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Abstract Activated partial thromboplastin time (aPTT)-based clot waveform analysis (CWA) is a plasma-based global haemostatic assay. Elevated CWA parameters have been associated with hypercoagulability in venous thromboembolism, but its role in arterial thrombotic disease is uncertain. This study aims to explore the relationship between aPTT-based CWA and acute myocardial infarction (AMI) and its complications. In a retrospective cohort study of patients with AMI who underwent emergency cardiac catheterisation, pre-procedural aPTT and CWA parameters—min1, min2 and max2 were measured. These were compared against a control group of patients, consisting of patients who underwent elective orthopaedic and urological procedures. Within the AMI cohort, we also compared aPTT and CWA parameters of those with and without clinical complications of AMI. Results: Compared to controls (N = 109), patients with AMI (N = 214) had shorter aPTT (26.7 ± 3.3 s vs 27.9 ± 1.7 s, P

ObjectiveFocusing on digital health literacy， this study elucidated the current research status， focal points， and developmental trends in this field over the past decade through bibliometric analysis and knowledge mapping of relevant papers.MethodsUtilizing software such as CiteSpace and VOSviewer， this study analyzed literature on digital health literacy from 2012 to 2022 retrieved from the Web of Science （WoS） database， employing bibliometric approaches such as keyword co-occurrence， timeline clustering， keyword burst detection， and author collaboration networks.ResultsThe research generally exhibited a continuing upward trend in publication volume； application fields were concentrated in disciplines such as mathematics and medicine； keywords include healthcare， intervention measures， health management， and technological applications. Research in digital health literacy （DHL） has evolved from an early focus on mobile health and behavior change to mid-term focus on health information and internet technology， and more recently to a greater focus on mental health and information technology applications， as well as the application of digital health and mobile technology in health behaviors， reflecting the field’s continuous development towards diversification.ConclusionResearch on digital health literacy is steadily growing and has received widespread recognition and attention from the academic community. With the development of mobile technologies and data science， the field of DHL is expected to make more in-depth research and application breakthroughs in education， scientific research， healthcare， public health， and social welfare.

【Objective】In order to improve the confidentiality and performance of the mixed Radio Frequency (RF)/Free Space Optical (FSO) communication systems, it is necessary to study the security performance of the Reconfigurable Intelligent Surface (RIS)-assisted mixed RF/FSO system to obtain the relationship between system security performance and parameters such as RIS deployment location and the degree of correlation between different antennas branches.【Methods】In the article, a single eavesdropper is considered to eavesdrop against RF links and FSO links respectively, with RF links obeying an arbitrarily correlated Nakagami-m distribution and FSO links obeying a Gamma-Gamma distribution. Closed expressions for the Security Outage Probability (SOP) and Strictly Positive Security Capacity (SPSC) probability of the communication system for the two eavesdropping scenarios are derived using the decode-and-forward protocol, and the SOP is analyzed asymptotically. Simulation experiments are also conducted using the Matlab software to verify the accuracy of the derived formulas through Monte Carlo simulation.【Results】Simulation results show that deploying the RIS close to the receiver reduces the security outage probability of the system. It is also shown that an increase in the degree of antenna correlation increases the SOP of the system when the channel quality of the RF main channel is better compared to the eavesdropping channel.【Conclusion】The RIS-assisted FSO link has better security compared to the RF link. Although the multi-antenna diversity technique can effectively improve the security performance of the system, antenna correlation, similar to the fading caused by pointing error and atmospheric turbulence, can also damage the security performance of the system. It is also shown that the security of the system can be effectively improved by reducing the degree of antenna correlation.

