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Operation of the safety gears is the last means of protecting passengers in a high-speed or even freely falling lift car. EN81-20 stipulates that the average retardation when the safety gears are engaged should lie between 0.2 g n and 1.0 g n while g n is the gravitational acceleration. Decades ago, in Hong Kong, to conduct a formal test on the safety gears, the car was fully loaded and the machine brake was manually released to allow the car fall freely until the overspeed governor triggered the engagement of the safety gears. This test was rather vigorous to both the gear jaws and the guiderails. Recently, tests have been conducted with 125% in-car load while the car travels under an inspection (or levelling) speed and the governor is manually triggered. Such a revised test, though much less vigorous, may not be able to verify the average retardation as required. Even a test with full load and free-falling may not reveal the whole truth by merely measuring the resulting contact scratches on the guiderails because a majority of the retardation could have been assisted by the counterweight via the suspension ropes. A method that involves an empty car traveling downward at 1 m/s with the governor manually triggered was first developed in Germany. This method has been improved to form a comprehensive procedure as detailed in this article so that a no-load rated speed, or slightly reduced speed, test is conducted, which is almost non-invasive or much less vigorous. By calculation, the average retardation when all suspension ropes are broken can be estimated. Cross-checking in our experiments revealed the validity of this procedure. The procedure also involves a test to verify the validity of parameters used to perform the estimation and takes care of some modern overspeed governors which cannot be manually triggered. It is hoped that this procedure could encourage maintenance professionals carry out safety gears tests more often to ensure a high safety standard. Practical application : This comprehensive procedure could encourage more frequent tests on the car safety gears, which is almost non-invasive for manually triggerable overspeed governors or less vigorous for non-triggerable ones. An empty car traveling downward at rated speed, or at slightly reduced speed, is tested by manually triggering the governor while a partially loaded free-falling car is tested if the governor is not manually triggerable. Results can be used to estimate the average retardation of the lift car when all suspension ropes are broken. A pre-test is included to validate critical parameters necessary for the estimation. Experiments conducted so far were on the safety gears of low- to medium-speed lifts. For high-speed lifts beyond 4 m/s, that may be considered in the next stage of research. Although the title of this article includes the city where the procedure was developed, there is no reason why this testing procedure could not be extensively applicable to any traction lift systems around the world at such speed levels. [ABSTRACT FROM AUTHOR]

CaBi2Nb2O9 ceramics were fabricated via the solid-state reaction method by the addition of B2O3 as a sintering aid at lower sintering temperatures than that prepared without B2O3. Ferroelectricity, piezoelectricity, and resistivity can be still greatly enhanced when the sintering temperature is decreased from 1075 °C for CaBi2Nb2O9 to 975 °C for CaBi2Nb2O9–0.25 wt. % B2O3. The high resistivity and weak c-axis texture ensure that the ceramics can be fully polarized in a high enough electric field. The increased spontaneous ferroelectric and remanent polarization result in a significant enhancement in the piezoelectric properties of CaBi2Nb2O9–0.25 wt. % B2O3. The sample sintered at 975 °C possesses a high piezoelectric coefficient d33 of ∼15.0 pC/N and resistivity of 1.4 × 106 Ω cm (at 600 °C) along with a high ferroelectric Curie temperature TC of ∼954 °C. This work is beneficial for the preparation of high-temperature piezoelectric ceramics with excellent electrical properties at a low sintering temperature. [ABSTRACT FROM AUTHOR]

Theaflavin-3'-gallate was synthesised using polyphenol oxidase (PPO) from gallocatechin (EGC) and epicatechin gallonic acid (ECG). Using PPO, Box-Behnken design, and single factor test, the optimal reaction conditions were determined: ECG/EGC ratio of 3:7, magnetic stirring speed of 200 rpm, reaction temperature of 37°C, and enzyme concentration of 20 mg/100 mL. Under these conditions, the yield of TF-3'-G was 18.1%. These parameters represent the optimal conversion conditions for theaflavin-3'-monogallate. [ABSTRACT FROM AUTHOR]

