Context: COVID-19 can spread rapidly in haemodialysis centres, leading to fatal outcomes. Implementing physical measures is crucial in limiting the spread of infection. Aims: To assess adherence to physical measures a...Context: COVID-19 can spread rapidly in haemodialysis centres, leading to fatal outcomes. Implementing physical measures is crucial in limiting the spread of infection. Aims: To assess adherence to physical measures against SARS-Cov2 in haemodialysis patients. Methods and Material: From 13 to 19 July 2021, we administered the questionnaire to haemodialysis patients during or immediately after the dialysis session. The dependent variables were adherence to wearing masks, hand washing outside the dialysis centre, social distancing of at least 1.5 meters, and cough and sneeze hygiene. Statistical Analysis Used: Data were analyzed using Epi info software;descriptive statistics were presented as mean, headcount, and percentage;related factors were determined by multi-logistic regression. The significance level was 5%. The Health Research Ethics Committee approved the research protocol. Results: 142 patients were included (mean age: 42.5 ± 14 years). Wearing masks, hand-washing, social distancing, and coughing and sneezing hygiene were observed by 88%, 75%, 47%, and 60% of patients, respectively. Conclusion: Wearing masks was the most respected physical measure, while social distancing was the least respected.展开更多
Marine umbilical is one of the key equipment for subsea oil and gas exploitation,which is usually integrated by a great number of different functional components with multi-layers.The layout of these components direct...Marine umbilical is one of the key equipment for subsea oil and gas exploitation,which is usually integrated by a great number of different functional components with multi-layers.The layout of these components directly affects manufacturing,operation and storage performances of the umbilical.For the multi-layer cross-sectional layout design of the umbilical,a quantifiable multi-objective optimization model is established according to the operation and storage requirements.Considering the manufacturing factors,the multi-layering strategy based on contact point identification is introduced for a great number of functional components.Then,the GA-GLM global optimization algorithm is proposed combining the genetic algorithm and the generalized multiplier method,and the selection operator of the genetic algorithm is improved based on the steepest descent method.Genetic algorithm is used to find the optimal solution in the global space,which can converge from any initial layout to the feasible layout solution.The feasible layout solution is taken as the initial value of the generalized multiplier method for fast and accurate solution.Finally,taking umbilicals with a great number of components as examples,the results show that the cross-sectional performance of the umbilical obtained by optimization algorithm is better and the solution efficiency is higher.Meanwhile,the multi-layering strategy is effective and feasible.The design method proposed in this paper can quickly obtain the optimal multi-layer cross-sectional layout,which replaces the manual design,and provides useful reference and guidance for the umbilical industry.展开更多
BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses met...BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses metabolic health and insulin resistance,and has been linked to gastrointestinal cancers.AIM To investigate the potential association between the TyG index and CPs,as the relation between them has not been documented.METHODS A total of 2537 persons undergoing a routine health physical examination and colonoscopy at The First People's Hospital of Kunshan,Jiangsu Province,China,between January 2020 and December 2022 were included in this retrospective cross-sectional study.After excluding individuals who did not meet the eligibility criteria,descriptive statistics were used to compare characteristics between patients with and without CPs.Logistic regression analyses were conducted to determine the associations between the TyG index and the prevalence of CPs.The TyG index was calculated using the following formula:Ln[triglyceride(mg/dL)×glucose(mg/dL)/2].The presence and types of CPs was determined based on data from colonoscopy reports and pathology reports.RESULTS A nonlinear relation between the TyG index and the prevalence of CPs was identified,and exhibited a curvilinear pattern with a cut-off point of 2.31.A significant association was observed before the turning point,with an odds ratio(95% confidence interval)of 1.70(1.40,2.06),P<0.0001.However,the association between the TyG index and CPs was not significant after the cut-off point,with an odds ratio(95% confidence interval)of 0.57(0.27,1.23),P=0.1521.CONCLUSION Our study revealed a curvilinear association between the TyG index and CPs in Chinese individuals,suggesting its potential utility in developing colonoscopy screening strategies for preventing CRC.展开更多
BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even afte...BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even after the pandemic.However,less is known about this topic.AIM To analyze mental health,insomnia problems,and their influencing factors in HCWs after the COVID-19 pandemic.METHODS This multicenter cross-sectional,hospital-based study was conducted from June 1,2023 to June 30,2023,which was a half-year after the end of the COVID-19 emergency.Region-stratified population-based cluster sampling was applied at the provincial level for Chinese HCWs.Symptoms such as anxiety,depression,and insomnia were evaluated by the Generalized Anxiety Disorder-7,Patient Health Questionnaire-9,and Insomnia Severity Index.Factors influencing the symptoms were identified by multivariable logistic regression.RESULTS A total of 2000 participants were invited,for a response rate of 70.6%.A total of 1412 HCWs[618(43.8%)doctors,583(41.3%)nurses and 211(14.9%)nonfrontline],254(18.0%),231(16.4%),and 289(20.5%)had symptoms of anxiety,depression,and insomnia,respectively;severe symptoms were found in 58(4.1%),49(3.5%),and 111(7.9%)of the participants.Nurses,female sex,and hospitalization for COVID-19 were risk factors for anxiety,depression,and insomnia symptoms;moreover,death from family or friends was a risk factor for insomnia symptoms.During the COVID-19 outbreak,most[1086(76.9%)]of the participating HCWs received psychological interventions,while nearly all[994(70.4%)]of them had received public psychological education.Only 102(7.2%)of the HCWs received individual counseling from COVID-19.CONCLUSION Although the mental health and sleep problems of HCWs were relieved after the COVID-19 pandemic,they still faced challenges and greater risks than did the general population.Identifying risk factors would help in providing targeted interventions.In addition,although a major proportion of HCWs have received public psychological education,individual interventions are still insufficient.展开更多
