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Abstract Predicting the magnitude of herbicide impacts on marine primary productivity remains challenging because the extent of worldwide herbicide pollution in coastal waters and the concentration-response relationships of phytoplankton communities to multiple herbicides are unclear. By analyzing the spatiotemporal distribution of herbicides at 661 bay and gulf stations worldwide from 1990 to 2022, we determined median, third quartile and maximum concentrations of 12 triazine herbicides of 0.18 nmol L−1, 1.27 nmol L−1 and 29.50 nmol L−1 (95%Confidence Interval: CI 1.06, 1.47), respectively. Under current herbicide stress, phytoplankton primary productivity was inhibited by more than 5% at 25% of the sites and by more than 10% at 10% of the sites (95%CI 3.67, 4.34), due to the inhibition of highly abundant sensitive species, community structure/particle size succession (from Bacillariophyta to Dinophyceae and from nano-phytoplankton to micro-phytoplankton), and resulting growth rate reduction. Concurrently, due to food chain cascade effects, the dominant micro-zooplankton population shifted from larger copepod larvae to smaller unicellular ciliates, which might prolong the transmission process in marine food chain and reduce the primary productivity transmission efficiency. As herbicide application rates on farmlands worldwide are correlated with residues in their adjacent seas, a continued future increase in herbicide input may seriously affect the stability of coastal waters.

Abstract The indiscriminate distribution of a large number of unlicensed images through the Internet seriously harms the benefits of image owners, which prompts the study of image copyright protection solutions. Existing blockchain‐free solutions are limited to using centralized servers to store copyright information, leaving data vulnerable to being lost or tampered with by external attacks. Although the blockchain‐based image copyright protection solutions are capable of addressing the above problem, improvements are needed in choosing a suitable blockchain platform and supporting integrated copyright life cycle management. To this end, this paper designs a blockchain‐based reliable image copyright protection system named BB‐RICP using Hyperledger Fabric. For one thing, the adoption of Fabric mitigates the limitations of other blockchain platforms represented by Ethereum in terms of efficiency, economy, and availability. For another, BB‐RICP successes in achieving integrated copyright lifecycle management. In addition, BB‐RICP achieves enhanced applicability performance by firstly introducing GM algorithms recommended by Chinese national standard and adapting the more consortium blockchain‐oriented practical byzantine fault tolerance algorithm. Moreover, the adoption of spread spectrum watermarking brings convenience to users. Finally, Kubernetes is used to assist in the simulation of BB‐RICP to verify that users can operate reliably in the blockchain network.

In modern power systems, efficient ground fault line selection is crucial for maintaining stability and reliability within distribution networks, especially given the increasing demand for energy and integration of renewable energy sources. This systematic review aims to examine various artificial intelligence (AI) techniques employed in ground fault line selection, encompassing artificial neural networks, support vector machines, decision trees, fuzzy logic, genetic algorithms, and other emerging methods. This review separately discusses the application, strengths, limitations, and successful case studies of each technique, providing valuable insights for researchers and professionals in the field. Furthermore, this review investigates challenges faced by current AI approaches, such as data collection, algorithm performance, and real-time requirements. Lastly, the review highlights future trends and potential avenues for further research in the field, focusing on the promising potential of deep learning, big data analytics, and edge computing to further improve ground fault line selection in distribution networks, ultimately enhancing their overall efficiency, resilience, and adaptability to evolving demands.

Intelligent manufacturing (IM), sometimes referred to as smart manufacturing (SM), is the use of real-time data analysis, machine learning, and artificial intelligence (AI) in the production process to achieve the aforementioned efficiencies. Human-machine interaction technology has recently been a hot issue in smart manufacturing. The unique interactivity of virtual reality (VR) innovations makes it possible to create a virtual world and allow users to communicate with that environment, providing users with an interface to be immersed in the digital world of the smart factory. And virtual reality technology aims to stimulate the imagination and creativity of creators to the maximum extent possible for reconstructing the natural world in a virtual environment, generating new emotions, and transcending time and space in the familiar and unfamiliar virtual world. Recent years have seen a great leap in the development of intelligent manufacturing and virtual reality technologies, yet little research has been done to combine the two popular trends. To fill this gap, this paper specifically employs Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines to conduct a systematic review of the applications of virtual reality in smart manufacturing. Moreover, the practical challenges and the possible future direction will also be covered.

