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Abstract Background Medical dispute is a global public health issue, which has been garnering increasing attention. In this study, we used machine learning (ML) method to establish a dispute prediction model and explored the clinical-application efficiency of this model in effectively reducing the occurrence of medical disputes. Methods Retrospective study of All disputes filed by Gansu Medical Mediation Committee from 2019 to 2021 and patients with the same hospital level as that of the dispute group and hospitalization year were randomly selected as the control group in 1:1 ratio. SPSS software was used for univariate feature selection of the 14 factors that may cause disputes, and factors with statistical differences were selected. The data were divided into training and test sets in a 7:3 ratio. Six ML models were selected, and Python was used to establish a dispute prediction model. The area under the curve (AUC) of the receiver operating characteristic curve (ROC), sensitivity, specificity, accuracy, precision, average precision (AP), and F1 score were used to characterize the fitting and accuracy of the models, while decision curve analysis (DCA) was used to evaluate their clinical utility. Results A total of 1189 patients in the dispute and control groups were extracted. Following 11 influencing factors were selected: the inpatient department, doctor title, patient age, patient gender, patient occupation, payment method, hospitalization days, hospitalization times, discharge method, blood transfusion volume, and hospitalization espenses. Compared to other models, the AUC (0.945, 95% CI 0.913–0.981), Sensitivity (0.887), Accuracy (0.887), AP (0.834), and F1 score (0.880) of the random forest model were higher than those of other models, while the DCA curve indicated its high clinical benefits. Conclusions Inpatient department, hospitalization expenses, and discharge type are the primary influencing factors of dispute. Random forest exhibited high dispute prediction and clinical-application value and is expected to be promoted for offline dispute prediction.

This work investigates the influence of erbium (Er) content on the microstructure, mechanical properties, and corrosion behavior of T6 state AA6061 sheets. The findings reveal that nanoscale Al(Fe, Mn)Si particles are the main factors hindering dislocation motion and grain boundaries (GBs) migration. The addition of an appropriate amount of Er (0.6 wt%) effectively inhibits the precipitation of nanoscale Al(Fe, Mn)Si particles, promoting dislocation motion and grain boundary migration, thus significantly enhancing the alloy's plasticity. Furthermore, the sufficient migration of GBs leads to an increase in grain size, significantly reducing the quantity of GBs. This reduces the path for the propagation of corrosion cracks, resulting in improved corrosion resistance. Simultaneously, the addition of an appropriate amount of Er refines the coarse iron-rich phases into short rod-shaped Er-containing iron-rich phases with lower height and potential. This enables the alloy to obtain a more uniform oxide film and significantly reduces the tendency for microgalvanic corrosion, which is conducive to slowing down the initiation of corrosion. However, excessive Er addition (0.8–1.4 wt%) lead to the extensive precipitation of Er-containing iron-rich phases and nanoscale Al(Fe, Mn)Si particles, along with a continuous increase in the number of GBs, adversely affecting the plasticity and corrosion resistance of the alloy. This work offers a new strategy for obtaining 6XXX series alloys with excellent plasticity and corrosion resistance.

IntroductionThis study aims to investigate whether exercise adherence and positive mental character significantly affect subjective well-being among Chinese college students during the COVID-19 pandemic and whether positive mental character plays a mediating role.MethodsThe study employed questionnaires, including the Exercise Adherence Scale, the Positive Mental Character Scale, and the Subjective Well-Being Scale, which were administered to students across seven universities in Henan Province, China. A total of 1,001 participants were analyzed in the final sample. Data were analyzed using SPSS 21.0 for descriptive statistics, independent samples T-test, correlation, and regression analyses. Furthermore, structural equation model with AMOS was conducted to examine the potential mediating effect of positive mental characteristics on the relationship between exercise adherence and subjective well-being.ResultsThe results indicated significant differences in exercise adherence, positive mental character, and subjective well-being between male and female participants, with males scoring higher in all three domains. Among Chinese university students during the COVID-19 pandemic, there was a significant correlation among exercise adherence, positive mental character, and subjective well-being. Exercise adherence was found to have a significant and positive impact on both positive mental character and subjective well-being. Additionally, it was found that positive mental character had a significant positive association with subjective well-being. The mediating role of positive mental character in the relationship between exercise adherence and subjective well-being was partially supported.DiscussionExercise adherence among Chinese college students had a significant positive association on both positive mental character and subjective well-being throughout the COVID-19 pandemic. The exercise adherence can directly or indirectly enhance subjective well-being through its association with positive mental character. Therefore, positive mental and subjective well-being can be enhanced by consistent physical activity even during a pandemic.

