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ObjectiveTo observe the differences in brain network activation and functional connectivity of patients with post-stroke cognitive impairment (PSCI) of different severity using functional near-infrared spectroscopy (fNIRS).MethodsA total of 40 stroke patients in the outpatient and inpatient Rehabilitation Department in the Pudong District of Huashan Hospital, Fudan University from April to November 2020 were recruited and divided into normal group (n=14), mild to moderate group (n=11) and severe group (n=15) according to the mini-mental state examination (MMSE) score. Fugl-Meyer assessment scale (FMA) and functional comprehensive assessment (FCA) were used to evaluate the motor function of upper and lower limbs; 64-channel fNIRS functional imaging device was used to collect the resting-state brain network data of patients. The whole brain functional connectivity was analyzed based on oxyhemoglobin (HbO2) and deoxyhemoglobin (HbR). Differences in functional connectivity strengths between homologous and heterologous brain networks in dorsal attention network (DAN), sensorimotor network (SEN), ventral attention network (VAN), frontoparietal network (FPN), default mode network (DMN) and visual network (VIS) regions were analyzed.Results(1) Motor function: there was no significant difference in FMA and FCA scores in three groups (P>0.05). (2) Whole brain functional connectivity and strength of homologous brain network functional connectivity: there was no significant difference in whole brain functional connectivity based on HbO2 and HbR in three groups (P>0.05). Compared with the normal group, there were significant differences in the strength of functional connectivity of the in the SEN and FPN regions of the HbO2-based homologous brain network in the severe group (PP>0.05). (3) Functional connectivity strength of heterologous brain networks: compared with the normal group, the functional connectivity of SEN-VAN, SEN-DMN, SEN-FPN, VAN-FPN and DMN-FPN in the severe group decreased significantly, and the differences were statistically significant (PPP>0.05). (4) Correlation analysis between SEN-FPN heterologous functional connectivity and MMSE, FCA scores: MMSE score (r=0.32, Pr=0.38, P

ObjectiveTo investigate the effect of multi-joint functional electrical stimulation (FES) combined with conventional rehabilitation therapy on lower limb motor function of patients with stroke.MethodsA total of 35 patients with lower limb motor dysfunction after stroke were admitted to the Department of Rehabilitation Medicine in the Huashan Hospital, Fudan University from January to December 2023. The patients were randomly divided into control group and experimental group by SPSS 25.0 statistical software, with 16 and 19 cases in each group, respectively. During the course of the treatment, one case in the control group dropped out due to early discharge, four cases in the experimental group discontinued or dropped out for various reasons, and finally 15 cases were included in each group. The control group received routine rehabilitation treatment and routine walking training. Routine rehabilitation treatment included stretching training, muscle strength training, joint mobility training, motor control training and functional mobility training for transfer, 40 minutes a time, once a day, five times a week for four weeks; routine walking training included pelvic control training, knee joint stability training, balance training, up and down stairs training, 20 minutes a time, once a day, five times a week for four weeks. The experimental group received multi-joint FES treatment in addition to the conventional rehabilitation treatment received in the control group, 20 minutes a time, once a day, five times a week for four weeks. Before treatment, two and four weeks after treatment, Fugl-Meyer assessment lower extremity (FMA-LE) was used to assess lower limb motor function; the JiBuEn three-dimensional gait analysis system was used to assess the walking speed, stride length, double support phase (the stage of the gait cycle in which both feet landed simultaneously), and average knee flexion and extension angles (the average of the maximum knee flexion and extension angles); the modified Barthel index (MBI) was used to assess the activities of daily living.Results(1) FMA-LE and MBI scores: compared with that before treatment, the FMA-LE and MBI scores of both groups increased significantly after two and four weeks of treatment, with statistically significant differences (PPPPPP

The issues of environment and health caused by emerging contaminants have become a worldwide focus. The sewage discharged from medical institutions is one of the important sources of emerging contaminants in the environment. During the current period of normalization of key infectious disease prevention and control, the concentration of emerging contaminants in medical wastewater has significantly increased, along with an increase of potential hazards to aquatic ecology. In response to such phenomena, the category and concentration of antibiotics,endocrine disrupting chemicals, and potential emerging contaminants in medical wastewater were discussed. The fate, removal rate, and contribution of emerging contaminants in medical wastewater to the environment was explored. Further the single compound toxicity and comprehensive toxicity of emerging contaminants in medical wastewater was elaborated. Finally, the current sewage discharge standards for medical institutions in China failure to control emerging contaminants was point out, the traditional sewage treatment processes were hard to effectively remove of emerging contaminants. Therefore, it was imperative to develop advanced techniques for standardized and tertiary treatment of medical wastewater.

Abstract Background Electronic medical record (EMR) systems provide timely access to clinical information and have been shown to improve medication safety. However, EMRs can also create opportunities for error, including system-related errors or errors that were unlikely or not possible with the use of paper medication charts. This study aimed to determine the detection and mitigation strategies adopted by a health district in Australia to target system-related errors and to explore stakeholder views on strategies needed to curb future system-related errors from emerging. Methods A qualitative descriptive study design was used comprising semi-structured interviews. Data were collected from three hospitals within a health district in Sydney, Australia, between September 2020 and May 2021. Interviews were conducted with EMR users and other key stakeholders (e.g. clinical informatics team members). Participants were asked to reflect on how system-related errors changed over time, and to describe approaches taken by their organisation to detect and mitigate these errors. Thematic analysis was conducted iteratively using a general inductive approach, where codes were assigned as themes emerged from the data. Results Interviews were conducted with 25 stakeholders. Participants reported that most system-related errors were detected by front-line clinicians. Following error detection, clinicians either reported system-related errors directly to the clinical informatics team or submitted reports to the incident information management system. System-related errors were also reported to be detected via reports run within the EMR, or during organisational processes such as incident investigations or system enhancement projects. EMR redesign was the main approach described by participants for mitigating system-related errors, however other strategies, like regular user education and minimising the use of hybrid systems, were also reported. Conclusions Initial detection of system-related errors relies heavily on front-line clinicians, however other organisational strategies that are proactive and layered can improve the systemic detection, investigation, and management of errors. Together with EMR design changes, complementary error mitigation strategies, including targeted staff education, can support safe EMR use and development.