Abstract Objective Unequal utilization of medical services will have a significant impact on the consumption of resources entitled through health insurance claims of patients. With the proposal of the goal of Healthy China, it is essential to achieve the equity of medical service utilization of patients with rare diseases to further promote social equity and justice. To analyze the consumption of medical resources of rare disease patients, so as to explore how different medical insurance types impact patients’ medical resources consumption. This study pioneeringly used medical data from Peking Union Medical College Hospital. By analyzing the consumption data, this paper fills the research gap of existing studies on the analysis of medical service utilization inequality based on the perspective of insurance participation by examining the effects of different types of insurance coverage on medical resource consumption of hemophiliacs. At the same time, rare disease patients as a minority group have long been neglected in the analysis of medical resource consumption, and this paper fills the research gap of medical service utilization of this group to a certain extent by taking hemophiliacs as the object of analysis. Methods Based on the medical data of hemophilia patients in Peking Union Medical College Hospital from 2010 to 2020, we analyze the consumption of medical resources of the patients, and use a multiple regression model to explore how different medical insurance types impact patients’ medical resources consumption. Results The study has three main findings. Firstly, the disparity in medical expenditure among different hemophilia patients is quite obvious, and the drug expense accounts for a large proportion of the total cost. Secondly, the ratio of reimbursement is generally low, and there is a wide difference in the amount of reimbursement for different types of medical insurance. Thirdly, the resource consumption of patients with different medical insurance types differs a lot. Conclusion In order to improve the current medical insurance system and mechanism for providing orphan drugs, we put forward the following suggestions. First of all, the medical security system should expand its coverage to eliminate the medical expenditure gap between different hemophilia patients, therefore better promoting equity under the same insurance type. At the same time, the reimbursement level of medical expenses for patients with rare diseases should be appropriately improved, so as to reduce the financial burden of patients with rare diseases, and promote the realization of economic equity. In addition, society should pay special attention to the disadvantaged groups, reduce the differences between various medical insurance, and improve the level of health and equity of the whole society.

Sodium ion insertion plays a critical role in developing robust sodium-ion technologies (batteries and hybrid supercapacitors). Diffusion coefficient values of sodium (DNa+) in tin phosphide between 0.1 V and 2.0 V vs. Na/Na+ are systematically determined by galvanostatic intermittent titration technique (GITT), electrochemical impedance spectroscopy (EIS), and potentiostatic intermittent titration technique (PITT). These values range between 4.55 × 10−12 cm2 s−1 and 1.94 × 10−8 cm2 s−1 and depend on the insertion/de-insertion current and the thickness of the electrode materials. Additionally, DNa+ values differ between the first and second cation insertion because of the solid electrolyte interface (SEI) formation. DNa+ vs. insertion potential alters non-linearly in a “W” form due to the strong interactions of Na+ with tin phosphide particles. The results reveal that GITT is a more appropriate electrochemical technique than PITT and EIS for evaluating DNa+ in tin phosphide.

ObjectiveTo analyze the impact of the contract of family doctors in community-level in Beijing on residents’ medical expenses, so as to explore the efficacy of family physician contract service to facilitate the hierarchical treatment system. This study pioneeringly used the panel data of medical records and medical insurance settlement details provided by a community hospital in Beijing. By analyzing the correlation between family doctors and medical expenses, the study provided empirical support for the advancement of family doctor contracting in China.MethodsUsing the panel data of medical records and medical insurance settlement details of 5,851 residents in a community hospital in Beijing from January 2018 to May 2021 for a total of 41 months, mixed-effects model and random-effects model were used for analysis.ResultsThe contract of family doctor has significantly increased residents’ medical expenses. The types of medical insurance and whether patients with chronic diseases have a significant impact on residents’ medical expenses.ConclusionFamily doctor contracting increases the probability of residents seeing a doctor in community hospitals. Community family doctor contracting services should be vigorously promoted, especially for special groups such as chronic disease patients and the elderly. The increase in the contracting rate of family doctors will become an important starting point for promoting hierarchical medical system and increasing the primary treatment at the community-level.

