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Abstract Objective With the increase in the prevalence rate and improvements in the survival of breast cancer patients, there is a growing interest in understanding the level of psychosocial adjustment in these patients. The study aimed to describe the illness perception and psychosocial adjustment levels of both breast cancer patients and their spouses, to use the Actor-Partner Interdependence Model (APIM) to clarify the actor-partner relationships between spouses, and to explore the impact of illness perception on psychosocial adjustment to the disease within the joint actions of both spouses. Methods A total of 216 female patients with breast cancer and their spouses participated in the study. They were selected from two tertiary hospitals in Guangdong Province, China from October 2022 to May 2023 using a convenience sampling method. The participants were assessed using the Brief Illness Perception Questionnaire and the Psychosocial Adjustment to Illness Scale to examine the relationship between illness perception and psychosocial adjustment. AMOS24.0 was used to test and analyze the actor-partner interdependence model. Results The illness perception score (57.75 ± 10.91) was slightly higher than that of the spouse (57.10 ± 11.00), and the psychosocial adjustment score (64.67 ± 6.33) was slightly lower than that of the spouse (64.76 ± 7.49). The results of the actor-partner interdependence model indicated that there was a couple partner between breast cancer patients and their spouses: the spouse’s illness perception significantly affected the patient’s psychosocial adjustment (β = 0.095, p = 0.015); the patient’s illness perception also significantly affected the spouse’s psychosocial adjustment (β = 0.106, p = 0.033). Among them, the patient’s psychosocial adjustment was found to be related to the patient’s illness comprehensibility or coherence of illness (β = 0.433, p = 0.009), the spouse’s emotional illness representation (β = 0.218, p = 0.037), and the spouse’s illness comprehensibility or coherence of illness (β = 0.416, p = 0.007), while the spouse’s psychosocial adjustment was only related to the spouse’s illness comprehensibility or coherence of illness (β = 0.528, p = 0.007). Conclusions The psychosocial adjustment of breast cancer patients is affected by both their own and spouse’s illness perception. Therefore, in the future, the healthcare staff can implement early psychological interventions for patients diagnosed with breast cancer and their spouses as a unit to promote the psychosocial adjustment of them.

Abstract Impedance theory has become a favorite method for metasurface design as it allows perfect control of wave properties. However, its functionality is strongly limited by the condition of strict continuity of normal power flow. In this paper, it is shown that acoustic impedance theory can be generalized under the integral equivalence principle without imposing the continuity of power flow. Equivalent non-local power flow transmission is instead realized through local design of metasurface unit cells that are characterized by a passive, asymmetric impedance matrix. Based on this strategy, a beam splitter loosely respecting local power flow is designed and demonstrated experimentally. It is concluded that arbitrary wave fields can be connected through arbitrarily shaped boundaries, i.e. transformed into one another. Generalized impedance metasurface theory is expected to extend the possible design of metasurfaces and the manipulation of acoustic waves.

Abstract Purpose Gestational diabetes mellitus (GDM) negatively affects the quality of life of pregnant women and is influenced by several factors. Research to date treats pregnant women with gestational diabetes as a homogeneous group based on their quality of life. We attempted to identify subgroups based on self-reported quality of life and explored variables associated with subgroups. Methods From September 1, 2020 to November 29, 2020, pregnant women with GDM from two hospitals in Guangdong Province were selected as subjects by convenience sampling method. Medical records provided sociodemographic data, duration of GDM, pregnancy status, and family history of diabetes. Participants completed validated questionnaires for quality of life, anxiety and depression. Latent profile analysis was used to identify profiles of quality of life in pregnant women with GDM, and then a mixed regression method was used to analyze the influencing factors of different profiles. Results A total of 279 valid questionnaires were collected. The results of the latent profile analysis showed that the quality of life of pregnant women with GDM could be divided into two profiles: C1 “high worry-high support” group (75.6%) and C2 “low worry-low support” group (24.4%). Daily exercise duration and depression degree are negative influencing factors, making it easier to enter the C1 group (p