Abstract Background More than 50% of people who die by suicide have not been in contact with formal mental health services. The rate of people who fly ‘under the radar’ of mental health services is higher among men than women, indicating a need to improve engagement strategies targeted towards men who experience suicidal thoughts and/or behaviours. In Australia, a range of mental health support services exist, designed specifically for men, yet, a substantial proportion of men do not use these services. The aim of this study is to evaluate whether a brief online video-based messaging intervention is an effective approach for encouraging men with suicidal thoughts and/or behaviours to engage with existing support services. Methods Informed by a literature review, surveys, and consultation with men with a lived experience of suicidal thoughts and/or behaviours, we designed five video-based messages that will be used in this five-arm randomised controlled trial. A total of 380 (76 per arm) men aged 18 years or older with suicidal thoughts who are not currently accessing formal mental health services will be recruited online and randomly assigned to watch one of the five web-based video messages. After viewing the video, men will be presented with information about four existing Australian support services, along with links to these services. The primary outcome will be help-seeking, operationalised as a click on any one of the four support service links, immediately after viewing the video. Secondary outcomes include immediate self-reported help-seeking intentions in addition to self-reported use of the support services during a 1-week follow-up period. We will also use the Discrete Choice Experiment methodology to determine what aspects of support services (e.g. low cost, short appointment wait times) are most valued by this group of men. Discussion This study is the first to evaluate the effectiveness of a brief web-based video messaging intervention for promoting engagement with existing support services among men with suicidal thoughts who are not currently receiving formal help. If found to be effective, this would represent a scalable, cost-effective approach to promote help-seeking for this at-risk population. Limitations and strengths of this study design are discussed.

In this article, the complete convergence and the Kolmogorov strong law of large numbers for weighted sums of (α,β)\left(\alpha ,\beta )-mixing random variables are presented. An application to simple linear errors-in-variables model is provided. Simulation studies are also carried out to support the theoretical results.

Sleep disorder after stroke are classified into sleep-disordered breathing (SDB), insomnia, excessive daytime sleepiness (EDS) and restless legs syndrome (RLS), which have a great impact on the prognosis of cognitive and motor functions and the quality of life of stroke patients. Rehabilitation treatment for sleep disorder in stroke patients should be initiated as early as possible. This study provides an overview of the pathogenesis and rehabilitation treatment of sleep disorder after stroke. The pathogenesis research of post-stroke sleep disorder mainly includes the pathogenesis of SDB [obstructive sleep apnea syndrome (OSAS), central sleep apnea syndrome (CSAS) and mixed sleep apnea syndrome (MSAS)], insomnia, EDS and RLS. Research on rehabilitation treatments for post-stroke sleep disorder mainly includes rehabilitation treatments for SDB [continuous positive airway pressure (CPAP), body positioning therapy, and oropharyngeal muscle training], insomnia [cognitive behavioral therapy (CBT), acupuncture, non-invasive transcranial neuromodulation techniques (low-frequency repetitive transcranial magnetic stimulation and transcranial direct current stimulation), and light therapy], EDS (CPAP and light therapy) and RLS (acupuncture). However, the pathogenesis of post-stroke sleep disorder is not yet fully clarified, and its basic research is still at the phenotypic determination stage. Issues such as treatment compliance, safety, and accuracy remain in rehabilitation treatment, and there is limited research on the rehabilitation of post-stroke EDS and RLS. Future explorations are needed on experimental animal models suitable for the basic research on post-stroke sleep disorder. In addition, more high-quality, large-sample, multicenter clinical randomized controlled trials are needed to provide references for the rehabilitation treatment of post-stroke sleep disorder.

Digital phenotyping is a promising method for advancing scalable detection and prediction methods in mental health research and practice. However, little is known about how digital phenotyping data are used to make inferences about youth mental health. We conducted a scoping review of 35 studies to better understand how passive sensing (e.g., Global Positioning System, microphone etc) and electronic usage data (e.g., social media use, device activity etc) collected via smartphones are used in detecting and predicting depression and/or anxiety in young people between 12 and 25 years-of-age. GPS and/or Wifi association logs and accelerometers were the most used sensors, although a wide variety of low-level features were extracted and computed (e.g., transition frequency, time spent in specific locations, uniformity of movement). Mobility and sociability patterns were explored in more studies compared to other behaviours such as sleep, phone use, and circadian movement. Studies used machine learning, statistical regression, and correlation analyses to examine relationships between variables. Results were mixed, but machine learning indicated that models using feature combinations (e.g., mobility, sociability, and sleep features) were better able to predict and detect symptoms of youth anxiety and/or depression when compared to models using single features (e.g., transition frequency). There was inconsistent reporting of age, gender, attrition, and phone characteristics (e.g., operating system, models), and all studies were assessed to have moderate to high risk of bias. To increase translation potential for clinical practice, we recommend the development of a standardised reporting framework to improve transparency and replicability of methodology.

Mild cognitive impairment (MCI) is a transition state between normal aging and dementia, in which a person is still able to be independent in daily activities, but memory and logical thinking skills may have a distinctly decline. In clinical practice, MCI has a high risk of progressing to dementia, so early treatment of MCI is crucial in delaying the onset and progression to dementia. Drug treatment is now the primary approach for MCI, but long-term drug treatment can lead to strong addictive tendencies and produce toxic side effects. Therefore, it is extremely urgent to explore effective rehabilitation training methods. Rehabilitation training for MCI patients mainly includes cognitive training, aerobic exercise, non-invasive brain stimulation (NIBS), and hyperbaric oxygen therapy, etc. Cognitive training is a kind of continuous stimulation of patients through multi-task combined pattern to rebuild the neural network in the brain so as to improve cognitive function. This intervention has been widely sought after by patients for its effectiveness in cognitive rehabilitation. Aerobic exercise is a kind of daily training mode, which aims to increase the perfusion of patients' brain tissue through the coordination of muscle groups, improve patients' reaction ability and cognitive function. Its training method is close to life which makes it easily accepted by patients. NIBS is an emerging technology characterized by simplicity and safety. It uses external devices to connect with the cerebral cortical areas and activate the corresponding functions in the brain, thereby improving cognitive function. Hyperbaric oxygen therapy is a relatively mature treatment method, which uses atmospheric pressure difference to effectively improve the oxygen content in brain tissue and blood flow, thereby stabilizing and controlling the blood oxygen saturation. It also has a significant therapeutic effect on brain tissue injury in MCI patients. Rehabilitation training has gradually caught the eye of the public due to its high safety and simple operation in clinical practice. Therefore, the common rehabilitation training methods have been summarized and generalized which could provide certain references for the development of clinical treatment programs.

The source and composition of hospital wastewater are complex，including pathogenic microorganisms，chemical drugs and metabolites，heavy metals，contrast agents，resistance genes，etc. When it in a special period of repeated outbreaks of Corona Virus Disease 2019（COVID-19）， the number of patients in the hospital is increasing rapidly，and the corresponding consumed therapeutic drugs，disinfectants，pathogenic microorganisms are increasing significantly. If the hospital wastewater is not effectively treated by cutting off the ways of pathogenic microorganisms and toxic and harmful substances into the environment，the risk caused by effluent would increase rapidly. This paper analyzes the current situation and problems of domestic hospital wastewater treatment，and clarifies the conventional and frontiers technologies on effluent treatment based on the main components and characteristics of hospital wastewater，and combines with the existing policies and technical specifications on hospital wastewater treatment. Finally，some relative countermeasures and constructive suggestions were proposed to provide some technical reference for the hospital wastewater treatment in China.

