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With the vigorous development of the medical industry in China, residents’ health has been significantly improved. However, along with the income gap, urban–rural gap, and healthcare resource gap caused by economic development, health inequality has become a fundamental barrier to the promotion of residents’ health. The popularity of the Internet has helped close the gap to some extent, but it also has drawbacks. Using data from the China Family Panel Studies (CFPS) from 2014 to 2018, we evaluated the effects of Internet usage on health disparities among residents using fixed effect models, mediation effect models, and other methodologies. The findings indicate that Internet usage can help to minimize health inequality since it lowers income inequality, promotes health consciousness, and reduces depression. Furthermore, Internet usage plays a greater role on the health improvement of the middle-aged, the elderly, urban residents, and females. Although the Internet has brought “digital dividends” in general, the Internet usage rates among different groups also reveal that there is a clear “digital gap” among rural residents, elderly groups, and low-income groups. These results have significant implications for promoting healthcare equality.

In this study, we examine the impact of inclusive leadership—being open, available, and accessible—on team creativity. Based on componential theory of creativity, we propose a moderated mediation m...

With the rapid decline in China’s fertility rate, the acceleration of aging, the continuous miniaturization and nucleation of China’s family structure, and the deterioration of the elderly’s living conditions and mental states, the elderly’s mental health has emerged as a major public health issue and a major social problem. Pensions are the elderly’s primary source of income, and they can help them meet their basic needs while also promoting family harmony and improving their mental health. Based on the data of the 2012, 2016, and 2018 Chinese Family Panel Studies (CFPS), we empirically examined the impact of pensions on the elderly’s mental health by using the fixed effects model, mediating effect model, and so on. The results show that receiving pension benefits can significantly reduce the level of depression and improve the mental health of the elderly. Receiving pension benefits causes reverse intergenerational economic transfer, which reduces the effect of pensions on the elderly’s mental health to some extent, but the life care and mental comfort provided by children increases when the elderly share pensions with their children. Overall, receiving pension benefits improves the mental health of the elderly. In addition, the effect of pensions on the elderly with different characteristics is heterogeneous. The older elderly, women, the elderly living with their children, and the elderly in rural areas all benefit more from receiving pension benefits. Moreover, the worse the mental health of the elderly is, the stronger the influence of pensions on their mental health is. Our discussion has important policy implications.

Objectives: This study aimed to characterise the accuracy of multiparametric magnetic resonance imaging (mpMRI) as an adjunct to prostate biopsy, and to assess the effect of the new Australian Medicare rebate on practice at a metropolitan public hospital. Patients and methods: We identified patients who underwent transrectal ultrasound (TRUS)-guided prostate biopsy at a single institution over a two-year period. Patients were placed into two groups, depending upon whether their consent was obtained before or after the introduction of the Australian Medicare rebate for mpMRI. We extracted data on mpMRI results and TRUS-guided biopsy histopathology. Descriptive statistics were used to demonstrate baseline patient characteristics as well as MRI and histopathology results. Results: A total of 252 patients were included for analysis, of whom 128 underwent biopsy following the introduction of the Medicare rebate for mpMRI. There was a significant association between Prostate Imaging Reporting and Data System v2 (PI-RADS) classification and the diagnosis of clinically significant prostate cancer ( pConclusion: mpMRI is an important adjunct to biopsy in the diagnosis of clinically significant prostate cancer. Our findings support the safety of omitting/delaying prostate biopsy in men with negative mpMRI. Level of evidence: Level 3 retrospective case-control study.

With the vigorous development of the medical industry in China, residents’ health has been significantly improved. However, along with the income gap, urban–rural gap, and healthcare resource gap caused by economic development, health inequality has become a fundamental barrier to the promotion of residents’ health. The popularity of the Internet has helped close the gap to some extent, but it also has drawbacks. Using data from the China Family Panel Studies (CFPS) from 2014 to 2018, we evaluated the effects of Internet usage on health disparities among residents using fixed effect models, mediation effect models, and other methodologies. The findings indicate that Internet usage can help to minimize health inequality since it lowers income inequality, promotes health consciousness, and reduces depression. Furthermore, Internet usage plays a greater role on the health improvement of the middle-aged, the elderly, urban residents, and females. Although the Internet has brought “digital dividends” in general, the Internet usage rates among different groups also reveal that there is a clear “digital gap” among rural residents, elderly groups, and low-income groups. These results have significant implications for promoting healthcare equality.

