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Background Stroke is highly prevalent in patients with atrial fibrillation (AF) , a most common cardiac arrhythmia with high morbidity, and anticoagulation therapy is a key strategy to prevent AF-related stroke. However, there is short of research on the use of anticoagulation therapy in patients with AF in the community. Objective To explore the prevalence of use of anticoagulation therapy and influencing factors in elderly patients with nonvalvular atrial fibrillation (NVAF) in Shanghai's communities. Methods A cross-sectional survey design was used. Stratified sampling was used to select elderly patients with AF who received the 2018 annual physical examination at four community health centers in Shanghai during July to December 2019, and they were surveyed using a questionnaire (consisting of three parts: demographics, CHA2DS2-VASc score and ORBIT score) compiled by our research team for collecting information on their AF prevalence and associated medication use, awareness of AF, comorbidities, and complication, as well as risk for stroke and bleeding. Based on the results of the survey, we excluded those without previous AF-related medical experience and valvular AF, then analyzed the prevalence of anticoagulation therapy in those with NVAF. Anticoagulation therapy was recommended for patients at high risk for stroke in accordance with the CHA2DS2-VASc score. Univariate and multivariate Logistic regression analyses were used to identify influencing factors of anticoagulation therapy in NVAF patients at high risk of stroke. Results Three hundred and two patients with NVAF were finally included, of whom the prevalence of current use of anticoagulant and antiplatelet drugs was 29.5% (89/302) , and 39.7% (120/302) , respectively, and that of non-use of anticoagulant or antiplatelet drugs was 30.8% (93/302) . By the CHA2DS2-VASc score, 279 of the 302 NVAF patients (92.4%) were assessed with high risk of stroke, among whom the prevalence of current use of anticoagulant and antiplatelet drugs was 30.5% (85/279) , 40.1% (112/279) , respectively, and the rest 29.4% (82/279) did not take anticoagulant or antiplatelet drugs. Univariate Logistic regression analysis demonstrated that age, marital status, type of AF, onset of AF symptoms, duration of AF, prescription of anticoagulants at the first visit for AF, knowledge of the harmfulness of AF, prevalence of hyperlipidemia, and risk of bleeding were associated with the use of anticoagulation therapy in NVAF patients at high risk of stroke (P

ObjectiveTo compare the risk of hospitalisation and associated costs in patients after treatment for prostate cancer.Patients and methodsWe identified 29 571 patients aged 66-75 years without significant comorbidity from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database who were diagnosed with localised prostate cancer between 2004 and 2009. We compared the rates of all-cause and treatment-related hospitalisation that occurred within 365 days of the initiation of definitive therapy. We used multivariable logistic regression analysis to identify determinants associated with hospitalisation.ResultsMen who underwent radical prostatectomy (RP) rather than radiotherapy (RT) had lower odds of being hospitalised for any cause after therapy [odds ratio (OR) 0.80, 95% confidence interval (CI): 0.74-0.87]. Patients who underwent RP rather than RT had higher odds of being hospitalised for treatment-related complications (OR 1.15, 95% CI: 1.03-1.29). However, men who underwent external beam RT (EBRT)/intensity modulated RT (IMRT) (OR 0.84, 95% CI: 0.72-0.99) had a 16% lower odds of hospitalisation from treatment-related complications than patients undergoing RP. Using propensity score-weighted analyses there was no significant difference in the odds of hospitalisation from treatment-related complications for men who underwent RP vs RT (OR 1.06, 95% CI: 0.92-1.21). Patients hospitalised for treatment-related complications after RT were costlier than patients who underwent RP (Mean $18 381 vs $13 203, P < 0.001).ConclusionsWith the exception of men who underwent EBRT/IMRT, there was no statistically significant difference in the odds of hospitalisation from treatment-related complications. Costs from hospitalisation after treatment were significantly higher for men undergoing RT than RP. Our findings are relevant in the context of penalties linked to hospital readmissions and bundled payment models.

