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Abstract To investigate the effectiveness of cap-assisted endoscope synchronous advancement and tube direction adjustment for inserting transnasal ileus tubes in patients with malignant adhesive bowel obstruction (MABO). 25 patients with cap-assisted endoscopic synchronous method (Group A, Dec 2023–Apr 2024) were reviewed retrospectively. Accordingly, those with forceps-grasping method (Group B: 27, Aug 2022–Nov 2023) were included as controls. Both groups were similar in terms of age, sex, primary tumor, doctor experience distribution and technical success rate. The proportion of gynecological cancers was the highest in either group. The time required for insertion was shorter in Group A than in Group B (5 vs. 12 min; P = 0.000). Group A also had slightly longer tube insertion length than Group B (129.8 ± 14.1 vs. 121.3 ± 12.0 cm; P = 0.008), and the remission rate of intestinal obstruction symptoms in Group A was similar to that in Group B (75.0% vs. 74.1%; P = 0.940). There were no significant differences in complications between the two groups. One patient suffered MABO recurrence 14 days after withdrawal of the tube. Our findings indicate that transnasal ileus tube insertion with cap-assisted endoscopic synchronous method took shorter time and had the same rate of technical success and advantage of decompression compared with forceps-grasping method.

Cushion materials can effectively reduce the impact load acting on the rigid protective structures such as shed tunnel and improve the impact resistance of the structures. In order to investigate the variation of cushioning performance of recycled concrete aggregate (RCA) under successive impacts, drop weight impact tests and discrete element simulations are carried out. Test results show that compared with the quartz sand cushion, the transmitted load at the center of concrete shed for RCA under the first impact reduces by 83%, and it is distributed more uniformly. With the increase in the number of impacts, the cushioning performances of both the RCA and quartz sand deteriorate. For the sixth impact, the maximum transmitted loads at the center of concrete shed for RCA and quartz sand are 11.2 times and 1.4 times those of the first impact, respectively. Furthermore, the cushioning performance is strongly influenced by particle shape. The numerical simulation results show that when the proportion of strip particles increases from 0% to 100%, the rotation angle and translation distance of the particles decrease by 40% and 20%, respectively, and the maximum drop weight impact load increases by 37%. The inter-locking effect between particles increases with the irregularity of particle shape, which limits the rotation and translation of the particles, and increases the drop weight impact load and the transmitted load on the concrete slab. The research results may provide theoretical basis and engineering guidance for RCA as a new type of eco-friendly cushion.

ABSTRACT Molecular dynamics (MD) and the material point method (MPM) are both particle methods in spatial discretization. Molecular dynamics is a discrete particle method that is widely applied to predict fundamental physical properties and dynamic materials behaviors at nanoscale. The MPM is a continuum‐based particle method that was proposed about three decades ago to simulate large‐deformation problems involving multiphase interaction and failure evolution beyond the nanoscale. However, it is still a challenging task to validate MD responses against the experimental data due to the spatial limitation in impact and/or shock tests. The objective of this investigation is therefore to compare the MPM and MD solutions for the impact responses of porous solids at nanoscale. Since the governing equations for MD and explicit MPM are similar in temporal domain with different spatial discretization schemes, the MPM solutions could be verified against the MD ones, and the MD solutions might then be indirectly validated against the MPM ones as validated beyond the nanoscale. Since both MD forcing functions and MPM constitutive modeling are well‐formulated for metallic solids, we report a comprehensive comparative study of 40×40×40nm$40\ \times \ 40\ \times \ 40\ {\mathrm{nm}}$ porous and non‐porous gold cubic targets impacted by full density non‐porous gold cubic flyers using the MPM and MD, respectively. The overall deformation patterns and particle‐velocity histories are demonstrated and analyzed, as obtained with the two particle methods. It appears that the MD and MPM solutions are consistent in capturing the physical responses, which shows the potential of using the MPM for multiscale simulations of extreme events involving porous solids, such as underground penetration and space exploration. In addition, MD solutions might be indirectly validated against the MPM ones for evaluating geological responses to extreme loadings, which provides an alternative route for multiscale verification and validation. [ABSTRACT FROM AUTHOR]

As the global demographic shifts toward an aging population, aging-related problems, particularly in older individuals with dynapenia, are increasingly gaining attention. However, interventional studies focusing on physical and cognitive function and sleep quality in such individuals are limited, indicating a need for further exploration. The present study investigated the effects of whole-body vibration (WBV) training on physical and cognitive function and sleep quality in older people with dynapenia residing in long-term care institutions. This study was a randomized controlled trial. The experimental group underwent WBV training three times a week for 3 months, whereas the control group continued with their regular daily care routine. Statistical analyses were performed using the Traditional Chinese version of SAS Statistics version 9.4. Paired t tests, a one-way analysis of variance, independent t tests, and generalized estimating equation analysis were performed. The results revealed that compared with the control group, the experimental group experienced significant improvements in grip strength, instrumental activities of daily living, cognitive function, and sleep quality in terms of latency and duration. These findings suggest that 3 months of WBV training can effectively enhance physical and cognitive function and sleep quality in older people with dynapenia residing in long-term care institutions. [ABSTRACT FROM AUTHOR]