BiFe0.93Mn0.07O3-0.82BiFe0.975Ti0.025O3-0.18CaTiO3 thin films were prepared on Pt/Si substrate by chemical solution deposition. The microstructure, ferroelectric and piezoelectric properties of the composite films under different annealing temperature were studied systematically. The thin film annealed at 500 °C possesses the maximum remanent polarization and piezoelectric coefficient of 112.6 µC/cm2 and 878.2 pm/V, respectively, which is comparable to most of BiFeO3-based orientated films. The results can be ascribed to the dense and uniform grain distribution in the surface morphology, and coexistence of rhombohedral twisted perovskite symmetrical structure (R3c space group) and pseudo-cubic structural phase. This work provides a feasible way to prepare high-quality lead-free composite ferroelectric films at low-cost. [ABSTRACT FROM AUTHOR]

Objective Explore the mental health status and its influencing factors of local community residents under the post-epidemic era of coronavirus disease 2019 (COVID-19) in China. Methods The basic information scale, self-rating depression scale and self-rating anxiety scale were used to carry out an online questionnaire survey among community residents in Jiangsu Province, China, and the influencing factors of depression and anxiety were analyzed by multivariate logistic regression. Results A total of 993 residents completed the mental health survey. It was found that the incidence of depressive and anxiety symptoms was 37.06% and 22.86%. Multivariate logistic regression analysis showed that women [odds ratio (OR) 95% confidence interval (95% CI) = 26.239 (14.743–46.698)], college degree and above [OR (95% CI) = 1.843 (1.085–3.130)] and ordinary residents [OR (95% CI) = 2.222 (1.441–3.425)] were risk factors for depressive symptoms, urban residents had lower risk [OR (95% CI) = 0.655 (0.394–0.829)]. Women [OR (95% CI) = 33.595 (15.812–71.381)] and ordinary residents [OR (95% CI) = 3.017 (1.602–5.680)] were risk factors for anxiety symptoms while the incidence was reduced in professional and technical personnel [OR (95% CI) = 0.271 (0.123–0.597)], workers [OR (95% CI) = 0.383 (0.168–0.876)], soldiers or policemen [OR (95% CI) = 0.200 (0.042–0.961)], married residents [OR (95% CI) = 0.463 (0.230–0.931)] and urban residents [OR (95% CI) = 0.531 (0.251–0.824)]. Conclusion The incidence of symptoms of depression and anxiety among residents was relatively high under the post-epidemic era of COVID-19, which could be affected by various factors. [ABSTRACT FROM AUTHOR]

Smoothed Particle Hydrodynamics (SPH) has outstanding advantages in dealing with nonlinear problems. However, it is difficult to find an efficient and accurate non-reflecting boundary for SPH. In this paper, the scaled boundary finite element (SBFE) virtual particle boundary is proposed to model the non-reflecting characteristics of the boundary in SPH. It is implemented by 2–4 layers of SBFE virtual particles whose pressure and velocity are calculated by the Lagrange interpolation from the nearby SBFE nodes. The SBFE virtual particle boundary can effectively and accurately simulate the transmission process of pressure waves on the boundary, and eliminate the influence of the reflecting waves on pressure and velocity fields. [ABSTRACT FROM AUTHOR]

The authors express gratitude for the comments received on their study about depression among Chinese residents during the later stages of the COVID-19 pandemic. They acknowledge that certain potential risk factors, such as younger age, lower education, tobacco use, and comorbidities, were not included in their study but have been identified in other research. The authors explain that their study focused on specific demographic and lifestyle variables chosen based on their appearance in literature and feasibility of measurement. They recognize the complexity of the pandemic and its impact on mental health, stating that capturing all potential factors in a single study is challenging. The authors emphasize that their aim was to provide valuable insights to guide public health interventions, rather than an exhaustive list of risk factors. [Extracted from the article]

