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Abstract Background The triglyceride–glucose (TyG) index has garnered recognition as a surrogate marker for insulin resistance, a pivotal factor in the pathogenesis of various metabolic disorders. Despite its emerging role, the empirical evidence delineating its association with prediabetes mellitus (Pre-DM) remains scant. This research aims to clarify the link between the TyG index and the likelihood of Pre-DM development within a Chinese demographic. Methods This investigation was structured as a retrospective cohort analysis, encompassing a sample of 179,177 Chinese adults. These individuals underwent medical examinations at the Rich Healthcare Group over a period spanning from 2010 to 2016. To ascertain the relationship between the TyG index and the incidence of Pre-DM, this study employed Cox regression analysis complemented by sensitivity and subgroup assessments. Furthermore, Cox proportional hazards regression with cubic spline functions and smooth curve fitting was incorporated to explore the existence of any non-linear connection within this association. Results Upon adjusting for a comprehensive array of confounding variables, a statistically significant positive correlation between the TyG index and the risk of Pre-DM was identified (HR: 1.60, 95%CI 1.56–1.65, P

Abstract This study aimed to assess the reliability and validity of a novel clinical tool for distributing rehabilitation patients (DRP) for measuring a population of rehabilitation patients based on first-hand data from the field survey in China. A multi-stage sampling scheme was used to select 2512 rehabilitation outpatients from 21 medical institutions in seven cities in China. The evaluation indicators of the DRP tool consisted of five clinical indexes on multiple dysfunctions, self-care ability, vital signs, disease status, and disease course. The evaluation of rehabilitation ways of the DRP tool mainly included outpatient rehabilitation treatment, admission to primary healthcare, admission to secondary hospitals, and admission to tertiary hospitals. The mean age of participants was 54.22 years (SD:17.91), and nearly half (48.68%) were male. The majority (70.15%) were diagnosed with orthopaedic disorders. The Cronbach’s alpha (0.66), the Kendall test (Kendall coefficient = 0.86; P

Abstract The lipid accumulation product (LAP) is a novel, sex-specific indicator of lipid accumulation. While previous studies have investigated the relationship between LAP and diabetes, they have not specifically addressed potential sex differences in this association. The present study explores the potential sex-specific differences in the relationship between LAP and diabetes mellitus (DM) risk in the Japanese population. From 2004 to 2015, a total of 15,263 Japanese individuals without DM underwent physical assessments at Murakami Memorial Hospital. The association between LAP and incident diabetes was analyzed using Cox proportional hazards regression models, incorporating cubic spline functions and smooth curve fitting to identify potential non-linear relationships. Subgroup and sensitivity analysis assessments were conducted to validate the robustness of our findings. After adjusting for covariates, a positive association between LAP and DM risk was observed in both females (HR: 1.02, 95% CI: 1.00-1.03, P = 0.0138) and males (HR: 1.01, 95% CI: 1.00-1.01, P = 0.0314). A non-linear association between LAP and incident DM was identified for both sexes. The inflection points for LAP were 16.58 for females and 11.11 for males. In females, the HR to the left and right of the inflection point were 1.09 (95% CI: 1.02–1.17) and 1.01 (95% CI: 1.00-1.03), respectively. In males, the HR to the left and right of the inflection point were 0.92 (95% CI: 0.86–0.98) and 1.01 (95% CI: 1.00-1.01), respectively. Sensitivity analysis indicated a stronger association between LAP and DM risk. Elevated baseline LAP levels were associated with an increased risk of incident DM, with the relationship exhibiting non-linear characteristics. These findings suggest that maintaining lower LAP levels may help mitigate the risk of developing diabetes.

Abstract Background In 2020, China declared that the absolute poverty in the country had been eradicated, but older people in rural areas are deprived in multiple domains. Poverty is multidimensional and involves deprivations in health, social welfare, living standards, and income. This study focused on assessing the poverty status of rural older persons and providing a basis for decision-making at all levels of government in China. Methods A multicenter cross-sectional survey was conducted in four rural areas of China. Individuals aged 60 years and older were selected through stratified sampling. People with aphasia and severe cognitive impairment were excluded. An electronic questionnaire was used to collect older people’s information, including basic demographics, major illnesses, disabilities, chronic diseases, functional disorders, and ability to perform activities of daily living. It also asked about the medical, financial, and social security assistance that respondents received, food and clothing standards, safe housing, clean energy, safe drinking water, and reliable electricity. Specific questions were asked regarding income sufficiency, financial support from children, and pension income. Multidimensional poverty measurements were used to compare regional disparities and indicators differences. Logistic regression was used to identify the risk factors influencing poverty. Results A total of 1272 older people were analyzed. Of them, 704 (55.35%) were women and 652 (51.26%) were aged between 60 and 69 years. The most frequently mentioned causes of poverty were illness, a lack of employment, inadequate technology, and poor transportation. We found that as multidimensional poverty indicators increased (from 6 to 10), the number of poor older people decreased (from 1218 to 437), as did the poverty incidence (from 95.75 to 34.36%) and multifaceted poverty index (from 53.41 to 25.06%). Xuanwei had the highest incidence of poverty (66.61%) and multidimensional poverty index (0.66) among the four provinces studied. Regarding the contribution of indicators, financial alleviation made the greatest contribution to multidimensional poverty among rural older adults (up to 70.51%). Age, marital status, education level, awareness of poverty alleviation policies, and region were significant predictors of multidimensional poverty among older rural residents(P

Abstract To develop new types of dynamic molecular devices with atomic-scale control over electronic function, new types of molecular switches are needed with time-dependent switching probabilities. We report such a molecular switch based on proton-coupled electron transfer (PCET) reaction with giant hysteric negative differential resistance (NDR) with peak-to-valley ratios of 120 ± 6.6 and memory on/off ratios of (2.4 ± 0.6) × 103. The switching dynamics probabilities are modulated by bias voltage sweep rate and can also be controlled by pH and relative humidity, confirmed by kinetic isotope effect measurements. The demonstrated dynamical and environment-specific modulation of giant NDR and memory effects provide new opportunities for bioelectronics and artificial neural networks.

Abstract Background Relative fat mass (RFM) is a newly developed, sex-specific anthropometric formula designed to estimate total body fat percentage. However, research investigating the correlation between RFM and the risk of non-alcoholic fatty liver disease (NAFLD) remains limited. This study evaluates the association between RFM and the risk of NAFLD within the Japanese population. Methods This study including 14,250 Japanese adults who underwent physical examinations at Murakami Memorial Hospital between 2004 and 2015. We employed binary logistic regression to elucidate the direct relationship between RFM levels and the incidence of NAFLD. Additionally, a generalized additive model (GAM) coupled with smooth curve fitting techniques was utilized to map the non-linear association. Results The cohort had an average age of 43.53 ± 8.89 years, with a male majority of 52.00%. NAFLD was identified in 17.59% of the participants. After adjusting for confounding factors, a significant positive correlation between RFM and NAFLD risk was observed (OR: 1.15, 95%CI: 1.10–1.21, P

Abstract Injurious falls pose a significant threat to the safety of stroke patients, particularly among older adults. While the influence of activities of daily living (ADL) on falls is acknowledged, the precise connection between ADL ability and fall-related injuries in older stroke patients undergoing rehabilitation, particularly those with varying mobility levels, remains unclear. This multicenter cross-sectional study in China recruited 741 stroke patients aged 65 years and above, categorized into bedridden, domestic, and community groups based on their mobility levels using the Longshi Scale. ADL ability was assessed using the Barthel Index. Logistic regression models, generalized additive models, smoothed curve-fitting, and threshold effect analysis were employed to explore the relationship between ADL ability and injurious falls across the three mobility groups. Results revealed an inverted U-shaped relationship between ADL ability and injurious falls among patients in the domestic group (p = 0.011). Below the inflection point of 35 on the Barthel Index, the likelihood of injurious falls increased by 14% with each unit increase in ADL ability (OR = 1.14, 95% CI 1.010–1.29, p = 0.0331), while above the inflection point, it decreased by 3% per unit increase (OR = 0.97, 95% CI 0.95–0.99, p = 0.0013). However, no significant association between ADL ability and injurious falls was observed in either the bedridden or community groups (p > 0.05). These findings suggest that only older stroke patients capable of engaging in activities at home demonstrate a correlation between ADL ability and injurious falls. The identified inverted U-shaped relationship may aid in identifying fall injury risk in this population.

