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This paper deals with a class of Kirchhoff type elliptic Dirichlet boundary value problems where the combined effects of Kirchhoff term and nonlinear term allow us to establish a bifurcation-type result as the positive parameter varies.

Mycoplasma pneumoniae is a major cause of respiratory tract infections, particularly in children and young adults. M. pneumoniae accounts for 10%-30%) of community-acquired pneumonia (1). Macrolides are the primary treatment, [...]

ObjectiveTo evaluate the correlation between ultrasound ossification ratio(OR) and exercise intensity among adolescents.MethodsThis cross-sectional study used stratified sampling to select adolescents aged 11-15 years from a sports school and some ordinary middle schools in Shandong Province in June 2023. The participants were divided into two groups: competitive sports group (high exercise intensity), and general sports group (moderate exercise intensity), based on their exercise intensity. Ultrasound images of long bones from nine body regions (including 3 upper limb bones and 6 lower limb bones) were collected for both groups. Two sonographers interpreted the images and calculated the ultrasound OR values (the ratio of ossification center length to epiphyseal length on the standard ultrasound section). The intraclass correlation coefficient (ICC) was used to assess the consistency of image interpretation between the observers. Differences in ultrasound OR values between the two groups were compared, and multivariate Logistic regression analysis was performed to assess the correlation between ultrasound OR values and exercise intensity.ResultsA total of 252 adolescents who met the inclusion and exclusion criteria were included, with 154 in the competitive sports group (97 males and 57 females) and 98 in the general sports group (52 males and 46 females). The median height and average daily exercise duration were significantly higher in the competitive sports group than in the general sports group (all P < 0.001). The overall ICC for the interpretation of ultrasound OR values of long bones at 9 sites in 50 adolescents by the two sonographers was 0.930 (range: 0.853-0.964), indicating excellent inter-observer consistency. The medial femoral ultrasound OR values were higher in the competitive sports group than in the general sports group for both males and females (males: 0.87±0.07 vs. 0.84±0.04, P=0.025; females: 0.90±0.06 vs.0.85±0.14, P=0.027). Additionally, the differences in ultrasound OR values between the groups were observed in the lateral femoral and fibular bones in males and the radial bone in females (all P < 0.05). Multivariate Logistic regression analysis showed that the reciprocal of the medial femoral ultrasound OR value was correlated with exercise intensity (OR=0.046, 95% CI: 0.012-0.145, P=0.043), indicating that a decrease of 0.1 in the reciprocal of the medial femoral ultrasound OR value (equivalent to an increase of approximately 0.05-0.10 in the ultrasound OR value) was associated with a 2.17-fold increase in the likelihood of high-intensity exercise.ConclusionsThe medial femoral ultrasound OR value was correlated with exercise intensity among adolescents. This indicator may serve as an objective imaging parameter for assessing whether adolescent exercise meets recommended standards.

ObjectiveTo research on area ossification ratio (AOR), a novel parameter for quantitatively assessing adolescent bone age by conventional ultrasonography, and evaluate the correlation between AOR and radiographic bone age.MethodsThe study selected healthy adolescents from a middle school in Shandong Province in June 2023. Ultrasonic images were collected from five anatomical sites (the styloid process of the ulna, the styloid process of the radius, the lateral epicondyle of the femur, the medial condyle of the tibia, and the posterior median sagittal plane of the tibia). The second ossification center and epiphyseal area on these 2D ultrasound images were delineated to calculate AOR. This ratio was then compared with radiographic bone age measured by Greulich-Pyle (GP) atlas. Inter- and intra-observer consistency was evaluated using intraclass correlation coefficient (ICC) and the Bland-Altman method.ResultsA total of 179 healthy adolescents (109 males and 70 females) were included. For both genders, AOR of each site exhibited a significant to high correlation with radiological bone age (r=0.60~0.91). The sum of the AORs of the five sites showed a high correlation with radiological bone age (males: r=0.95, females: r=0.87). Measurements of AOR by different doctors and the same doctor at different times demonstrated high repeatability (inter-observer: ICC=0.926, P < 0.001, intra-observer: ICC=0.954, P < 0.001).ConclusionsThe sum of AORs in adolescents is highly correlated with radiographic bone age, and the measurement method shows high repeatability. The AOR is a reliable parameter for the ultrasonic quantitative assessment of bone age in adolescents.

