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In order to solve the problem of single design method of the existing guided anti-collision pad, the guided anti-collision pad is designed to meet the requirements of the current regulations, and based on the collision-resistant topology optimization method, by establishing the model of the car-anti-collision pad and topologically carrying out the topology optimization analysis under the condition of its positive encounter, from which to extract the basic configuration of the energy absorption unit, to the positive collision of the car center acceleration size as an evaluation index, the use of orthogonal design and robust design method to further optimize the size of the energy absorption unit, and finally obtain the optimal size of the energy absorption unit. The simulation results show that the design method based on collision resistance topology optimization is effective, and the TS-grade guided anti-collision pad is designed to meet the current requirements

Objective To measure sales of antibiotics without a prescription in pharmacies in China in 2017 and 2021, before and during the coronavirus disease 2019 (COVID-19) pandemic, and determine the factors associated with such sales. Methods We conducted cross-sectional surveys using the simulated patient method in retail pharmacies in 13 provinces in eastern, central and western China in 2017 and 2021. At the pharmacies, the simulated patients (trained medical students) reported that they had mild respiratory tract symptoms and asked for treatment, using a three-stage process: (i) request some treatment; (ii) request antibiotics; (iii) request specific antibiotics. We used multivariable logistic regression analysis to determine factors associated with sale of antibiotics without a prescription. Findings Of the pharmacies visited in 2017, 83.6% (925/1106) sold antibiotics without a prescription; this figure was 78.3% (853/1090) in 2021 (P-value: 0.002). After excluding pharmacies prohibited from selling antibiotics because of COVID-19, this difference was not significant (83.6% versus 80.9%; 853/1054; P-value: 0.11). Factors significantly associated with selling antibiotics without a prescription in both 2017 and 2019 were: location in central and western China compared with eastern China; being in a township or village compared with in a city; and presence of a counter where antibiotics were dispensed. Conclusion Although laws became stricter between 2017 and 2021, antibiotic sales without a prescription were still common in pharmacies across China. Existing regulations need to be more strictly enforced, and pharmacy staff and the public should be made more aware of the risks of antibiotic misuse and dangers of antimicrobial resistance. Objectif Mesurer les ventes d'antibiotiques sans ordonnance dans les pharmacies de Chine en 2017 et 2021, avant et pendant la pandemie de maladie a coronavirus 2019 (COVID-19), et determiner les facteurs associes a ces ventes. Methodes Nous avons mene des enquetes transversales a l'aide de la technique des patients simules dans des pharmacies de detail situees dans 13 provinces de Chine orientale, centrale et occidentale en 2017 et 2021. Dans ces pharmacies, les patients simules (des etudiants en medecine formes a cet effet) ont evoque des symptomes legers au niveau des voies respiratoires et sollicite un traitement selon un processus en trois etapes: (i) demande de traitement; (ii) demande d'antibiotiques; (ii) demande d'antibiotiques specifiques. Nous avons ensuite utilise une analyse multivariee de regression logistique afin d'identifier les facteurs lies a la vente d'antibiotiques sans ordonnance. Resultats Sur l'ensemble des pharmacies examinees en 2017, 83,6% (925/1106) ont vendu des antibiotiques sans ordonnance, contre 78,3% (853/1090) en 2021 (valeur-p: 0,002). Apres avoir exclu les pharmacies n'ayant pas le droit d'en vendre a cause de la COVID-19, cette difference s'est revelee negligeable (83,6% contre 80,9%; 853/1054; valeur-p: 0,11). Les principaux facteurs associes a la vente d'antibiotiques sans ordonnance, tant en 2017 qu'en 2019, etaient: le fait d'etre en Chine centrale et occidentale plutot qu'en Chine orientale; le fait d'etre une commune ou un village plutot qu'une ville; et enfin, le fait qu'il y ait ou non un comptoir oU se procurer des antibiotiques. Conclusion Bien que les lois soient devenues plus strictes entre 2017 et 2021, la vente d'antibiotiques sans ordonnance est restee monnaie courante partout en Chine. La reglementation en vigueur doit etre appliquee plus severement; en outre, le personnel des