Abstract The authors investigate the effects of nanofillers with varying band‐gap energies on the space charge properties, breakdown field strength, and bulk resistivity of epoxy (EP)‐based composites. Additionally, the molecular orbital distribution of both the epoxy resin and nanofillers were examined through density functional theory. Experimental results indicate that the space charge accumulation within silicon dioxide/EP and germanium oxide/EP is reduced, leading to a more uniformly distributed electric field intensity within the specimen when compared to epoxy. As a result, both materials exhibit improved AC breakdown field strength and volume resistivity. Conversely, the amount of charge accumulated within tin dioxide/EP is higher, resulting in lower breakdown field strength than epoxy. The lowest unoccupied molecular orbital and the highest occupied molecular orbital energy level differences between epoxy and nanofillers introduce electron traps and hole traps at the interface, forming interfacial traps that affect the space charge distribution within the specimen, as well as the trap energy levels within the material. From the experimental results, shallow traps promote space charge accumulation and reduce the breakdown field strength, while deep traps have the opposite effect.

IntroductionThis study explores how elevated CO2 concentration may alter the source-sink dynamics in rice by providing additional carbon for photosynthesis, thereby affecting nutrient absorption and distribution.MethodsA free-air CO2 enrichment experiment was conducted on a japonica cultivar Wuyunjing 27 in 2017 and 2018 growing seasons. The plants were exposed to ambient and elevated CO2 level (increased by 200 μmol·mol-1) and two source-sink manipulation treatments (control with no leaf cutting and cutting off the top three leaves at heading).ResultsThe elevated CO2 significantly increased the above-ground biomass and the straw non-structural carbohydrate concentration by an average of 19.3% and 12.5%, respectively. Significant changes in the concentrations of N, S, Fe, and Zn in straw were noted under elevated CO2, with average decreases by 7.1, 7.2, 11.6, and 10.1%, respectively. The exposure to elevated CO2 significantly enhanced the elements accumulation, yet it had minimal impact on their distribution across different organs. When compared to intact rice, removing the top three leaves at heading reduced the above-ground biomass by 36.8% and the straw non-structural carbohydrate content by 44.8%. Leaf-cutting generally increased the concentration of elements in stem, leaf, and grain, likely due to a concentration effect from reduced biomass and carbohydrate accumulation. Leaf-cutting reduced element accumulation and shifted element allocation in rice organs. It increased the proportion of elements in stems while reduced their presence in leaves and grains.DiscussionOur study suggests that a dilution effect may cause a decrease in mineral elements concentrations under elevated CO2 because of the increase in biomass and carbohydrates.

IntroductionStroke remains a predominant cause of mortality and accounts for one-third of all stroke-related fatalities worldwide. Increasing expenses associated with stroke are a matter of significant concern; however, this aspect has been insufficiently examined.MethodsThe purpose of this study was to analyze in-hospital stroke costs and explore potential factors influencing them across stroke subtypes. The records of stroke patients from 50 hospitals in southeastern China between 2019 and 2022 were reviewed using multistage stratified cluster random sampling. We focused on the cost patterns of four stroke types and used multivariate linear regression to identify cost determinants.ResultsA total of 417 (1.1%) patients had subarachnoid hemorrhage (SAH), 9309 (25.9%) had intracerebral hemorrhage (ICH), 22,248 (61.8%) had ischemic stroke (IS), and 4025 had transient ischemic attack (TIA). The number of stroke patients has sharply increased since the onset of COVID-19, with a majority of them being male (72.2%). Despite the fact that hospitalization costs are highest in tertiary hospitals (Chinese yuan [CNY] 30610.8/United States dollar [USD] 4551.0, interquartile range [IQR] 9944.9, 29668.4/1478.6, 4410.9), the majority of patients are admitted to tertiary hospitals (74.6%) or public hospitals (90.2%). Across all stroke subtypes, patients with SAH had the highest costs (CNY 93,454.9/USD13894.4, IQR 12273.2, 169920.0/1824.7, 25262.8), followed by those with ICH (CNY 48,724.2/USD 7244.0, IQR 16789.6, 57540.7/2496.2, 8554.8), IS (CNY 26,550.3/USD3947.4, IQR 8684.2, 28697.7/1291.1, 4266.6), and TIA (CNY 11,170.1/USD1660.7, IQR 6823.7, 12965.2/1014.5, 1927.6). Therapy fees comprised a significant portion of costs in ICH and IS cases (47.9% and 42.7%, respectively). Materials accounted for the highest proportion of expenses for SAH (56.1%), whereas patients with TIA spent more time on examinations (34.1%). Linear regression analysis revealed that length of stay (LOS), stroke subtype, hospital level, and stroke type were key factors influencing hospitalization costsDiscussionThe visiting rate and charges were highest in tertiary public hospitals, and hospitalization costs were higher in hemorrhagic types of stroke than in ischemic types of stroke; the proportion of hospitalization cost categories varied among different types of stroke, with LOS, hospital type, and level substantially affecting hospitalization costs. Enhancing medical insurance reimbursement rates for hemorrhagic strokes, implementing a hierarchical medical system, tailoring cost categories to accommodate varying stroke subtypes, and shortening LOS may help alleviate the economic burden of stroke.

Objective: This study examines the relationship between health communication on integrated healthcare and primary healthcare visits among rehabilitation outpatients in China. Methods: A multi-stage sampling scheme was used to select the rehabilitation outpatients as study participants. A total of 3415 participants from 21 medical institutions in seven cities in China were included in the final analysis. The measurement included primary healthcare visits, health communication on integrated healthcare, and basic characteristics (age, sex, educational level, marital status, household income, and diagnoses). The association between health communication on integrated healthcare and primary healthcare visits was modeled using logistic regression controlling the general characteristics and disease status. Results: Among 3415 rehabilitation outpatients, the mean age of participants was 45.3 years (SD:24.9), and more than half (54.0 %) were male. The majority (56.3 %) were diagnosed with orthopaedic disorders. Received information of integrated healthcare from organizational communication (OR = 2.00; 95 % CI = 1.56, 2.56) and interpersonal communication (OR = 6.03; 95 % CI = 2.49, 14.62), patients who had a higher level of knowledge on integrated healthcare (OR = 1.02; 95% CI = 1.00, 1.03), the interaction terms of ‘organizational communication ∗ knowledge’(OR = 0.98; 95 % CI = 0.97, 1.00), and ‘interpersonal communication ∗ knowledge’(OR = 0.92; 95 % CI = 0.87, 0.97) were associated with visiting primary healthcare initially when had an illness the last two weeks. Conclusion: This study indicated that rehabilitation outpatients display a low level of primary healthcare visits, calling for interpersonal-based health communication interventions to be implemented to improve their integrated healthcare knowledge and promote better primary healthcare visits practices in China.