Introduction: Ischemic stroke is the second most common chronic disease worldwide and is associated with high morbidity and mortality. Thromboembolism and platelet aggregation are the most characteristic features of stroke. Other than aspirin, no standard, accepted, or effective treatment for acute ischemic stroke has been established. Consequently, it is essential to identify novel therapeutic compounds for this condition.Methods: In this study, novel ozagrel/paeonol-containing codrugs were synthesized and characterized using 1H-NMR, 13C-NMR, and mass spectroscopy. Their antiplatelet aggregation activity was evaluated, with compound PNC3 found to exhibit the best effect. Subsequently, studies were conducted to assess its neuroprotective effect, pharmacokinetic properties and model its binding mode to P2Y12 and TXA2, two proteins critical for platelet aggregation.Results: The results indicated that PNC3 has good bioavailability and exerts protective effects against oxygen-glucose deprivation injury in PC12 cells. Molecular docking analysis further demonstrated that the compound interacts with residues located in the active binding sites of the target proteins.Conclusion: The codrugs synthesized in this study display promising pharmacological activities and have the potential for development as an oral formulation.

In this work, a series of isothermal hot compression tests were performed at the temperature of 900–1150 °C with the strain rate ranging from 0.01 to 10s−1 in Inconel X-750 alloy (referred as Alloy X-750). Based on the flow stress data, the back-propagation artificial neural network model was utilized to accurately predict the flow stress at elevated temperatures. Subsequently, by constructing a modified hot processing map coupled with the variation of Σ3n (n = 1, 2, and 3) twin boundaries fraction, the optimal processing parameters were determined to be in the range of 1100–1150 °C and 1-10s−1 for Alloy X-750. Moreover, the possibility of grain boundary engineering via hot deformation were also evaluated by using some critical quantification descriptors of twin related domains (TRDs), such as the number of grains in the TRDs, the lengths of the longest chain, and the average TRDs size. All the results can further verify the validity of modified hot processing map. Finally, the high-temperature flow behavior combined with the relevant microstructure characterization showed that discontinuous dynamic recrystallization is considered as the predominant softening mechanism, while the continuous dynamic recrystallization and particle-stimulated nucleation also additionally contribute to the recrystallization nucleation during the hot deformation of Alloy X-750.

The isothermally hot compression tests of Incoloy 925 were conducted over a temperature range of 900–1150 °C and strain rate of 0.01–10 s−1 to investigate the dynamic recrystallization (DRX) kinetics behavior and its effect on the microstructure evolution. The values of DRX fraction under different deformation conditions were evaluated through electron backscatter diffraction analysis combined with artificial neural network approach. The DRX behavior was also investigated based on the traditional Avrami-DRX kinetics model and the strain-rate dependent Avrami-DRX kinetics model modified by genetic algorithm & BiHill function, respectively. The results reflected that the modified model shows a better robustness to describe the DRX behavior under the deformation condition with a relatively low DRX fraction or at the domain with higher strain rate. Besides, the crystallographic orientation parallel to the compressive direction tends to form the fiber highlighted by the deformed grains, while the predominant orientations of DRX grains show a tendency towards fiber. Moreover, the transition rule of the main DRX mechanism was further studied by discussing the linear relationship between the Z parameter and DRX grain size.

Inflammatory bowel disease (IBD) is a chronic, recurrent, and refractory inflammatory disease of the gastrointestinal tract, accompanied by inflammatory cell infiltration and damage to the intestinal mucosa, with a certain risk of cancer. A large number of studies have shown that dietary fiber, as a prebiotic, has significant effects in improving intestinal flora structure, strengthening intestinal barrier function, alleviating intestinal inflammation and other aspects, with multiple nutritional and health functions, showing great potential in the intervention of IBD, but the mechanism of action remains unclear. In addition, DFs can be classified into soluble dietary fiber (SDF) and insoluble dietary fiber (IDF) according to their water solubility, which have different characteristics and effects on IBD. Therefore, this paper reviews the basic principles, existing evidence and mechanism of SDF and IDF in the prevention and treatment of IBD, and comprehensively analyzes DFs intervention strategies for IBD, so as to provide reference for further research, development and application of DFs.