Water covers most of the Earth’s surface and is nowhere near a good ecological or recreational state in many areas of the world. Moreover, only a small fraction of the water is potable. As climate change-induced extreme weather events become ever more prevalent, more and more issues arise, such as worsening water quality problems. Therefore, protecting invaluable and useable drinking water is critical. Environmental agencies must continuously check water sources to determine whether they are in a good or healthy state regarding pollutant levels and ecological status. The currently available tools are better suited for stationary laboratory use, and domain specialists lack suitable tools for on-site visualisation and interactive exploration of environmental data. Meanwhile, data collection for laboratory analysis requires substantial time and significant effort. We, therefore, developed an augmented reality system with a Microsoft HoloLens 2 device to explore the visualisation of water quality and status in situ. The developed prototype visualises geo-referenced sensor measurements incorporated into the perspective of the surroundings. Any users interested in water bodies’ conditions can quickly examine and retrieve an overview of water body status using augmented reality and then take necessary steps to address the current situation.

The COVID-19 pandemic has suspended physical classes and influenced students from underprivileged groups more seriously due to their poor living conditions and digital disadvantages. To understand the impact of the constrained learning, we conducted a study on game-based learning to examine the effectiveness of computer-aided and autonomous learning of traditional Chinese by underprivileged students. From December 2020 to May 2021, we collected 3245 quiz results from 26 underprivileged students over six months. The quizzes systematically covered the fundamentals of learning traditional Chinese in six aspects, i.e., literacy, orthography, phonology, morphology, speaking, and writing. We analyzed the results to understand the learning efficacy of students. Remarkably, students can significantly improve their skills in literacy and phonology through unsupervised game-based learning. Furthermore, by parsing the writing tasks, we observe substantial improvements among 7 out of 13 common types of writing mistakes. Our study provides a critical lens to understand the design opportunities of game-based learning without direct supervision.

Non-alcoholic fatty liver disease (NAFLD) is a liver manifestation of metabolic syndrome, and is estimated to affect one billion individuals worldwide. An increased intake of a high-fat diet (HFD) and sugar-sweetened beverages are risk-factors for NAFLD development, but how their combined intake promotes progression to a more severe form of liver injury is unknown. Here we show that fructose metabolism via ketohexokinase (KHK) C isoform leads to unresolved endoplasmic reticulum (ER) stress when coupled with a HFD intake. Conversely, a liver-specific knockdown of KHK in mice consuming fructose on a HFD is adequate to improve the NAFLD activity score and exert a profound effect on the hepatic transcriptome. Overexpression of KHK-C in cultured hepatocytes is sufficient to induce ER stress in fructose free media. Upregulation of KHK-C is also observed in mice with genetically induced obesity or metabolic dysfunction, whereas KHK knockdown in these mice improves metabolic function. Additionally, in over 100 inbred strains of male or female mice hepatic KHK expression correlates positively with adiposity, insulin resistance, and liver triglycerides. Similarly, in 241 human subjects and their controls, hepatic Khk expression is upregulated in early, but not late stages of NAFLD. In summary, we describe a novel role of KHK-C in triggering ER stress, which offers a mechanistic understanding of how the combined intake of fructose and a HFD propagates the development of metabolic complications.

C26H36N4O14Co, triclinic, P1̄ (no. 2), a = 7.1895(7) Å, b = 8.7773(9) Å, c = 10.9067(11) Å, α = 98.180(2)°, β = 104.0480(10)°, γ = 90.180(2)°, V = 660.37(11) Å3, Z = 1, Rgt (F) = 0.0287, wRref (F 2) = 0.0751, T = 296.15 K.