Objective: To compare the difference of reimbursement payments between diagnosis-related group (DRG) and a novel patient classification-based payment system, diagnosis-intervention packet (DIP), among rehabilitation inpatients in tertiary hospitals. Design: Retrospective cohort study. Setting: TTertiary hospitals in Shenzhen, China. Participants: We assessed the records of 268,362 individuals who visited tertiary hospitals providing rehabilitation services. Interventions: Not applicable. Main Outcome Measures: The outcome variable was the patients’ rehabilitation hospitalization cost of in our study. A quantile regression analysis was conducted to estimate the effects of DIP payment on the rehabilitation hospitalization cost. Results: The results showed that the predicted marginal hospitalization cost with DRG payment were 9%, 7%, 14%, and 10% higher than that with DIP payments in 2019, 2020, 2021, and 2022. The total difference in predicted marginal hospitalization cost between DRG and DIP was −1269 RMB (−193 USD). This difference in 2019, 2020, 2021, and 2022 was −1419 RMB (−228 USD), −1088 RMB (−158 USD), −1585 RMB (−246 USD), and −1034 RMB (−154 USD), respectively. All differences in predicted marginal hospitalization cost between DRG and DIP was significant (P

BackgroundThe triglyceride-glucose (TyG) index, recognized for its cost-efficiency and simplicity, serves as an accessible indicator of insulin resistance. Yet, its correlation with the risk of prediabetes and diabetes (Pre-DM/DM) in the Chinese demographic remains uncertain. Consequently, our study explored the association between the TyG index and the development of Pre-DM/DM within the Chinese population.MethodsThe retrospective cohort study was carried out utilizing data from a health screening initiative. The study included 179541 adults over 20 who underwent medical examinations at the Rich Healthcare Group over a period spanning from 2010 to 2016. The correlation between the TyG index and Pre-DM/DM risk was investigated using Cox regression analysis. Furthermore, Cox proportional hazards regression with cubic spline functions and smooth curve fitting was incorporated to explore their non-linear connection.ResultsThe mean age of study participants was 41.18 ± 12.20 years old, and 95255 (53.05%) were male. During a median follow-up of 3.01 years, 21281 (11.85%) participants were diagnosed with Pre-DM/DM. After adjusting the potential confounding factors, the results showed that the TyG index was positively correlated with incident Pre-DM/DM (HR: 1.67, 95%CI: 1.62-1.71, P< 0.001). Additionally, a non-linear association was observed between the TyG index and the onset of Pre-DM/DM, with an inflection point identified at 8.73. Hazard ratios (HR) to the left and right of this inflection point were 1.95 (95%CI: 1.86-2.04) and 1.34 (95%CI: 1.27-1.42), respectively. Furthermore, sensitivity analyses confirmed the stability of these findings.ConclusionThe TyG index exhibited a non-linear positive relationship with the risk of Pre-DM/DM. These findings imply that maintaining the TyG index at a lower, specified threshold may be beneficial in mitigating the onset of Pre-DM/DM.

AimsThis study aimed to assess the effects of Low-to-Moderate Intensity Continuous Training (LMICT), Moderate-Intensity Interval Training (MIIT), and Reduced-Exertion High-Intensity Training (REHIT) on blood glucose regulation, functional recovery, and lipid levels in individuals who have experienced a stroke and are diagnosed with Type 2 Diabetes Mellitus (T2DM).MethodsForty-two T2DM stroke patients were randomly allocated to four groups: LMICT, MIIT, REHIT, and a control group (CON). Participants continuously monitored their blood glucose levels throughout the intervention using continuous glucose monitoring (CGM) devices. The study comprised two exercise intervention cycles: the first lasting from Day 3 to Day 14 and the second from Day 15 to Day 28, with the initial two days serving as contrasting periods. Primary outcomes encompassed CGM-derived blood glucose measurements, the Barthel Index (BI), Fugl-Meyer Assessment lower-extremity subscale (FMA-LE), and alterations in triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c).ResultsCompared with the CON, the MIIT group showed significant improvements in mean glucose (MG), glucose standard deviation (SD), time above range (TAR), and time in range (TIR). The REHIT group exhibited significantly reduced time below range (TBR), glucose SD, and coefficient of variation (CV). Regarding lipid levels, although the REHIT group achieved a significant reduction in TG levels compared with the CON, the overall effects of LMICT, MIIT, and REHIT on lipid profiles were relatively modest. Concerning functional recovery, the REHIT group significantly improved the BI and FMA-LE.ConclusionAlthough the short-term quantitative impact of exercise on lipid levels may be limited, both REHIT and MIIT significantly improved glycemic management and reduced glucose variability in post-stroke patients with Type 2 Diabetes Mellitus. Additionally, REHIT notably enhanced functional recovery.

IntroductionBreast cancer is a heterogeneous disease comprising various molecular subtypes, including Luminal A, Luminal B, human epidermal growth factor receptor-2 (HER2) positive, and triple negative types, each with distinct biological characteristics and behaviors. Triple negative breast cancer (TNBC) remains a particularly challenging subtype worldwide. Our study aims to evaluate whether Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (18F-FDG PET/CT) parameters, clinical pathological features, and biochemical indicators serve as prognostic risk factors for TNBC. Additionally, we explore correlations between biochemical indicators and 18F-FDG PET/CT parameters.MethodsWe conducted a retrospective analysis of 95 TNBC patients who underwent preoperative 18F-FDG PET/CT examinations at Tianjin Medical University Cancer Institute and Hospital from 2013 to 2018. Collected data included 18F-FDG PET/CT parameters, clinical and pathological features, and biochemical indicators. We used Kaplan-Meier survival analysis and multivariate Cox regression analysis to evaluate associations between 18F-FDG PET/CT parameters/biochemical indicators and disease free survival (DFS)/overall survival (OS). The log-rank test determined significant differences in survival curves, and the Spearman correlation coefficient analyzed correlations between quantitative variables. Visualization and analysis were performed using R packages.ResultsAmong 95 TNBC patients, mean standardized uptake value (SUVmean) was significantly correlated with DFS. Fasting blood glucose (FBG), α- L-fucosylase (AFU) and Creatine kinase (CK) were independent predictors of DFS, while Precursor albumin (PALB) and CK were independent predictors of OS. FBG showed correlations with SUVpeak and SUVmean, and CK was correlated with peak standardized uptake value (SUVpeak). Our results indicated that 18F-FDG PET/CT parameters and biochemical indicators may constitute a new prognostic model for TNBC patients post-surgery.DiscussionWe found that SUVmean, FBG, AFU and CK are predictive factors for DFS in TNBC patients post-surgery, while PALB and CK are predictive factors for OS, which prompts us to pay more attention to these indicators in clinical practice. Also 18F-FDG PET/CT parameters and biochemical indicators have potential utility in constituting a new prognostic model for TNBC patients post-surgery.

Due to factors such as changing customer demands and supply disruptions, product design changes are inevitable during the product development process. Selecting an appropriate product change propagation path not only maintains product performance but also reduces generation time and cost. This paper investigates an intelligent optimization method for complex product change propagation paths. Firstly, considering change duration, change cost, and the impact degree on product performance, a parameter network model of the product is constructed based on the parameter linkage relationship between product parts. Secondly, to solve this model a change propagation path optimization method based on an improved ant colony algorithm is proposed. Finally, the effectiveness of the proposed model and algorithm is validated on the design change problem of TV products at Skyworth RGB Co., Ltd. Experimental results demonstrate that the proposed algorithm can generate highly competitive optimal change paths for TV products.