Objective This study aimed to explore the relationships between residential greenness and cardiometabolic risk factors among rural adults in Xinjiang Uygur Autonomous Region(Xinjiang)and thus provide a theoretical bas...Objective This study aimed to explore the relationships between residential greenness and cardiometabolic risk factors among rural adults in Xinjiang Uygur Autonomous Region(Xinjiang)and thus provide a theoretical basis and data support for improving the health of residents in this region.Methods We recruited 9,723 adult rural residents from the 51st Regiment of the Third Division of the Xinjiang Production and Construction Corps in September 2016.The normalized difference vegetation index(NDVI)was used to estimate residential greenness.The generalized linear mixed model(GLMM)was used to examine the association between residential greenness and cardiometabolic risk factors.Results Higher residential greenness was associated with lower cardiometabolic risk factor prevalence.After adjustments were made for age,sex,education,and marital status,for each interquartile range(IQR)increase of NDVI500-m,the risk of hypertension was reduced by 10.3%(OR=0.897,95%CI=0.836-0.962),the risk of obesity by 20.5%(OR=0.795,95%CI=0.695-0.910),the risk of type 2 diabetes by 15.1%(OR=0.849,95%CI=0.740-0.974),and the risk of dyslipidemia by 10.5%(OR=0.895,95%CI=0.825-0.971).Risk factor aggregation was reduced by 20.4%(OR=0.796,95%CI=0.716-0.885)for the same.Stratified analysis showed that NDVI500-m was associated more strongly with hypertension,dyslipidemia,and risk factor aggregation among male participants.The association of NDVI500-m with type 2 diabetes was stronger among participants with a higher education level.PM10 and physical activity mediated 1.9%-9.2%of the associations between NDVI500-m and obesity,dyslipidemia,and risk factor aggregation.Conclusion Higher residential greenness has a protective effect against cardiometabolic risk factors among rural residents in Xinjiang.Increasing the area of green space around residences is an effective measure to reduce the burden of cardiometabolic-related diseases among rural residents in Xinjiang.展开更多
Reduction of the radar cross-section(RCS) is the key to stealth technology. To improve the RCS reduction effect of the designed checkerboard metasurface and overcome the limitation of thinlayer plasma in RCS reduction...Reduction of the radar cross-section(RCS) is the key to stealth technology. To improve the RCS reduction effect of the designed checkerboard metasurface and overcome the limitation of thinlayer plasma in RCS reduction technology, a double-layer-plasma-based metasurface—composed of a checkerboard metasurface, a double-layer plasma and an air gap between them—was investigated. Based on the principle of backscattering cancellation, we designed a checkerboard metasurface composed of different artificial magnetic conductor units;the checkerboard metasurface can reflect vertically incident electromagnetic(EM) waves in four different inclined directions to reduce the RCS. Full-wave simulations confirm that the doublelayer-plasma-based metasurface can improve the RCS reduction effect of the metasurface and the plasma. This is because in a band lower than the working band of the metasurface, the RCS reduction effect is mainly improved by the plasma layer. In the working band of the metasurface,impedance mismatching between the air gap and first plasma layer and between first and second plasma layers cause the scattered waves to become more dispersed, so the propagation path of the EM waves in the plasma becomes longer, increasing the absorption of the EM waves by the plasma. Thus, the RCS reduction effect is enhanced. The double-layer-plasma-based metasurface can be insensitive to the polarization of the incoming EM waves, and can also maintain a satisfactory RCS reduction band when the incident waves are oblique.展开更多
3D elastic-plastic FE model for simulating the force controlled stretch-bending process of double-cavity aluminum profile was established using hybrid explicit−implicit solvent method.Considering the computational acc...3D elastic-plastic FE model for simulating the force controlled stretch-bending process of double-cavity aluminum profile was established using hybrid explicit−implicit solvent method.Considering the computational accuracy and efficiency,the optimal choices of numerical parameters and algorithms in FE modelling were determined.The formation mechanisms of cross-section distortion and springback were revealed.The effects of pre-stretching,post-stretching,friction,and the addition of internal fillers on forming quality were investigated.The results show that the stress state of profile in stretch-bending is uniaxial with only a circumferential stress.The stress distribution along the length direction of profile is non-uniform and the maximum tensile stress is located at a certain distance away from the center of profile.As aluminum profile is gradually attached to bending die,the distribution characteristic of cross-section distortion along the length direction of profile changes from V-shape to W-shape.After unloading the forming tools,cross-section distortion decreases obviously due to the stress relaxation,with a maximum distortion difference of 13%before and after unloading.As pre-stretching and post-stretching forces increase,cross-section distortion increases gradually,while springback first decreases and then remains unchanged.With increasing friction between bending die and profile,cross-section distortion slightly decreases,while springback increases.Cross-section distortion decreases by 83%with adding PVC fillers into the cavities of profile,while springback increases by 192.2%.展开更多
Dyslipidemia is a disorder where abnormally lipid concentrations circulate in the bloodstream. The disorder is common in type 2 diabetics (T2D) and is linked with T2D comorbidities, particularly cardiovascular disease...Dyslipidemia is a disorder where abnormally lipid concentrations circulate in the bloodstream. The disorder is common in type 2 diabetics (T2D) and is linked with T2D comorbidities, particularly cardiovascular disease. Dyslipidemia in T2D is typically characterized by elevated plasma triglyceride and low high-density lipoprotein cholesterol (HDL-C) levels. There is a significant gap in the literature regarding dyslipidemia in rural parts of Africa, where lipid profiles may not be captured through routine surveillance. This study aimed to characterize the prevalence and demo-graphic profile of dyslipidemia in T2D in the rural community of Ganadougou, Mali. We performed a cross-sectional study of 104 subjects with T2D in Ganadougou between November 2021 and March 2022. Demographic and lipid profiles were collected through cross-sectional surveys and serological analyses. The overall prevalence of dyslipidemia in T2D patients was 87.5% (91/104), which did not differ by sex (P = .368). High low-density lipoprotein cholesterol (LDL-C) was the most common lipid abnormality (78.9%, [82/104]). Dyslipidemia was associated with age and hypertension status (P = .013 and.036, respectively). High total and high LDL-C parameters were significantly associated with hypertension (P = .029 and .006, respectively). In low-resource settings such as rural Mali, there is a critical need to improve infrastructure for routine dyslipidemia screening to guide its prevention and intervention approaches. The high rates of dyslipidemia observed in Gandadougou, consistent with concomitant increases in cardiovascular diseases in Africa suggest that lipid profile assessments should be incorporated into routine medical care for T2D patients in African rural settings.展开更多