Plasma treatment of wood surfaces has shown significant effects, but different excitation methods used for different species of wood generally result in varied characteristics of wood surfaces. Secondly, plasma modification greatly enhances the absorption of liquids by wood, but the relationship between liquid absorption and surface wettability is rarely studied. Limited detailed investigation of the modification effects and mechanisms has hindered the large-scale applications of plasma treatment in the wood industry. In this study, two typical plasmas, radio frequency (RF) plasma and gliding arc discharge (GAD) plasma, were employed to treat three species of wood: poplar, black walnut, and sapele. By focusing on changes in the contact angle of the wood surface, an exponential equation fitting method is used to determine the measurement time for contact angles. The research identified that factors contributing to the decrease in contact angle after plasma modification include not only the increase in surface energy but also liquid absorption. SEM and XPS analyses demonstrate that plasma etching accelerated liquid absorption by modifying the surface topography, while the increase in surface energy was due to the addition of oxygen-containing groups. High-valence C=O and O-C=O groups serve as indicators of plasma-induced surface chemical reactions. RF modification primarily features surface etching, whereas GAD significantly increases the active surface groups. Thus, different plasmas, due to their distinct excitation modes, produce diverse modification effects on wood. Considering the various physical and chemical properties of plasma-modified wood surfaces, recommendations for adhesive use on plasma-modified wood are provided. [ABSTRACT FROM AUTHOR]

The energy consumption of oil collection increases rapidly after oilfield enters the stage of high water cut. Carrying out gathering and transportation at normal or low temperature can save cost and bring certain enterprise benefit. In order to judge whether the gathering and transportation can be carried out at normal or low temperature, the thermodynamic hydraulic calculation model is constructed and modified according to the field measured data. Then the thermally hydraulic coupling calculation is carried out to determine the gathering and transportation radius. The single factor sensitivity analysis method was used to rank the sensitivity of the factors influencing the gathering and transportation radius, and the radius chart is made. The results show that the modified thermo-hydraulic model can better predict the temperature and pressure drop, and the average error of the calculated and the measured value is 2.5% and 7.67%. The four most influential factors from strong to weak are starting point temperature, liquid yield, moisture content of mass and ambient temperature. The chart drawn by the factors provides the basis for the normal temperature gathering and transportation of the pipeline, so the required temperature at the start of the pipe can be determined by querying the chart.

A blind super-resolution network with dual-channel attention is proposed for images captured by the 0.37 mm diameter sub-millimeter fiberscope. The fiberscope can used in scenarios where other image acquisition devices cannot be applied based on its flexible, soft, and minimally invasive characteristics. However, the images have black reticulated noise and only 3000 pixels. To improve image quality, the Butterworth band-stop filter is used to reduce the frequency of the reticulated noise. By optimizing the blind super-resolution model, high-quality images can be reconstructed that do not require a lot of synthetic paired fiberscope image data. Perceptual loss is utilized as a loss function, and channel and spatial attention mechanisms are introduced to the model to enhance the high-frequency detail information of the reconstructed image. In the comparative experiment with other methods, our method showed improvements of 2.25 in peak signal-to-noise ratio (PSNR) and 0.09 in structural similarity (SSIM) based on objective evaluation metrics. The learned perceptual image patch similarity (LPIPS) based on learning was reduced by 0.6. Furthermore, four different methods were used to enhance the resolution of the fiberscope images by a factor of four. The results of this paper improve the information entropy and Laplace clarity by 0.44 and 2.54, respectively, compared to the average of other methods. Validation results show that the approach in this paper is more applicable to sub-millimeter-diameter fiberscopes. [ABSTRACT FROM AUTHOR]