There is an increasing need for virtual reality (VR) health applications. In the field of pain, VR has been used mainly as a distraction, with minimal use of VR to answer basic clinical questions. Pain is multifactorial and inherently threatening. Our lab recently designed two VR clinical environments with varying threat values; the present study sought to validate these environments. Subjects were randomly allocated into either the threatening or non-threatening VR consultation room and both subjective (threat questionnaire) and physiological (salivary cortisol) measurements were taken. As hypothesised, subjects in the threat condition recorded a higher threat score (p < 0.001; effect size = 0.76). There was a cortisol change across time in the threat condition (χ2(2) = 13.83, p < 0.001), but there were unexpected decreases at both 20 (p = 0.001) and 26 min (p = 0.03) following VR. While the physiological findings need further clarification, this study provides some validation of the threat value of our VR clinical tools. As such, these VR environments can potentially be used in pain experiments to help better our understanding of basic pain mechanisms. It is only with such understanding that we might offer new avenues for pain management.

With the rapid development of information technology, online learning of legal specialty in the era of artificial intelligence has become a significant trend. This study explores the pedagogical reform path of integrating course ideology into online learning for law majors. Multiple linear regression models and Apriori association rule algorithms were used to analyze the learning effects of 457 law students. The integration of the course Civics and Politics significantly impacted students’ learning outcomes, especially showing significant differences among students of different genders and grades. Different genders showed significant differences (p

Acid sphingomyelinase (ASM) is a sphingolipid metabolizing enzyme that catalyzes the hydrolysis of sphingomyelin to ceramide, and previous work has shown it is upregulated in models of Alzheimer’s disease. Here the authors demonstrate in a mouse model of Alzheimer’s disease that antibody-based immunotherapy targeting plasma ASM resulted in attenuated neuropathological features by suppressing pathogenic Th17 cells.

Objectives Thrombin generation assays and activated partial thromboplastin time (aPTT)-based clot waveform analysis (CWA), are some examples of global coagulation assays. Each modality evaluates different aspects of the clot forming process to globally define haemostasis with exclusive measurement parameters. Data on CWA are emerging, but its performance against other haemostatic assays is yet to be ascertained. This study evaluates the correlation between aPTT-based CWA and CAT parameters across a range of INR in warfarin-treated patients.Patients/Methods A prospective study consisting of patients on warfarin anticoagulation with varying INR levels. CWA and CAT were performed for the study subjects.Results 54 samples were included covering an INR range from 1.33–6.89, with a mean of 4.31 +/- 1.13. For CAT parameters, endogenous thrombin potential (ETP) and peak thrombin were assessed. Both unadjusted and adjusted (adjusted for final plateau transmittance) aPTT-based CWA were evaluated for parameters min1 (maximum velocity), min2 (maximum acceleration) and max2 (maximum deceleration). Peak thrombin showed significant correlation with all CWA parameters (min1: r = 0.435, P

A decoupling controller based on linear/nonlinear switching active disturbance rejection control (SADRC) is designed for a class of continuous linear nominal multi-input multi-output (MIMO) system. The system model is introduced and a linear matrix inequality (LMI) based absolute stability analysis approach is proposed for the designed SADRC decoupling controller. Finally, the effectiveness of the proposed method is verified by numerical simulations.

C20H15F5N2O3, orthorhombic, Pbca (no. 61), a = 10.9913 (4) Å, b = 11.0451(5) Å, c = 30.3925(14) Å, V = 3689.6 (3) Å3, Z = 8, R gt(F) = 0.0360, wR ref(F 2) = 0.0927, T = 170 K.

(1) Background: The activated partial thromboplastin time (APTT)- based clot waveform analysis (CWA) quantitatively extends information obtained from the APTT waveform through its derivatives. However, pre-analytical variables including reagent effects on the CWA parameters are poorly understood and must be standardized as a potential diagnostic assay. (2) Methods: CWA was first analysed with patient samples to understand reagent lot variation in three common APTT reagents: Pathromtin SL, Actin FS, and Actin FSL. A total of 1055 healthy volunteers were also recruited from seven institutions across the Asia-Pacific region and CWA data were collected with the Sysmex CS analysers. (3) Results: CWA parameters varied less than 10% between lots and the linear mixed model analysis showed few site-specific effects within the same reagent group. However, the CWA parameters were significantly different amongst all reagent groups and thus reagent-specific 95% reference intervals could be calculated using the nonparametric method. Post-hoc analysis showed some degree of influence by age and gender with weak correlation to the CWA (r < 0.3). (4) Conclusions: Reagent type significantly affects APTT-based CWA with minimal inter-laboratory variations with the same coagulometer series that allow for data pooling across laboratories with more evidence required for age- and gender-partitioning.