Abstract Background The Longshi Scale is a pictorial assessment tool for evaluating activities of daily living (ADL) in patients with stroke. The paper-based version presents challenges; thus, the WeChat version was created to enhance accessibility. Herein, we aimed to validate the inter-rater and test–retest reliabilities of the WeChat version of the Longshi Scale and explore its potential clinical applications. Methods We recruited 115 patients with stroke in the study. The ADL results of each patient were assessed using both the WeChat and paper-based version of the Longshi Scale; each evaluation was conducted by 28 health professionals and 115 caregivers separately. To explore the test–retest reliability of the WeChat version, 22 patients were randomly selected and re-evaluated by health professionals using the WeChat version. All evaluation criteria were recorded, and all evaluators were surveyed to indicate their preference between the two versions. Results Consistency between WeChat and the paper-based Longshi Scale was high for ADL scores by health professionals (ICC2,1 = 0.803–0.988) and caregivers (ICC2,1 = 0.845–0.983), as well as for degrees of disability (κw = 0.870 by professionals; κw = 0.800 by caregivers). Bland–Altman analysis showed no significant discrepancies. The WeChat version exhibited good test–retest reliability (κw = 0.880). The WeChat version showed similar inter-rater reliability in terms of the ADL score evaluated using the paper-based version (ICC2,1 = 0.781–0.941). The time to complete assessments did not differ significantly, although the WeChat version had a shorter information entry time (P

Abstract This study aimed to assess the effectiveness and optimal dosage of aspirin in preventing preeclampsia in high‐risk pregnant women. Traditional and network meta‐analyses were conducted on data from 23 randomized controlled trials involving 10 547 pregnant women. The findings demonstrated that aspirin significantly reduced the incidence of preeclampsia (OR = 0.66, 95%CI [0.58, 0.75]), with the best preventive effect observed at a dosage of 80–100 mg/day (OR = 0.51, 95%CI [0.36, 0.72]). No significant differences were found in the occurrence of postpartum hemorrhage (OR = 1.03, 95%CI [0.79, 1.33]), small for gestational age (OR = 0.83, 95%CI [0.50, 1.35]), placental abruption (OR = 0.96, 95%CI [0.53, 1.73]), and intrauterine growth restriction (OR = 0.63, 95%CI [0.45, 1.86]) between women taking aspirin and those taking placebos. Different doses of aspirin showed a reduction in preeclampsia incidence, but there was no significant difference in efficacy between the dosage groups. Side effects did not significantly differ between placebo and different aspirin dosage groups. SUCRA analysis suggested that 80–100 mg/day may be the optimal dosage, prioritizing both effectiveness and minimizing side effects. Sensitivity analysis confirmed the robustness of the findings. However, improvements are needed in addressing issues like loss to follow‐up, reporting bias, and publication bias. In conclusion, a dosage of 80–100 mg/day is recommended for preventing preeclampsia in high‐risk pregnant women, although individual circumstances should be considered for optimizing the balance between effectiveness and safety.

Abstract Although papillary thyroid cancer (PTC) has a good prognosis, its recurrence rate is high and remains a core concern in the clinic. Molecular factors contributing to different recurrence risks (RRs) remain poorly defined. Here, we perform an integrative proteogenomic and metabolomic characterization of 102 Chinese PTC patients with different RRs. Genomic profiling reveals that mutations in MUC16 and TERT promoter as well as multiple gene fusions like NCOA4-RET are enriched by the high RR. Integrative multi-omics analyses further describe the multi-dimensional characteristics of PTC, especially in metabolism pathways, and delineate dominated molecular patterns of different RRs. Moreover, the PTC patients are clustered into four subtypes (CS1: low RR and BRAF-like; CS2: high RR and metabolism type, worst prognosis; CS3: high RR and immune type, better prognosis; CS4: high RR and BRAF-like) based on the omics data. Notably, the subtypes display significant differences considering BRAF and TERT promoter mutations, metabolism and immune pathway profiles, epithelial cell compositions, and various clinical factors (especially RRs and prognosis) as well as druggable targets. This study can provide insights into the complex molecular characteristics of PTC recurrences and help promote early diagnosis and precision treatment of recurrent PTC.

Abstract Stroke survivors frequently experience difficulties in daily activities, such as bathing, feeding, and mobility. This study aimed to evaluate the reliability and validity of a computer-adaptive test-Longshi scale (CAT-LS) for assessing activities of daily living (ADL) in stroke survivors. This cross-sectional study collected data using an electronic application. The ADL function of stroke survivors in rehabilitation departments of hospitals was assessed using both the CAT-LS and BI. Correlations between the CAT-LS and Barthel index (BI) and concurrent validity were evaluated using Pearson’s correlation test and multiple linear regression. Interrater reliability was evaluated using the intraclass correlation coefficient based on a two-way random effect. The internal consistency of the CAT-LS was assessed using Cronbach’s coefficient (α) and corrected item-total correlations. Overall, 103 medical institutions in China were used in this study. In total, 7151 patients with stroke were included in this study. The CAT-LS classified patients into three ADL groups (bedridden, domestic, and community) with significantly different BI scores (P

Abstract Objective In patients experiencing acute ischemic stroke, there is ongoing debate surrounding the connection between chronic hyperglycemic status and their initial clinical outcomes. Our objective was to examine the connection between glycated hemoglobin (HbA1c) levels and adverse clinical outcomes at both 3-months adverse clinical outcomes in individuals with acute ischemic stroke (AIS) with and without diabetes. Methods The present prospective cohort study involved 896 AIS patients without diabetes and 628 with diabetes treated at a South Korean hospital from January 2010 to December 2016. The target independent variable is HbA1c. The outcome variable is a modified Rankin scale score ≥ 3. A binary logistic regression model was applied to assess the connection between HbA1c levels and 3-month poor clinical outcomes in AIS patients with and without diabetes. Additionally, a generalized additive model and smoothed curve fitting were utilized to explore potential nonlinear associations between HbA1c levels and 3-month adverse clinical outcomes in AIS patients with and without diabetes. Results The binary logistic regression model could not identify any statistically significant connection between HbA1c and 3-month adverse clinical outcomes in AIS patients, both those with and without diabetes, after correcting for various factors. However, a nonlinear relationship emerged between HbA1c and 3-month adverse clinical outcomes in AIS patients with diabetes. The inflection point for HbA1c was determined to be 6.1%. For HbA1c values ≤ 6.1%, an inverse association was observed between HbA1c and 3-month adverse clinical outcomes in diabetic AIS patients, and each 1% increase in HbA1c in AIS patients with DM was associated with an 87% reduction in 3-month adverse clinical outcomes (OR = 0.13, 95% CI: 0.02–0.81). Conversely, when HbA1c exceeded 6.1%, a positive association between HbA1c and 3-month adverse clinical outcomes became apparent in diabetic AIS patients, and each 1% increase in HbA1c in AIS patients with DM was associated with a 23% increase in 3-month adverse clinical outcomes (OR = 1.23, 95%CI: 1.03–1.47). However, it’s important to note that no significant linear or nonlinear relationships were observed between HbA1c levels and 3-month adverse clinical outcomes in AIS patients without diabetes. Conclusion Our findings suggest a nonlinear connection and threshold effect between HbA1c and 3-month adverse clinical outcomes in AIS patients with diabetes. AIS patients with diabetes had a lower risk of 3-month adverse clinical outcomes when their HbA1c control was close to 6.1%. Our findings may aid treatment decision-making and potentially guide interventions to optimize glycemic control in AIS patients.

The association between the red blood cell distribution width-platelet ratio (RPR) and mortality in heart failure patients remains unclear. We aimed to investigate the potential non-linear relationship between RPR and 1-year mortality risk. A retrospective cohort study was conducted involving 6982 participants from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Multivariable Cox regression and restricted cubic spline analyses were performed to evaluate the association between RPR and 1-year mortality, adjusting for potential confounders. We observed 1091 patients died in hospital and 2535 patients died during 1 year follow-up period. The prevalence or incidence of mortality did not show statistically significant differences among RPR groups in the overall study population. However, a positive association between RPR and the risk of mortality was noted after adjusting for multiple variables (HR = 1.38, 95 % CI = 1.06–1.81, P = 0.018). Analysis using restricted cubic splines indicated a U-shaped relationship between RPR levels and the risk of mortality (P nonlinearity 0.104) (HR = 2.656, 95 % CI: 1.692–4.170).This U-shaped association was consistent across subgroup analyses (all interaction P values > 0.05). RPR exhibits a U-shaped association with 1-year mortality in heart failure patients, suggesting both low and high RPR levels are linked to increased risk. RPR may serve as a relevant biomarker for risk stratification in this population. We incorporated RPR into the SOFA (AUC 0.731) and SAPS II (AUC 0.746) models, which significantly improved their predictive ability for in-hospital mortality. For 1-year mortality prediction, RPR + SAPS II (AUC 0.683) showed significantly improved accuracy, while RPR + SOFA (AUC 0.626) did not improve significantly.