With the development of the new medical science, the traditional traditional education mode of morphology is facing to weakness and challenges. Under the guidance of learning by doing, we constructed a 3D model workshop as an innovative teaching platform. The questionnaire investigation showed that students were approved by the learning mode of 3D model workshop, which was helpful to improve students capacity building in terms of skill and exploration.

IntroductionMammographic density (MD) is a strong biomarker of breast cancer risk. MD increases after women start estrogen plus progestin therapy (EPT) and decreases after women quit EPT. A large interindividual variation in EPT-associated MD change has been observed, but few studies have investigated genetic predictors of the EPT-associated MD change. Here, we evaluate the association between polymorphisms in hormone metabolism pathway genes and MD changes when women quit EPT.MethodsWe collected mammograms before and after women quit EPT and genotyped 405 tagging single nucleotide polymorphisms (SNPs) in 30 hormone metabolism pathway genes in 284 non-Hispanic white participants of the California Teachers Study (CTS). Participants were ages 49 to 71 years at time of mammography taken after quitting EPT. We assessed percent MD using a computer-assisted method. MD change was calculated by subtracting MD of an 'off-EPT' mammogram from MD of an 'on-EPT' (that is baseline) mammogram. Linear regression analysis was used to investigate the SNP-MD change association, adjusting for the baseline 'on-EPT' MD, age and BMI at time of baseline mammogram, and time interval and BMI change between the two mammograms. An overall pathway and gene-level summary was obtained using the adaptive rank truncated product (ARTP) test. We calculated 'P values adjusted for correlated tests (P(ACT))' to account for multiple testing within a gene.ResultsThe strongest associations were observed for rs7489119 in SLCO1B1, and rs5933863 in ARSC. SLCO1B1 and ARSC are involved in excretion and activation of estrogen metabolites of EPT, respectively. MD change after quitting was 4.2% smaller per minor allele of rs7489119 (P = 0.0008; P(ACT) = 0.018) and 1.9% larger per minor allele of rs5933863 (P = 0.013; P(ACT) = 0.025). These individual SNP associations did not reach statistical significance when we further used Bonferroni correction to consider the number of tested genes. The pathway level summary ARTP P value was not statistically significant.ConclusionsData from this longitudinal study of EPT quitters suggest that genetic variation in two hormone metabolism pathway genes, SLCO1B1 and ARSC, may be associated with change in MD after women stop using EPT. Larger longitudinal studies are needed to confirm our findings.

Background Recent studies suggest that 5α-reductase inhibitors (5ARIs) for benign prostate hyperplasia (BPH) result in abnormal retinal anatomical alteration. Objective To compare age-related macular degeneration (AMD) incidence in BPH patients receiving 5ARIs or tamsulosin. Design Retrospective, population-based cohort study using new-user and active-comparator design. Setting General population. Subjects Males with BPH, newly receiving 5ARIs or tamsulosin from 2010 to 2018. Methods Data were extracted from Taiwan's National Health Insurance Research Database. We used Cox proportional hazards model with 1:4 propensity score (PS) matching, based on intention-to-treat analysis to determine the risk of incident AMD. Sensitivity analyses included an as-treated approach and weighting-based PS methods. We also separately reported the risks of incident AMD in patients receiving finasteride and dutasteride to determine risk differences among different 5ARIs. Results We included 13 586 5ARIs users (mean age: 69 years) and 54 344 tamsulosin users (mean age: 68.37 years). After a mean follow-up of 3.7 years, no differences were observed in the risk of incident AMD between 5ARIs and tamsulosin users [hazard ratio (HR): 1.06; 95% confidence intervals (95% CI): 0.98–1.15], with similar results from sensitivity analyses. However, increased risk of incident age-related macular degeneration was observed in patients receiving dutasteride [HR: 1.13; 95% CI: 1.02–1.25], but not in those receiving finasteride [HR: 0.99; 95% CI: 0.87–1.12], in the subgroup analyses. Conclusions We found no difference between 5ARIs and tamsulosin regarding the incidence of AMD in BPH patients. However, the risk profiles for AMD differed slightly between dutasteride and finasteride, suggesting that the potency of androgen inhibition is a factor related to AMD incidence. [ABSTRACT FROM AUTHOR]