The Orr mechanism is revisited to understand its precise role in the transition of plane Couette flow. By considering homogeneous shear flow and plane Couette flow, it is identified that the Orr mechanism induces a lift-up effect which significantly amplifies spanwise velocity. An optimal perturbation analysis for an individual velocity component reveals that the amplification of spanwise velocity is most active at the streamwise length comparable to the given spanwise length of the perturbation. The relevance of this mechanism to transition is subsequently examined in plane Couette flow. To this end, a set of initial conditions, which combines the optimal perturbation for spanwise velocity with the one for all the velocity components, is considered by varying their amplitudes. Two representative transition scenarios are found: oblique and streak transitions. In the former, the spanwise velocity perturbation amplified with the Orr mechanism initiates both streak amplification and breakdown, whereas in the latter, its role is limited only to the streak breakdown at the late stage of transition. As such, the oblique transition offers a route to turbulence energetically more efficient than the streak transition, at least for the cases examined in the present paper. Finally, the oblique transition is found to share many physical similarities with the transition by the minimal seed.

Background: This study aims to establish lung biologically effective dose (BED)–based uniform dosimetric constraints for minimizing the risk of symptomatic radiation pneumonitis (SRP) from stereotactic body radiation therapy (SBRT) using variable fractionations in patients with lung tumors.Materials and Methods: A total of 102 patients with primary or oligometastatic lung tumors treated with SBRT in our institution were enrolled into this study. The associations between the clinical and dosimetric parameters and the incidences of SRP were analyzed using univariate and multivariate Cox regression hazard models. The receiver operating characteristic (ROC) curve was generated to evaluate the predictive performance of lung BED on the SRP risk compared with the physical dose.Results: SRP occurred in 11 patients (10.8%). In univariate analysis, the mean lung dose (p = 0.002), V5 (p = 0.005), V20 (p < 0.001), and the percentage of non-target normal lung volume receiving more than a BED of 5–170 Gy (VBED5−170, p < 0.05) were associated with SRP. Multivariate logistic regression analysis showed that there existed a significant statistical correlation between SRP and VBED70 (p < 0.001), which performed better than V5 or V20 on the ROC curves, resulting in an optimal cut-off value of lung VBED70 of 2.22%.Conclusions: This retrospective study indicated that non-target lung BED may better predict SRP from patients with SBRT-treated lung cancer. Limiting the lung VBED70 below 2.22% may be favorable to reduce the incidence of SRP, which warranted further prospective validation.

We introduce the concept of startup identity conflict as disagreements among founding team members about the core, enduring, and distinctive characteristics of a nascent business, and relate it wit...

Postoperative atrial fibrillation (POAF) is a common complication after coronary artery bypass grafting (CABG) and is associated with increased short-term and long-term mortality. While the precise etiology of POAF remains unclear, inflammation is a known contributing factor. Preliminary studies have suggested that an elevated preoperative platelet-to-lymphocyte ratio (PLR), an inexpensive and readily available novel inflammatory biomarker, may be associated with increased incidence of POAF after CABG. This study sought to further investigate this hypothesis.The study cohort included all patients undergoing isolated CABG, with no prior history of arrhythmia, who were operated on between August 1, 2010, and December 31, 2018, at a major Australian tertiary center (n = 1457). Patients were divided into low (86) or high (≥86) PLR groups based on an optimal cutoff derived from receiver-operating characteristic curve analysis. The incidence of POAF was then compared. Categorical variables were analyzed using the chi-square test and continuous variables using logistic regression.Of 1457 patients, 495 (34.0%) developed POAF. There was no statistically significant difference in the incidence of POAF between patients in the high-PLR and low-PLR groups (34.8% vs 31.0%; P = .22). Using multivariable logistic regression analysis, high PLR was not independently associated with POAF (odds ratio, 1.04; P = .78).Elevated preoperative PLR is not independently associated with POAF in patients undergoing isolated CABG. The findings of this study differ from those of 2 previous smaller studies.