BackgroundMusic therapy is a rapidly evolving multidisciplinary field. But there has been no research analyzing the latest research status and development trends in this research field from a macro perspective. We aim to identify hotspots, knowledge base, and frontiers in the field of music therapy through bibliometric analysis.MethodsAll data were retrieved from the Web of Science core database from January 1, 2013 to December 31, 2022.CiteSpace and Bibliometrix software were employed for bibliometric analysis and visualization analysis.ResultsA total of 2,397 articles were included. In the past decade, there has been a consistent increase in the number of publications. The countries and institutions with the largest production in this field are the USA and the University of London. Based on the analysis of the total number of citations, centrality, and production, the results show that the most influential journals are PLoS One and Cochrane Database Syst Rev. Keyword co-occurrence analysis and highly cited study analysis are mainly used to analyze research hotspots in the field of music therapy, while the keyword burst analysis is employed to explore frontiers and potential developmental trends. Hot keywords include “interventions”, “anxiety” and “randomized controlled trial”. The burst keywords include “validity”, “preterm infants”, and “mild cognitive impairment”. In the ranking of highly cited study, the top ranked studies are “Music-based interventions in neurological rehabilitation” and “Music interventions for improving psychological and physical outcomes in cancer patients”.ConclusionIn the past decade, the research focus in music therapy was the effect of music therapy on neurological diseases and the improvement of psychological symptoms such as pain and anxiety. The neurophysiological mechanisms that bring about these therapeutic effects need to be future researched.

Background Intracranial haemorrhage (ICH) poses a significant threat to patients on Direct Oral Anticoagulants (DOACs), with existing risk scores inadequately predicting ICH risk in these patients. We aim to develop and validate a predictive model for ICH risk in DOAC-treated patients. Methods 24,794 patients treated with a DOAC were identified in a province-wide electronic medical and health data platform in Tianjin, China. The cohort was randomly split into a 4:1 ratio for model development and validation. We utilized forward stepwise selection, Least Absolute Shrinkage and Selection Operator (LASSO), and eXtreme Gradient Boosting (XGBoost) to select predictors. Model performance was compared using the area under the curve (AUC) and net reclassification index (NRI). The optimal model was stratified and compared with the DOAC model. Results The median age is 68.0 years, and 50.4% of participants are male. The XGBoost model, incorporating six independent factors (history of hemorrhagic stroke, peripheral artery disease, venous thromboembolism, hypertension, age, low-density lipoprotein cholesterol levels), demonstrated superior performance in the development dateset. It showed moderate discrimination (AUC: 0.68, 95% CI: 0.64–0.73), outperforming existing DOAC scores (ΔAUC = 0.063, P = 0.003; NRI = 0.374, P

Background Neuroinflammatory responses are closely associated with poststroke prognosis severity. This study aimed to develop a predictive model, combining inflammation‐derived markers and clinical indicators, for distinguishing functional outcomes in patients with subacute ischemic stroke. Methods and Results Based on activities of daily living assessments, ischemic stroke participants were categorized into groups with little effective (LE) recovery and obvious effective (OE) recovery. Initial biocandidates were identified by overlapping differentially expressed proteins from proteomics of clinical serum samples (5 LE, 5 OE, and 6 healthy controls) and differentially expressed genes from an RNA sequence of the ischemic cortex in middle cerebral artery occlusion mice (n=3). Multidimensional validations were conducted in ischemia–reperfusion models and a clinical cohort (15 LE, 11 OE, and 18 healthy controls). Models of robust biocandidates combined with clinical indicators were developed with machine learning in the training data set and prediction in another test data set (15 LE and 11 OE). We identified 194 differentially expressed proteins (LE versus healthy controls) and 174 differentially expressed proteins (OE versus healthy controls) in human serum, and 5121 differentially expressed genes (day 3) and 5906 differentially expressed genes (day 7) in middle cerebral artery occlusion mice cortex. Inflammation‐derived biomarkers TIMP1 (tissue inhibitor metalloproteinase‐1) and galactosidase‐binding protein LGLAS3 (galectin‐3) exhibited robust increases under ischemic injury in mice and humans. TIMP1 and LGALS3 coupled with clinical indicators (hemoglobin, low‐density lipoprotein cholesterol, and uric acid) were developed into a combined model for differentiating functional outcome with high accuracy (area under the curve, 0.8). Conclusions The combined model is a valuable tool for evaluating prognostic outcomes, and the predictive factors can facilitate development of better treatment strategies.

ABSTRACT Monkeypox virus (MPXV) poses a global health threat. Droplet digital PCR (ddPCR) holds potential as an accurate diagnostic tool for clinical microbiology. However, there is limited literature on the applicability of ddPCR in clinical settings. In this study, the clinical features of patients with MPXV during the initial outbreak in China in June 2023 were reviewed, and an optimized ddPCR method with dilution and/or inhibitor removal was developed to enhance MPXV detection efficiency. Eighty-two MPXV samples were tested from nine different clinical specimen types, including feces, urine, pharyngeal swabs, anal swabs, saliva, herpes fluid, crust, and semen, and the viral load of each specimen was quantified. A comparative analysis was performed with qPCR to assess sensitivity and specificity and to investigate the characteristics of MPXV infection by analyzing viral loads in different clinical specimens. Consequently, common pharyngeal and gastrointestinal symptoms were observed in patients with MPXV. The optimized ddPCR method demonstrated relatively high sensitivity for MPXV quantification in the clinical materials, with a limit of detection of 0.1 copies/μL. This was particularly evident in low-concentration samples like whole blood, semen, and urine. The optimized ddPCR demonstrated greater detection accuracy compared with normal ddPCR and qPCR, with an area under the curve (AUC) of 0.939. Except for crust samples, viral loads in the specimens gradually decreased as the disease progressed. Virus levels in feces and anal swabs kept a high detection rate at each stage of post-symptom onset, and feces and anal swabs samples may be suitable for clinical diagnosis and continuous monitoring of MPXV.IMPORTANCEThe ddPCR technique proved to be a sensitive and valuable tool for accurately quantifying MPXV viral loads in various clinical specimen types. The findings provided valuable insights into the necessary pre-treatment protocols for MPXV diagnosis in ddPCR detection and the potentially suitable sample types for collection. Therefore, such results can aid in comprehending the potential characteristics of MPXV infection and the usage of ddPCR in clinical settings.

Abstract Gelatin was widely used as scaffold materials in 3D bio-printing due to its excellent bioactivity and availability and especially that their arginine–glycine–aspartic acid (RGD) sequences could efficiently promote cell adhesion and proliferation. In this study, an electroactive and 3D bio-printable hydrogel was prepared through a two-step chemical cross-linking process. Specifically, residual free amino groups of methacrylated gelatin (GelMA) were cross-linked with the aldehyde groups of dibenzaldehyde-terminated telechelic polyethylene glycol (DF-PEG) via Schiff base bonds, forming a gel at 37 °C. During the subsequent 3D bio-printing process, GelMA underwent UV curing, forming a secondary cross-linked network to the mechanical strength and stability of the printed structure. The uniform dispersion of carbon nanotubes (CNTs) in the GelMA/DF-PEG composite hydrogel significantly increased its conductivity. The optimized GelMA/DF-PEG composite hydrogel, i.e., 30% GelMA and 25% DF-PEG (G30D25-CNTs), exhibited superior bio-printability. When the content of CNTs was above 4%, the conductivity of G30D25-CNTs hydrogel exceeded 10–2 S/m, which satisfied the needs of cells for micro-current stimulation. Furthermore, the pore microstructures, swelling behavior, degradation ability and cell toxicity of G30D25-CNTs electroactive hydrogels were thoroughly evaluated. Thus, the G30D25-CNTs hydrogel with 4% MWCNTs could be considered for further application in electrical stimulation of tissue regeneration such as muscle and cardiac nerve tissue repair.