To predict the soft error rate for applications, it is essential to study the energy dependence of the single-event-upset(SEU) cross-section. In this work, we present a direct measurement of the SEU cross-section with...To predict the soft error rate for applications, it is essential to study the energy dependence of the single-event-upset(SEU) cross-section. In this work, we present a direct measurement of the SEU cross-section with the Back-n white neutron source at the China Spallation Neutron Source. The measured cross section is consistent with the soft error data from the manufacturer and the result suggests that the threshold energy of the SEU is about 0.5 Me V, which confirms the statement in Iwashita’s report that the threshold energy for neutron soft error is much below that of the(n, α) cross-section of silicon.In addition, an index of the effective neutron energy is suggested to characterize the similarity between a spallation neutron beam and the standard atmospheric neutron environment.展开更多
Background: Infertility and abortion are significant reproductive health concerns globally, impacting individuals' well-being and healthcare systems. In Saudi Arabia, cultural, social, and religious factors influe...Background: Infertility and abortion are significant reproductive health concerns globally, impacting individuals' well-being and healthcare systems. In Saudi Arabia, cultural, social, and religious factors influence perceptions and management of these issues, necessitating research to understand the patterns and associated factors. Study Aim: This cross-sectional study aimed to investigate the patterns of infertility and abortion among 458 women in Saudi Arabia, focusing on demographic profiles, reproductive histories, medical conditions, and lifestyle factors. Methodology: Participants were recruited from healthcare facilities, and data on age, BMI, reproductive history, medical conditions, assisted reproduction methods, and lifestyle behaviors were collected. Statistical analyses, including chi-square tests, were conducted to examine associations between variables. Results: The majority of participants were aged 30 - 39 years (47.4%), with 76.9% experiencing secondary infertility. Among those with offspring (76.9%), 31% reported using assisted reproduction methods, primarily ovarian stimulators (54.2%). Abortion history was reported by 39.5% of participants. Significant associations were found between age and infertility type (X2 = 5.8, p = 0.054), having offspring and infertility type (X2 = 458.0, p = 0.001), menstrual irregularity and infertility type (X2 = 11.4, p = 0.001), and abortion history and delayed fertility (X2 = 10.4, p = 0.001). Conclusion: Our study reveals significant associations between demographic, medical, and lifestyle factors with infertility patterns and abortion history among Saudi women. These findings emphasize the need for tailored interventions addressing medical conditions, age-related factors, and access to reproductive healthcare services.展开更多
Based on the unified Hauser–Feshbach and exciton model,which can describe the particle emission processes between discrete energy levels with energy,angular momentum,and parity conservations,a statistical theory of l...Based on the unified Hauser–Feshbach and exciton model,which can describe the particle emission processes between discrete energy levels with energy,angular momentum,and parity conservations,a statistical theory of light nucleus reaction(STLN)is developed to calculate the double-differential cross-sections of the outgoing neutron and light charged particles for the proton-induced^(6) Li reaction.A significant difference is observed between the p+^(6) Li and p+^(7) Li reactions owing to the discrepancies in the energy-level structures of the targets.The reaction channels,including sequential and simultaneous emission processes,are analyzed in detail.Taking the double-differential cross-sections of the outgoing proton as an example,the influence of contaminations(such as^(1) H,^(7)Li,^(12)C,and^(16)O)on the target is identified in terms of the kinetic energy of the first emitted particles.The optical potential parameters of the proton are obtained by fitting the elastic scattering differential cross-sections.The calculated total double-differential cross-sections of the outgoing proton and deuteron at E_(p)=14 MeV agree well with the experimental data for different outgoing angles.Simultaneously,the mixed double differential cross-sections of^(3) He andαare in good agreement with the measurements.The agreement between the measured data and calculated results indicates that the two-body and three-body breakup reactions need to be considered,and the pre-equilibrium reaction mechanism dominates the reaction processes.Based on the STLN model,a PLUNF code for the p+^(6) Li reaction is developed to obtain an ENDF-6-formatted file of the double-differential cross-sections of the nucleon and light composite charged particles.展开更多
The dynamic load distribution within in-service axlebox bearings of high-speed trains is crucial for the fatigue reliability assessment and forward design of axlebox bearings. This paper presents an in situ measuremen...The dynamic load distribution within in-service axlebox bearings of high-speed trains is crucial for the fatigue reliability assessment and forward design of axlebox bearings. This paper presents an in situ measurement of the dynamic load distribution in the four rows of two axlebox bearings on a bogie wheelset of a high-speed train under polygonal wheel–rail excitation. The measurement employed an improved strain-based method to measure the dynamic radial load distribution of roller bearings. The four rows of two axlebox bearings on a wheelset exhibited different ranges of loaded zones and different means of distributed loads. Besides, the mean value and standard deviation of measured roller–raceway contact loads showed non-monotonic variations with the frequency of wheel–rail excitation. The fatigue life of the four bearing rows under polygonal wheel–rail excitation was quantitatively predicted by compiling the measured roller–raceway contact load spectra of the most loaded position and considering the load spectra as input.展开更多