CaBi2Nb2O9 ceramics were fabricated via the solid-state reaction method by the addition of B2O3 as a sintering aid at lower sintering temperatures than that prepared without B2O3. Ferroelectricity, piezoelectricity, and resistivity can be still greatly enhanced when the sintering temperature is decreased from 1075 °C for CaBi2Nb2O9 to 975 °C for CaBi2Nb2O9–0.25 wt. % B2O3. The high resistivity and weak c-axis texture ensure that the ceramics can be fully polarized in a high enough electric field. The increased spontaneous ferroelectric and remanent polarization result in a significant enhancement in the piezoelectric properties of CaBi2Nb2O9–0.25 wt. % B2O3. The sample sintered at 975 °C possesses a high piezoelectric coefficient d33 of ∼15.0 pC/N and resistivity of 1.4 × 106 Ω cm (at 600 °C) along with a high ferroelectric Curie temperature TC of ∼954 °C. This work is beneficial for the preparation of high-temperature piezoelectric ceramics with excellent electrical properties at a low sintering temperature. [ABSTRACT FROM AUTHOR]

Background: HER2-targeted antibody-drug conjugates (ADCs) such as disitamab vedotin (DV) and trastuzumab deruxtecan (T-Dxd) have emerged as effective treatment options and received regulatory approvals for HER2 expressing locally advanced or metastatic urothelial carcinoma (la/mUC). In addition, ADCs in combination with immunotherapy have demonstrated anti-tumor activity. The current study aimed to evaluate the combination of DV and toripalimab in patients with la/mUC., Patients and Methods: This open-label phase 1b/2 study enrolled patients with untreated or chemo-refractory la/mUC. During the dose escalation phase, DV was administered at escalating doses of 1.5 and 2.0 mg/kg in combination with toripalimab 3.0 mg/kg once every two weeks. Primary endpoints were safety and the recommended phase 2 dose (RP2D). Secondary endpoints included objective response rate (ORR), progression-free survival (PFS), and overall survival (OS)., Results: From August 2020 to December 2021, a total of forty-one patients were enrolled, including six in the dose-escalation phase, and thirty-five in the dose-expansion phase. Sixty-one percent of patients were treatment naïve. No dose-limiting toxicity was observed. The RP2D was determined as DV (2.0 mg/kg) plus toripalimab (3.0 mg/kg). By the data cutoff date of March 1, 2024, the confirmed ORR was 73.2%. The median PFS was 9.3 months, and the median OS was 33.1 months. The most common treatment-related adverse events (TRAEs) were aspartate aminotransferase increased (65.9%), alanine aminotransferase increased (63.4%), and peripheral sensory neuropathy (63.4%). Grade 3 or higher TRAEs occurred in 51.2% of patients, with the most common being gamma-glutamyltransferase increased (12.2%), asthenia (9.8%), and alanine aminotransferase increased (7.3%). One treatment-related death (due to pneumonitis) was reported., Conclusions: The combination of DV and toripalimab demonstrated promising response rate and overall survival results with a manageable safety profile in HER2 unselected la/mUC patients. This combination represents a promising first-line option for la/mUC. Randomized phase III study is currently ongoing., (Copyright © 2024 European Society for Medical Oncology. Published by Elsevier Ltd. All rights reserved.)