Visual snow syndrome(VSS)is a visual-disturbance disease characterized by continuous flickering tiny dots in the entire visual field, sometimes with visual symptoms like photophobia or nyctalopia and non-visual symptoms such as anxiety and depression.VSS can remain stable or worsen, causing distress to patients′ visual experience and mental state. The pathological mechanism of VSS is still unclear and a hypothesis indicates a relationship between VSS and increased cortical excitability of the visual cortex. Some case reports suggest anti-seizure medications, colored filters and TMS may help eliminate symptoms, but futher studies are required to verify these treatments. This review will systematically introduce what we know about VSS so far.

Abstract Introduction Preventing falls is a priority for aged care providers. Research to date has focused on fall prevention strategies in single settings (e.g., residential aged care (RAC) or community settings). However, some aged care providers deliver care, including fall prevention interventions, across RAC and community settings. We conducted an umbrella review to identify what type of fall prevention interventions had the greatest impact on falls outcomes in RAC and community settings. Methods Five databases were searched for systematic reviews of falls prevention randomised control trials in older adults living in the community or RAC. Data extracted included systematic review methods, population characteristics, intervention characteristics, setting details (RAC or community), and fall-related outcomes (falls, people who have had a fall, fall-related hospitalisations, and fall-related fractures). Review quality was appraised using the Assessment of Multiple Systematic Reviews-2 tool. Results One-hundred and six systematic reviews were included; 63 and 19 of these stratified results by community and RAC settings respectively, the remainder looked at both settings. The most common intervention types discussed in reviews included ‘exercise’ (61%, n = 65), ‘multifactorial’ (two or more intervention types delivered together) (26%, n = 28), and ‘vitamin D’ (18%, n = 19). In RAC and community settings, ‘exercise’ interventions demonstrated the most consistent reduction in falls and people who have had a fall compared to other intervention types. ‘Multifactorial’ interventions were also beneficial in both settings however demonstrated more consistent reduction in falls and people who fall in RAC settings compared to community settings. ‘Vitamin D’ interventions may be beneficial in community-dwelling populations but not in RAC settings. It was not possible to stratify fall-related hospitalisation and fall-related fracture outcomes by setting due to limited number of RAC-specific reviews (n = 3 and 0 respectively). Conclusion ‘Exercise’ interventions may be the most appropriate falls prevention intervention for older adults in RAC and community settings as it is beneficial for multiple fall-related outcomes (falls, fall-related fractures, and people who have had a fall). Augmenting ‘exercise’ interventions to become ‘multifactorial’ interventions may also improve the incidence of falls in both settings.

PurposeThe aim of this study was to evaluate the bioequivalence of two formulations of rupatadine (10-mg tablets) under fasting and fed conditions in healthy Chinese subjects.MethodsA total of 72 subjects were randomly assigned to the fasting cohort (n = 36) and fed cohort (n = 36). Each cohort includes four single-dose observation periods and 7-day washout intervals. Blood samples were collected at several timepoints for up to 72 h post-dose. The plasma concentration of rupatadine and the major active metabolites (desloratadine and 3-hydroxydesloratadine) were analyzed by a validated HPLC–MS/MS method. The non-compartmental analysis method was employed to determine the pharmacokinetic parameters. Based on the within-subject standard deviation of the reference formulation, a reference-scaled average bioequivalence or average bioequivalence method was used to evaluate the bioequivalence of the two formulations.ResultsFor the fasting status, the reference-scaled average bioequivalence method was used to evaluate the bioequivalence of the maximum observed rupatadine concentration (Cmax; subject standard deviation > 0.294), while the average bioequivalence method was used to evaluate the bioequivalence of the area under the rupatadine concentration–time curve from time 0 to the last detectable concentration (AUC0-t) and from time 0 to infinity (AUC0-∞). The geometric mean ratio (GMR) of the test/reference for Cmax was 95.91%, and the upper bound of the 95% confidence interval was 95.91%. For AUC0-t and AUC0-∞ comparisons, the GMR and 90% confidence interval (CI) were 98.76% (93.88%–103.90%) and 98.71% (93.93%–103.75%), respectively. For the fed status, the subject standard deviation values of Cmax, AUC0-t, and AUC0-∞ were all

BackgroundHome-based intervention occupies a prominent place in the treatment of autism spectrum disorder （ASD） in children， whereas previous studies on the effect of home-based early intensive behavioral intervention on verbal ability of children with ASD are somewhat inadequate.ObjectiveTo study the effects of intensive family behavioral of intervention based on Verbal Behavior Milestones Assessment and Placement Program （VB-MAPP） on the language ability of children with ASD， so as to provide references for the development of family intervention strategies for children with ASD.MethodsChildren aged 2 to 3 years old who attended the Children's Rehabilitation Department of the Second Affiliated Hospital of Shantou University Medical College from September 2020 to December 2021 and met the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） diagnostic criteria for ASD were selected as the study objects. A non-randomized concurrent control trial was conducted to compare a study group （n=24） receiving home-based early intensive behavioral intervention using VB-MAPP with a control group （n=14） receiving training from other special institutions or early childhood education institutions. The intervention lasted for 6 months in both groups. Before and after the intervention， the VB-MAPP milestone assessment was performed in the two groups， and the VB-MAPP milestone score， mand， trac and listener responds were selected as the study indicators. Then the intervention effect was compared between two groups， and the multiple linear regression was performed to screen the related influencing factors.ResultsAfter intervention， the total milestone assessment score， mand， tact and listener responds scores of study group were higher than those of control group， with statistical difference （Z=-4.339~-2.195， P

Green ecological control of stored grain pests is one of the important tasks to promote green grain storage. Predator mite control of stored grain pests is a biological control technology that employs ecological factors to suppress the population of stored grain pests. Cheyletus malaccensis control the pest populations by feeding on the eggs and larvae of insect pests and mites. As Cheyletus malaccensis is the dominant predatory mites in Chinese grain warehouse, it has several advantages, including wide distribution, large quantity, significant quantities, a broad predation spectrum, and high predation levels. This paper briefly described the control technique for stored grain pests by C. malaccensis and the advantages of control by C. malaccensis based on our team's researches in recent years. In addition, low-cost and convenient artificial propagation and release technologies have been developed. These methods are non-polluting, residue-free and are effective in preventing resistance within warehouse applications. This paper provides guidance for the green, ecological and safe stored grain pests comprehensive control and for reduced application of chemical pesticides.