Double differential cross section (DDCS) of First-Born approximation is calcu-lated for the ionization of metastable 3d-state hydrogen atoms by electron impact energy at 150 eV and 250 eV. A multiple scattering theory...Double differential cross section (DDCS) of First-Born approximation is calcu-lated for the ionization of metastable 3d-state hydrogen atoms by electron impact energy at 150 eV and 250 eV. A multiple scattering theory is applied in the present study. The present results are compared with the other related the-oretical results for the ionization of hydrogen atoms from different metastable states and ground-state experimental results. The findings demonstrate a strong qualitative agreement with the existing results. The obtained results have an extensive scope for further study of such an ionization process.展开更多
Objective:To study the prevalence of anemia,the proportion of hemoglobin(Hb)levels,the treatment methods,and the influencing factors of Hb levels in maintenance hemodialysis(MHD)and peritoneal dialysis patients.Method...Objective:To study the prevalence of anemia,the proportion of hemoglobin(Hb)levels,the treatment methods,and the influencing factors of Hb levels in maintenance hemodialysis(MHD)and peritoneal dialysis patients.Methods:In this study,602 patients with maintenance hemodialysis and continuous ambulatory peritoneal dialysis were enrolled from December 2020 to December 2022 in our hospital,and their medical records were collected and summarized.The main contents included the patient’s gender,age,primary disease,dialysis duration,dialysis method,the use of erythropoietic stimulating agents(ESA),intravenous iron,and laboratory tests.A Hb index exceeding 110 g/L was set as the standard for the prevalence of anemia.Results:The rate of anemia in patients undergoing blood purification was 83%.The proportion of ESA use was 84.1%,and the proportion of iron use was 76.7%,of which the proportion of intravenous iron used was 17.0%,and the proportion of folic acid used was 28.3%.Conclusion:The incidence of anemia in MHD patients was relatively high,with a low proportion of patients reaching the standard Hb levels.Risk factors include albumin(ALB)levels,iron storage,white blood cells,C-reactive protein,cholesterol,etc.Nutritional support,iron supplementation,and prevention of micro-inflammatory reactions can effectively promote the improvement of Hb indicators in dialysis patients to prevent anemia.展开更多
BACKGROUND Neuropathy is a common complication of diabetes mellitus resulting from direct damage by hyperglycemia to the nerves and/or ischemia by microvascular injury to the endoneurial vessels which supply the nerve...BACKGROUND Neuropathy is a common complication of diabetes mellitus resulting from direct damage by hyperglycemia to the nerves and/or ischemia by microvascular injury to the endoneurial vessels which supply the nerves. Median nerve is one of the peripheral nerves commonly affected in diabetic neuropathy. The median nerve size has been studied in non-Nigerian diabetic populations. In attempt to contribute to existing literature, a study in a Nigerian population is needed.AIM To evaluate the cross-sectional area(CSA) of the median nerve using B-mode ultrasonography(USS) and the presence of peripheral neuropathy(PN) in a cohort of adult diabetic Nigerians.METHODS Demographic and anthropometric data of 85 adult diabetes mellitus(DM) and 85 age-and sex-matched apparently healthy control(HC) subjects were taken. A complete physical examination was performed on all study subjects to determine the presence of PN and modified Michigan Neuropathy Screening Instrument(MNSI) was used to grade its severity. Venous blood was taken from the study subjects for fasting lipid profile(FLP), fasting blood glucose(FBG) and glycated haemoglobin(HbA1 c) while their MN CSA was evaluated at a point 5 cm proximal to(5 cmCATL) and at the carpal tunnel(CATL) by high-resolution Bmode USS. Data was analysed using SPSS version 22.RESULTS The mean MN CSA was significantly thicker in DM subjects compared to the HC at 5 cmCATL(P < 0.01) and at the CATL(P < 0.01) on both sides. The presence of diabetic peripheral neuropathy(DPN) further increased the MN CSA at the CATL(P < 0.05) but not at 5 cmCATL(P > 0.05). However, the severity of DPN had no additional effect on MN CSA 5 cm proximal to and at the CATL. There was no significant association between MN CSA and duration of DM and glycemic control.CONCLUSION Thickening of the MN CSA at 5 cmCATL and CATL is seen in DM. Presence of DPN is associated with worse thickening of the MN CSA at the CATL but not at5 cmCATL. Severity of DPN, duration of DM, and glycemic control had no additional effect on the MN CSA.展开更多
This study was designed to measure the performance of county health systems in central and western China utilizing routine healthcare data.Drawing on a literature review and expert consultation,the study established a...This study was designed to measure the performance of county health systems in central and western China utilizing routine healthcare data.Drawing on a literature review and expert consultation,the study established a theoretical framework and an indicator system for performance review.Questionnaires were designed and disseminated to collect empirical data on health system performance in four counties of two central and western provinces.Quantitative data were subjected to descriptive statistical analysis through SPSS12.0.Three dimensions were introduced in the performance review framework—health outcomes,financial risk protection and consumer and provider satisfaction.Health outcomes were assessed from four secondary indicators：infant mortality rate;maternal mortality rate;under-5 child mortality rate;and the incidence of Class A and Class B notifiable diseases.Financial risk was assessed using two secondary indicators：the proportion of the cost of inpatient care that was reimbursed under the New Cooperative Medical System（NCMS） insurance scheme,and the rate of NCMS funds utilization.The assessment of satisfaction was made using two secondary indicators：the overall satisfaction of local residents with healthcare services,and the satisfaction of health practitioners at the township and village level.The study indicated better health system performance in the two counties in Chongqing than those in Shanxi.It was concluded that outcome framework scores can fairly reveal performance differences among county health systems in central and western China,and can provide practical evidence for optimizing the operation and inputs of county health systems.Caution needs to be exercised in generalizing such performance outcomes as many factors such as spending and organization that contribute to county health system performance were not included in the study.展开更多