Objective: To analyze the longitudinal association between hyperopia reserve and the cumulative incidence of myopia in grade 1 primary school students. Methods: Cohort study. This study included 2 628 grade 1 primary school students (2 628 eyes) who without myopic at baseline from the Anyang Childhood Eye Study. There were 1 515 male and 1 113 female, aged(7.16±0.40) years. Every year, cycloplegic autorefraction was performed with 1% cyclopentolate eye drops to obtain data of hyperopia reserve. Students with different ranges of hyperopia reserve at baseline were analyzed. Axial length, anterior chamber depth, corneal curvature, lens thickness, and other parameters were obtained by ocular biometrics and compared by the independent sample t test. Qualitative data were described by frequency and percentage, and comparison between groups was performed by the Chi-square test or exact probability method. Linear regression was used to analyze the association between baseline hyperopia reserve and spherical equivalent at 5 years. Results: The average hyperopia reserve was (+1.09±0.78) diopters (D) in grade 1 non-myopic children. Axial length, anterior chamber depth, corneal radius of curvature, and lens thickness were (22.66±0.72), (2.88±0.24), (7.80±0.25) and (3.62±0.19) mm, respectively. The cumulative incidence of myopia among non-myopic grade 1 primary school students was 8.5%, 21.5%, 35.6%, 47.6% and 64.1% at 1, 2, 3, 4 and 5 years, respectively. The incidence of myopia in girls was significantly higher than that in boys at 3, 4 and 5 years. The 5-year cumulative incidence of myopia was 4.6%, 26.3%, 52.3%, 78.6%, 92.6% and 94.3%, respectively, corresponding to students with baseline hyperopia reserve of >+2.00 D,+1.50 D to +2.00 D,+1.00 D to +1.50 D,+0.50 D to +1.00 D, 0.00 D to +0.50 D and -0.50 D to 0.00 D, and the difference was statistically significant ( χ ²=490.59, P <0.001). The regression equation between baseline hyperopia reserve and 5-year spherical equivalent was as follows: 5-year spherical equivalent=-3.135+1.692·baseline hyperopia reserve ( R 2 =0.454, P The lower the hyperopia reserve, the higher the incidence of myopia. Monitoring children's hyperopia reserve and early protection to reduce its consumption and timely detection of children at high risk of myopia are of great significance to prevent the occurrence and development of myopia.(This article was published ahead of print on the Online-First Publishing Platform for Excellent Scientific Researches of Chinese Medical Association Publishing House on March 15, 2022).Conclusions: The lower the hyperopia reserve, the higher the incidence of myopia. Monitoring children's hyperopia reserve and early protection to reduce its consumption and timely detection of children at high risk of myopia are of great significance to prevent the occurrence and development of myopia.(This article was published ahead of print on the Online-First Publishing Platform for Excellent Scientific Researches of Chinese Medical Association Publishing House on March 15, 2022).

Background: No standard of care for mucosal melanoma (MM) in the adjuvant setting has been established. Meanwhile, relapse-free survival (RFS) is only ∼5 months after surgery alone. This phase II trial aimed to compare toripalimab versus high-dose interferon-α2b (HDI) as an adjuvant therapy for resected MM., Patients and Methods: From July 2017 to May 2019, 145 patients with resected MM were randomized (1 : 1) to receive HDI (n = 72) or toripalimab (n = 73) for 1 year until disease relapse/distant metastasis, unacceptable toxicity, or withdrawal of consent. The primary endpoint was RFS. The secondary endpoints included distant metastasis-free survival (DMFS), overall survival (OS), and safety., Results: After a median follow-up of 26.3 months, the number of RFS, OS, and DMFS events was 51 versus 46, 33 versus 29, and 49 versus 44 in the toripalimab arm and the HDI arm, respectively. The median RFS was 13.6 [95% confidence interval (CI) 8.31-19.02] months and 13.9 (95% CI 8.28-19.61) months in the toripalimab arm and the HDI arm, respectively. The DMFS was not significantly different between the two arms [hazard ratio (HR) 1.00; 95% CI 0.65-1.54]. The median OS was 35.1 months (95% CI 27.93 months-not reached) in the toripalimab arm, with no significant difference in all-cause death (HR 1.11, 95% CI 0.66-1.84) for the two arms. The median sums of the patients' actual infusion doses were 3672 mg and 1054.5 MIU in the toripalimab arm and the HDI arm, respectively. The incidence of treatment-emergent adverse events with a grade ≥3 was much higher in the HDI arm than in the toripalimab arm (87.5% versus 27.4%)., Conclusions: Toripalimab showed a similar RFS and a more favorable safety profile than HDI, both better than historical data, suggesting that toripalimab might be the better treatment option. However, additional translational studies and better treatment regimens are still warranted to improve the clinical outcome of MM., Competing Interests: Disclosure JG is a member of the advisory board/consultant of MSD, Roche, Pfizer, Bayer, Novartis, Simcere, Shanghai Junshi Bioscience, and Oriengene. XT, FR, and SY are employees of Shanghai Junshi Biosciences Co. Ltd. All other authors have declared no conflicts of interest. Data sharing The datasets generated and analyzed in the present study are available from the sponsor upon reasonable request., (Copyright © 2022. Published by Elsevier Ltd.)

