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Objective By studying the carbon footprint of two kinds of side wallboard made of different materials for rail vehicles, the accounting method for the carbon footprint of interior products is explored to guide designers in achieving low-carbon design. Method Side wallboards made of PC (polycarbonate) and FRP (fiberglass-reinforced plastic) for rail vehicle interiors are selected as research objects. Following the lifecycle assessment method outlined in PAS 2050:2011 'Specification for the Assessment of the Life Cycle Greenhouse Gas Emissions of Goods and Services', published by the British Standards Institution, the carbon footprints and contributions of the two different materials' side wallboards at each lifecycle stage are calculated. Result & Conclusion Within the defined system boundaries, the carbon footprint of FRP side wallboard is greater than that of PC one, with the highest contribution to the carbon footprint observed during the raw material acquisition stage for both types of wallboards. Under the premise of meeting vehicle performance requirements, selecting PC side wallboards with a lower carbon footprint is more conducive to overall vehicle decarbonization.

Objective With the increasing demand of passengers for air quality and uniform air supply in metro train interiors, it is necessary to study how to improve the uniformity of cleanable air supply in metro vehicles. Method The airflow organization inside the air supply ducts is simulated numerically by computational fluid dynamics (CFD). The internal structure of the ducts is optimized, and a set of full-size air supply duct is fabricated for air-conditioning and duct matching tests. Result & Conclusion The overall variation trend of the airflow quantities predicted by numerical simulation is consistent with that of the experimental-measurement results. After adding baffle, the uniformity of air supply significantly improved, with deviations between predicted and test airflow quantities at over 80% outlets within 15%, and the rest between 15% and 20%. Additionally, the issue of air reversal at outlets adjacent to the inlets is alleviated, thereby validating the reliability of the numerical simulation calculations.

Malnutrition is a common complication in patients undergoing chemoradiotherapy for esophageal cancer. This paper reviewed the studies on nutrition support and nursing management of patients undergoing chemoradiotherapy for esophageal cancer, and provided reference for clinical nursing practice. (营养不良是食管癌放化疗患者常见的并发症, 不仅影响整体治疗效果, 严重者可危及生命安全。本研究就食管癌放化疗患者营养支持及护理现状进行综述, 旨在为开展临床相关护理干预工作提供参考。)

Human metapneumovirus (HMPV) is a common virus associated with acute respiratory distress syndrome in pediatric patients. There are no HMPV vaccines or therapeutics that have been approved for prevention or treatment. In this study, we constructed a novel recombinant influenza virus carrying partial HMPV fusion protein (HMPV-F), termed rFLU-HMPV/F-NS, utilizing reverse genetics, which contained (HMPV-F) in the background of NS segments of influenza virus A/PuertoRico/8/34(PR8). The morphological characteristics of rFLU-HMPV/F-NS were consistent with the wild-type flu virus. Additionally, immunofluorescence results showed that fusion proteins in the chimeric rFLU-HMPV/F-NS could work well, and the virus could be stably passaged in SPF chicken embryos. Furthermore, intranasal immunization with rFLU-HMPV/F-NS in BALB/c mice induced robust humoral, mucosal and Th1-type dominant cellular immune responses in vivo. More importantly, we discovered that rFLU-HMPV/F-NS afforded significant protective efficacy against the wild-type HMPV and influenza virus challenge, with significantly attenuated pathological changes and reduced viral titers in the lung tissues of immunized mice. Collectively, these findings demonstrated that chimeric recombinant rFLU-HMPV/F-NS as a promising HMPV candidate vaccine has potentials for the development of HMPV vaccine.

Objective This study examined knowledge and practice of breakthrough cancer pain (BTcP) management among general practitioners (GPs) providing palliative care in Shanghai.Design Cross-sectional study using a self-administered questionnaire.Setting and participants A total of 393 GPs providing palliative care in 32 community health service centres in Shanghai were recruited by stratified cluster random sampling between 1 May and 30 June 2022.Outcome measures Knowledge and practice concerning BTcP management.Results A total of 375 questionnaires were collected and declared valid. The median knowledge score was 11 out of 21 points. Only 36.3% (n=136) of the participating GPs scored 11 points or more, which was categorised as good knowledge. Only 24.8% (n=93) of the GPs used Davies’ adapted diagnostic algorithm as the gold standard for diagnosis. All of the GPs assessed the intensity of BTcP; however, less than a quarter of the GPs evaluated the relationship between background pain and BTcP (22.1%, n=83), the impact of BTcP on activities of daily living (24.0%, n=90), the impact of BTcP on social relationships (14.4%, n=54) and the impact of BTcP on mood (10.1%, n=38). 56.5% (n=212) of the GPs reported that they used pain tools in the assessment of BTcP. All of the GPs prescribed immediate-release morphine as rescue medication for relieving BTcP; however, 60.5% (n=227) prescribed the dose based on their personal experiences, irrespective of the basal opioid dose, and 57.3% (n=215) did not conduct dose titration after providing the initial dose. No GPs reported that they ever administered interventional treatment to their patients.Conclusions Insufficient knowledge and inappropriate behaviours in BTcP diagnosis, assessment and treatment were identified. There is an urgent need to improve BTcP management among GPs providing palliative care in Shanghai.