Prediction models were proposed to estimate the reduced Townsend ionization coefficient and ionization cross-section.A shape function of the reduced Townsend ionization coefficient curves was derived from the ionizati...Prediction models were proposed to estimate the reduced Townsend ionization coefficient and ionization cross-section.A shape function of the reduced Townsend ionization coefficient curves was derived from the ionization collision probability model.The function had three parameters:the first ionization potential energy,A_(α),and B_(α).A_(α)and B_(α)were related to the molecule symmetry and size.The polarization of molecules could characterize the molecule symmetry.The multi-layer molecular cross-section(MMCS)was proposed to describe the contributions of electrons and molecule radius on different molecule surfaces to collisions.A prediction model of the ionization cross-section was also proposed based on Aα.The molecule parameters were calculated by the Becke3–Lee–Yang–Parr(B3LYP)method and the 6–311G**basis set.We used available data of 30 and 23 gases,respectively,to build the prediction models of reduced Townsend ionization coefficients and ionization cross-sections.The relationships between the molecular parameters Aαand Bαand the ionization cross-section were built up via nonlinear fittings.The determination coefficients R^(2)of Aα,Bα,and the ionization cross-section were 0.877,0.887,and 0.838,respectively.The results showed that the accuracy of models was positively correlated with the molecule symmetry and reduced electric field.This was mainly related to the accuracy of the MMCS model in predicting Aα.The MMCS model needed to be improved to describe the collision direction selectivity caused by the molecule asymmetry.Under a high reduced electric field,that error of Aαhad less influence on the prediction results.However,the prediction results for single atoms with high symmetry were poor.This may be due to the absolute error of the model close to single atoms’reduced Townsend ionization coefficients.The models could provide the basis for gas insulation prediction and discharge calculations,especially for symmetric molecules under a high electric field.展开更多
Objective The popularization of gastroenteroscopy and the introduction of comfortable medical care have further promoted the growth of people's demand,especially the demand for painless endoscopy.This cross-sectio...Objective The popularization of gastroenteroscopy and the introduction of comfortable medical care have further promoted the growth of people's demand,especially the demand for painless endoscopy.This cross-sectional study aims to investigate the current situation and change in county people's demand for endoscopy to promote the development of endoscopy centers in county hospitals in southeast China.Methods From October to December 2021,patients and their family members who came to the Gastroenterology Department in Suichang County People's Hospital of Zhejiang Province were randomly selected to complete the questionnaire.A total of 838 valid questionnaires were collected.Additionally,the original software data of the Endoscopy Center were sampled and retrieved(from October to December every year from 2018 to 2021)for statistical analysis of real-world data.Those who would choose painless endoscopy the next time in the valid questionnaires were included in the painless endoscopy group,while those who would choose ordinary endoscopy the next time were included in the ordinary endoscopy group.Results The stepwise forward binary logistic regression model analysis showed that,patients with“secondhand smoke exposure”were more willing to choose painless endoscopy(OR=1.459,95%CI:1.050-2.028,p=0.025).However,patients with an education level of“primary and below”and“junior high school”,and patients who are suffering from“currently experiencing abdominal distension”,were more willing to choose ordinary endoscopy(OR=0.270,95%CI:0.149-0.488,p<0.001;OR=0.528,95%CI:0.330-0.845,p=0.008;OR=0.536,95%CI:0.334-0.861,p=0.010).Patients with previous experience in painless endoscopy tended to choose painless endoscopy the next time,while patients with previous experience in ordinary endoscopy tended to choose ordinary endoscopy the next time(χ^(2)=140.97,p<0.001).From 2018 to 2021,the proportion of painless endoscopy has increased yearly(p<0.001).Most patients indicated that they would“regularly review gastroenteroscopy”(477/838,56.9%).Conclusions With Suichang County of Zhejiang Province as the representative,the demand for painless endoscopy for people's gastrointestinal cancer detection in southeast China has been increasing yearly.The development of endoscopy centers in county-level hospitals can basically meet the demand growth.Meanwhile,advanced concepts such as comfortable medical care and regular follow-up are gradually popularized at the grassroots level in southeast China.展开更多
Background:To examine the correlation between the dietary mineral intake and the nutritional status of patients suffering from malignan-cies.Methods:This multi-center cross-sectional study included a total of 866 pati...Background:To examine the correlation between the dietary mineral intake and the nutritional status of patients suffering from malignan-cies.Methods:This multi-center cross-sectional study included a total of 866 patients with malignant tumors recruited from seven hospitals throughout China.The information of socio-demographic characteristics and biochemical indicators were obtained from electronic medical records of inpatients.Dietary data were collected using a 3-day 24-hour dietary recall questionnaire.The intake of energy,dietary calcium(Ca),phosphorus(P),potassium(K),sodium(Na),magnesium(Mg),iron(Fe),zinc(Zn),selenium(Se),copper(Cu)and manganese(Mn)were estimated according to the Chinese Food Composition Tables standard edition.The weight and height of patients were measured,and the body mass index(BMI)was calculated.Nutritional risk and malnutrition were assessed by the Nutritional Screening 2002(NRS 2002)and Global Leadership Initiative on Malnutrition(GLIM)diagnostic criteria.We used a multivariable logistic regression model to estimate the asso-ciations between dietary minerals and malnutrition.Results:The patients had an average age of 61.98(±15.49)years,and 40.6%(n=352)were female.Slightly less than half(44.5%)of the patients were at nutritional risk(NRS 2002≥3),and 32.7%were diagnosed with malnutrition(using the GUM criteria).Univariate analy-ses revealed that there was a statistically significant relationship between dietary mineral intake and the occurrence of nutritional risk(P<0.001).After adjusting the collinearity,we found that higher levels of P,Mn and Se intake were negatively associated with nutritional risk as-sessed by the NRS 2002 score.Moderate intake of Ca and high intake of Zn might also decrease the nutritional risk(Ca:OR,0.53,95%CI,0.32-0.88;Zn:OR,0.36,95%CI,0.19-0.68).However,no significant relationships were observed between any dietary mineral intake and malnutrition identified by the GUM criteria.Conclusions:Dietary minerals,especially P,Se,and Mn,may have a protective effect on the occurrence of nutritional risk in patients with malignant tumors.In addition,patients should maintain appropriate levels of Ca and Zn.展开更多