Objective: To evaluate the diagnostic efficacy of indirect haemagglutination assay (IHA) for detection of Schistosoma japonicum infections among boatmen and fishermen in Dongting Lake region, so as to provide insights into improving the schistosomiasis surveillance program among boatmen and fishermen., Methods: The boatmen and fishermen were detected for S. japonicum infections using IHA and Kato-Katz technique or miracidium hatching test nylon gauze simultaneously at schistosomiasis testing sites in the anchor sites for boatmen and fishermen in the Dongting Lake region during the period from 2014 to 2016, and using IHA for serological screening followed by parasitological testing of seropositives during the period from 2017 to 2019. The sensitivity and specificity of IHA were evaluated for detection of S. japonicum infections among boatmen and fishermen, with the 2014-2016 parasitological testing results as a gold standard. In addition, the seroprevalence of S. japonicum infections was compared among boatmen and fishermen with different characteristics and among years., Results: A total of 306 schistosomiasis testing sites were assigned for boatmen and fishermen, and a total of 143 360 person-time boatmen and fishermen were tested for S. japonicum infections in the Dongting Lake region from 2014 to 2019. The sensitivity and specificity of IHA were 69.9%, 97.3% and 96.1% ( χ 2 = 74.6, P < 0.05), and 70.9%, 74.5% and 71.9% for detection of S. japonicum infections from 2014 to 2016 ( χ 2 = 29.4, P < 0.05), respectively. The seroprevalence of S. japonicum infections reduced from 30.3% in 2014 to 1.8% in 2019 among boatmen and fishermen, appearing an overall tendency towards a decline ( Z = 1 552.4, P < 0.05). In addition, male, individuals at ages of 45 to 60 years, full-time boatmen and fishermen were more likely to be seropositive for S. japonicum infections (all P values < 0.05)., Conclusions: The seroprevalence of S. japonicum infections appeared a tendency towards a decline among boatmen and fishermen in the Dongting Lake region year by year from 2014 to 2019. IHA presented a high efficacy for screening of S. japonicum infections among boatmen and fishermen in the Dongting Lake region.

Objective: To retrospectively analyze the characteristics and influencing factors of liver function changes in 111 elderly patients with COVID-19 pneumonia. Methods: 111 elderly patients with COVID-19 admitted to the Department of Infectious Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from February 5 to March 3, 2020 were enrolled. According to the severity of disease and liver function condition, they were divided into severe group ( n =40), normal group ( n =71), abnormal liver function group ( n =86) and normal liver function group ( n =25). The indexes related to liver function changes [total bilirubin (TBil), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and γ-glutamyl transferase (GGT)] and related influencing factors were analyzed. Results: Among 111 cases, 86 (77.5%) had abnormal liver function of varying degrees, and 28 (25.2%) had liver injury. The abnormal rates of TBil, AST, ALP and GGT were significantly higher in the severe group than normal group ( P <0.05). There were no significant differences in age, ribavirin, glucocorticoid and the application of lopinavir-ritonavir tablets between the abnormal liver function and the normal group ( P >0.05). The proportion of male was significantly higher in the abnormal liver function than normal liver function group ( P <0.05). Conclusion: Elderly COVID-19 patients have a higher proportion of abnormal liver function, and patients in the severe group are more likely to have higher level of TB, AST, ALP and GGT. The abnormal liver function may be related to the direct viral infection of the liver and the inflammatory immune response of the body after infection in elderly patients.