Objective To evaluate the rate of vascular restenosis following interventional therapy for lower extremity vascular disease and the factors contributing to its occurrence in type 2 diabetic patients. Methods We collected the data from 138 diabetic patients with lower extremity arterial disease (involving 154 limbs) undergoing interventional therapy in our department between January, 2008 and March, 2018. The patients received balloon dilatation and/or stent implantation according to the findings by digital angiography (DSA) of the lower extremity arteries. All the patients were followed up for more than 1 year to assess the surgical success rate, symptom improvement, ankle brachial index (ABI), toe brachial index (TBI), and restenosis rate. Glycosylated hemoglobin (HbA1c) level, liver function, renal function, blood lipids, and high-sensitivity C-reactive protein (hs-CRP) level were measured at 3 days and 1, 3, 6 and 12 months after the interventional therapy. Some of the patients underwent computed tomographic angiography (CTA) or ultrasound examination for assessment of the lower extremity blood vessels. Results The abnormalities in HDL-C, LDL-C, hs-CRP, and HbA1c levels were significantly improved in these patients after interventional therapy (P < 0.05). At 1, 3, 6, and 12 months after the operation, the ABI and TBI showed significant improvements (P < 0.05 or 0.01) and the restenosis rates were 17.6%, 17.8%, 20%, and 20.9% in these patients, respectively. In patients with diseased vessels above the knee, the restenosis rate was 8.3%, 7.7%, 5.6%, and 23.1% at 1, 3, 6 and 12 months after the operation, respectively, as compared with 37.5%, 30%, 37.5%, and 30.8% in patients with diseased vessels below the knee and with 7.9%, 15%, 14.0%, 10.7% in those with diseased vessels both below and above the knee. Multivariate logistic regression analysis suggested that preoperative total cholesterol (TC) level was a risk factor that affected the outcome of interventional therapy (R=0.356, P=0.026), and preoperative HbA1c was a risk factor for the occurrence of restenosis (R=1.348, P=0.040). In patients with diseased vessels below the knee, TC and LDL-C levels were decreased more obviously in patients without than in those with vascular restenosis. Conclusion Interventional therapy can significantly improve lower limb perfusion in type 2 diabetic patients with lower extremity arterial disease. The incidence of postoperative vascular restenosis is associated with the site of operation, and is higher in patients having operations below the knee than those with operations above the knee or both below and above the knee. Controlling blood glucose, blood lipids and other metabolic indicators can help to improve the efficacy of interventional therapy and reduce the occurrence of postoperative vascular restenosis.

Abstract Background Primary care may be an avenue to increase coverage of HIV testing but it is unclear what challenges primary healthcare professionals in low- and middle-income countries face. We describe the HIV testing practices in community health centres (CHCs) and explore the staff’s attitude towards further development of HIV testing services at the primary care level in China. Methods We conducted a national, cross-sectional survey using a stratified random sample of CHCs in 20 cities in 2015. Questionnaires were completed by primary care doctors and nurses in CHCs, and included questions regarding their demographics, clinical experience and their views on the facilitators and barriers to offering HIV testing in their CHC. Multivariate logistic regression was conducted to examine the association between staff who would offer HIV testing and their sociodemographic characteristics. Results A total of 3580 staff from 158 CHCs participated. Despite the majority (81%) agreeing that HIV testing was an important part of healthcare, only 25% would provide HIV testing when requested by a patient. The majority (71%) were concerned about reimbursement, and half (47%) cited lack of training as a major barrier. Almost half (44%) believed that treating people belonging to high-risk populations would scare other patients away, and 6% openly expressed their dislike of people belonging to high-risk populations. Staff who would offer HIV testing were younger (adjusted odds ratio (aOR) 0.97 per year increase in age, 95% confidence interval (CI):0.97–0.98); trained as a doctor compared to a nurse (aOR 1.79, 95%CI:1.46–2.15); held a bachelor degree or above (aOR 1.34, 95%CI:1.11–1.62); and had previous HIV training (aOR 1.55, 95%CI:1.27–1.89). Conclusions Improving HIV training of CHC staff, including addressing stigmatizing attitudes, and improving financial reimbursement may help increase HIV testing coverage in China.