The technology of drilling tests makes it possible to obtain the strength parameter of rock accurately in situ. In this paper, a new rock cutting analysis model that considers the influence of the rock crushing zone(R...The technology of drilling tests makes it possible to obtain the strength parameter of rock accurately in situ. In this paper, a new rock cutting analysis model that considers the influence of the rock crushing zone(RCZ) is built. The formula for an ultimate cutting force is established based on the limit equilibrium principle. The relationship between digital drilling parameters(DDP) and the c-φ parameter(DDP-cφ formula, where c refers to the cohesion and φ refers to the internal friction angle) is derived, and the response of drilling parameters and cutting ratio to the strength parameters is analyzed. The drillingbased measuring method for the c-φ parameter of rock is constructed. The laboratory verification test is then completed, and the difference in results between the drilling test and the compression test is less than 6%. On this basis, in-situ rock drilling tests in a traffic tunnel and a coal mine roadway are carried out, and the strength parameters of the surrounding rock are effectively tested. The average difference ratio of the results is less than 11%, which verifies the effectiveness of the proposed method for obtaining the strength parameters based on digital drilling. This study provides methodological support for field testing of rock strength parameters.展开更多
文摘Context: COVID-19 can spread rapidly in haemodialysis centres, leading to fatal outcomes. Implementing physical measures is crucial in limiting the spread of infection. Aims: To assess adherence to physical measures against SARS-Cov2 in haemodialysis patients. Methods and Material: From 13 to 19 July 2021, we administered the questionnaire to haemodialysis patients during or immediately after the dialysis session. The dependent variables were adherence to wearing masks, hand washing outside the dialysis centre, social distancing of at least 1.5 meters, and cough and sneeze hygiene. Statistical Analysis Used: Data were analyzed using Epi info software;descriptive statistics were presented as mean, headcount, and percentage;related factors were determined by multi-logistic regression. The significance level was 5%. The Health Research Ethics Committee approved the research protocol. Results: 142 patients were included (mean age: 42.5 ± 14 years). Wearing masks, hand-washing, social distancing, and coughing and sneezing hygiene were observed by 88%, 75%, 47%, and 60% of patients, respectively. Conclusion: Wearing masks was the most respected physical measure, while social distancing was the least respected.
基金financially supported by the National Natural Science Foundation of China(Grant Nos.52001088,52271269,U1906233)the Natural Science Foundation of Heilongjiang Province(Grant No.LH2021E050)+2 种基金the State Key Laboratory of Ocean Engineering(Grant No.GKZD010084)Liaoning Province’s Xing Liao Talents Program(Grant No.XLYC2002108)Dalian City Supports Innovation and Entrepreneurship Projects for High-Level Talents(Grant No.2021RD16)。
文摘Marine umbilical is one of the key equipment for subsea oil and gas exploitation,which is usually integrated by a great number of different functional components with multi-layers.The layout of these components directly affects manufacturing,operation and storage performances of the umbilical.For the multi-layer cross-sectional layout design of the umbilical,a quantifiable multi-objective optimization model is established according to the operation and storage requirements.Considering the manufacturing factors,the multi-layering strategy based on contact point identification is introduced for a great number of functional components.Then,the GA-GLM global optimization algorithm is proposed combining the genetic algorithm and the generalized multiplier method,and the selection operator of the genetic algorithm is improved based on the steepest descent method.Genetic algorithm is used to find the optimal solution in the global space,which can converge from any initial layout to the feasible layout solution.The feasible layout solution is taken as the initial value of the generalized multiplier method for fast and accurate solution.Finally,taking umbilicals with a great number of components as examples,the results show that the cross-sectional performance of the umbilical obtained by optimization algorithm is better and the solution efficiency is higher.Meanwhile,the multi-layering strategy is effective and feasible.The design method proposed in this paper can quickly obtain the optimal multi-layer cross-sectional layout,which replaces the manual design,and provides useful reference and guidance for the umbilical industry.
基金Supported by Suzhou Municipal Science and Technology Program of China,No.SKJY2021012.
文摘BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses metabolic health and insulin resistance,and has been linked to gastrointestinal cancers.AIM To investigate the potential association between the TyG index and CPs,as the relation between them has not been documented.METHODS A total of 2537 persons undergoing a routine health physical examination and colonoscopy at The First People's Hospital of Kunshan,Jiangsu Province,China,between January 2020 and December 2022 were included in this retrospective cross-sectional study.After excluding individuals who did not meet the eligibility criteria,descriptive statistics were used to compare characteristics between patients with and without CPs.Logistic regression analyses were conducted to determine the associations between the TyG index and the prevalence of CPs.The TyG index was calculated using the following formula:Ln[triglyceride(mg/dL)×glucose(mg/dL)/2].The presence and types of CPs was determined based on data from colonoscopy reports and pathology reports.RESULTS A nonlinear relation between the TyG index and the prevalence of CPs was identified,and exhibited a curvilinear pattern with a cut-off point of 2.31.A significant association was observed before the turning point,with an odds ratio(95% confidence interval)of 1.70(1.40,2.06),P<0.0001.However,the association between the TyG index and CPs was not significant after the cut-off point,with an odds ratio(95% confidence interval)of 0.57(0.27,1.23),P=0.1521.CONCLUSION Our study revealed a curvilinear association between the TyG index and CPs in Chinese individuals,suggesting its potential utility in developing colonoscopy screening strategies for preventing CRC.
