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BackgroundArtificial intelligence (AI)-driven chatbots are increasingly being used in health care, but most chatbots are designed for a specific population and evaluated in controlled settings. There is little research documenting how health consumers (eg, patients and caregivers) use chatbots for self-diagnosis purposes in real-world scenarios. ObjectiveThe aim of this research was to understand how health chatbots are used in a real-world context, what issues and barriers exist in their usage, and how the user experience of this novel technology can be improved. MethodsWe employed a data-driven approach to analyze the system log of a widely deployed self-diagnosis chatbot in China. Our data set consisted of 47,684 consultation sessions initiated by 16,519 users over 6 months. The log data included a variety of information, including users’ nonidentifiable demographic information, consultation details, diagnostic reports, and user feedback. We conducted both statistical analysis and content analysis on this heterogeneous data set. ResultsThe chatbot users spanned all age groups, including middle-aged and older adults. Users consulted the chatbot on a wide range of medical conditions, including those that often entail considerable privacy and social stigma issues. Furthermore, we distilled 2 prominent issues in the use of the chatbot: (1) a considerable number of users dropped out in the middle of their consultation sessions, and (2) some users pretended to have health concerns and used the chatbot for nontherapeutic purposes. Finally, we identified a set of user concerns regarding the use of the chatbot, including insufficient actionable information and perceived inaccurate diagnostic suggestions. ConclusionsAlthough health chatbots are considered to be convenient tools for enhancing patient-centered care, there are issues and barriers impeding the optimal use of this novel technology. Designers and developers should employ user-centered approaches to address the issues and user concerns to achieve the best uptake and utilization. We conclude the paper by discussing several design implications, including making the chatbots more informative, easy-to-use, and trustworthy, as well as improving the onboarding experience to enhance user engagement.

Test anxiety disorder is a group of symptoms related to stress caused by tests, exams, evaluations, and others. It is among the severe psychological problems in exams. Long-term test anxiety is likely to cause tension, fear, irritability, depression, and other negative emotions, and it disturbs working memory, attention, and other cognitive abilities and even leads to suicidal ideation. In order to standardize the clinical diagnosis and treatment of test anxiety disorder, under the organization of the Test Anxiety Disorder Collaboration of the Chinese Society of Psychosomatic Medicine, this expert consensus was formulated by 13 experts in the field of psychiatry and psychology. We collaborate and announce the expert consensus based on current research and clinical experience. We hope the consensus can provide clinicians with scientific and comprehensive guidance on test anxiety disorder, including epidemiology, etiology, clinical manifestations, evaluation, and treatment.

In response to the tight maintenance schedule of the acetylene wet gas cabinet bell cover at a chemical plant in Inner Mongolia， the subsequent layers of coating were carried out before the previous coatings had fully cured， leading to defects in the coating itself.After longterm operation， phenomena such as cracking and peeling occurred， and the outer wall of the bell cover became severely rusted， even perforated， posing a significant safety hazard.To control the corrosion of the outer wall of gas cabinet bell cover， the magnesium anode and zinc anode were installed in the fixed area in the early stage， and the corrosion rate was tested by hanging corrosion coupons to get the best anti-corrosion effect of magnesium anode.Based on theoretical calculations and the proper arrangement of anodes in the later stage， construction and installation carried out during the maintenance period， and the cathodic protection effect was tested to meet ≤-0.85 V (vs CSE) after the installation was completed.By combining cathodic protection with existing coatings， corrosion on the outer wall of the bell cover was slowed or suppressed，thereby extending its service life.

Studies on the retrieval of ocean surface current by Synthetic Aperture Radar (SAR) mainly concentrate on coastal regions with land coverage, allowing for continuous land to estimate non-geophysical Doppler shifts. As a strong western boundary in the Western Pacific, the Kuroshio flows through mostly islands or open sea, and lacks land coverage for range bias correction. We propose a non-geophysical Doppler shift correction algorithm suitable for Kuroshio observation. Three solutions matching different land coverage were adopted in the range direction, and the scalloping was removed by using average filtering in the azimuth direction. Comparison between SAR radial velocity and Global Surface Lagrangian Drifter (GLD) reveals that the correlation coefficient (R2) increase to 0.686, and root mean square error (RMSE) of 0.215 m/s after non-geophysical corrections, while the wind-wave bias corrections make R2 increase to 0.806 and RMSE decrease to 0.13 m/s. There is also a good consistency between SAR inversion and Regional Ocean Circulation Model (ROMS). Sensitivity analysis illustrates that ascending pass is more suitable for monitoring Kuroshio, and high incidence angles are less affected by ocean conditions and non-geophysical factors. The algorithm can be used in regions with discontinuous or absent land.

Objectives: Diabetes is closely linked to hearing loss, yet the exact mechanisms remain unclear. Cochlear stria vascularis and pericytes (PCs) are crucial for hearing. This study investigates whether high glucose induces apoptosis in the cochlear stria vascularis and pericytes via elevated ROS levels due to oxidative stress, impacting hearing loss.Methods: We established a type II diabetes model in C57BL/6J mice and used auditory brainstem response (ABR), Evans blue staining, HE staining, immunohistochemistry, and immunofluorescence to observe changes in hearing, blood-labyrinth barrier (BLB) permeability, stria vascularis morphology, and apoptosis protein expression. Primary cultured stria vascularis pericytes were subjected to high glucose, and apoptosis levels were assessed using flow cytometry, Annexin V-FITC, Hoechst 33342 staining, Western blot, Mitosox, and JC-1 probes.Results: Diabetic mice showed decreased hearing thresholds, reduced stria vascularis density, increased oxidative stress, cell apoptosis, and decreased antioxidant levels. High glucose exposure increased apoptosis and ROS content in pericytes, while mitochondrial membrane potential decreased, with AIF and cytochrome C (CytC) released from mitochondria to the cytoplasm. Adding oxidative scavengers reduced AIF and CytC release, decreasing pericyte apoptosis.Discussion: Hyperglycemia may induce mitochondrial apoptosis of cochlear stria vascularis pericytes through oxidative stress.

Background In recent years, in the context of global aging, the number of patients with chronic diseases in China has increased significantly, and the the coexistence of multiple diseases has become more and more common, which seriously threatens the life safety and quality of life of the older adults in China. Objective To investigate the status of multimorbidity of older adults, and explore the relationship and pathways of action between sleep, physical activity, social network and multimorbidity of older adults, providing ideas for the effective prevention of multimorbidity and health improvement of older adults. Methods Elderly people aged≥60 years in the Community Health and Behavior of the Elderly Panel Study (CHBEPS) established by our team in 2021 were selected as the subjects of the survey, a questionnaire was used to investigate the study population, the research objects were investigated by questionnaire, and the general situation was collected by self-designed basic information collection form, IPAQ-S-C, LSNS-6 and PSQI were used to assess the physical activity, social network and sleep of the subjects. AMOS 28.0 statistical software was used to set up the structural equation model. Results A total of 3 392 valid questionnaires were collected from 3 531 people over 60 years old, with an effective recovery rate of 96.06%. The average score of physical activity was 2 426.42 (495.00, 3 060.00) MET-min/w, the average score of social network was (15.91±6.43), and the average score of sleep was (5.49±3.53). There were 788 (23.23%) older adults with insufficient social network and 353 (10.41%) older adults with fair or very poor sleep quality. The prevalence of multimorbidity among the survey respondents was 41.13% (1 395/3 392). The results of correlation analysis showed that social network was negatively correlated with sleep level (rs=-0.113, P