Abstract Background While single-method studies have reported on the effectiveness of simulated interprofessional teaching, our understanding of its full effects remains incomplete. Teaching design also provides no relevant theoretical guidance, which reduces the scientific quality and rigor of research. The purpose of this work was to study the effects of the simulated interprofessional education (SIPE) teaching model based on the 3P theory on the course of "Clinical Critical Thinking Training" through a convergent mixed method, and to provide the basis for future teaching design. Methods A convergent mixed-method design was used, which consisted of a survey and a semi-structured interview. Data collection took place from September 2021 to July 2022. A cluster sampling method was used to select 60 full-time nursing students from a school in China, and randomly divide them into a control group of 36 and an experimental group of 24. According to the principle of voluntary participation, 6 students majoring in clinical medicine and 6 students majoring in pharmacy were recruited to join the experimental group to form an interprofessional team. The students studied “Clinical Critical Thinking Training” together, in which the control group used traditional simulation teaching and the experimental group used SIPE. The CCTDI (California Critical Thinking Disposition Inventory) and AITCS-II Student (Assessment of Interprofessional Team Collaboration in Student Learning Scale) were used for quantitative evaluation before and after the course, and descriptive statistics and Mann–Whitney U test were used to compare the critical thinking and interprofessional collaboration skills of the two groups of students. Semi-structured interviews were used for qualitative evaluation. Thematic analysis was used to understand student development on the basis of inter-professional core competencies and learning experience. Results The students’ interprofessional cooperation abilities and critical thinking scores improved compared with the beginning of the course, but the scores of the experimental group were significantly higher than the control group (p

Abstract Extreme impedance mismatch causes sound insulation at water–air interfaces, limiting numerous cross‐media applications such as ocean‐air wireless acoustic communication. Although quarter‐wave impedance transformers can improve transmission, they are not readily available for acoustics and are restricted by the fixed phase shift at full transmission. Here, this limitation is broken through impedance‐matched hybrid metasurfaces assisted by topology optimization. Sound transmission enhancement and phase modulation across the water–air interface are achieved independently. Compared to the bare water–air interface, it is experimentally observed that the average transmitted amplitude through an impedance‐matched metasurface at the peak frequency is enhanced by ≈25.9 dB, close to the limit of the perfect transmission 30 dB. And nearly 42 dB amplitude enhancement is measured by the hybrid metasurfaces with axial focusing function. Various customized vortex beams are experimentally realized to promote applications in ocean‐air communication. The physical mechanisms of sound transmission enhancement for broadband and wide‐angle incidences are revealed. The proposed concept has potential applications in efficient transmission and free communication across dissimilar media.

Background: Inflammation promotes the progression of Alzheimer’s disease (AD). In this study, we explored the effect of dexmedetomidine on inflammation and cognitive function in a mouse model of AD.Methods: 5xFAD mice were intragastrically administered saline, dexmedetomidine, or dexmedetomidine and yohimbine for 14 days. The effects of dexmedetomidine on the acquisition and retention of memory in the Morris water-maze test and Y maze were evaluated. The deposition of amyloid beta protein (Abeta) and cytokine levels in the hippocampus were assessed. The expression of Bace1 protein and NFκB-p65 protein was assessed by Western blotting.Results: Compared with WT mice, 5xFAD mice exhibited cognitive impairment in the Morris water maze test and Y maze test. Cognitive decline was alleviated by dexmedetomidine and this was reversed by the α2 adrenoceptor antagonist yohimbine. Compared with saline treatment, dexmedetomidine led to a reduction in the Abeta deposition area (p < 0.05) and in the mean gray value (p < 0.01) in the hippocampus of 5xFAD mice. Compared with saline treatment, dexmedetomidine inhibited the activation of astrocytes and microglia in the hippocampal DG of 5xFAD mice and reduced the area of GFAP (p < 0.01) and IBA1 (p < 0.01). The level of IL-1β in the hippocampus decreased significantly after dexmedetomidine treatment compared with saline treatment in 5xFAD mice (p < 0.01). Yohimbine neutralized the effects of dexmedetomidine. Dexmedetomidine inhibited the expression of BACE1 and NF-κB p65 (p < 0.01), and these changes were reversed by yohimbine treatment.Conclusion: Dexmedetomidine alleviates cognitive decline, inhibits neuroinflammation, and prevents the deposition of Abeta in 5xFAD mice. The effect is mediated by the α2 adrenoceptor-mediated anti-inflammatory pathway. Dexmedetomidine may be effective for the treatment of AD and a better choice for the sedation of AD.

Seismic metamaterials (SMs) are expected to assist or replace traditional isolation systems owing to their strong attenuation of seismic waves. In this work, a one-dimensional inverted T-shaped SM (1D ITSM) composed of arrays of inverted T-shaped structures on a half space is proposed, which have an ultra-wide first bandgap (FBG) from 6.7 to 17.2 Hz. We find that the FBG is composed of two parts; part 1 with surface evanescent waves from 6.7 to 11.0 Hz and part 2 with no surface modes from 11.0 to 17.2 Hz by using the complex band structures. The propagation of seismic surface waves in the 1D ITSM is different in these two frequency ranges of the FBG. In part 1, the seismic surface waves are significantly attenuated in the 1D ITSM because of the surface evanescent waves, while in part 2, the surface waves are converted into bulk waves because surface waves cannot exist in the ITSM. Finally, the ultra-wide FBG is verified by using a kind of the two-dimensional ITSM in large-scale field experiments.