Abstract Background Ventricular septal defect (VSD) is the most common subtype of congenital heart disease. In the present study, we aimed to determine whether chromosome aberration was associated with the occurrence of VSD and evaluate the association of VSD size, location and chromosome aberration with adverse outcomes in the Chinese fetuses. Methods Fetuses with VSD and comprehensive follow-up data were included and evaluated retrospectively. Medical records were used to collect epidemiological data and foetal outcomes. For VSD fetuses, conventional karyotype and microarray analysis were conducted. After adjusting confounding factors by using multivariable logistic regression analyses, the association between chromosome variations and VSD occurrence was explored. The association between defect size, location and chromosome aberrations and adverse foetal outcomes was also investigated. Results Chromosome aberration was the risk factor for VSD occurrence, raising 6.5-fold chance of developing VSD. Chromosome aberration, peri-membranous site and large defect size of VSD were significant risk factors of adverse fetal outcome. Chromosome aberrations, including pathogenic copy number variations (CNVs) and variations of uncertain significance (VUS), were both risk factors, increasing the risk of the adverse fetal outcome by 55.9 times and 6.7 times, respectively. The peri-membranous site would increase 5.3-fold risk and defects larger than 5 mm would increase the 7.1-fold risk for poor fetal outcome. Conclusions The current investigation revealed that chromosomal abnormalities, large defects, and the peri-membranous site were all risk factors for poor fetal outcomes. Our study also indicated that chromosome aberration was one of risk factors for the VSD occurrence.

Since the occurrence of landslide disasters is random and complex, which often causes serious economic losses to people's lives and even threatens life safety, establishing landslide early warning criteria and models is an important means to reduce losses. In this paper, the effective rainfall-deformation rate-improved tangent angle is determined as the key criterion for the early warning of rainfall-type step landslide. Then, the slope single-variable point method is applied to determine the “damage inflection point” and “stability inflection point” on the landslide “step” deformation curve to extract detailed information of the deformation acceleration interval, so as to solve the effective The threshold value of rainfall-deformation rate-improved tangent angle integrated warning criterion. Finally, a 4-stage progressive integrated warning model was established by combining the macroscopic deformation characteristics of the landslide at each stage of development and the spatial and temporal evolution laws. The results show that the transport form of landslide No. 1 in Machi Village is traction type, and the cumulative displacement curve shows typical “step” deformation characteristics under the excitation of rainfall factors. The deformation of landslide No. 1 in Machi village is affected by the early rainfall, and the time interval threshold between the early rainfall and the current rainfall is 10 d, and the corresponding rainfall thresholds in the “early + current rainfall” mode are 24 mm and 32 mm respectively. The study can provide theoretical basis and technical guidance for early warning of this type of landslide hazard.

This paper considers the supply chain composed of altruistic retailers and selfish manufacturers under risk aversion. We use the mean variance (MV) method to construct two types of behavior models. One is a two-stage supply chain model with a single manufacturer and a single retailer, and the other is a competitive supply chain model with two retailers and two manufacturers. We discuss the decision-making problems under manufacturer Stackelberg (MS) game and retailer Stackelberg (RS) game, respectively. We analyze the role of risk aversion and power structure. Results show that the more risk aversion manufacturers are, the lower the emission reduction levels are. It also find that the prices increase with power shift from retailers to manufacturers. Finally, we point out that the competing can help the firms earn more benefits via numerical studies.

Objective To identify barriers to hospital participation in controlled cluster trials of clinical decision support (CDS) and potential strategies for addressing barriers.Design Qualitative descriptive design comprising semistructured interviews.Setting Five hospitals in New South Wales and one hospital in Queensland, Australia.Participants Senior hospital staff, including department directors, chief information officers and those working in health informatics teams.Results 20 senior hospital staff took part. Barriers to hospital-level recruitment primarily related to perceptions of risk associated with not implementing CDS as a control site. Perceived risks included reductions in patient safety, reputational risk and increased likelihood that benefits would not be achieved following electronic medical record (EMR) implementation without CDS alerts in place. Senior staff recommended clear communication of trial information to all relevant stakeholders as a key strategy for boosting hospital-level participation in trials.Conclusion Hospital participation in controlled cluster trials of CDS is hindered by perceptions that adopting an EMR without CDS is risky for both patients and organisations. The improvements in safety expected to follow CDS implementation makes it challenging and counterintuitive for hospitals to implement EMR without incorporating CDS alerts for the purposes of a research trial. To counteract these barriers, clear communication regarding the evidence base and rationale for a controlled trial is needed.

Integrated management digitization is an important way to boost the competitiveness of commercial management enterprises. In this paper, we first design the functional architecture and system deployment of the commercial management enterprise digital system, including digital operation management, commercial operation data mining analysis, and other functional modules to meet the commercial operation management needs of commercial complexes, office buildings, and urban integrated operation business. The K-means clustering algorithm is then improved by using a particle swarm algorithm that is based on it. Specifically, the distribution estimation algorithm and stagnation perturbation strategy are used to update the population information and control the particle position boundary. Then, the greedy approach is used to select the advantageous particles. Then, the digital unified construction system of the commercial management enterprise is finally constructed to realize the data mining function of the operation and management and to assist the enterprise in carrying out customer management, property rights management, scientific decision-making, risk assessment, and so on. Finally, after testing the data analysis performance of the system, the business performance of the W commercial management group company that uses the system of this paper for digital transformation is analyzed. It is found that the accuracy of this paper's algorithm is the same as the PSO-Kmeans method. Still, the number of iterations of this paper's algorithm is the least; the lowest is only 14 times, and the optimization of efficiency is significant. The return on net assets and the net sales margin of W Commercial Management improved from 15.8% and 28.12% in 2016 to 20.20% and 28.12% in 2023. The debt repayment and operation ability are also optimized substantially, and the system designed in this paper The effectiveness of the developed system is proved. This study provides a proven solution for the digital transformation of commercial management enterprises and improves the operational efficiency of commercial management.

C31H28N2O2, triclinic, P1‾$P\overline{1}$ (no. 2), a = 9.0809(9) Å, b = 9.2626(9) Å, c = 14.8540(15) Å, α = 93.574(8)°, β = 98.554(8)°, γ = 99.558(8)°, V = 99.558(8) Å3, Z = 2, Rgt(F) = 0.0541, wRref(F2) = 0.1424, T = 293(2) K.