ObjectiveTo analyze the effects of tooth brushing frequency on blood indicators among adolescents and to preliminarily explore the effects of tooth brushing frequency on general health.MethodsUsing convenience sampling method, the study included the students of class 2021 of Jining No. 7 Middle School and student athletes from the Jining Sports Training Center. Univariate and multivariate linear regression analyses were used to investigate the correlation between tooth brushing frequency and blood indicators such as eosinophil percentage (EOS%), eosinophil count (EOS#), basophil percentage (BAS%), basophil count (BAS#), superoxide dismutase (SOD), insulin-like growth factor 1 (IGF-1) and uric acid (UA).ResultsA total of 305 students were included (167 from Jining No. 7 Middle School, 138 from Jining Sports Training Centre), with 192 (62.95%) males and 113 (37.05%) females. They were divided into three groups based on daily teeth brushing frequency: ≤1 time (40.33%, 123/305), 2 times (53.77%, 164/305), and ≥3 times (5.90%, 18/305).Univariate linear regression analysis showed that brushing twice daily was negatively correlated with EOS%, EOS#, BAS%, and BAS#(all β > 0, all P < 0.05), and positively correlated with SOD and IGF-1(both β < 0, P=0.028, P=0.007). Brushing three or more times daily was negatively correlated with UA[β(95% CI): -0.16(-0.27~0.04), P=0.008]. Multivariate linear regression analysis showed that brushing twice daily was negatively correlated with BAS%(β < 0, P=0.042) and positively correlated with SOD and IGF-1(both β > 0, P=0.036, P=0.012), while brushing three or more times daily was negatively correlated with UA(β < 0, P=0.026). Subgroup analysis revealed that in male adolescents, brushing twice daily was positively correlated with IGF-1(β > 0, P=0.044), and in female adolescents, brushing three or more times daily was negatively correlated with UA(β < 0, P=0.014).ConclusionThe adolescent tooth brushing frequency correlates with several blood indicators affecting general health, suggesting that there may be a potential association between oral health and general health.

Hypothalamic obesity (HO) is a complicated and uncommon disease affecting multiple regulatory pathways of energy intake and metabolism in the brain, regulation of the autonomic nervous system and peripheral hormonal signaling. Currently, drug treatment mainly involves stimulating sympathetic nerve excitation and fat tissue thermogenesis, thereby inhibiting rapid weight gain by increasing fat breakdown and energy consumption. In addition, some drugs can also act on the reward center of the brain to inhibit excessive food intake in HO patients. This article systematically introduces the clinical benefit data, adverse reactions, and application prospects of newly developed drugs such as oxytocin (OXT), phentermine and topiramate(Ph/T), tesofensine, setmelanotide, etc.

ObjectivePreliminary exploration of using ultrasound to quantitatively evaluate the development of epiphyseal cartilage and analyze its correlation with bone age, based on the ultrasound findings of the long bone joint end.MethodsA study was conducted on adolescents studying at a sports school in Jining from March to June 2023. Age, height and other information were recorded. Bone age assessment by X ray were performed within 1 week with an endocrinologist interpreted the bone age using the Greulich-Pyle atlas. Two sonographers scanned a total of 7 sites in the hand, wrist and knee joint of the non-dominant side (including the dorsal side of the third metacarpal head, the ulnar styloid process, the radial styloid process, the medial and the lateral femoral epicondyle, dorsal tibia, and medial tibial condyle). The ultrasonic epiphyseal cartilage thickness (UECT) was measured and its correlation with bone age was analyzed. Intraclass correlation coefficient (ICC) was used to evaluate the reliability and repeatability of UECT measurement.ResultsA total of 141 adolescents were included, with 80 males and 61 females. The average age was 13 (12-14) years old. The average bone age was 15(13-17) years in males and 16 (14-17) years in females. The proportion of the males and females whose bone age was 1 year older than chronological age was 60% and 67%, respectively, and the height of the males was significantly higher than that of the females(P < 0.001). The UECT of 7 sites in the males and females decreased with the increase of bone age, and there was a significant negative correlation between UECT and bone age. In males, UECT was highly and negatively correlated with bone age (|r|≥0.80), while in females, it was moderately and negatively correlated (0.65≤|r|≤0.75). The correlation between the sum of UECT at seven sites and bone age reached high levels in both sexes(|r|=0.93, |r|=0.80).When 3 sites of hand and wrist or 4 sites of knee joint were selected separately, the UECT of the females was highly negatively correlated with bone age (|r| ≥0.76), while that of the males showed a very high correlation (|r| ≥0.90). The measurement consistency of UECT in all seven sites was good (ICC≥0.75).ConclusionUltrasound can observe and describe the developmental change of long bone, and UECT has potential value in quantitative evaluation of bone maturity.