Runoff generated by heavy rainfall in natural catchment area and caused by ditch clogging in artificial structure increases the instability of the slope. The effects of runoff are usually neglected in traditional rainfall-induced slope failure analysis. In order to consider the effects of runoff on the slope instability, this study attempts to simulate the runoff, infiltration and slope instabilities simultaneously on both wide/narrow area. For this purpose, this study firstly proposes a coupled model of surface flow, subsurface flow, and soil mechanics based on Diffusion wave equations, Richards’s equation, Green-Ampt infiltration capacity model, and local factor of safety approach in wide area simulation. Next, snowmelt and surface grass layer are additionally considered in narrow area simulation. Finally, the proposed coupled model is applied to two slopes at Nissho Pass and Kuromatsunai in Hokkaido, Japan. The slope instabilities assessment approach provides an effective method for simulating runoff and slope instabilities. In wide area, the distribution map of the factor of safety has significant implications for precisely determining the dangerous spots and accurately releasing the warning information. In narrow area, the slope disaster points caused by the ditch clogging are extracted and effect of grass layer on slope stability assessment is demonstrated. The construction and maintenance of the drainage system can be re-designed to ensure all the surface flow caused by the precipitation drain out smoothly.

Quantum key distribution (QKD) has rapidly developed recently. The repetition frequency of the QKD system increases from tens or hundreds of MHz to GHz. A laser diode (LD) operating in gain-switched mode is widely used as a weak coherent light source in a QKD system. We present an LD driver circuit fabricated in 0.18 μm SiGe heterojunction bipolar transistor bipolar complementary metal oxide semiconductor technology. The circuit can operate at frequencies up to 2.5 GHz, satisfying the requirements of high-speed laser drives in practical QKD systems. The output current of the driver circuit can reach 100 mA when driving an LD whose input equivalent resistance is ∼21 Ω. The extinction ratio of the 1550-nm distributed feedback LD light source driven by our driver circuit reaches 23 dB at the operating frequency of 2.5 GHz, meeting the requirements of QKD systems. This circuit will be used in miniaturized QKD systems.

Abstract To semi-quantitatively assess the effects of climate change on the slope failures, this paper proposes an effective approach for evaluating the influences of climate change on slope stability in seasonally cold regions. To discuss climate change, this study firstly analyzes the trend of the two main climate factors (precipitation and air temperature) based on the regression analysis results of the meteorological monitoring data during the past 120 years in different scales (e.g., world, country (Japan), and city (Sapporo)), and the downscaled outputs of three different regional atmospheric models (RAMs) with lateral boundary conditions from three different general circulation models (GCMs). Next, to discuss the effects of different climate factors (air temperature, precipitation, etc.) and to determine the key climate factors on the slope instability, a slope stability assessment approach for evaluating the effects of climate changes on slope instability is proposed through the water content simulation and slope stability analysis with considering freeze-thaw action. Finally, to check the effectiveness of the above assessment approach, assessment of instability of an actual highway embankment slope with the local layer geometry is done by applying the past and predicted future climate data. The results indicate that affected by global warming, the air temperature rise in some cold cities is more serious. The climate changes (especially the increase in precipitation) in the future will increase the infiltration during the Spring season. It will lengthen the time that the highway slope is in an unstable state due to high volumetric water content, causing the occurrence of slope failures will be more concentrated in April. While during the Ssummer-Autumn period, the time domain of its occurrence will become wider.