[Objective] To ensure the reliability of the stator insulation in EMU (electric multiple unit) traction motors during stator manufacturing or maintenance, it is necessary to conduct tests such as ground insulation withstand voltage, interphase withstand voltage, and coil-to-coil insulation withstand voltage to screen for defects of stator-to-ground insulation, interphase insulation, and coil-to-coil insulation. Therefore, an analysis of stator insulation faults in traction motors is required, and corresponding countermeasures are proposed. [Method] The fault characteristics and causes of ground insulation breakdown, interphase short circuit, and non-coinciding waveform attenuation in coil-to-coil insulation are introduced. Corresponding improvement measures and stator repair methods for these faults are analyzed. [Result & Conclusion] After repair, the stator of traction motor successfully passes the screening tests for ground insulation withstand voltage, interphase withstand voltage, and coil-to-coil insulation withstand voltage, and the test results demonstrate that the analyzed fault causes can accurately diagnose stator insulation faults, and the formulated improvement measures effectively resolve stator insulation issues.

In order to study the division method and fractal characteristics of the overburden gas slow permeability zone in up-dip fully mechanized face of inclined thick coal seam, based on the fractal theory and grey theory, the plane physical similarity simulation experiment was used to study the crack evolution law of the overburden gas slow permeability zone in up-dip fully mechanized face. The dynamic expansion law of the overburden gas slow permeability zone was obtained, and then the division method of the overburden gas slow permeability zone was constructed. The grey correlation analysis method was used to determine the maximum correlation degree between the horizontal direction (the advancing direction of the working face) and vertical direction (perpendicular to the upward direction of the coal seam floor) fractal dimensions of the overburden gas slow permeability zone and the separation amount, the fracture density and the stress concentration coefficient. The results show that the overburden gas slow permeability zone is initially formed after the first periodic weighting. After each periodic weighting, the caving angle on both sides of the overburden gas slow permeability zone decreases continuously and the width and height increase continuously. Specifically, from the initial formation of the slow permeability zone to the full development of the slow permeability zone, the caving angles of the open-off cut side and the working face side of the slow permeability zone are reduced from 68.3° and 76.2° to 44.7° and 53.5° respectively. The width and height of the slow permeability zone increased from 16.3 m and 19.2 m to 52.1 m and 38.4 m respectively. According to the established division criterion and process of the overburden gas slow permeability zone, combined with the grey correlation analysis method, it is obtained that the variation of fractal dimension along the horizontal and vertical directions of the overburden gas slow permeability zone has the strongest correlation with the variation of the separation amount (\begin{document}$ {r_1} $\end{document}=0.93,\begin{document}$ {r_1}^ * $\end{document}=0.91), and the accuracy of theoretical calculation is verified by experiments. Therefore, when the final hole (roadway) of pressure relief gas extraction borehole (roadway) is determined in the later stage, the boundary of the overburden gas slow permeability area can be judged by field observing the separation amount. The research results have certain guiding significance for accurate and efficient extraction of pressure relief gas in goaf.

Abstract Background Acremonium terricola is used in the feed of dairy animals to promote growth and control diseases. However, the effects of dietary supplementation with A. terricola on the gut microbial structure of weaning piglets remain poorly understood. Therefore, in this study, we investigated the effects of dietary supplementation with A. terricola culture (ATC) on the growth performance, antioxidant status, immunity, and gut environment of weaning piglets. Sixty piglets were fed a basal diet supplemented with 1 g ATC/kg of basal diet (experimental group). Another 60 piglets did not receive ATC (control group). The intervention lasted for 20 days. Results The experimental group had higher daily weight gain and feed efficiency than did the control group. Significant increases were noted in the levels of serum insulin (P = 0.0018), insulin-like growth factor (P = 0.0018), triiodothyronine (P = 0.0031), immunoglobulin A (P

Accurate monitoring of lithium-ion battery temperature is essential to ensure these batteries’ efficient and safe operation. This paper proposes a relevance-based reconstruction-oriented EMD-Informer machine learning model, which combines empirical mode decomposition (EMD) and the Informer framework to estimate the surface temperature of 18,650 lithium-ion batteries during charging and discharging processes under complex operating conditions. Initially, based on 9000 data points from the U.S. NASA Prognostics Center of Excellence’s random battery-usage dataset, where each data point includes three features: temperature, voltage, and current, EMD is used to decompose the temperature data into intrinsic mode functions (IMFs). Subsequently, the IMFs are reconstructed into low-, medium-, and high-correlation components based on their correlation with the original data. These components, along with voltage and current data, are fed into sub-models. Finally, the model captures the long-term dependencies among temperature, voltage, and current. The experimental results show that, in single-step prediction, the mean squared error, mean absolute error, and maximum absolute error of the model’s predictions are 0.00095, 0.02114, and 0.32164 °C; these metrics indicate the accurate prediction of the surface temperature of lithium-ion batteries. In multi-step predictions, when the prediction horizon is set to 12 steps, the model achieves a hit rate of 93.57% where the maximum absolute error is within 0.5 °C; under these conditions, the model combines high predictive accuracy with a broad predictive range, which is conducive to the effective prevention of thermal runaway in lithium-ion batteries.

The aims of this study were to explore the protective effect of Xiaochaihu decoction in mice with sepsis induced by intraperitoneal injection; to explore its anti-inflammatory effect on the TLR4-MyD88-NF-κB signalling pathway; and to explore the main material basis of the anti-inflammatory effect of Xiaochaihu decoction, with the aim of supplementing and expanding the associated research and providing a scientific foundation for the clinical use of the decoction. The effects of Xiaochaihu decoction on septic mice were analysed by measurements of white blood cells (WBC) and Platelets (PLT); Nitric Oxide (NO) level in serum; IL-6, IL-1β and TNF-α levels in serum; RT-PCR; Haematoxylin-Eosin (HE) immunohistochemistry; western blotting (WB). The results showed the excellent in vivo anti-inflammatory effects of Xiaochaihu decoction in LPS-induced septic mice, through down regulation of the gene and protein expression of TLR4, MYD88, TRAF6, IKK, IKBα and p65 and the subsequent reduction in the release of inflammatory mediators IL-6, IL-1β, TNF-α and NO. Moreover, significant anti-septic effect was observed from high and medium doses of Xiaochaihu decoction, but not from the low dose.

Abstract Our study aimed to explore the association between serum C-reactive protein (CRP) and COVID‐19 mortality. This is a retrospective cohort study of all patients admitted to 4 hospitals within the Montefiore Health System between March 1 and April 16, 2020, with SARS-CoV-2 infection. All-cause mortality were collected in 7 May 2020. The mortality risk was estimated using Cox proportional hazards models. Of the 3545 patients with a median age of 63.7 years, 918 (25.9%) died within the time of cohort data collection after admission. When the CRP was 15.6 mg/L, with the increase of CRP, the mortality rate increases relatively flat.

Groundwater in mining areas play an important supporting role in the surrounding residents' living and the construction of coal industries. Mine drainage during coal mining will change the original groundwater circulation process in mining areas, leading to changes in the groundwater environment. Therefore, clarifying the mutual transformation relationship between the “three waters” is the key to the scientific utilization of water resources in mining areas. Chemical components and hydrogen and oxygen isotopes of the groundwater in the Pingyu mining area are combined to determine the characteristics of groundwater circulation after large-scale drainage of the mine, identify the origin and controlling factors of the major components in the groundwater. Hydrohemical analyses show that most of the groundwater are of HCO3—Ca·Mg type, The hydrochemical components are controlled by the weathering and dissolution of silicate, and the ions in the groundwater mainly come from water-rock interactions and the waste generated by human activities, with concentration of \begin{document}${\rm{NO}}_3^- $\end{document} exceeding the standard. The hydrogen and oxygen isotopic data demonstrates that the groundwater in the study area receives recharge from modern precipitation, and there is a close hydraulic relationship between the groundwater in the unconsolidated aquifers and the groundwater in the karst aquifer. After the mine drainage, the groundwater circulation process in the mining area changes, the karst groundwater changes from supporting the upper pore groundwater to accepting the leakage recharge of the upper pore groundwater, and then discharges to the surface water by the mine drainage. The mine drainage becomes the main groundwater drainage way in the mine area. The research results can provide scientific and effective basis for groundwater development management and land subsidence prevention in mining areas.