Purpose – The purpose of this paper is to investigate the factors that affect handicraft export from Vietnam to trading partners in the period 2007–2017, and how those factors influence the export of handicraft products of Vietnam. Design/methodology/approach – The research uses the approach of gravity model based on panel data to evaluate the export of Vietnamese handicraft to 50 main trading partners, covering the period from 2007 to 2017. Findings – The estimated results reveal that Vietnam’s GDP, importer’s GDP, trading partner’s population, Vietnam’s inflation, the economic distance between Vietnam and importer, the openness of Vietnam, importing country’s common language and the issue that both Vietnam and importer are member of APEC are the main factors affecting Vietnamese handicraft export. Research limitations/implications – This study also has some limitations. It is limited in the data, as some other areas in the world have not been observed and included in the research. In the future, a study with large-scale data of space and time should be conducted, which will certainly give a universal result and fewer errors. However, this paper, in our opinion, provides a significant result and may help the government and policy makers to undertake appropriate measures to improve and promote the export of Vietnamese handicrafts to the world markets. Practical implications – The research describes the current situation, and it studies factors influencing Vietnam’s handicraft export using the qualitative analysis. The result should be useful for the policy maker and enterprises to promote export activities of Vietnamese handicrafts to international markets. Social implications – Handicraft export of Vietnam plays an important part in retaining the culture value and social development as well as encouraging sustainable development for the rural poor within the country. Originality/value – The past research related to Vietnamese handicraft export almost analyzed the situation to promote export handicrafts. This research is based on the study of factors affecting trade and the gravity model to elaborate and supplement the factors that affect the export of handicraft in accordance with the actual conditions of Vietnam.

Objective To compare the sensitivity and specificity of chemiluminescence immunoassay (CLIA) and radioimmunoassay (RIA) in detection of aldosterone and renin, and to explore the optional detection methods and indicators for screening primary aldosteronism (PA). Methods A cross-sectional study was carried on 60 PA patients (with males accounting for 53.3% and at a median age of 50 years) diagnosed in our department from January to October 2018. Another baseline-matched 82 patients with essential hypertension (with males accounting for 50.0% and at a median age of 50 years) and 114 healthy controls (males accounting for 38.6% and at a median age of 46 years) at the same period were also recruited in this study. The plasma aldosterone concentration and renin concentration/renin activity were measured by CLIA and RIA respectively. The screening value of the 2 methods was evaluated by correlation analysis. Meanwhile, the plasma aldosterone concentration, plasma renin concentration (or activity), ratio of aldosterone/direct rennin concentration (ADRR), ratio of aldosterone/plasma rennin activity (ARR) and 2 combined indicators were measured by receiver operating characteristic (ROC) curve, to calculate sensitivity and specificity and determine the optimal cut-off point. Results There was a high correlation between plasma renin activity and direct renin concentration (r=0.880 4, P < 0.001), but the correlation between plasma aldosterone concentration measured by the 2 methods was not good (r=0.365 0, P < 0.001). The sensitivity of ADRR was the highest (91.53%) among all screening indices, and the specificity of diagnosis was significantly improved by combining plasma aldosterone concentration (CLIA, 96.49%). Among PA at an average age of 50 years, ADRR screening cut-off point was 12 (pg·mL-1)/(μU·mL-1), and ARR screening cut-off point was 20 (ng·dL-1)/(ng·mL-1·h-1). Conclusion CLIA is superior to RIA in detection of screening indices for PA. The diagnostic specificity of combined plasma aldosterone concentration (CLIA) and ADRR indices is the best.

Chromophobe renal cell carcinoma (chRCC) has a favorable prognosis. Due to irregular nuclei and nuclear pleomorphism, chRCC has a high Fuhrman nuclear grade (FNG). The chromophobe tumor grade (CTG) is a novel three-tier grading system that has been reported to be a better prognosticator than the traditional FNG. We compared the two nuclear grading systems in terms of patients’ clinical outcomes.

Penile calciphylaxis is a rare cause of penile gangrene that presents in patients with end-stage renal disease. The rates of comorbidity and mortality of penile calciphylaxis are extremely high. Unlike other penile gangrene, such as Fournier’s gangrene, the benefit of aggressive surgical therapy is controversial. Here we present a case of penile calciphylaxis in a 43-year-old man with end-stage renal disease on hemodialysis. He received total penectomy but died due to multisystem complications 2 weeks after surgery. We review the literature on the management options and outcomes in patients with penile calciphylaxis.