Abstract COVID-19 caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and other respiratory viral (non-CoV-2-RV) infections are associated with thrombotic complications. The differences in prothrombotic potential between SARS-CoV-2 and non-CoV-2-RV have not been well characterised. We compared the thrombotic rates between these two groups of patients directly and further delved into their coagulation profiles. In this single-center, retrospective cohort study, all consecutive COVID-19 and non-CoV-2-RV patients admitted between January 15th and April 10th 2020 were included. Coagulation parameters studied were prothrombin time and activated partial thromboplastin time and its associated clot waveform analysis (CWA) parameter, min1, min2 and max2. In the COVID-19 (n = 181) group there were two (1.0 event/1000-hospital-days) myocardial infarction events while one (1.8 event/1000-hospital-day) was reported in the non-CoV-2-RV (n = 165) group. These events occurred in patients who were severely ill. There were no venous thrombotic events. Coagulation parameters did not differ throughout the course of mild COVID-19. However, CWA parameters were significantly higher in severe COVID-19 compared with mild disease, suggesting hypercoagulability (min1: 6.48%/s vs 5.05%/s, P

Objective: The aim of the present study was to investigate the hypoglycemic effects of silkworm extract (SE) on experimental type 2 diabetes mellitus (T2DM) rats. Methods: SE was prepared by dissolving freeze-dried silkworm powder in 70% (v/v) aqueous ethanol. T2DM rats were induced by feeding them a high fat diet and an intraperitoneal injection of streptozotocin (STZ). The blood glucose, free fatty acid (FFA), malondialdehyde (MDA), tumor necrosis factor alpha (TNF-α) and superoxide dismutase (SOD) levels were detected by enzyme-linked immunosorbent assay (ELISA). The quality of SE was controlled by high performance liquid chromatography (HPLC; Agilent 1260, Agilent, USA). Hematoxylin-eosin (HE) staining was performed for histological evaluation. Antibody expression was assessed via immunohistochemistry (IHC) staining. Results: SE could improve insulin resistance and islet cell function by reducing FFA, MDA and TNF-α levels and increasing SOD level. In addition, pancreatic HE staining analysis revealed that SE has a protective effect on islet β-cells. Conclusions: The present study indicates that SE has hypoglycemic as well as pancreatic protective effects in T2DM model rats.

The measurement of the right and wrong results of cognitive tasks has important applications in many commercial and educational areas such as the drivers’ training system, the simulation training and online learning system. This Letter aims to distinguish the heartbeat pattern of cognitively wrong responses to that of cognitively right responses based on the electrocardiogram (ECG) through 36 subjects with different professional backgrounds. The experimental design methods were double-digit and five-digit addition/subtraction, which were blindly selected by subjects from a black box. Through the R–R interval (RRI) series obtained from the ECG data, some linear, nonlinear and moment features were extracted to evaluate the cognitive task results by using pattern recognition methods. The binary classification of RRI datasets indicated that autonomic nerve patterns of the right and wrong cognitive heartbeat responses were distinguishable.

In current supplier management business status of power enterprises, exists many common pain points, such as weak supplier data management, weak risk management awareness. With the intention of solving these problems, this research proposes a deep portrait system of suppliers of power enterprises by constructing full information database of suppliers, establishing a comprehensive evaluation index system of suppliers, and building a supplier label library. With the application of this system, this paper designs the business mechanism optimization scheme of the whole life cycle auxiliary management, which includes supplier qualification and performance verification, professional performance evaluation, market performance insight and risk control. This system proposed is of great significance to improve the lean level and informatization process of supplier management in power enterprises.