Objectives: To summarize the clinical phenotypes and the variation spectrum of ATP7B gene in Chinese children with Wilson's disease (WD) and to investigate their significance for early diagnosis. Methods: Retrospective analysis was performed on the clinical data of 316 children diagnosed as WD in Guangzhou Women and Children's Medical Center during the period from January 2010 to June 2021. The general situations, clinical manifestations, lab test results, imaging examinations, and ATP7B gene variant characteristics were collected. The patients were divided into asymptomatic WD group and symptomatic WD group based on the presence or absence of clinical symptoms at the time that WD diagnosis was made. The χ 2 test, t test or Mann-Whitney U test were used to compare the differences between groups. Results: Among the 316 children with WD, 199 were males and 117 were females, with the age of 5.4 (4.0, 7.6) years at diagnosis; 261 cases (82.6%) were asymptomatic with the age of 4.9 (3.9, 6.4) years; whereas 55 cases (17.4%) were symptomatic with the age of 9.6 (7.3, 12.0) years. The main symptoms invloved liver, kidney, nervous system, or skin damage. Of all the patients, 95.9% (303/316) had abnormal liver function at diagnosis; 98.1% (310/316) had the serum ceruloplasmin lever lower than 200 mg/L; 97.7% (302/309) had 24-hour urine copper content exceeding 40 μg; only 7.4% (23/310) had positive corneal K-F rings, 8.2% (23/281) had abnormal MRI signals in the lenticular nucleus, and all of them had symptoms of damage in liver, kidney or nervous system. Compared with the group of symptomatic WD, asymptomatic group had higher levels of serum alanine aminotransferase and lower levels ceruloplasmin and 24-hour urine copper [(208±137) vs. (72±78) U/L, (55±47) vs. (69±48) mg/L, 103 (72, 153) vs. 492 (230, 1 432) μg; t =9.98, -1.98, Z =-4.89, all P <0.001]. Among the 314 patients completing genetic sequencing, a total of 107 mutations in ATP7B gene were detected, of which 10 are novel variants, and 3 cases (1.0%) had large heterozygous deletion (exons 10 to exon 11) in ATP7B gene. The percentage of missense mutation in asymptomatic WD children was significantly higher than that in symptomatic WD (81.5% (422/518) vs. 69.1% (76/110), χ²=8.47, P <0.05). WD patients carrying homozygous variant of c.2 333G>T had significantly low levels of ceruloplasmin than those not carrying this variant ((23±5) vs. (61±48) mg/L, t =-2.34, P <0.001). Conclusions: The elevation of serum ALT is an important clue for early diagnosis of WD in children, while serum ceruloplasmin and 24-hour urine copper content are specific markers for early diagnosis of WD. In order to confirm the diagnosis of WD, it is necessary to combine the Sanger sequencing with multiplex ligation-dependent probe amplification or other testing technologies.

Objective: To analyze the efficacy and safety of toripalimab combined with axitinib in the treatment of advanced renal cell carcinoma. Methods: Clinical data of 50 patients with advanced renal cell carcinoma who received axitinib combined with toripalimab were retrospectively collected from the database of Peking University Cancer Hospital. ORR, DCR, PFS, and OS were analyzed. Results: Among the 50 patients, 37 were males; median age was 56 (22-73) years; 38 were pathologically diagnosed as clear cell renal cell carcinoma and 12 were non-clear cell carcinoma. Common metastatic sites included lung, bone, lymph node, liver, and so on. 90% of the patients had received at least one-line of systemic therapy. With a median follow-up time of 11.9 months (0.8-24), 27 of the 50 patients are still on treatment, ORR was 34%, DCR was 86%, median PFS was 13.1 months (95% CI 5.8-20.4), and median OS has not yet reached. One-year OS rate was 84.6%. Common adverse reactions were proteinuria, diarrhea, hypertension, abnormal thyroid function, elevated transaminase, and hand-foot syndrome. Most adverse events were grade 1-2. Conclusion: Toripalimab combined with axitinib was efficient in the treatment of advanced renal cell carcinoma, and had manageable adverse reactions.