Huatuo Jiuxin Pills (HJP), a traditional Chinese medicine (TCM) preparation, has been widely used to treat Cardiovascular Diseases (CVDs) for more than 20 years. However, there were still gaps in the study of chemical components and potential pharmacological effects in the HJP. In this study, ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF/MSE) combined with network pharmacology was used to comprehensively explore the chemical components in HJP and explore its potential active compounds and the mechanism for the treatment of CVDs. A total of 117 compounds, mainly including saponins, cholic acids, and bufadienolides, were rapidly identified and characterized. Simultaneously, the fragmentation mode and characteristic ion analysis of different types of representative compounds were carried out. Network pharmacology results showed that the more important active ingredients mainly include 5β‐hydroxybufotalin, 19 oxo‐cinobufagin, bufarenogin, etc. While, the main targets were PIK3CA, MAPK1, VEGFA and so on. Importantly, HJP has therapeutic effects on CVDs by acting on endocrine resistance, PI3K-Akt signaling pathway, HIF-1 signaling pathway, etc. In addition, molecular docking results showed that the core active ingredients with higher degrees in HJP have a strong affinity with the core targets of CVDs. The current work fills the gap in the chemical substance basis of HJP, and also facilitates a better understanding of the effective components, therapeutic targets, and signaling pathways of HJP in the treatment of CVDs.

Background: We compared the efficacy, safety, and immunogenicity of MIL60 with reference bevacizumab as first-line treatment in patients with advanced or recurrent non-squamous non-small cell lung cancer (NSCLC) in this phase 3, randomized, double-blind study. Methods: Patients with untreated advanced or recurrent NSCLC were randomized (1:1 ratio) to receive either MIL60 or bevacizumab in combination with paclitaxel/carboplatin. Patients with non-progressive disease continued maintenance single-agent MIL60 until disease progression, or intolerable toxicity. The primary endpoint was the 12-week objective response rates (ORR12) by independent review committee (IRC) using RECIST 1.1. Bioequivalence was established if the ORR ratio located between 0.75 and 1/0.75. The trial was registered with clinicaltrials.gov (NCT03196986). Findings: Between Aug 23, 2017, and May 8, 2019, 517 patients were randomly assigned to MIL60 group (n=257) and bevacizumab group (n=260). In the full analysis set (FAS) population including all randomized and evaluable patients who received at least one dose of MIL60 or bevacizumab, the ORR12 in MIL60 group and bevacizumab group were 48.6% and 43.1%, respectively. The ORR ratio of these two groups were 1.14 (90% CI 0.97-1.33), which fell within the pre-specified equivalence boundaries (0.75-1/0.75). The median DOR was 5.7 months (95% CI 4.5-6.2) for MIL60 and 5.6 months (95% CI 4.3-6.4) for bevacizumab. No significant difference was noted in median PFS (7.2 vs. 8.1 months; HR 1.01, 95% CI 0.78-1.30, p=0.9606) and OS (19.3 vs. 16.3 months; HR 0.81, 95% CI 0.64-1.02, p=0.0755). Safety and tolerability profiles were similar between the two groups. No patient detected positive for Anti-drug antibody (ADA). Interpretation: The efficacy, safety and immunogenicity of MIL60 were similar with bevacizumab, providing an alternative treatment option for advanced or recurrent non-squamous NSCLC. Funding: This study was sponsored by Betta Pharmaceutical Co., Ltd.

This paper presents a transient-dynamic method (TDM), to investigate the dynamic responses of a railway formation under a train moving load using a three-dimensional finite element model. First, the feasibility of the TDM was verified, by comparing the vertical stress in a railway formation calculated using this method with the steady-state method (SSM). Next, the effects of train speed and embankment stiffness on the dynamic response of the railway formation were evaluated using TDM. The numerical results indicated that the vertical displacement/stress of the railway formation were remarkably increased with an increased train speed, within the shear wave velocity of the soft soil. In contrast, the vertical displacement/stress attenuation with the depth of the ground caused by high-speed trains was faster than that caused by low-speed trains. As for the effect of embankment stiffness, the enhancement of embankment stiffness had little effect on the transfer of vertical stress to the underlying soil. Finally, a determination of the dynamic stress for different train speeds was evaluated. This design code may underestimate the dynamic stress in a railway formation in high-speed situations (e.g., v = 112 m/s).