In the K-12 settings, teachers are encouraged to teach STEM subjects using a more integrated approach, and not be treated as stand-alone disciplines. STEM integration represents a way to think about curriculum change. It is a concept of how to restructure what is taught and what students learn. The nature of STEM disciplines no doubt creates certain challenges for STEM teachers. Despite researchers having made extensive progress in understanding of STEM integrative approaches, there are considerable barriers that relate to revolution of curriculum, assessment, and teaching practices in the K-12 STEM education system. For example, tools for assessing integrated STEM instruction have been developed, yet there has been limited implementation or adoption of teacher assessment for integrated STEM instruction. The purpose of this action research study was to understand how the preservice educators interpreted the language in the integrated STEM through AFNR rubric that was developed in 2018 (Wang & Knobloch, 2018). Four themes emerged when examining how preservice educators interpreted and applied the rubric for integrated STEM education: (1) Prejudgments based on prior knowledge and experiences, or course expectations informed interpretation of levels of STEM integration; (2) limited to no teaching experience resulted in novice interpretation of the integrated STEM lessons; (3) level one (Exploring) was a clean cut, but gray areas existed in interpreting levels two (Developing) and three (Advancing); and (4) the rubric was a tool that helped preservice educators reflect on the purpose of teaching certain content/concepts. Preservice educators also gave recommendations to improve the rubric. Additionally, they recommended more scaffolding, examples, expert modeling, group discussion, and experiences when learning to use the rubric.

In this paper, according to the characteristics of Dian Zhong Water Diversion Project, as big flow, small cross section, and insufficient escaping capacity, a numerical model of the project is developed. In addition, with analysis, a worst accident condition and operations dealing with it are developed and simulated by the numerical model. With the simulation results, a checking condition is suggested to the structure design.

The inter-basin water transfer project is one of the most important means to solve the uneven distribution of water resources in time and space, rationally allocate water resources, and promote the construction of water ecological civilization. Research on the operation impact and channel hydraulic response is meaning for the safe operation of long-distance water conveyance canals. Taking the Middle Route Project (MRP) of South-to-North Water Diversion (SNWD) as example, this paper built the onedimensional steady and unsteady flow model and investigated the impact of roughness change, emergency rescue technology and equipment, and sluice control failure. Results showed that increased roughness decreased the water diversion efficiency of MRP to some degree. The emergency rescue technology and equipment occupied the channel section and declined flow capacity. The occurrence of sluice control failure relatively played an increasing impact on upstream water level and a decreasing impact downstream water level and flow discharge. The impact of the above scenarios on the scheduling operation can be reduced to a certain extent by regular cleaning and maintenance, development of rational water emergency rescue project, development of staff skill, etc. This research can provide support for safe operation and regulation of the MRP of SNWD.

Drought is a worldwide natural disaster and has become an obstacle to the socio-economic development of the Daqinghe watershed in North China, the drought risk of which is analyzed in this study. PDSI is established and validated by the SPI, SRI, SMI, and agriculture drought-affect area in Baoding, a city in Daqinghe watershed. The result shows that PDSI performs well in describing the drought evolution, especially in the monthly scale. Then, the drought risk is assessed combining the drought hazard derived from PDSI with the exposed vulnerabilities consisting of the population, Gross Domestic Product (GDP), cropland area, and vegetation area. It indicates that the subwatersheds with high drought risk mainly concentrate in the downstream plain area.

The purpose of this paper is to investigate inter-tablet coating thickness variability based on different tablet shapes and filling levels. To achieve this goal, the Discrete Element Method (DEM) is applied, and efforts are made as following: For the first step, four different tablet shapes, referred to as Sphere, SRC (Standard Round Concave), Oval and Triangular, are built by importing three (except Sphere) CAD templates to create one or more spherical surfaces. Furthermore, a spray zone in the coating pan is presented to monitor the change of the “coating mass”, by virtue of which we calculate the inter-tablet coating variability. And to complete this work, custom contact models and properties are created to describe coating. Then, three different filling levels are added to the simulation. Eventually, the compared results are analyzed between three diverse filling degrees among tablet particles with four discrepant shapes.