This paper explores the influence of micro textures on cutting performance of polycrystalline cubic boron nitride (PCBN) tools from two aspects, that is, tool wear and machined surface roughness. By designing micro-hole textures with different forms and scales on the rake face of tools when PCBN tools turn hardened steel GCr15, and combining finite element analysis (FEA) technology and cutting experiments, the cutting performance of micro-textured tools is simulated and analyzed. This paper analyses the influence of micro textures on tool wear and machined surface roughness by analyzing cutting force, Mises stress and maximum shear stress of tool surface. Results of finite element analysis (FEA) and cutting experiments show that the reasonable micro-hole textures can significantly alleviate tool wear and improve machined surface quality when compared with the non-textured tools. Besides, the size of micro-hole textures on the rake face play an important role in reducing the cutting force and tool wear. This is mainly because micro-hole textures can reduce cutting force and improve tool surface stress. Finally, by designing reasonable micro-hole textures on the rake face, the problems of bad roughness of machined workpiece and severe tool wear of PCBN tools in cutting GCr15 material are solved. Consequently, the paper shows that micro-hole textures have a positive effect on improving the cutting performance of tool.

The fiber composites were impregnated at different times and bonded to metal materials; the mechanical properties of the bonded composites were measured. In this article, two kinds of materials, the carbon fiber fabric and the Kevlar fiber fabric, were compounded with epoxy resin E51 to form the fiber fabric composite material. The composite material was bonded to the surface of 45 steel by modified epoxy resin adhesive. The bond strength of composites were measured by the tensile method of determination of the bond strength between vulcanized rubber and metal, the shear strength of composites were measured by Four-plate shear method of determination of the bond strength of vulcanized rubber and rigid metal sheets by the international standard ISO 1747-1976, to obtain the maximum bond strength and shear strength of the composite material, and the corresponding optimum immersion time of the carbon fiber fabric.

The objective of this study was to investigate the correlation between dual-energy computed tomography (DECT)-based iodine quantitation and fluorine-18 fluorodeoxyglucose (F-FDG) positron emission tomography (PET)/computed tomography (CT) imaging for response evaluation of lung cancers to treatment.In this prospective study, a total of 32 pairs of DECT and F-FDG PET/CT imaging acquired consecutively from 13 patients with primary or metastatic lung cancers receiving either radiotherapy alone or chemoradiotherapy were analyzed. Imaging examinations were performed before, immediately, and no later than 6 months after treatment for response evaluation. Iodine-related parameters including the total iodine uptake (TIU) and vital volume (VIV) from DECT and metabolic metrics such as the standardized uptake value normalized to lean body mass (SULpeak), metabolic tumor volume (MTV), and the total lesion glycolysis (TLG) from F-FDG-PET/CT were generated and measured by semiautomatic approaches. Dual-energy CT and PET/CT metrics were calculated and followed up with comparison with response evaluation criteria in solid tumors (RECIST).Analysis of pretreatment imaging data revealed a strong correlation between DECT metrics (RECIST, TIU, and VIV) and F-FDG PET/CT metrics (MTV, TLG) with coefficients of R ranging from 0.86 to 0.90 (P0.01). With the delivery of treatment, all measured DECT and PET/CT metrics significantly decreased whereas the descending amplitude in RECIST was significantly smaller than that of the remaining parameters (P0.05). During follow-up examinations, both metrics followed a similar changing pattern. Overall, strong consistency was found between RECIST, TIU, VIV and SULpeak, MTV, TLG (R covers 0.78-0.96, P0.05).Semiautomatic iodine-related quantitation in DECT correlated well with metabolism-based measurements in F-FDG PET/CT, suggesting that DECT-based iodine quantitation might be a feasible substitute for assessment of lung cancer response to chemoradiotherapy/radiotherapy with comparison with F-FDG PET/CT.