A low-profile dual-polarized magneto-electric dipole (MED) is presented in this communication. The low profile was achieved using meander slots on the vertical magneto dipole, reducing the antenna height to 0.15λ0, where λ0 is the wavelength of the center frequency. Relatively, the proposed MED structure is easier to process and more stable than the traditional low-profile MED structure. The broadband performance for 5G Applications was realized based on MED structure, and the dual-polarization structure has wider coverage area and lower multipath transmission losses. Moreover, the orthogonal feeding structure provides a satisfying isolation between two ports. To verify the simulation results, a prototype of the proposed antenna was fabricated and measured. The results show that the overlapped operating frequency bandwidth with |S11| ≤ −10 dB, |S12| ≤ −20 dB was 36.8% from 3.1 GHz to 4.5 GHz, the peak gain reached 10.2 dBi, and the average gain exceeded 8.5 dBi. The measured 3 dB beamwidth with more than 44 degrees beamwidth was realized in both E-plane and H-plane. In addition, cross-polarization levels below −22 dB that covered the above frequency band were achieved. Compared with other MED antennas, in addition to broadband and high gain, the proposed antenna has the advantages of a low profile, easy processing, and low cost, which make it a competitive candidate for 5G applications.

Hot compression experiments were performed on alloy 5182 with small additions of Sc and Zr. The 5182 alloy containing Sc and Zr is critical for expanding the 5182 alloy’s range of applications, and a thorough understanding of its thermal processing behavior is of great importance to avoid processing defects. Alloy microstructure, including grain structures and Al3(ScxZr1−x) dispersoids were analyzed by EBSD and TEM. Stable flow stresses were observed below a strain rate of 1 s−1 for the Sc-Zr containing alloy. The results of constitutive models, with and without strain−compensation, and artificial neural network (ANN) were used to compare to the experimental results. The Al3(ScxZr1−x) dispersoid data was introduced into the ANN model as a nonlinear influence factor. Addition of the Al3(ScxZr1−x) dispersoid information as input data improved the accuracy and practicality of the artificial neural network in predicting the deformation behavior of the alloy. The squared correlation coefficients of ANN prediction data reached 0.99.

In this study, the reduction characteristics of single magnetite particles with melting products at high temperature were investigated by using visualization and surface analytical techniques. The morphology evolution, product type, reduction degree, and reduction rate of single magnetite particles during the reduction process were analyzed and compared at different reduction temperatures. The results showed that the morphology of the product formed at the reduction temperature of 1300 °C was a mainly nodular structure. When the reduction temperature was above 1400 °C, the products were melted to liquid and flowed out of the particle to form a layered structure. The morphology of the melted products finally transformed to be root-like in structure on the plate around the unmelted core. Raman spectroscopy was used to determine the product types during the reduction process. Experiments studying the effects of gas flowrate and particle size on the reduction degree were carried out, and the results showed that both increasing the temperature and gas flowrate can increase the reduction degree. The internal/external diffusion influence can be ignored with a particle size smaller than 100 μm and a gas flowrate more than 200 mL/min. However, owing to the resistance of the melted products to gas diffusion, the reduction rates at 1400 and 1500 °C were reduced significantly when the reduction degree increased from 0.5 to 1.0. Conversely, the formation of the liquid enlarged the contact area of the reducing gas and solid–liquid and further increased the reduction degree. The kinetics parameters, including average activation energy and pre-exponential factor, were calculated from the experimental data. The reduction kinetics equation of the single magnetite particle, considering the effect of melted products is also given in this study.

The rock mass has special properties, such as inhomogeneity, anisotropy, discontinuity, and nonelastic, due to various internal or external stress in the process of its formation. In this study, similar materials are considered to simulate the rock mass and analyze the failure law using laboratory tri-axial tests based on the similarity principle. The rock mass and discontinuity are constituted in the process of model construction by considering the influence of the orientation, spacing, and number of discontinuity, respectively. Then, the influences of the orientation, spacing, number of discontinuity, and the combination of different discontinuous strength on rupture mechanism of the rock mass are analyzed by considering lots of numerical test schemes using the discontinuous deformation analysis method. Finally, considering water conveyance tunnel in Jurong Pumped Storage Power Station in China as a test case, the tunnel stability under different discontinuities combination is analyzed using discontinuous deformation analysis method. The influence of the optimal tunnel axis and tunnel shape on the stability of surrounding rock is studied by comparative analysis of surrounding rock stability under different tunnel axis and tunnel shapes. The stress concentration in case of the circular tunnel with corner is somehow less than that of the rectangular one.