Abstract Background Prescribing the optimal antipsychotic treatment to schizophrenia is very important as it is well established that patients have different sensitivity to the available antipsychotic drugs. The genotype of the HTR2A T102C (rs6313) polymorphism has been suggested to affect the efficacy of antipsychotic drugs, but the results of different studies have been inconsistent Methods In this study, a meta-analysis was used to ascertain the association between allele and genotype polymorphism of rs6313 and the efficacy of antipsychotic drugs. Related studies publicated from January 1995 to December 2021 were retrieved from PubMed, Embase, ScienceDirect, and Web of Science databases. The correlations between allele and genotype polymorphism of rs6313 and the responder rate and scale score reduction rate of antipsychotics were analyzed. In addition, subgroup analyses were performed on time, drug, and ethnicity. Results A total of 18 studies were included. The meta-analysis showed that allele and genotype polymorphisms at the rs6313 locus overall were not associated with antipsychotic drug responder rate or scale score reduction rate. Ethnicity subgroup analysis showed that antipsychotic drugs were more effective in patients with allele T in the Caucasian population. Indian patients with the TT genotype had the lowest scale score reduction rate and poor drug treatment effect. East Asian patients with the TC genotype had better treatment effect, whereas in patients with the CC genotype, the treatment was less effective. Drug subgroup analysis showed that patients with the TC genotype treated with clozapine had the highest responder rate and score reduction rate. Conclusions The association between rs6313 polymorphism and the efficacy of antipsychotic drugs is mainly influenced by drug and ethnicity. Caucasian patients with the T allele respond better to drug therapy, and Asian patients with TC genotype. The TC genotype was also a good predictor of the efficacy of clozapine treatment.

Abstract Design change is an inevitable part of the product development process. This study proposes an improved binary multi‐objective PSO algorithm guided by problem characteristics (P‐BMOPSO) to solve the optimisation problem of complex product change plan considering service performance. Firstly, a complex product multi‐layer network with service performance is established for the first time to reveal the impact of change effect propagation on the product service performance. Secondly, the concept of service performance impact (SPI) is defined by decoupling the impact of strongly associated nodes on the service performance in the process of change affect propagation. Then, a triple‐objective selection model of change nodes is established, which includes the three indicators: SPI degree, change cost, and change time. Furthermore, an integer multi‐objective particle swarm optimisation algorithm guided by problem characteristics is developed to solve the model above. Experimental results on the design change problem of a certain type of Skyworth TV verify the effectiveness of the established optimisation model and the proposed P‐BMOPSO algorithm.

Abstract Background Long term care (LTC) services for functionally impaired senior citizens are crucial for addressing the challenges of aging. However, research on eligibility criteria and coverage of LTC in China is lacking. Our objective is to assess the current status of LTC and explore eligibility criteria and coverage for the elderly. Methods This is a cross-sectional study conducted in two first-tier cities in China. Residents aged 65 or over were recruited from a nursing home and four primary hospitals. Participants were divided into three groups (bedridden, domestic, and community), then six grades (grade one to six) according to the Longshi Scale, and their functional ability was assessed using the Modified Barthel Index. Information such as diseases, complications, and daily care needs were collected. Nursing staff were invited to indicate patients’ needs for care. A one-way ANOVA test, Kruskal Wallis H test and Mann–Whitney U test were used to explore the differences of variables in three Longshi groups or Longshi grades. Results Among all 1157 participants, with an average age of 80.54, 69.3% were in the bedridden group. The most common diagnosis was stroke (71.4%), with the most prevalent complication being pulmonary infection (25.2%). In the nursing assessment, basic health care, disease care, activity care, complication prevention care and psychosocial care were summarized as the five main aspects of LTC for the elderly. Feeding, bathing, drinking, bowel management and bladder management were identified as the basic care which fulfills participants’ basic physical needs in each Longshi group. Mouth care, artificial airway management, and body reposition, which can prevent immobility complications, were highly demanded by bedridden elderly. Conclusions The elderly in grade one to three are the ones in need of LTC most. The content of LTC for elderly should include basic care which fulfills their basic physical needs and complication care which can prevent immobility complications. The evidence of this research may contribute to the design of LTC in China. Trial registration The study design was registered in the Chinese Clinical Trial Registry (ChiCTR-2000034067, Registered 22 Jun 2020, http://www.chictr.org.cn/showproj.aspx?proj=54770 ).

The rotor cage is a key component of the classifying device, and its structural parameters directly affect classification performance. To improve the classification performance of the straw micro-crusher classifying device, this paper proposes a CFD-ML-GA (Computational Fluid Dynamics-Machine Learning-Genetic Algorithm) method to quantitatively analyze the coupled effects of rotor cage structural parameters on classification performance. Firstly, CFD and orthogonal experimental methods are used to qualitatively investigate the effects of the number of blades, length of rotor blades, and blade installation angle on the classification performance. The conclusion obtained is that the blade installation angle exerts the greatest effect on classification performance, while the number of blades has the least effect. Subsequently, four machine learning algorithms are used to build a cut size prediction model, and, after comparison, the Random Forest Regression (RFR) model is selected. Finally, RFR is integrated with a Genetic Algorithm (GA) for quantitative parameter optimization. The quantitative analysis results of GA indicate that with 29 blades, a blade length of 232.8 mm, and a blade installation angle of 36.8°, the cut size decreases to 47.6 μm and the classifying sharpness index improves to 0.62. Compared with the optimal solution from the orthogonal experiment, the GA solution reduces the cut size by 9.33% and improves the classifying sharpness index by 9.68%. This validates the feasibility of the proposed method.

In this study, we synthesized spinel high-entropy oxide (HEO) (Cr0.2Mn0.2Co0.2Ni0.2Zn0.2)3O4 nanoparticles by a simple solution combustion method. These particles were investigated for their performance as anodes in lithium-ion batteries. The reversible capacity is 132 mAh·g−1 after 100 cycles at a current density of 100 mA·g−1, 107 mAh·g−1 after 1000 cycles at a current density of 1 A g−1, and 96 mAh·g−1 rate capacity at a high current density of 2 A g−1. The outstanding cycle stability under high current densities and remarkable rate performance can be attributed to the stable structure originating from the high entropy of the material.

Abstract: Introduction: Public-welfare behavior is a special prosocial behavior. Actively participating in public welfare activities has an important impact on the psychological development of adolescents. According to the group identity theory, national identity may be an important factor affecting public-welfare behavior, but its functional mechanism remains unclear. This study explored how national identity influenced adolescents’ public-welfare behavior through the mediating role of social responsibility and the moderating role of sex. Methods: We selected a total of 969 adolescents by cluster sampling to complete the questionnaires. We used the Hayes PROCESS macro for SPSS to test the mediating role of social responsibility and the moderating role of sex in the relationship between national identity and public-welfare behavior. Results: Results showed that social responsibility fully mediated the relationship between national identity and public-welfare behavior among adolescents. In addition, the mediating effect of social responsibility was moderated by sex, that is, the mediating effect of social responsibility was significant in male adolescents but not in female adolescents. Conclusion: National identity may affect the public-welfare behavior of adolescents by improving social responsibility, albeit significantly only in male adolescents. Our findings enrich existing research on adolescents’ public-welfare behavior and inspire the targeted promotion of public-welfare behavior among adolescents.