Lobectomy remains the standard treatment for early-stage non-small cell lung cancer (NSCLC). However, due to medical comorbidities (such as severe diabetes, severe hypertension, and chronic obstructive pulmonary disease), some patients may not tolerate surgical procedures. For this fragile patient population, stereotactic ablation radiotherapy (SABR) provides a noninvasive but radical treatment option with limited impact on quality of life and acceptable efficacy. In contrast with conventional radiotherapy, SABR is characterized by delivering a high biological effective dose in several fractionations (

This paper applies micro textures to the rake face of PCBN (Polycrystalline Cubic Boron Nitride) tools, including three types of micro textures that are microgroove textures vertical to the cutting edge, microgroove textures parallel to the cutting edge, and microhole textures. In this paper, the effects of different cutting speeds on the surface quality of hardened bearing steel GCr15 by dry turning with non-texture PCBN tools and micro-texture PCBN tools are studied, and the surface roughness values obtained by different micro textures were compared and analyzed. The results showed that, compared to that of non-texture tools, the influence degree of the micro-texture tools on the machined surface roughness was different. The microhole texture and vertical microgroove texture were able to effectively reduce the surface roughness of the workpiece, and microhole texture had the best effective influence on surface roughness, but the parallel microgroove texture increased surface roughness. The influence of cutting speeds on surface roughness was different due to different types of micro textures. The influence of micro textures on surface roughness has huge potential for tool applications.

This paper is based on the theoretical analysis designs of a dry cutting orthogonal test in order to study a phenomenon that the radial force is larger than the main cutting force when a PCBN (polycrystalline cubic boron nitride) tool hard turns GCr15. Finite element modelling and cutting tests show the cutting depth and the spindle speed having an impact on the main cutting force, the radial force, and the axial force. In this study, due to the shear function of the cutting process, the squeezing effect between the tool and the workpiece, and the metal softening effect of the workpiece material, the different cutting depth and the spindle speed bring about different cutting force changes, and also different spindle speeds have different effects on the three components of the total cutting force. The research result provides a basis for further study on dry turning of hardened bearing steel.

Over decades of development, surgical procedures in stage I non-small cell lung cancer (NSCLC) have been advanced from open thoracotomy to video-assisted minimally invasive thoracoscopic surgery (VATS). Lobectomy (with preference of VATS technique) remains the standard of care for stage I NSCLC (1). The unstopping advances in surgical devices and techniques have contributed to the VATS transition from the conventional multiportal approach to uniportal approach, which has demonstrated advantages in safety and preservation of patient’s quality of life over the former (2). Curiously, is that possible to perform lobectomy with no port at all, or to rephrase the question, is a noninvasive procedure reasonable and available for definitive treatment of this malignancy with outcomes same to or even better than surgery?

Polar plants have to adapt to the rigorous environment, such as: chilliness, storm wind, and intense illumination. Six Arctic plants were measured by chlorophyll content, leaf area, photosynthesis characters and chlorophyll fluorescence parameters. The results showed that they appeared obvious differences by measuring chlorophyll content for 24 h. The highest chlorophyll contents of Silene acaulis and Deschampsia alpina were in the evening, and their photosynthesis were ongoing, but the highest chlorophyll contents of others were in the noon. The rapid light curve (RLC) showed that the Arctic plants have adapted to the stronger light intensity of daytime. For the photosynthetic ability of photosystem II [Y(II)], Saxifraga hieracifolia was the highest, Salix polaris, Deschampsia alpina, and Silene acaulis were intermediate; the quotient of photochemical quenching (qP) showed the photosynthetic activity of Saxifraga hieracifolia was the highest, and Salix polaris was the lowest; the quotient of non-photochemical quenching (qN) showed most Arctic plants were more adaptive to intense light than the control Poa pratensis, except Silene acaulis and Deschampsia alpina.