ObjectiveTo discuss the rehabilitation treatment methods and matters needing attention of one patient two years after replantation of ankle amputation, the rehabilitation evaluation and treatment were studied.MethodsAdopt comprehensive rehabilitation therapy methods such as joint mobility training, functional training, physical agents and so on. The changes from baseline to end-of-intervention were evaluated respectively by measuring ankle ROM, the score of BBS, NRS and the limb circumference.ResultsAfter 3 weeks of treatment, the range of ankle dorsiflexion and plantar flexion, balance function, aching feeling while walking and the strength of lower limb were significantly improved.ConclusionFor ankle amputation patients after replantation surgery, comprehensive rehabilitation therapy can significantly improve their function even in the period after surgery. However, rehabilitation training should be gradual, exercise intensity should be controlled according to objective standards, personalized and accurate rehabilitation treatment plans should be formulated in accordance with different surgical results.

Ultrasound was widely used in clinical practice as a tool for diagnosis and treatment. With the development of technology, the research and development of new algorithms and high-sensitivity ultrasound transducers have made up for the attenuation of ultrasound in the skull to a certain extent, and realized the application of ultrasound in the field of brain science. The advantages of ultrasound technology are non-invasive, safe, portable, low-cost and radiation-free, which has a great potential in the detection and rehabilitation of brain injury. Ultrasonic brain imaging techniques such as transcranial doppler (TCD), functional ultrasound imaging (fUS) and ultrasound localization microscopy (ULM) improve the signal to noise ratio by signal superposition or the cavitation effect of microbubbles, and achieve a higher resolution than CT and MRI in cerebral angiography. These ultrasound brain imaging techniques can obtain real-time images of brain tissue structures and quantify cerebral hemodynamic parameters. It can also be combined with EEG to simultaneously record the changes of the cerebral blood flow and neural activities, so as to conduct multi-dimensional evaluation of the neurovascular function after the occurrence of cerebrovascular disease. In terms of ultrasound treatment, transcranial focused ultrasound can penetrate the skull noninvasively and focus accurately on the cortex or deep brain tissues. High intensity focused ultrasound (HIFU) and low intensity focused ultrasound (LIFU) use the thermal and mechanical effects respectively to perform tissue ablation, blood-brain barrier opening, drug targeted delivery, ultrasound-assisted catheter-directed thrombolysis and neuromodulation, and can be applied to the treatment of brain tumors, brain trauma, stroke, Parkinson's disease, Alzheimer's disease, epilepsy, depression and other neurological diseases and mental diseases. At present, ultrasound brain imaging and therapeutic transcranial ultrasound are still in development. In the future, it is necessary to make further efforts to solve the problems such as cranial attenuation effect, 3D imaging development, establishment of the standard parameters on ultrasound neuromodulation and the reduction of the side effects in hearing. Meanwhile, more clinical researches will be conducted to provide strong support for the applications of ultrasound brain imaging and non-invasive transcranial ultrasound treatment in the diagnosis and rehabilitation of brain injury diseases.

BackgroundENN Science and Technology Development Co., Ltd. (ENN Fusion Technology R&D Center) is upgrading its compact fusion research facility EXL-50 to EXL-50U. Both devices are the conventional conductor tokamak, on which the magnet power supply system is composed by 1 TF (Toroidal Field) power supply, 1 CS (Center Solenoid) power supply and 10 PF (Poloidal Field) power supplies PF1-10. All 12 sets of power supply system are powered by 2 AC pulse generators and output DC current through thyristor-based converters.PurposeThis study aims to design EXL-50U magnet power supply for satisfying high parameter requirements of EXL-50U.MethodsPower supply capacity was the first concern for upgrading and the corresponding protection strategies under high parameter conditions was taken into account as well. The configuration of AC pulse generator was introduced at the beginning. Then transformers and converters were listed and designed in scheme. Control system and protection process were implemented respectively, followed by detail power supply system illustration and commissioning waveforms display for each power supply.ResultsThe reliability and controllability of developed power supply system are verified by the waveforms that forms plasma current under the condition of CS breakdown.ConclusionIt is proved that this power supply system can work stably, and output waveforms can be repeated no matter it works alone or under complex condition of joint debugging.

Objective To identify ulcerative colitis (UC) and Crohn's disease (CD) with aid of deep learning technology for endoscopists. Methods From January 2018 to November 2020, the endoscopic images of 1 576 subjects (including 34 300 CD, UC and normal images) were collected from the Department of Gastroenterology of Army Medical Center of PLA and Sir Run Run Shaw Hospital.The training set and test set were randomly divided according to the ratio of 9:1 to train and test the neural network.A novel spatial and bilinear deep network (SABA-ResNet) was constructed on the basis of ResNet50.The spatial attention mechanism was introduced, and the receptive field was expanded by dilated convolution to leverage contextual information, which was combined with the local induction of standard convolution to adaptively focus the lesion region.Bilinear attention was applied to improve the feature representation ability of the network, and the second-order information was used to weight the channel information of the feature map, so as to improve the classification performance of the model. Results The overall accuracy of SABA-ResNet for the recognition of CD, UC and normal tissues on the test set was 92.67%(95%CI: 91.91~93.37), the AUC value was 0.978(95%CI: 0.972~0.983), 0.977(95%CI: 0.971~0.982) and 0.999(95%CI: 0.998~1.000), the sensitivity was 88.40%, 89.07% and 98.89%, the specificity was 95.49%, 94.88% and 98.93%, and the F1 value was 88.80%, 89.01% and 98.60%, respectively.The ablation experiment and the class activation map suggested that spatial attention and bilinear attention could help the model capture more features of the lesion region. Conclusion Our constructed network combines spatial attention and bilinear attention, achieves excellent performance in the recognition of CD, UC and normal tissue, and effectively assist endoscopists in the diagnosis of UC and CD.