The increasing number of newborns has stimulated the infant market. In particular, the baby stroller, serving as an important life partner for both babies and parents, has attracted more attention from society. Stroller design and functionality are of vital importance to babies' physiological and psychological health as well as brain development. Therefore, in this paper, we propose a modularization design method for the novel four-wheeled baby stroller based on the KANO model to ensure the mechanical safety and involve more functionalities. Manual control of the baby stroller requires the rapid response of human motor systems in a completely controlled manner, which could be a potential risk. To enhance the safety and stability of the stroller motion, especially in situations where manual control is hard to achieve (e.g., sharp turns), we propose an autonomous motion control scheme based on model predictive control. Both the modularization design and the motion controller are verified in the MATLAB simulation environment through path tracking tasks. The feasibility is validated by the satisfactory experimental results with lateral position error in a reasonable range and good trajectory smoothness.

Megremis, Walker at al. identify immunogenic epitopes in dermatomyositis patients. They identify antibodies recognizing a wider diversity of microbial antigens including poxviruses, and autoantibodies recognizing a large portion of the human proteome. Shared epitope homology between viral and human proteins suggests that molecular mimicry and epitope spreading events may play a role in dermatomyositis pathogenesis.

With the scarcity of fresh water resources and the increase in labor prices, rice cultivation is changing from transplanting to direct seeding. Weedy rice is a malignant weed with strong drought tolerance in seed germination in direct-seeding rice fields. As the same species of cultivated rice (Oryza sativa L.), weedy rice (Oryza sativa f. spontanea) has the potential of domestication into direct-seeding rice with strong drought tolerance in seed germination by changing a few unfavorable traits. The red pericarp, one of the harmful traits of weedy rice, seriously affects the quality and commercial value of cultivated rice. The recently developed CRISPR/Cas9 (Clustered Regular Interspaced Short Palindromic Repeats) technology can accurately edit the function of genes, providing a possibility for the directed evolution. Weedy rice (WRL-162) with red pericarp was used as a mutant material. Two mutation sites, upstream and downstream of the 14 bp differential fragment of exon 6 of Rc gene, were designed using the CRISPR-Cas9 gene-editing technique. Consequently, three mutant types in T1 generation weedy rice with CRISPR-Cas9 vector changed from red to white pericarp. One mutant type in T1 generation weedy rice with CRISPR-Cas9 vector maintained red pericarp. Comparing the wild type of weedy rice and rice variety control (Nipponbare), mutant types in T3 generation weedy rice without CRISPR-Cas9 vector significantly improved the drought resistance in seed germination. In addition, there was no significant difference in panicle number, seed setting rate per plant, grain length and width between wild type and T3 generation mutant weedy rice without CRISPR-Cas9 vector. Comparing the wild type, some mutant types in T3 generation weedy rice without CRISPR-Cas9 vector significantly decreased plant height, decreased spikelet number per main panicle, decreased plump seed number per main panicle, and increased 1000-grain weight. Our results showed that the Rc gene editing using CRISPR/Cas9 technology can not only remove the harmful pericarp character of weedy rice, but also improve drought tolerance in seed germination. This study might provide new insights for the utilization of weedy rice as germplasm resources for direct-seeding rice by precisely editing genes to remove unfavorable traits.

Abstract Mechanical cues are widely used for regulating cell behavior because of their overarching, extensive, and non‐invasive advantages. However, unlike chemical cues, mechanical cues are not efficient enough to determine cell fate independently and improving the mechanosensitivity of cells is rather challenging. In this study, the combined effect of chemical and mechanical cues on the osteogenic differentiation of human mesenchymal stem cells is examined. These results show that chemical cues such as the presence of an osteogenic medium, induce cells to secrete more collagen, and induce integrin for recruiting focal adhesion proteins that mature and cascade a series of events with the help of the mechanical force of the scaffold material. High‐resolution, highly ordered hollow‐micro‐frustum‐arrays using double‐layer lithography, combined with modified methacrylate gelatin loaded with pre‐defined soluble chemicals to provide both chemical and mechanical cues to cells. This approach ultimately facilitates the achievement of cellular osteodifferentiation and enhances bone repair efficiency in a model of femoral fracture in vivo in mice. Moreover, the results also reveal these pivotal roles of Integrin α2/Focal adhesion kinase/Ras homolog gene family member A/Large Tumor Suppressor 1/Yes‐associated protein in human mesenchymal stem cells osteogenic differentiation both in vitro and in vivo. Overall, these results show that chemical cues enhance the microtopographical sensitivity of cells.