Abstract Background While negative parenting style has considered as a risk factor for suicide ideation, little attention has been given to the mechanisms between harsh parenting and suicide ideation in the context of Chinese culture. This study explored the the potential mediating roles of self-esteem and the potential moderating roles of school social support in the relationship between harsh parenting and suicide ideation among Chinese adolescents. Methods We conducted a cross-sectional study among 4189 Chinese adolescents who completed measures of harsh parenting, school social support, self-esteem, and suicide ideation. The moderated mediation model was used to test the roles of self-esteem and school social support on the association between harsh parenting and adolescent suicide ideation. Results (1) There were significant positive correlations between harsh parenting and adolescents suicide ideation. (2) Self-esteem mediates the relationship between harsh parenting and suicide ideation in adolescents. (3) School social support moderates the indirect effect of harsh parenting on suicidal ideation. Conclusions Beyond the direct impact of harsh parenting, harsh parenting also indirectly contributes to adolescent suicide ideation via the mediator of adolescents’ self-esteem. School social support moderates the relationship between harsh parenting and self-esteem as well as the relationship between self-esteem and suicide ideation. The findings suggest potential pathways for suicide prevention and intervention strategies and highlighted that buffering effect of school social support is limited as risk increasing.

Abstract. Parvovirus B19 (B19V) infection can cause pure red cell aplasia (PRCA) in patients with human immunodeficiency virus (HIV) infection. Intravenous immunoglobulin (IVIG) is a preferred treatment option. From July 2019 to March 2022, four patients with HIV infection were admitted to Guangzhou Eighth People’s Hospital with dizziness and fatigue and were diagnosed with PRCA. Blood investigations revealed severe anemia and the B19V genome. Therefore, the four patients were diagnosed with B19V-induced PRCA. All four patients received red blood cell transfusion in the setting of antiretroviral therapy, and two of the four patients received intravenous immunoglobulin (IVIG). After 3–7 months of treatment, all four patients recovered, although two did not receive IVIG. This suggests that IVIG is not always necessary for the treatment of PRCA in patients with HIV infection and that effective antiretroviral therapy and immunological reconstitution play an important role in the eradication of parvovirus.

Objective: To evaluate the quality of the citrus, a gas chromatography (GC) coupled with flame ion detector was established for the determination of sixteen kinds of free amino acids in citrus simultaneously. Methods: Firstly, the single factor tests werre used to optimize the derivatization conditions of isobutyl chloroformate. Subsequently, a method was developed by liquid-liquid microextraction (LLME)/solid phase microextraction (SPME) coupled with GC using a home-made sol-gel butylmethacrylate/divinylbenzene (BMA/DVB) fibers. Results: The results showed that the derivatization conditions were the best under one derivation with one min. The best SPME conditions can be obtained as follows: The extraction temperature of 40 ℃, the extraction time of 30 min and the 30% sodium sulfate at the extraction speed of 1000 r·min−1. Under the optimized experimental parameters, there were good linear relationships for 16 analytes with correlation coefficients larger than 0.99. The limit of detection was 0.85~12.60 μg·kg−1 and the standard recoveries of the spiked samples ranged from 82.51% to 121.75%, with relative standard deviations of 2.51%~12.80%. Conclusion: The method was convenient, accurate, and matrix resistant. It could be used as a new model for the determination of the free amino acids in citrus pulp samples and can also provide a valuable reference for the quality evaluation of cirtrus.

Abstract Background Regional anesthesia appears to reduce cancer recurrence, but the optimal anesthesia modality for non-muscle invasive bladder cancer (NMIBC) were still under debate. Therefore, we sought to assess the effect of regional and GA only upon the recurrence and long-term prognosis of NMIBC through this meta-analysis. Methods We performed an extensive literature search of PubMed, Embase, Web of Science, the Cochrane Library and China National Knowledge Infrastructure (up to October 30, 2022) to identify eligible articles on the possible impact of different anesthetic modalities for the recurrence rate of NMIBC. Results Eight studies comprising 3764 participants, including 2117 subjects with RA and 1647 with GA, were finally enrolled. Cancer recurrence rate was significantly lower in subjects with RA than those with GA (RR 0.84, 95%CI 0.72–0.98, P = 0.03). We didn’t detect the differences between GA and RA in the time of recurrence (SMD 2.07, 95% CI -0.49–4.63, P = 0.11) and cancer progression (RR 1.14, 95%CI 0.71–1.84, P = 0.59). Results from subgroup analysis demonstrated that spinal anesthesia could significantly decrease the incidence of cancer recurrence in comparison with general anesthesia (RR 0.80, 95%CI 0.72–0.88, P

Conclusion: Patients who are bedridden after stroke face a higher potential risk of cardiac hemodynamic impairment following SARS-CoV-2 infection, emphasizing the need for meticulous hemodynamic monitoring during treatment and rehabilitation of these patients to prevent any potential cardiovascular complications.

Objectives Patients with stroke often remain bedridden despite rehabilitation. Serum N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) levels increase after stroke. Our study aimed to investigate the difference in NT-pro-BNP levels between bedridden and non-bedridden patients with stroke and to explore the factors influencing NT-pro-BNP levels in bedridden patients.Design A single-centre, cross-sectional study.Setting This study was conducted in a hospital, Shenzhen, China.Participants Between January 2019 and December 2022, 465 participants were included in this study.Outcome measures The collected data included basic information, laboratory data and echocardiographic parameters. Binary logistic regression analysis and receiver operating characteristic curves were used to identify factors associated with high NT-pro-BNP levels.Results Bedridden patients with stroke had higher levels of NT-pro-BNP, D-dimer, high-sensitivity C reactive protein (hs-CRP) and lower levels of creatinine, high-density lipoprotein cholesterol, albumin and haemoglobin, as well as lower left ventricular ejection fraction, fractional shortening and the ratio between the peak velocities of early and late diastolic filling than non-bedridden patients. In bedridden patients, age ≥75 years, high levels of hs-CRP and creatinine, and low levels of albumin were associated with high NT-pro-BNP levels. In non-bedridden patients, age ≥75 years and high creatinine levels were associated with high NT-pro-BNP levels. In bedridden patients with stroke, the area under the curve (AUC) of hs-CRP was 0.700 (p

IntroductionThe panicle fertilization strategy for japonica and indica rice under wheat straw return (SR) has not been updated, especially on the elaboration of their impacts on spikelet differentiation and degeneration. This study aimed to verify the hypothesis that SR increases spikelet number by reducing spikelet degeneration and to explore the possibility of simplifying panicle fertilization.MethodsIn three consecutive years, four varieties of japonica and indica rice were field-grown in Yangzhou, Jiangsu Province, China. Six panicle fertilization rates and split treatments were applied to SR and no straw return (NR) conditions.ResultsThe results showed that SR promoted rice yield significantly by 3.77%, and the highest yields were obtained under the T2 (split panicle fertilization at the panicle initiation (PI) and spikelet primordium differentiation (SPD) stages) and T1 (panicle fertilization only at the PI stage) treatments, for indica and japonica rice, respectively. Correlation and path analysis revealed that the number of spikelets per panicle was the most attributable to yield variation. SR significantly increased the concentration of alkali hydrolyzable N in the soil 40 days after rice transplantation, significantly increased the nitrogen accumulation per stem (NA) during the SPD-pollen mother cell meiosis (PMC) stage, and increased the brassinosteroids level in the young panicles at the PMC stage. SR also reduced the degeneration rate of spikelets (DRS) and increased the number of surviving spikelets (NSS). The dry matter accumulation per stem was more important to increasing the NA in japonica rice at the PMC stage, whereas NA was more affected by the N content than the dry matter accumulation in indica rice. In japonica rice, panicle N application once only at the PI stage combined with the N released from SR was enough to improve the plant N content, reduce the DRS, and increase the NSS. For indica rice, split application of N panicle fertilization at both the PI and SPD stages was still necessary to achieve a maximum NSS.DiscussionIn conclusion, under wheat SR practice, panicle fertilization could be simplified to once in japonica rice with a significant yield increase, whereas equal splits might still be optimal for indica rice.