Objective To explore the application of deep-learning technology in automatic classification of intraventricular hemorrhage. Methods The brain CT images of 1 027 patients with spontaneous ICH from the First Affiliated Hospital of Army Medical University from January 2010 to December 2020 were collected and retrospectively analyzed, which were subsequently divided into 3 types: normal, intracerebral hemorrhage with/without intraventricular extension.Six typical deep networks, including DenseNet121, ResNet101, ResNet50, Swin-base, Vit-base and VGG16, were used to construct classification models for identifying whether there was intraventricular extension of intracerebral hemorrhage.The performance of each model was assessed on both the internal and external data sets (CQ500) respectively.In order to enhance the interpretability of the deep learning networks, the EigenGradCAM method was adopted to generate heatmaps for visualization of the interested regions of the model. Results The performance of the models was evaluated based on precision, recall rate, specificity, negative predictive value (NPV) and F1 value.On the internal test set of VGG16 model, the normal group achieved 0.983, 0.977, 0.984, 0.978 and 0.980, respectively; the intracerebral hemorrhage without intraventricular extension group achieved 0.917, 0.902, 0.965, 0.958 and 0.909;and the intraventricular extension of intracerebral hemorrhage group obtained 0.877, 0.911, 0.966, 0.976 and 0.894, respectively.Meanwhile, on the external test set of VGG16 model, the normal group reached 0.967, 0.870, 0.985, 0.938 and 0.916;the intracerebral hemorrhage without intraventricular extension group reached 0.827, 0.939, 0.902, 0.967 and 0.879;and the intraventricular extension of intracerebral hemorrhage group achieved 0.938, 0.906, 0.970, 0.954 and 0.922.The accuracy (ACC) of internal and external test sets was 0.940 and 0.905, respectively.Finally, the heatmaps generated by EigenGradCAM method showed the VGG16 could reasonably focus on the relevant areas. Conclusion The VGG16 achieved the best predictive performance for identifying whether there is an intraventricular extension in intracerebral hemorrhage or not, indicating that deep learning can be effectively applied to the judgement of intraventricular hemorrhage.

In this study, 1H magnetic resonance spectroscopy (1H MRS) was used to analyze metabolites in the hippocampus of chronic type 1 diabetes mellitus (T1DM) rats induced by streptozocin and T1DM rats treated with long-term insulin. The results showed that, compared with control rats and insulin-treated T1DM rats, the fasting blood glucose of T1DM rats increased significantly, while the body weight of T1DM rats decreased remarkably (p < 0.05). The contents of myo-inositol (Ins), taurine (Tau) and glutamate (Glu) of T1DM rats were significantly higher than those of control rats (p=0.000, p=0.003, p=0.014, respectively), and the contents of Ins and Tau of insulin-treated T1DM rats were significantly decreased than those in the T1DM diabetic rats (p=0.000, p=0.010, respectively). Contents of Glu and Glx (Glu and glutamine) of insulin-treated T1DM rats were significantly higher than those in the control group (p=0.007, p=0.042, respectively). The metabolite changes of Ins and Tau in hippocampus of T1DM rats are sensitive to insulin treatment.

Objective: To establish a method for simultaneous determination of wogonoside, 4'-hydroxywogonin, norwogonin, baicalein, wogonin and chrysin in health care products by high performance liquid chromatography （HPLC）. Methods: The samples were extracted with acetone, C18 solid phase extraction column was used for purification. The target compounds were determined by HPLC, quantified by matrix-matched standard curve method. Phenomenex Luna®C18（250 mm×4.6 mm, 5 μm）column was applied, mobile phase was acctonitrile-acetic acid, using gradient elution）at the flow rate of 1.0 mL/min. The temperature of column was 30 ℃ and the detection wavelength was set at 280 nm. Results: The results showed that these 6 target compounds had good separation and the corresponding concentration had a good linear relationship with the peak area. Correlation coefficients （R2） were all greater than 0.99, RSDs of precision and stability tests were within 3.08% and the average recoveries were 83%~100% （RSD＜4.63%）. The limits of detection were 0.02~0.07 mg/kg. The limits of quantification were 0.08~0.25 mg/kg. Conclusion: This method is suitable for simultaneous determination of flavonoids in health care products with good reproducibility, and less consumption of organic solvents.

Introduction Meta-analytical evidence confirms a range of interventions, including mindfulness, physical activity and sleep hygiene, can reduce psychological distress in university students. However, it is unclear which intervention is most effective. Artificial intelligence (AI)-driven adaptive trials may be an efficient method to determine what works best and for whom. The primary purpose of the study is to rank the effectiveness of mindfulness, physical activity, sleep hygiene and an active control on reducing distress, using a multiarm contextual bandit-based AI-adaptive trial method. Furthermore, the study will explore which interventions have the largest effect for students with different levels of baseline distress severity.Methods and analysis The Vibe Up study is a pragmatically oriented, decentralised AI-adaptive group sequential randomised controlled trial comparing the effectiveness of one of three brief, 2-week digital self-guided interventions (mindfulness, physical activity or sleep hygiene) or active control (ecological momentary assessment) in reducing self-reported psychological distress in Australian university students. The adaptive trial methodology involves up to 12 sequential mini-trials that allow for the optimisation of allocation ratios. The primary outcome is change in psychological distress (Depression, Anxiety and Stress Scale, 21-item version, DASS-21 total score) from preintervention to postintervention. Secondary outcomes include change in physical activity, sleep quality and mindfulness from preintervention to postintervention. Planned contrasts will compare the four groups (ie, the three intervention and control) using self-reported psychological distress at prespecified time points for interim analyses. The study aims to determine the best performing intervention, as well as ranking of other interventions.Ethics and dissemination Ethical approval was sought and obtained from the UNSW Sydney Human Research Ethics Committee (HREC A, HC200466). A trial protocol adhering to the requirements of the Guideline for Good Clinical Practice was prepared for and approved by the Sponsor, UNSW Sydney (Protocol number: HC200466_CTP).Trial registration number ACTRN12621001223820.

Dystonia is a specific type of abnormal movement characterized by involuntary movement, abnormal posture, or both due to persistent or intermittent muscle contractions. At present, symptomatic treatment is mainly used including a combination of psychological and rehabilitation treatments, oral medications, botulinum toxin injections and deep brain stimulation surgery. Existing animal studies suggested that the cerebellum affects dystonia through at least three mechanisms: 1) abnormal cerebellar efferent signal patterns; 2) abnormal connections between the cerebellum and basal ganglia nuclei; 3) abnormalities in the shape or structure of cerebellar cells. The specific role of cerebellum in dystonia has been explored from clinical and pathological observations, neuroelectrophysiology and neuroimaging. In the past, the main function of cerebellum was to maintain body balance and coordinate movement, while dystonia was mainly a disorder of basal ganglia. In recent years, with the development of the "cerebellum-thalamus-cerebral cortex" circuit, the cerebellum has been considered as a new node related to dystonia. As the role of cerebellum in dystonia becomes more and more important and non-invasive brain stimulation techniques have been developed, repetitive transcranial magnetic stimulation (rTMS) for cerebellum is gradually being used. Transcranial magnetic stimulation (TMS) is one of the most widely used neurophysiological techniques in human research. A magnetic field of varying intensity is applied to the central nervous system to generate local currents in the cerebral cortex. rTMS is the traditional mode of stimulation for TMS. Low frequency magnetic stimulation (≤1 Hz) inhibits cortical excitability in the stimulating region, while high frequency stimulation (>1 Hz) increases the excitability of cortical area of stimulation. Theta rhythm burst stimulation (θ rhythm burst stimulation, TBS) is a new type of rTMS. Intermittent TBS (iTBS) can increase excitability of thecortical area, while continuous TBS (cTBS) can inhibit activation of the cerebral cortex. Based on the theory of cerebellar-brain inhibition, TMS can improve symptoms by modulating cerebellar-brain inhibition. Stimulation of the cerebellar cortex by iTBS can inhibit the development of subsequent associative plasticity in the motor cortex, whereas inhibition of the cerebellar cortex by cTBS can enhance subsequent plasticity in the motor cortex. Therefore, cerebellum has gradually become a new regulatory target of higher brain functional stimulation.