We demonstrate experimentally the manipulation of Lamb waves guided along reconfigurable phononic circuits created by defects composed of threaded rods held with nuts in a perforated solid phononic crystal slab. Adjusting the free length of the rod, the resonant frequency of the defect can be tuned, without any change in the supporting phononic crystal slab. Both straight and bent waveguides are fabricated and measured in an aluminum sample with a lattice constant of 20 mm and a complete bandgap extending from 50 to 70 kHz. Guidance of Lamb waves is clearly observed by a Doppler vibrometer, even after 90° bends. The eigenmodes of guided waves are obtained using finite element analysis to explain the tuning of resonances through a bending cantilever model. Numerical and experimental results are generally found to be in fair agreement. They also suggest that the guiding frequency is rather independent of the details of the waveguides. They are of significance for the design of reconfigurable phononic devices.

Acoustic metasurfaces can reshape a reflected wavefront rather arbitrarily, despite being much thinner than the wavelength, thus allowing on-demand wavefront modulation in a variety of applications. Recent passive metasurfaces, however, have suffered from bandwidth limitations, thus restricting their range of operation. In this work, we propose the systematic design of ultra-broadband passive metasurfaces by combining the broadband local reflection rule with an optimization method. The validation of the technique is demonstrated by fabrication and measurement of an ultra-broadband carpet cloak. Numerical and experimental results show that the relative bandwidth of the optimized carpet cloak, thinner than one fifth of the maximum wavelength, can exceed 93.33%, a value that is much larger than that of previous passive metasurfaces. Furthermore, multi-frequency pulse incidence tests reveal the excellent time-domain broadband characteristics of the metasurface over a wide range of angles of incidence. The proposed strategy opens a new route for the design of advanced passive metasurfaces for ultra-broadband wave manipulation and thus promotes practical applications of broadband acoustical devices.

Vacuum sealing drainage (VSD) is frequently used in abdominal surgeries. However, relevant guidelines are rare. Chinese Trauma Surgeon Association organized a committee composed of 28 experts across China in July 2017, aiming to provide an evidence-based recommendation for the application of VSD in abdominal surgeries.Eleven questions regarding the use of VSD in abdominal surgeries were addressed: (1) which type of materials should be respectively chosen for the intraperitoneal cavity, retroperitoneal cavity and superficial incisions? (2) Can VSD be preventively used for a high-risk abdominal incision with primary suture? (3) Can VSD be used in severely contaminated/infected abdominal surgical sites? (4) Can VSD be used for temporary abdominal cavity closure under some special conditions such as severe abdominal trauma, infection, liver transplantation and intra-abdominal volume increment in abdominal compartment syndrome? (5) Can VSD be used in abdominal organ inflammation, injury, or postoperative drainage? (6) Can VSD be used in the treatment of intestinal fistula and pancreatic fistula? (7) Can VSD be used in the treatment of intra-abdominal and extra-peritoneal abscess? (8) Can VSD be used in the treatment of abdominal wall wounds, wound cavity, and defects? (9) Does VSD increase the risk of bleeding? (10) Does VSD increase the risk of intestinal wall injury? (11) Does VSD increase the risk of peritoneal adhesion?Focusing on these questions, evidence-based recommendations were given accordingly. VSD was strongly recommended regarding the questions 2–4. Weak recommendations were made regarding questions 1 and 5–11. Proper use of VSD in abdominal surgeries can lower the risk of infection in abdominal incisions with primary suture, treat severely contaminated/infected surgical sites and facilitate temporary abdominal cavity closure. Keywords: Guideline, Vacuum sealing drainage, Abdominal surgery

