worldwide, colorectal cancer (CRC) poses a serious threat to people’s health. In recent years, circRNA has been widely reported as a new biomarker in CRC, but a comprehensive summary and analysis is lacking. This study aims to evaluate the diagnostic, therapeutic and prognostic significance of circRNAs in CRC by systematically analysing their expression patterns, biological functions and clinical significance in CRC. The literature on circRNA in CRC was searched in the PubMed database and included for analysis after screening according to strict inclusion and exclusion criteria. The UALCAN online tool was used to obtain host gene expression data. The miRTargetLink 2.0 was used to predict target genes for miRNAs action in CRC patients. Cytoscape was used to construct circRNA-miRNA-mRNA interaction networks. From the 236 included papers, we identified 217 circRNAs and their associated 108 host genes and 145 miRNAs. Among the 145 miRNAs, 27 miRNAs had no corresponding target genes. After prediction of target genes and differential analysis, a total of 25 target genes were obtained and a circRNA-miRNA-mRNA interaction network was constructed. Among the 217 circRNAs, 74 were associated with diagnosis, 160 with treatment and 51 with prognosis. And 154 of them function as oncogenes while 58 as tumour suppressor genes. In addition, these circRNAs include 32 exosomal circRNAs, which have unique advantages as biomarkers. In total, we summarize and analyze the expression patterns, biological functions and clinical significance of circRNAs in CRC. In addition, we constructed some new circRNA-miRNA-mRNA regulatory axes based on the miRNAs sponged by circRNAs.

Accurately quantifying the spatiotemporal patterns in ecosystem service (ES)11 ES-Ecosystem service. supply and demand and their coupling coordination dynamics, as well as identifying the spatial heterogeneity of the influencing factors for coupling coordination degree are necessary for regional sustainable development. This study used the Ulansuhai Basin in Inner Mongolia Province of China as a case to quantify the supply, demand, and supply-demand ratio of ES (meat production, grain production, carbon storage, water yield, nitrogen purification, and phosphorus purification) from 2000 to 2020. The synthesized coefficient of ES supply (ESCI)22 ESCI-Synthesized coefficient of ES supply. and demand (ESDI),33 ESDI-Synthesized coefficient of ES demand. the match degree of total supply and demand (MD),44 MD-Match degree of total ES supply and demand. and the coupling coordination degree (CD)55 CD-Coupling coordination degree between total ES supply and demand. were taken as indices to explore the relationship between the ESCI and ESDI and the coordination relationships. A mixed effects model was used to determine the spatial heterogeneity response of CD to different influencing factors. The results showed that the total ES supply in the Ulansuhai Basin always met the demand. The area with the highest ESCI was always observed in the Urad Front Banner, while Linhe district had the highest ESDI. Although incoordination improved from mild to superior from 2000 to 2020 at the basin scale, significant spatial variations were observed at the county scale. In addition, the variation in CD was significantly correlated with population, followed by precipitation, and cropland area. The findings comprehensively explore the match and coordination between ES supply and demand, and the spatial heterogeneity of the effects of the influencing factors on CD. Our study can contribute to the formulation of future policies for regional ecological restoration and sustainable development.

In the ecologically fragile mining area of northwest China, high-intensity mining has seriously affected the aquifer and surface eco-environment. In order to better implement water-preserved mining in ecologically fragile areas, the aquifer failure characteristics should be first detected accurately; therefore, it is necessary to find a convenient and fast detection method. Based on the analysis of the basic principles and influencing factors of the magnetotelluric (MT) method, the feasibility of using the MT method to detect aquifer failure is verified by testing the mined area with MT detection and field borehole measurement. Subsequently, the failure characteristics of overburden and unconsolidated aquifers under high-intensity mining are studied by MT detection and physical simulation. By comparing the physical simulation with the field measurement from the aspects of the maximum surface subsidence, interval of periodic weighting and step cracks, the reliability of the height of the water flowing fracture zone and caving zone obtained from physical simulation is verified. The analysis from MT detection and physical simulation shows that the results of the two methods are in accord with each other, which further confirms that the MT method can be used to detect the failure of overburdened structures and aquifers. The penetrating fractures are the main channel for the downward seepage of water resources, which is caused by the “two-zone” of overburden model and located in the “dimple” shape in the apparent resistivity (AR) isogram. It can provide a reference and technical support for the corresponding new water-preserved mining technology and the construction of digital mines.

Background: Dysphagia may delay the functional recovery and substantially affects the quality of life after stroke, mainly if left untreated. Electrical stimulation has been reported as a treatment for pharyngeal dysphagia in recent studies, but the therapeutic effect of neuromuscular electrical stimulation (VitalStim) therapy lacks convincing supporting evidence and needs further clinical investigation. Methods: A total of 135 subjects were randomly divided into 3 groups: traditional swallowing therapy (n = 45), VitalStim therapy (n = 45), and VitalStim therapy plus traditional swallowing therapy (n = 45). The traditional swallowing therapy included basic training and direct food intake training. Electrical stimulation was applied by an occupational therapist, using a modifi ed handheld batterypowered electrical stimulator (VitalStim Dual Channel Unit and electrodes, Chattanooga Group, Hixson, Tennessee). The surface electromyography (sEMG), standardized swallowing assessment (SSA), videofl uoroscopic swallowing study (VFSS), and visual analog scale (VAS) were used to assess swallowing function before and 4 weeks after the treatment. Results: A total of 118 subjects with dysphagia completed the study, 40 in the traditional swallowing group and VitalStim therapy group and 38 in the VitalStim and traditional swallowing therapy group. There were signifi cant differences in sEMG values and SSA and VFSS scores in each group after the treatment ( P < .001). After 4-week treatment, sEMG value (917.1; standard deviation [SD], 91.2), SSA value (21.8; SD, 3.5), oral transit time (0.4; SD, 0.1), and pharyngeal transit time (0.8; SD, 0.1) were signifi cantly improved in the VitalStim and traditional swallowing therapy group than in the other 2 groups ( P < .001). Conclusions: Data suggest that VitalStim therapy coupled with traditional swallowing therapy may be benefi cial for poststroke dysphagia. [ABSTRACT FROM AUTHOR]

Background The needs of outpatient services, a key accessible health resource, are increasing in an increasingly aging population in China. So rational allocation of outpatient service resources to meet older people's health needs is a key to improving their health level. Objective To explore the factors affecting the utilization of outpatient services in the elderly, to provide feasible suggestions for improving older people's health level and the allocation of medical resources. Methods This study was conducted in 2021 using the data of older people (≥60 years old) attending the CHARLS 2018. The number of using outpatient services in these people in the past month prior to the CHARLS 2018 and associated factors were studied using a system developed based on the framework of Anderson's Behavioral Model of Health Services Use, with sex, age, marital status, the type of hukou (rural or urban), education level, smoking and drinking were classified as predisposing factors, health insurance, monthly household income per capita and the average distance from home to medical institutions as enabling factors, and chronic disease prevalence and self-rated health as need factors. The zero-inflated negative binomial regression (ZINB) was used to identify factors associated with the use of outpatient services. Results In all, 9 551 older people were included for analysis. Among them, non-users of outpatient services in the past month numbered 8 038 (84.16%), and one-time, two-time, and three or more-time users numbered 749 (7.84%), 367 (3.84%), and 397 (4.16%), respectively. The number of using outpatient services differed statistically by the type of hukou, education level, smoking, drinking, health insurance prevalence, monthly household income per capita, chronic disease prevalence, and self-rated health status (P