文摘BACKGROUND Healthcare workers(HCWs)are at increased risk of contracting coronavirus disease 2019(COVID-19)as well as worsening mental health problems and insomnia.These problems can persist for a long period,even after the pandemic.However,less is known about this topic.AIM To analyze mental health,insomnia problems,and their influencing factors in HCWs after the COVID-19 pandemic.METHODS This multicenter cross-sectional,hospital-based study was conducted from June 1,2023 to June 30,2023,which was a half-year after the end of the COVID-19 emergency.Region-stratified population-based cluster sampling was applied at the provincial level for Chinese HCWs.Symptoms such as anxiety,depression,and insomnia were evaluated by the Generalized Anxiety Disorder-7,Patient Health Questionnaire-9,and Insomnia Severity Index.Factors influencing the symptoms were identified by multivariable logistic regression.RESULTS A total of 2000 participants were invited,for a response rate of 70.6%.A total of 1412 HCWs[618(43.8%)doctors,583(41.3%)nurses and 211(14.9%)nonfrontline],254(18.0%),231(16.4%),and 289(20.5%)had symptoms of anxiety,depression,and insomnia,respectively;severe symptoms were found in 58(4.1%),49(3.5%),and 111(7.9%)of the participants.Nurses,female sex,and hospitalization for COVID-19 were risk factors for anxiety,depression,and insomnia symptoms;moreover,death from family or friends was a risk factor for insomnia symptoms.During the COVID-19 outbreak,most[1086(76.9%)]of the participating HCWs received psychological interventions,while nearly all[994(70.4%)]of them had received public psychological education.Only 102(7.2%)of the HCWs received individual counseling from COVID-19.CONCLUSION Although the mental health and sleep problems of HCWs were relieved after the COVID-19 pandemic,they still faced challenges and greater risks than did the general population.Identifying risk factors would help in providing targeted interventions.In addition,although a major proportion of HCWs have received public psychological education,individual interventions are still insufficient.
基金funded by the Science and Technology Project of the Xinjiang Production and Construction Corps(NO.2021AB030)the Innovative Development Project of Shihezi University(NO.CXFZ202005)the Non-profit Central Research Institute Fund of the Chinese Academy of Medical Sciences(2020-PT330-003).
文摘Objective This study aimed to explore the relationships between residential greenness and cardiometabolic risk factors among rural adults in Xinjiang Uygur Autonomous Region(Xinjiang)and thus provide a theoretical basis and data support for improving the health of residents in this region.Methods We recruited 9,723 adult rural residents from the 51st Regiment of the Third Division of the Xinjiang Production and Construction Corps in September 2016.The normalized difference vegetation index(NDVI)was used to estimate residential greenness.The generalized linear mixed model(GLMM)was used to examine the association between residential greenness and cardiometabolic risk factors.Results Higher residential greenness was associated with lower cardiometabolic risk factor prevalence.After adjustments were made for age,sex,education,and marital status,for each interquartile range(IQR)increase of NDVI500-m,the risk of hypertension was reduced by 10.3%(OR=0.897,95%CI=0.836-0.962),the risk of obesity by 20.5%(OR=0.795,95%CI=0.695-0.910),the risk of type 2 diabetes by 15.1%(OR=0.849,95%CI=0.740-0.974),and the risk of dyslipidemia by 10.5%(OR=0.895,95%CI=0.825-0.971).Risk factor aggregation was reduced by 20.4%(OR=0.796,95%CI=0.716-0.885)for the same.Stratified analysis showed that NDVI500-m was associated more strongly with hypertension,dyslipidemia,and risk factor aggregation among male participants.The association of NDVI500-m with type 2 diabetes was stronger among participants with a higher education level.PM10 and physical activity mediated 1.9%-9.2%of the associations between NDVI500-m and obesity,dyslipidemia,and risk factor aggregation.Conclusion Higher residential greenness has a protective effect against cardiometabolic risk factors among rural residents in Xinjiang.Increasing the area of green space around residences is an effective measure to reduce the burden of cardiometabolic-related diseases among rural residents in Xinjiang.
基金supported in part by the China Postdoctoral Science Foundation (No. 2020M673341)in part by the Natural Science Basic Research Program of Shaanxi (No.2023-JC-YB-549)+1 种基金in part by National Natural Science Foundation of China (Nos. 62371375 and 62371372)Innovation Capability Support Program of Shaanxi (No. 2022TD-37)。
文摘Reduction of the radar cross-section(RCS) is the key to stealth technology. To improve the RCS reduction effect of the designed checkerboard metasurface and overcome the limitation of thinlayer plasma in RCS reduction technology, a double-layer-plasma-based metasurface—composed of a checkerboard metasurface, a double-layer plasma and an air gap between them—was investigated. Based on the principle of backscattering cancellation, we designed a checkerboard metasurface composed of different artificial magnetic conductor units;the checkerboard metasurface can reflect vertically incident electromagnetic(EM) waves in four different inclined directions to reduce the RCS. Full-wave simulations confirm that the doublelayer-plasma-based metasurface can improve the RCS reduction effect of the metasurface and the plasma. This is because in a band lower than the working band of the metasurface, the RCS reduction effect is mainly improved by the plasma layer. In the working band of the metasurface,impedance mismatching between the air gap and first plasma layer and between first and second plasma layers cause the scattered waves to become more dispersed, so the propagation path of the EM waves in the plasma becomes longer, increasing the absorption of the EM waves by the plasma. Thus, the RCS reduction effect is enhanced. The double-layer-plasma-based metasurface can be insensitive to the polarization of the incoming EM waves, and can also maintain a satisfactory RCS reduction band when the incident waves are oblique.