The loss of volatiles results in the deterioration of flavor in tomatoes. Volatiles are mainly derived from fatty acid, carotenoid, phenylpropane, and branched chain amino acids. In this study, the tomato accession CI1005 with a strong odor and accession TI4001 with a weak odor were analyzed. The volatile contents were measured in tomato fruits using gas chromatography-mass spectrometry. The scores of tomato taste and odor characteristics were evaluated according to hedonistic taste and olfaction. It was found that the content of fatty acid-derived volatiles accounted for more than half of the total volatiles that had grassy and fatty aromas. Phenylpropane-derived volatiles had irritation and floral aromas. Branched-chain amino acid-derived volatiles had a caramel aroma. Carotenoid-derived volatiles had floral, fruity, fatty, and sweet-like aromas, preferred by consumers. A lack of carotenoid-derived volatiles affected the flavor quality of tomato fruits. The accumulation of carotenoid-derived volatiles is regulated by carotenoid cleavage oxygenases (CCDs). A tissue-specific expression analysis of the SlCCD genes revealed that the expression levels of SlCCD1A and SlCCD1B were higher in tomato fruits than in other tissues. The expression levels of SlCCD1A and SlCCD1B were consistent with the trend of the carotenoid-derived volatile contents. The expression of SlCCD1A was higher than that for SlCCD1B. A bioinformatics analysis revealed that SlCCD1A was more closely linked to carotenoid metabolism than SlCCD1B. The overexpression of SlCCD1A indicated that it could cleave lycopene, α-carotene, and β-carotene to produce 6-methyl-5-hepten-2-one, geranylacetone, α-ionone, and β-ionone, increasing the floral, fruity, fatty, and sweet-like aromas of tomato fruits. The flavor quality of tomato fruits could be improved by overexpressing SlCCD1A.

Objective This study investigated the frequency of T-helper (Th)17 lymphocytes and production of cytokine interleukin (IL)-17 in peripheral blood of patients with non-small-cell lung cancer (NSCLC) and their use as a marker of clinical value. Methods Sixty patients with NSCLC and 60 healthy volunteers were enrolled in the study. Flow cytometry was used to detect the frequency of Th17 lymphocytes in peripheral blood, and enzyme-linked immunosorbent assay (ELISA) was used to detect serum levels of IL-17. We analyzed the association of Th17 lymphocytes and IL-17 levels in the peripheral blood of patients with their clinicopathological features. Results Frequency of Th17 lymphocytes and production of IL-17 were significantly higher in the NSCLC group than in the control group and were higher in patients with a smoking history compared with non-smokers. Moreover, Th17 lymphocyte and IL-17 expression levels were higher in patients with squamous cell carcinoma than in patients with adenocarcinoma, and significantly higher in patients with stage III and IV cancers than in patients at stage I or II. Conclusion Th17 lymphocytes and IL-17 play an important role in the development of NSCLC in patients and may have clinical value as markers for treatment of NSCLC.

The fabrication of a single-crystal hydrogen-terminated diamond metal-oxide-semiconductor field-effect transistor (MOSFET) with HfSiON/Al2O3 bilayer dielectric has been carried out. HfSiON and Al2O3 layers were deposited by sputtering-deposition (SD) and atomic layer deposition (ALD) techniques. The maximum output current for SD-HfSiON/ALD-Al2O3 was 36 mA mm−1, and for ALD-Al2O3, it was 31 mA mm−1. We reported that the hysteresis shift voltage of the bilayer dielectric MOSFET was one fourth of the single dielectric layer MOSFET. The leakage current density of SD-HfSiON/ALD-Al2O3 was one order of magnitude lower than the single layer dielectric. We also determined the dielectric constants of HfSiON/Al2O3 and Al2O3 dielectrics based on capacitance–voltage characteristics. The values of VTH, on/off ratio, subthreshold swing, and low field mobility for the bilayer dielectric MOSFET were evaluated to be 4.5 V, 105, 296 mV/decade, and 154 cm2 V−1 s−1, respectively.

Fabrication of microlenses on a diamond surface is an important way to enhance the performance of the embedded nitrogen vacancy (NV) center which is a promising single light source for quantum communication and quantum-based detection. In this work, lenses with a micrometer diameter were fabricated on a diamond surface by using the inductively coupled plasma (ICP) etching technique with a mask of polystyrene (PS) balls. First, 1 µm diameter PS balls were dispersed on the surface of deionized water. Then, the balls were transferred onto a diamond surface. Third, the sample was treated using the ICP technique to form microlenses. By increasing ICP etching time, the surface of fabricated microlenses became smoother. The simulation results demonstrate that the microlenses can greatly improve the photon collection efficiency of the embedded NV center and focus more excitation light to the NV center than bulk diamond.

Phononic coupled-resonator waveguide cavities are formed by a finite chain of defects in a complete bandgap phononic crystal slab. The sample is machined in a fused silica plate by femtosecond printing to form an array of cross-shape holes. The collective resonance of the phononic cavities, in the Megahertz frequency range, are excited by a piezoelectric vibrator and imaged by laser Doppler vibrometry. It is found that well-defined resonant cavity modes can be efficiently excited, even though the phononic cavities are distant by a few lattice spacings and are only weakly coupled through evanescent elastic waves. The results suggest the possibility of engineering the dynamical response of a set of coupled phononic cavities by an adequate layout of defects in a phononic crystal slab.