(1) Background: Studies have reported that COVID-19 may increase the risk of malnutrition among patients. However, the prevalence of such risk in hospitalized COVID-19 patients is uncertain due to the inconsistent use of assessment methods. (2) Methods: PubMed, Web of Science, and EMBASE were searched to identify studies on the nutritional status of hospitalized COVID-19 patients. A pooled prevalence of malnutrition risk evaluated by Nutrition Risk Score (NRS-2002) was obtained using a random effects model. Differences by study-level characteristics were examined by hospitalization setting, time of assessment, age, and country. Risk of bias was assessed using the Newcastle–Ottawa Scale. (3) Results: 53 studies from 17 countries were identified and summarized. A total of 17 studies using NRS-2002, including 3614 COVID-19 patients were included in the primary meta-analysis. The pooled prevalence of risk of malnutrition was significantly higher among ICU patients (92.2%, 95% CI: 85.9% to 96.8%) than among general ward patients (70.7%, 95% CI: 56.4% to 83.2%) (p = 0.002). No significant differences were found between age groups (≥65 vs. p = 0.306) and countries (p = 0.893). (4) Conclusions: High risk of malnutrition is common and concerning in hospitalized patients with COVID-19, suggesting that malnutrition screening and nutritional support during hospitalization are needed.

Abstract Background Ectopic mandibular third molar is a rare clinical entity with incompletely known etiology. Here, we sought to delineate its epidemiological, clinical and radiographic characteristics, and therapy by integrating and analyzing the cases treated in our institution together with previously reported cases. Method A new definition and classification for ectopic mandibular third molar was proposed based on its anatomic location on panoramic images. Thirty-eight ectopic mandibular third molars in 37 patients and 51 teeth in 49 patients were identified in our disease registry and from literature (1990–2016), respectively. These cases were further categorized and compared according to our classification protocol. The demographic, clinicopathological and radiographic data were collected and analyzed. Results These ectopic teeth were categorized into four levels, 33 in level I(upper ramus), 32 in level II (middle ramus), 15 in level III (mandibular angle) and 9 in level IV (mandibular body). The common clinical presentations included pain, swelling and limited mouth opening, although sometimes asymptomatic. Most teeth were associated with pathological lesions. Treatments included clinical monitor and surgical removal by intra- or extraoral approach with favorable outcomes. Clinical presentations and treatment options for these teeth were significantly associated with their ectopic locations as we classified. Conclusions Ectopic mandibular third molars are usually found in patients with middle ages and in upper and middle ramus of mandible. Surgery is preferred to remove these ectopic teeth and associated pathologies when possible.

Lithium-ion capacitors (LICs) are attracting increasing attention because of their potential to bridge the electrochemical performance gap between batteries and supercapacitors. However, the commercial application of current LICs is still impeded by their inferior energy density, which is mainly due to the low capacity of the cathode. Therefore, tremendous efforts have been made in developing novel cathode materials with high capacity and excellent rate capability. Graphene-based nanomaterials have been recognized as one of the most promising cathodes for LICs due to their unique properties, and exciting progress has been achieved. Herein, in this review, the recent advances of graphene-based cathode materials for LICs are systematically summarized. Especially, the synthesis method, structure characterization and electrochemical performance of various graphene-based cathodes are comprehensively discussed and compared. Furthermore, their merits and limitations are also emphasized. Finally, a summary and outlook are presented to highlight some challenges of graphene-based cathode materials in the future applications of LICs.