Background: This study was conducted to evaluate the influence of glutathione-S-transferase (GST) M1 and T1 polymorphisms in 184 patients with different stages of liver fibrosis and hepatitis C virus infection and 173 healthy control subjects. Methods: DNA samples were extracted from whole blood, and the polymorphisms of GSTM1 and GSTT1 were determined with PCR using fluorescence-labeled Taq Man probes. Associations between specific genotypes and progression of liver fibrosis were examined by use of the logistic regression analysis to calculate the odds ratio (OR) and 95% confidence intervals (CI). Results: Results show that no differences were found between the frequencies of GSTM1 (49.8% versus 50.2%) and GSTT1 (52.2% versus 47.8%) null genotypes in HCV-infected patients and healthy controls, respectively. In addition, there was also no significant relation between the frequency of GSTM1 or GSTT1 gene polymorphisms and fibrosis stage as classified by the METAVIR group. Conclusions: The combined GSTM1 and GSTT1 null genotypes showed an association between GSTM1 [-]/GSTT1 [-] and progression of liver fibrosis.

Cases of newly developed advanced schistosomiasis (NDAS) have occurred in areas where schistosomiasis transmission has been blocked for more than 25 years. The causes and pathogenesis of NDAS are still unknown. Diagnosis of NDAS relies on historical investigation and clinical symptoms, such as liver fibrosis, hepatic ascites and abnormal biochemical indexes in serum. It is important but difficult at this stage to develop a new tool for early screening and rapid diagnosis. In this study, serum peptides from thirty patients with NDAS and thirty healthy controls were captured with weak cation exchange magnetic beads, and subjected to MALDI-TOF mass spectrometry and ClinProTools analysis. Eleven peaks with m/z 924, 2661, 2953, 2991, 3241, 3884, 5337, 5905, 5943, 7766 and 9289 were decreased and three peaks with m/z 1945, 2082 and 4282 were increased in the NDAS group. The proteomic detection pattern (PDP) was established with 14 different peptide peaks, and its sensitivity and specificity were investigated with a blind test. The peptide mass fingerprints of sera from 50 NDAS patients and 100 healthy controls were double-blind subjected to the PDP method, and 50 patients and 92 healthy controls were classified as NDAS and healthy separately, which showed 100% sensitivity and 92% specificity. Our results showed that the PDP could be a new and useful method to detect NDAS.

The paper introduced a calculation method of grounding capacity current of high-voltage power network in coal mine,and gave a calculation of actual example.Using the method to calculate and analyze several coal mine power networks,the calculation results fit in measured results,which proved the calculation method is factual,simple,accurate,and is an accurate and valuable method.

Few studies have investigated the contagion effects of exposure to others' confided suicidal thoughts among adolescents. The aim of this study was to investigate whether recent real-world exposure to confided suicidal thoughts was associated with adolescent self-harm and suicidality within one month, and if so, to determine the related risk and protective factors. A total of 5,879 Taiwanese first-year senior high school students participated in this study and completed on-line questionnaires regarding their experience of exposure to confided suicidal thoughts, self-harm and suicidality, socio-demographic information, Patient Health Questionnaire 9-item, Multi-Dimensional Support Scale, Rosenberg Self-Esteem Scale, and alcohol and cigarette use. Of the enrolled adolescents, 3.4% had been exposed to confided suicidal thoughts (N = 200) within one month. The most common source of exposure was friends (N = 186). After controlling for a large variety of confounders, the adolescents with recent exposure to others' suicidal thoughts were four times more likely to harm themselves within one month (OR = 3.77; 95% CI: 2.26 - 6.30). The risks of suicidal ideation and suicide plans were also markedly increased (both OR = 5.15; 95% CI: 3.48 - 7.64 and 2.78 - 9.52, respectively). The risk ratios were highest if the source of exposure was from parents, and the contagion effects were dose-dependent. Support from parents and teachers could protect the adolescents from the impact of contagion. Our results suggest a contagion effect of exposure to confided suicidal thoughts among adolescents. Parents and school personnel should be aware of this and provide assistance for those in need., Author(s): Hui-Ching Liu [sup.1] , Yu-Hsin Huang [sup.1] [sup.2] , Jin-Jin Tjung [sup.3] , Fang-Ju Sun [sup.4] , Shen-Ing Liu [sup.1] [sup.2] Author Affiliations: (1) grid.413593.9, 0000 0004 0573 007X, [...]