The consideration of material losses in phononic crystals leads naturally to the introduction of complex valued eigenwavevectors or eigenfrequencies representing the attenuation of elastic waves in space or in time, respectively. Here, we propose a new technique to obtain phononic band structures with complex eigenfrequencies but real wavevectors, in the case of viscoelastic materials, whenever elastic losses are proportional to frequency. Complex-eigenfrequency band structures are obtained for a sonic crystal in air, and steel/epoxy and silicon/void phononic crystals, with realistic viscous losses taken into account. It is further found that the imaginary part of eigenfrequencies are well predicted by perturbation theory and are mostly independent of periodicity, i.e., they do not account for propagation losses but for temporal damping of Bloch waves.

Submicron lenses and cylinders exhibiting excellent properties in photodetector and quantum applications have been fabricated on a diamond surface by an inductively-coupled plasma (ICP) etching technique. During ICP etching, a layer containing 500 nm diameter balls of SiO2 was employed as mask. By changing the mixing ratio of O2, Ar and CF4 during ICP etching, several submicron structures were fabricated, such as cylinders and lenses. The simulation results demonstrated that such submicron structures on a diamond’s surface can greatly enhance the photon out-coupling efficiency of embedded nitrogen-vacancy center.

In this paper we present a comprehensive study on the multi-objective optimization of two-dimensional porous phononic crystals (PnCs) in both square and triangular lattices with the reduced topology symmetry of the unit-cell. The fast non-dominated sorting-based genetic algorithm II is used to perform the optimization, and the Pareto-optimal solutions are obtained. The results demonstrate that the symmetry reduction significantly influences the optimized structures. The physical mechanism of the optimized structures is analyzed. Topology optimization combined with the symmetry reduction can discover new structures and offer new degrees of freedom to design PnC-based devices. Especially, the rotationally symmetrical structures presented here can be utilized to explore and design new chiral metamaterials.

We investigate longitudinal near-field coupling between acoustic resonators grafted along a waveguide. Experiments are performed in the audible range with a simple acoustic system composed of a finite aperiodic sequence of air resonators. Transmission typically shows a zero around a resonance frequency of a single resonator, as is well known. When two identical resonators are brought in close proximity, however, we observe that longitudinal near-field coupling strongly influences the acoustic transmission. When the separation between resonators is increased so that they can be considered in the far field of one another, we further observe the appearance of Fano-like transmission profiles. We explain this observation by the formation of locally resonant Fabry-Perot interferometers from every pair of resonators. All experimental results are compared to three-dimensional finite element analysis of the acoustic system.

In this paper we propose four kinds of two-dimensional square beam-like zigzag lattice structures and study their bandgaps and directional propagation of elastic waves. The band structures are calculated by using the finite element method. Both the in-plane and out-of-plane waves are investigated simultaneously via the three-dimensional Euler beam elements. The mechanism of the bandgap generation is analyzed by studying the vibration modes at the bandgap edges. The effects of the geometry parameters of the xy- and z-zigzag lattices on the bandgaps are investigated and discussed. Multiple complete bandgaps are found owing to the separation of the degeneracy by introducing bending arms. The bandgaps are sensitive to the geometry parameters of the periodic systems. The deformed displacement fields of the harmonic responses of a finite lattice structure subjected to harmonic loads at different positions are illustrated to show the directional wave propagation. An extension of the proposed concept to the hexagonal lattices is also presented. The research work in this paper is relevant to the practical design of cellular structures with enhanced vibro-acoustics performance.

Bragg band gaps of phononic crystals generally, but not always, open at Brillouin zone boundaries. The commonly accepted explanation stems from the empty lattice model: assuming a small material contrast between the constituents of the unit cell, avoided crossings in the phononic band structure appear at frequencies and wavenumbers corresponding to band intersections; for scalar waves the lowest intersections coincide with boundaries of the first Brillouin zone. However, if a phononic crystal contains elastically anisotropic materials, its overall symmetry is not dictated solely by the lattice symmetry. We construct an empty lattice model for phononic crystals made of isotropic and anisotropic materials, based on their slowness curves. We find that, in the anisotropic case, avoided crossings generally do not appear at the boundaries of traditionally defined Brillouin zones. Furthermore, the Bragg “planes” which give rise to phononic band gaps, are generally not flat planes but curved surfaces. The same is found to be the case for avoided crossings between shear (transverse) and longitudinal bands in the isotropic case.