BACKGROUND:Cervical cancer is the most common female malignancy in the developing nations and the third most common cancer in women globally. An effective, inexpensive and self-applied topical treatment would be an ideal solution for treatment of screen-detected, pre-invasive cervical disease in low resource settings. METHODS:Between 01/03/2013 and 01/08/2013, women attending Kenyatta National Hospital's Family Planning and Gynaecology Outpatients clinics were tested for HIV, HPV (Cervista®) and liquid based cervical cytology (LBC-ThinPrep®). HIV negative women diagnosed as high-risk HPV positive with high grade squamous intraepithelial lesions (HSIL) were examined by colposcopy and given a 2 week course of 1 capsule of Lopimune (CIPLA) twice daily, to be self-applied as a vaginal pessary. Colposcopy, HPV testing and LBC were repeated at 4 and 12 weeks post-start of treatment with a final punch biopsy at 3 months for histology. Primary outcome measures were acceptability of treatment with efficacy as a secondary consideration. RESULTS:A total of 23 women with HSIL were treated with Lopimune during which time no adverse reactions were reported. A maximum concentration of 10 ng/ml of lopinavir was detected in patient plasma 1 week after starting treatment. HPV was no longer detected in 12/23 (52.2%, 95%CI: 30.6-73.2%). Post-treatment cytology at 12 weeks on women with HSIL, showed 14/22 (63.6%, 95%CI: 40.6-82.8%) had no dysplasia and 4/22 (18.2%, 95%CI: 9.9-65.1%) were now low grade demonstrating a combined positive response in 81.8% of women of which 77.8% was confirmed by histology. These data are supported by colposcopic images, which show regression of cervical lesions. CONCLUSIONS:These results demonstrate the potential of Lopimune as a self-applied therapy for HPV infection and related cervical lesions. Since there were no serious adverse events or detectable post-treatment morbidity, this study indicates that further trials are clearly justified to define optimal regimes and the overall benefit of this therapy. TRIAL REGISTRATION:ISRCTN Registry 48776874.

The oncogenic retrovirus human T-cell lymphotropic virus type 1 (HTLV-1) is endemic in some countries although its prevalence and relationship with other sexually transmitted infections in Sub-Saharan Africa is largely unknown. A novel endpoint PCR method was used to analyse the prevalence of HTLV-1 proviral DNA in genomic DNA extracted from liquid based cytology (LBC) cervical smears and invasive cervical carcinomas (ICCs) obtained from human immunodeficiency virus-positive (HIV+ve) and HIV-negative (HIV−ve) Kenyan women. Patient sociodemographic details were recorded by structured questionnaire and these data analysed with respect to HIV status, human papillomavirus (HPV) type (Papilocheck®) and cytology. This showed 22/113 (19.5%) of LBC’s from HIV+ve patients were positive for HTLV-1 compared to 4/111 (3.6%) of those from HIV−ve women (p = 0.0002; odds ratio (OR) = 6.42 (2.07–26.56)). Only 1/37 (2.7%) of HIV+ve and none of the 44 HIV−ve ICC samples were positive for HTLV-1. There was also a significant correlation between HTLV-1 infection, numbers of sexual partners (p < 0.05) and smoking (p < 0.01). Using this unique method, these data suggest an unexpectedly high prevalence of HTLV-1 DNA in HIV+ve women in this geographical location. However, the low level of HTLV-1 detected in HIV+ve ICC samples was unexpected and the reasons for this are unclear.

BACKGROUND: XMRV (xenotropic murine leukaemia virus-related virus) is a gammaretrovirus first discovered in human prostate carcinomas and later linked to chronic fatigue syndrome (CFS). Emerging conflicting data and lack of reproducibility of results within the scientific community has now led to the association of XMRV with CFS being discounted. Indeed the case for an involvement with any human disease has been questioned with the suggestion that XMRV is a laboratory generated recombinant virus. The fact that not all published positive findings can be easily explained as contamination artefacts coupled with the observation that XMRV may have a sexually transmitted mode of infectivity and can be infectious for primates, where it preferential resides in cells of the reproductive tract, prompted us to look for evidence of XMRV in the cervical cells of a cohort of Kenyan women both with and without pre-existing HIV/HPV infections. RESULTS: Using a highly sensitive and selective triplex PCR approach we analysed DNA from the liquid based cytology (LBC) cervical smears of 224 Kenyan women. There was no evidence of XMRV expression in any of the sample population irrespective of HPV and/or HIV status. CONCLUSIONS: The data presented show no indication of XMRV infection in any of the cervical samples screened in this study. Approximately 50% of the women were HIV positive but this did not influence the findings signifying that XMRV does not act as an opportunistic infection in this cohort nor is it related to HPV status. Our results therefore support the findings that XMRV is confined to the laboratory and does not currently represent an infectious agent for humans, with a cautionary adage that such potential zoonotic viruses should be carefully monitored in the future.