Objective To investigate the dynamic changes of HBV serum markers (HBV-M) in pregnant women with HBV infection and its clinical significance. Methods A total of 302 infants delivered by HBV infected pregnant women registered and examined in our hospital from January 2016 to April 2020 were included. Serum HBV-M and HBV-DNA were detected in the 302 pregnant women during late pregnancy and in their infants aged 6~12 months (time point 1, T1) and 20~30 months (time point 2, T2). The dynamic changes and influencing factors were analyzed. Results For the infants, HBsAg was negative at both time points, and there were 301 cases of anti-HBs positive, 3 cases of HBeAg positive, 46 cases of anti-HBe positive and 207 cases of anti-HBc positive at T1, and all these indicators were decreased gradually with the age of infants. At T2, 8 cases of anti-HBs positive turned negative, while those of HBeAg, anti-HBe and anti-HBc positive turned negative. The lower the titer of T1 anti-HBs was, the more likely it was to turn negative. At T2, the titer of anti-HBs was not related to feeding mode, delivery mode and mother HBV DNA level. Conclusion Serum HBeAg, anti-HBe and anti-HBc are all derived from the mother and metabolized gradually. The success rate of mother-to-child prevention for HBV infected pregnant women is quite high. If the titer of the initial test is relatively low, the time of reexamination should be shortened.

The compatibility of Eucommia ulmoides gum (EUG) with other synthetic rubbers, the discovery of bio-metabolic synthesis of EUG, and the new research methods for crystallization of EUG were summarized with 59 references. In this review, the chemical modification methods and application in the fields of the tire, functional film materials, shape-memory materials of EUG were discussed in detail. And its development trends were also prospected.

A new methodology for realizing fabrication-tolerant planar directional couplers is proposed and experimentally demonstrated. Performance of power splitting and WDM couplers can be made highly tolerant to typical process errors when an appropriate center-to-center spacing is chosen due to changes in the mode area compensating waveguide edge to edge variation along a very specific design locus. Using this approach, 2–3% index contrast waveguide couplers were fabricated and tested, demonstrating the predicted improved fabrication tolerances. High index contrast silicon-on-insulator systems are also shown to exhibit the same mechanism. The high fabrication tolerance demonstrated is of particular importance for vertically stacked hybrid integration of different materials platforms, where achieving tight critical dimension control over significant physical topology is problematic. Additionally the method will be of utility in circumstances where tight tolerances are required on coupling ratios such as coupled resonator filter devices etc.

Objective To evaluate the predictive efficacy of serum pregenomic RNA (pgRNA) level in HBeAg clearance for chronic hepatitis B (CHB) patients treated with polyethylene glycol interferon alfa (PEG-IFN-α). Methods Twenty-five CHB patients with HBeAg positive and quantitative < 50 S/CO treated in our outpatient department from November 2015 to July 2019 were recruited in this prospective study. They were treated with PEG-IFN-α alone or combined with nucleoside and nucleotide analogs (NAs) for 48 to 96 weeks. After treatment, the patients were followed up in the clinic. According to whether HBeAg was cleared during treatment or follow-up, the patients were divided into HBeAg clearance group (HBeAg quantitative < 1.00 COI) and HBeAg non-clearance group (HBeAg ≥1.00 COI). The baseline characteristics and dynamic changes of virological indexes were analyzed for every patient during treatment. The predictive value of virological markers to HBeAg clearance was evaluated by binary logistic regression analysis and receiver operating characteristic (ROC) curve. Results At the end of treatment, 13 patients (13/25, 52.00%) achieved HBeAg clearance. There were significant differences in the levels of serum pgRNA and HBcrAg between the 2 groups at baseline (P < 0.05); Baseline pgRNA was significantly correlated with HBcrAg (r=0.575, P=0.003) and HBeAg (r=0.496, P=0.012), and baseline HBcrAg was significantly correlated with HBeAg (r=0.888, P < 0.001) and HBsAg (r=0.423, P=0.035). During the treatment, the overall level of HBeAg in 25 patients showed a downward trend when compared with the baseline level, and the decline of HBeAg level was greater in the HBeAg clearance group than the HBeAg non-clearance group at different time points (P < 0.05). From baseline to 12 weeks, the levels of pgRNA and HBsAg were decreased significantly, and its decline of pgRNA was more significant in the HBeAg clearance group than the non-clearance group (P < 0.05). During the whole treatment process, the level of HBcrAg was in a slow downward trend, and a significant decrease was observed only at 12 to 24 week in the HBeAg clearance group (P < 0.05), not at other time points. ROC curve analysis showed that baseline pgRNA and HBcrAg were good indicators to predict HBeAg clearance. Multivariate binary logistic regression analysis indicated that baseline pgRNA level was an independent predictor of HBeAg clearance after treatment (P < 0.05), with an AUC of 0.763, cutoff value of 2.42 log10 copies/mL, a sensitivity of 69.23% and a specificity of 53.85%. Conclusion Pretreatment serum level of pgRNA shows good predictive value for the efficacy of PEG-IFN-α in CHB patients with low HBeAg level.

Ectrodactyly–ectodermal dysplasia–cleft (EEC) syndrome is an autosomal dominant disorder characterized by ectrodactyly, ectodermal dysplasia, and orofacial clefting. Reduced penetrance is manifested in these core features and additional under-recognized features, especially in prenatal cases. Here, we present a fetus with EEC syndrome at 22 weeks gestation, in which the cleft lip and palate and the right polycystic kidney are shown by prenatal ultrasound. A de novo missense mutation of R304W in the TP63 gene is confirmed by whole-exome sequencing associated with EEC syndrome. We further investigate the reported TP63-related prenatal cases and provide a more complete picture of the prenatal phenotypic spectrum about EEC. It illustrates the potential severity of genitourinary anomalies in TP63-related disorders and highlights the need to counsel for the possibility of EEC syndrome, given the occurrence of genitourinary anomalies with orofacial cleft or limb deformities.