Adjuvant chemotherapy of leucovorin‐modulated 5‐fluorouracil (5‐FU/LV), capecitabine, and adding oxaliplatin to 5‐FU/LV or capecitabine (FLOX/OX) have been standard regimens for high‐risk stage II or III colon cancer (CC). We aimed to evaluate their patterns of use, association with survival, and rate of emergency room visit (ER) or hospitalization during the treatment period. High‐risk stage II or III patients aged >65 years diagnosed between 2007 and 2015, underwent colectomy, and received any of these three regimens were selected from SEER and Texas Cancer Registry (TC) linked with Medicare data. Chi‐square test, Kaplan–Meier survival curves, Cox regression, and logistic regression were used in data analysis. A total of 5621 (1080 stage II and 4541 stage III) patients with median age of 72 years were included in this study. For stage II, 24.4% used 5‐FU/LV, 31.2% used capecitabine, and 44.4% used FLOX/OX; the respective numbers for stage III were 13.8%, 17.9%, and 68.3%. Patients aged <70 years, not in the West region, not in Medicare state‐buy‐in program, and with no comorbidity were more likely to use FLOX/OX. FLOX/OX was associated with improved overall survival (OS) in stage II and III patients and improved cancer‐specific survival in stage III patients compared with 5‐FU/LV. The survival benefit of FLOX/OX was sustained in stage III patients aged ≥70 years. Capecitabine had the lowest ER/hospitalization rate with 19.2% in stage II and 28.9% in III. The use of FLOX/OX was associated with improved survival compared with 5‐FU/LV among CC patients. Capecitabine was associated with the lowest ER/hospitalization rate. [ABSTRACT FROM AUTHOR]

Abstract Background The comparative effectiveness (CE) of endoscopic screening (versus no screening) for Barrett’s esophagus (BE) in patients with GERD symptoms, or among different endoscopic surveillance strategies in patients with BE, for the early detection of esophageal adenocarcinoma (EA) is unknown. Furthermore, it is unclear if patients or providers have or will adopt any of these strategies (screening only, screening and surveillance, vs. none), irrespective of their effectiveness. Endoscopic screening and surveillance is expensive and can be risky. Therefore, it is imperative to establish the CE and acceptability about the risks and outcomes related to these practices to better inform expert recommendations and provider-patient decisions. Methods/Results We propose a mixed methods study which will involve: (1) an analysis of secondary databases (VA and VA-Medicare linked datasets for 2004–09) to examine CE of endoscopic screening and surveillance in an observational study cohort (an estimated 680,000 patients with GERD; 25,000–30,000 with BE; and 3,000 with EA); (2) a structured electronic medical record (EMR) review on a national sample of patients using VA EMRs to verify all EA cases, identify cancer stage, cancer-targeted therapy, and validate the screening and surveillance endoscopy; and (3) qualitative in depth interviews with patients and providers to elicit preferences, norms, and behaviors to explain clinical contexts of these findings and address gaps arising from the CE study. Conclusion This study will compare clinical strategies for detecting and monitoring BE, a pre-cancerous lesion. Additionally, by eliciting acceptability of these strategies for patients and providers, we will be able to propose effective and feasible strategies that are likely to be implemented in routine use. Findings will inform recommendations for clinical practice guidelines. Our innovative approach is consistent with the methodological standards of patient-centered outcomes research, and our findings will offer a significant contribution to the literature on cancer surveillance. Trial Registration Not applicable

A distributed energy resource (DER) system, which can be defined as a medium or small energy conversion and utilization system with various functions for meeting multiple targets, is directly oriented towards users and achieves on-site production and energy supply according to users’ demands. Optimization research on system construction has recently become an important issue. In this paper, simple stochastic mathematical equations were used to interpret the optimal design problem of a DER system, and based on this, a novel method for solving the optimization problem, which has multi-dimensional stochastic uncertainties (involving the price of input-energy and energy supply and demand), was put forward. A mixed-integer linear programming (MILP) model was established for the optimal design of the DER system by combining the ideas of mean value and variance, aiming to minimize the total costs, including facility costs, energy purchase costs, and loss caused by energy supply shortage, and considering the energy balance and facility performance constraints. In the end, a DER system design for an office building district in Xuzhou, China, was taken as an example to verify the model. The influences of uncertainty on the selection of system facilities and the economic evaluation were analyzed. The result indicated that uncertainty of energy demand played a significant role in optimal design, whereas energy price played a negligible role. With respect to economy, if uncertainties are not considered in system design, it will result in a short supply, and therefore the total cost will increase considerably. The calculation convergence was compared with previous work. The implementation results showed the practicality and efficiency of the proposed method. [ABSTRACT FROM AUTHOR]