pharmacies et le grand public doivent etre mieux sensibilises aux risques lies a un usage inapproprie des antibiotiques et aux dangers que represente la resistance aux antimicrobiens. Objetivo Medir las ventas de antibioticos sin receta en farmacias de China en 2017 y 2021, antes y durante la pandemia de la enfermedad por coronavirus de 2019 (COVID-19), y determinar los factores asociados a estas ventas. Metodos Se realizaron encuestas transversales utilizando el metodo del paciente simulado en farmacias minoristas de 13 provincias de China oriental, central y occidental en 2017 y 2021. En las farmacias, los pacientes simulados (estudiantes de medicina entrenados) informaron que tenian sintomas leves del tracto respiratorio y solicitaron tratamiento, mediante un proceso de tres etapas: (i) solicitar algun tratamiento; (ii) solicitar antibioticos; (ii) solicitar antibioticos especificos. Se utilizo un analisis de regresion logistica multivariable para determinar los factores asociados a la venta de antibioticos sin receta. Resultados De las farmacias visitadas en 2017, el 83,6% (925/1106) vendian antibioticos sin receta; esta cifra fue del 78,3% (853/1090) en 2021 (valor de p: 0,002). Una vez excluidas las farmacias que tenian prohibida la venta de antibioticos debido a la COVID-19, esta diferencia no fue significativa (83,6% frente a 80,9%; 853/1054; valor de p: 0,11). Los factores que se asociaron significativamente con la venta de antibioticos sin receta tanto en 2017 como en 2019 fueron: la ubicacion en el centro y occidente de China en comparacion con el oriente del pais; estar en un municipio o pueblo en comparacion con estar en una ciudad; y la presencia de un mostrador donde se dispensaban antibioticos. Conclusion Aunque las leyes se hicieron mas estrictas entre 2017 y 2021, la venta de antibioticos sin receta seguia siendo habitual en las farmacias de toda China. Es necesario aplicar mas estrictamente la normativa vigente, y concienciar al personal de las farmacias y al publico en general sobre los riesgos del uso indebido de antibioticos y los peligros de la resistencia a los antimicrobianos., Introduction Antimicrobial resistance is one of the most serious threats to the health of the world's population. [1,2] In 2019, antimicrobial resistance was associated with 4.95 million deaths globally. [3] [...]

Background: Previous studies indicated that air pollution plausibly increases the risk of adverse outcomes in inflammatory bowel disease (IBD) via proinflammatory mechanisms. However, there is scant epidemiological data and insufficient prospective evidence assessing associations between ambient air pollution and clinical outcomes of IBD. Objectives: We aimed to investigate the associations between ambient air pollution and clinical outcomes among individuals with IBD. Methods: Leveraging data from the UK Biobank, we included 4,708 individuals with IBD recruited in the period 2006- 2010 in this study. A land use regression model was used to assess annual mean concentrations of ambient air pollutants nitrogen including oxides (N[O.sub.x]), nitrogen dioxide (N[O.sub.2]), and particulate matter (PM) with aerodynamic diameter [less than or equal to]10 [micro]m (P[M.sub.10]) and PM with aerodynamic diameter Results: During a mean follow-up of 12.0 y, 265 enterotomy events, 124 incident gastrointestinal cancer, and 420 death events were documented among individuals with IBD. We found that each interquartile range (IQR) increase in exposure to P[M.sub.2.5] was associated with increased risk of enterotomy (HR= 1.16; 95% CI: 1.00, 1.34, p = 0.043), whereas an IQR increase in exposure to N[O.sub.x] (HR=1.10; 95% CI: 1.01, 1.20, p = 0.016), N[O.sub.2] (HR = 1.16; 95% CI: 1.03, 1.29, p = 0.010), P[M.sub.10] (HR = 1.15; 95% CI: 1.03, 1.30, p = 0.015), and P[M.sub.2.5] (HR=1.14; 95% CI: 1.02, 1.28, p = 0.019) was associated with increased risk of all-cause mortality among individuals with IBD. We did not observe any significant associations between air pollutants and gastrointestinal cancer in the primary analyses. Consistent results were observed in subgroup and sensitivity analyses. Conclusions: Ambient pollution exposure was associated with an increased risk of enterotomy and all-cause mortality among individuals with IBD, highlighting the important role of environmental health in improving the prognosis of IBD. https://doi.org/ 10.1289/EHP12215, Introduction Inflammatory bowel disease (IBD), comprising Crohn's disease (CD) and ulcerative colitis (UC), is a chronic immune-mediated digestive disease that poses a substantial burden worldwide. (1) As an important environmental [...]