Objective To construct a three-dimensional of human hepatic functional unit through digital technology, and study its 3D shape and spatial adjoining relationship in order to understand the construction law of hepatic functional unit hepatic lobule cells. Methods We selected human hepatic lobule tissue, and used conventional paraffin serial sections, HE staining technology and microscope scanning to obtain hepatic lobule section in 4-μm thickness. We employed Photoshop software for image registration and used AMIRA software 2019.1 version for 3D reconstruction of hepatic functional unit which include hepatic lobule. Lobular contours, hepatic sinusoids, hepatocyte cords, central veins, interlobular arteries, veins and bile ducts were measured and studied for the tissue morphological parameters. Results A 3D digital model of the hepatic functional unit was reconstructed, and we founded that the contour of the hepatic lobule was irregularly round and blunt polygon structure with different edge lengths. The maximum diameter was 1 495.27 μm and the minimum diameter was 1 036.96 μm; The central vein of the hepatic lobule was not located in the middle of the hepatic lobule, at 322.38, 474.05, 878.7 and 880.16 μm, The hepatic sinusoids were interwoven vascular networks, which did not constitute a radial arrangement of blood vessel networks. Conclusion The Results of our 3D morphological study of hepatic lobule are different from the traditional anatomy textbooks and atlas, which not only update our knowledge of the structure of hepatic functional unit, and provide a 3D visualization image of the real human hepatic lobule structure. However, we think that the 3D morphology of hepatic functional unit structure is produced under the condition of hepatic lobule cell shaping development and reshaping redevelopment, therefore it provides a computer model for the 3D printing of hepatic lobule tissue cells.

Objective To construct a deep learning automatic segmentation model based on the magnetic resonance image (MRI) of the pelvic floor, and make the intelligent segmentation of the pelvic floor MR image so as to reduce the work intensity of doctors and improve the segmentation efficiency and accuracy of levator ani muscle. Methods Based on DenseUnet model, a network structure composed of encoder module, context extraction module and decoder module was established; In the context extraction module, we used dilated convolution and pyramid pooling module to overcome the disadvantages that Unet uses less context information and global information under different receptive fields. We employed the MRI data of 19 patients, including 14 normal cases, 1 case of grade 1 pelvic organ prolapse (POP1) and 2 cases of grade 2 pelvic organ prolapse (POP2) as training sets. One normal pelvic floor MRI image and 1 POP2 pelvic floor MR image were used for verification. Results The model can segment levator ani muscle in pelvic floor MR image automatically and effectively. Through verification, the average similarity coefficient of levator ani muscle in the test set is 77.1%, the average Hausdorff distance is 16 mm, and the average symmetry plane distance is 0.9 mm. The average similarity coefficient of levator ani muscle in normal volunteers was 81.2%, and that of POP2 female pelvic floor levator ani muscle was 74.5%. Conclusion The segmentation accuracy of DenseUnet model is better than that of Unet, ResUnet and Unet++. It has a strong practical value in the automatic segmentation task of levator ani muscle in MRI images. Through the automatic segmentation of levator ani muscle, the repetitive work of doctors is reduced, and the work efficiency is improved. At the same time, it also provides an alternative for the intelligent auxiliary diagnosis and treatment of pelvic organ prolapse.

Thermal barrier coating (TBC) is a kind of thermal insulation and protective ceramic material, which can effectively improve the working temperature and service life of aero-engine. It has important economic value and strategic position in this field. With the further improvement of thrust-to-weight ratio, the traditional YSZ coating no longer can meet the technical requirements of the new generation engine. In recent years, scholars both at home and abroad have shown that rare earth doping can improve the performance of TBCs to a certain extent. Therefore, rare earth doping modification has become the focus of the development of new high-performance TBCs. In this paper, the applications of rare earth doping in high-performance TBCs are summarized, with emphasis on the effects of rare earth doping on the mechanical, thermal-physical and corrosion resistance of TBCs to molten CMAS. The problem of performance deterioration of TBCs when rare earth is over doped and the deficiency in rare earth selection standard is discussed. Moreover, it is considered that the selection basis of rare earth doping amount and type will be the research focus of TBC materials in the next generation. How to further improves the performance of TBCs is the future development direction of rare earth doped TBCs.

In order to find out the types and distribution characteristics of stored-grain insect mites and provide basis for pest control in Anhui province, 59 grain-related places were investigated in 2016 and 2017.The survey results showed that a total of 51 species of 28 families and 7 orders of stored grain insects were founded in these areas, of which the amount of Coleoptera species was the largest, with a total of 40 species.According to the frequency，the main pests were Sitophilus oryzae (Linnaeus), Cryptolestes ferrugineus(Stephens), Tribolium castaneum (Herbst), Rhyzopertha dominica (Fabricius), with occurrence frequency of 100%, 76.3%, 66.1%, 64.4% respectively.The main occurrence of stored insects was in processing plants,and the species are abundant, accounting for 88% of the total species found, Among the three types of survey points including grain storage, processing plants and farmers, the main types of stored-grain insects were the same.The main types of occurrence were the same in different regions of the province, but the frequency of occurrence differed significantly.A total of 8 species of mites were collected, and a total of 5 species were identified.In addition, Anhui province had a rich variety of natural enemies of stored grain pests, mainly were parasitic wasps, scorpions and predatory mites.

Abstract Background Despite growing evidence that deprescribing can improve clinical outcomes, quality of life and reduce the likelihood of adverse drug events, the practice is not widespread, particularly in hospital settings. Clinical risk assessment tools, like the Drug Burden Index (DBI), can help prioritise patients for medication review and prioritise medications to deprescribe, but are not integrated within routine care. The aim of this study was to conduct formative usability testing of a computerised decision support (CDS) tool, based on DBI, to identify modifications required to the tool prior to trialling in practice. Methods Our CDS tool comprised a DBI MPage in the electronic medical record (clinical workspace) that facilitated review of a patient’s DBI and medication list, access to deprescribing resources, and the ability to deprescribe. Two rounds of scenario-based formative usability testing with think-aloud protocol were used. Seventeen end-users participated in the testing, including junior and senior doctors, and pharmacists. Results Participants expressed positive views about the DBI CDS tool but testing revealed a number of clear areas for improvement. These primarily related to terminology used (i.e. what is a DBI and how is it calculated?), and consistency of functionality and display. A key finding was that users wanted the CDS tool to look and function in a similar way to other decision support tools in the electronic medical record. Modifications were made to the CDS tool in response to user feedback. Conclusion Usability testing proved extremely useful for identifying components of our CDS tool that were confusing, difficult to locate or to understand. We recommend usability testing be adopted prior to implementation of any digital health intervention. We hope our revised CDS tool equips clinicians with the knowledge and confidence to consider discontinuation of inappropriate medications in routine care of hospitalised patients. In the next phase of our project, we plan to pilot test the tool in practice to evaluate its uptake and effectiveness in supporting deprescribing in routine hospital care.