High blood sugar is a symptom of diabetes mellitus (DM). Vascular endothelial cells (VECs) directly contact the blood and are damaged when blood sugar levels are high. However, the molecular mechanism underlying this process remains elusive. To analyze the effects of DM on migration, we simulated DM by applying high glucose (HG) to the human VEC. HG delayed cell migration and induced phosphorylation of MAPKs (JNK and ERK). By contrast, in presence of bFGF, cell migration was promoted and MAPK phosphorylation levels were reduced. Furthermore, treatment with JNK and ERK inhibitors rescued HG-mediated delay of cell migration. Molecular and cell biological studies demonstrated that HG increased ROS production, whereas treatment with bFGF or JNK/ERK inhibitors blocked HG-induced ROS accumulation. Addition of MnTMPyP, a ROS scavenger, reduced HG-induced ROS production and accelerated cell migration, suggesting that the influence of HG on bFGF-MAPK signaling causes accumulation of ROS, which in turn regulate cell migration. This is the first study to elucidate the molecular mechanism of HG-mediated VEC migration; these findings could facilitate the development of novel therapies for DM.

Spatial distribution pattern of biological related species present unique opportunities and challenges to explain species coexistence. In this study, we explored the spatial distributions and associations among congeneric species at both the species and genus levels to explain their coexistence through examining the similarities and differences at these two levels. We first used DNA and cluster analysis to confirmed the relative relationship of eight species within a 20 ha subtropical forest in southern China. We compared Diameter at breast height (DBH) classes, aggregation intensities and spatial patterns, associations, and distributions of four closely related species pairs to reveal similarities and differences at the species and genus levels. These comparisons provided insight into the mechanisms of coexistence of these congeners. O-ring statistics were used to measure spatial patterns of species. Ω0-10, the mean conspecific density within 10 m of a tree, was used as a measure of the intensity of aggregation of a species, and g-function was used to analyze spatial associations. Our results suggested that spatial aggregations were common, but the differences between spatial patterns were reduced at the genus level. Aggregation intensity clearly reduced at the genus level. Negative association frequencies decreased at the genus level, such that independent association was commonplace among all four genera. Relationships between more closely related species appeared to be more competitive at both the species and genus levels. The importance of competition on interactions is most likely influenced by similarity in lifestyle, and the habitat diversity within the species' distribution areas. Relatives with different lifestyles likely produce different distribution patterns through different interaction process. In order to fully understand the mechanisms generating spatial distributions of coexisting siblings, further research is required to determine the spatial patterns and associations at other classification levels.

One of the major symptoms of diabetes mellitus (DM) is delayed wound healing, which affects large populations of patients worldwide. However, the underlying mechanism behind this illness remains elusive. Skin wound healing requires a series of coordinated processes, including fibroblast cell proliferation and migration. Here, we simulate DM by application of high glucose (HG) in human foreskin primary fibroblast cells to analyze the molecular mechanism of DM effects on wound healing. The results indicate that HG, at a concentration of 30 mM, delay cell migration, but not cell proliferation. bFGF is known to promote cell migration that partially rescues HG effects on cell migration. Molecular and cell biology studies demonstrated that HG enhanced ROS production and repressed JNK phosphorylation, but did not affect Rac1 activity. JNK and Rac1 activation were known to be important for bFGF regulated cell migration. To further confirm DM effects on skin repair, a type 1 diabetic rat model was established, and we observed the efficacy of bFGF on both normal and diabetic rat skin repair. Furthermore, proteomic studies identified an increase of Annexin A2 protein nitration in HG-stressed fibroblasts and the nitration was protected by activation of bFGF signaling. Treatment with FGFR1 and JNK inhibitors delayed cell migration and increased Annexin A2 nitration levels, indicating that Annexin A2 nitration is modulated by bFGF signaling via activation of JNK. Together with these results, our data suggests that the HG-mediated delay of cell migration is linked to the inhibition of bFGF signaling, specifically through JNK suppression.