基金the National Natural Science Foundation of China(Nos.52005244,U20A20275)the Natural Science Foundation of Hunan Province,China(Nos.2021JJ30573,2023JJ60193)the Open Fund of State Key Laboratory of Advanced Design and Manufacture for Vehicle Body,China(No.31715011)。
文摘3D elastic-plastic FE model for simulating the force controlled stretch-bending process of double-cavity aluminum profile was established using hybrid explicit−implicit solvent method.Considering the computational accuracy and efficiency,the optimal choices of numerical parameters and algorithms in FE modelling were determined.The formation mechanisms of cross-section distortion and springback were revealed.The effects of pre-stretching,post-stretching,friction,and the addition of internal fillers on forming quality were investigated.The results show that the stress state of profile in stretch-bending is uniaxial with only a circumferential stress.The stress distribution along the length direction of profile is non-uniform and the maximum tensile stress is located at a certain distance away from the center of profile.As aluminum profile is gradually attached to bending die,the distribution characteristic of cross-section distortion along the length direction of profile changes from V-shape to W-shape.After unloading the forming tools,cross-section distortion decreases obviously due to the stress relaxation,with a maximum distortion difference of 13%before and after unloading.As pre-stretching and post-stretching forces increase,cross-section distortion increases gradually,while springback first decreases and then remains unchanged.With increasing friction between bending die and profile,cross-section distortion slightly decreases,while springback increases.Cross-section distortion decreases by 83%with adding PVC fillers into the cavities of profile,while springback increases by 192.2%.
文摘Dyslipidemia is a disorder where abnormally lipid concentrations circulate in the bloodstream. The disorder is common in type 2 diabetics (T2D) and is linked with T2D comorbidities, particularly cardiovascular disease. Dyslipidemia in T2D is typically characterized by elevated plasma triglyceride and low high-density lipoprotein cholesterol (HDL-C) levels. There is a significant gap in the literature regarding dyslipidemia in rural parts of Africa, where lipid profiles may not be captured through routine surveillance. This study aimed to characterize the prevalence and demo-graphic profile of dyslipidemia in T2D in the rural community of Ganadougou, Mali. We performed a cross-sectional study of 104 subjects with T2D in Ganadougou between November 2021 and March 2022. Demographic and lipid profiles were collected through cross-sectional surveys and serological analyses. The overall prevalence of dyslipidemia in T2D patients was 87.5% (91/104), which did not differ by sex (P = .368). High low-density lipoprotein cholesterol (LDL-C) was the most common lipid abnormality (78.9%, [82/104]). Dyslipidemia was associated with age and hypertension status (P = .013 and.036, respectively). High total and high LDL-C parameters were significantly associated with hypertension (P = .029 and .006, respectively). In low-resource settings such as rural Mali, there is a critical need to improve infrastructure for routine dyslipidemia screening to guide its prevention and intervention approaches. The high rates of dyslipidemia observed in Gandadougou, consistent with concomitant increases in cardiovascular diseases in Africa suggest that lipid profile assessments should be incorporated into routine medical care for T2D patients in African rural settings.
基金supported by the National Natural Science Foundation of China (Grant Nos. 2032165 and 62004158)the National Key Scientific Instrument and Equipment Development Project of China (Grant No. 52127817)+1 种基金the State Key Laboratory of Particle Detection and Electronics (Grant Nos. SKLPDE-ZZ-201801 and SKLPDE-ZZ-202008)the Special Funds for Science and Technology Innovation Strategy of Guangdong Province, China (Grant No. 2018A0303130030)。
文摘To predict the soft error rate for applications, it is essential to study the energy dependence of the single-event-upset(SEU) cross-section. In this work, we present a direct measurement of the SEU cross-section with the Back-n white neutron source at the China Spallation Neutron Source. The measured cross section is consistent with the soft error data from the manufacturer and the result suggests that the threshold energy of the SEU is about 0.5 Me V, which confirms the statement in Iwashita’s report that the threshold energy for neutron soft error is much below that of the(n, α) cross-section of silicon.In addition, an index of the effective neutron energy is suggested to characterize the similarity between a spallation neutron beam and the standard atmospheric neutron environment.
文摘Background: Infertility and abortion are significant reproductive health concerns globally, impacting individuals' well-being and healthcare systems. In Saudi Arabia, cultural, social, and religious factors influence perceptions and management of these issues, necessitating research to understand the patterns and associated factors. Study Aim: This cross-sectional study aimed to investigate the patterns of infertility and abortion among 458 women in Saudi Arabia, focusing on demographic profiles, reproductive histories, medical conditions, and lifestyle factors. Methodology: Participants were recruited from healthcare facilities, and data on age, BMI, reproductive history, medical conditions, assisted reproduction methods, and lifestyle behaviors were collected. Statistical analyses, including chi-square tests, were conducted to examine associations between variables. Results: The majority of participants were aged 30 - 39 years (47.4%), with 76.9% experiencing secondary infertility. Among those with offspring (76.9%), 31% reported using assisted reproduction methods, primarily ovarian stimulators (54.2%). Abortion history was reported by 39.5% of participants. Significant associations were found between age and infertility type (X2 = 5.8, p = 0.054), having offspring and infertility type (X2 = 458.0, p = 0.001), menstrual irregularity and infertility type (X2 = 11.4, p = 0.001), and abortion history and delayed fertility (X2 = 10.4, p = 0.001). Conclusion: Our study reveals significant associations between demographic, medical, and lifestyle factors with infertility patterns and abortion history among Saudi women. These findings emphasize the need for tailored interventions addressing medical conditions, age-related factors, and access to reproductive healthcare services.
基金supported by the National Natural Science Foundation of China(No.12065003)the Guangxi Key R&D Project(2023AB07029)+1 种基金the Scientific Research and Technology Development Project of Guilin(20210104-2)the Central Government Guides Local Scientific and Technological Development Funds of China(Guike ZY22096024)。
文摘Based on the unified Hauser–Feshbach and exciton model,which can describe the particle emission processes between discrete energy levels with energy,angular momentum,and parity conservations,a statistical theory of light nucleus reaction(STLN)is developed to calculate the double-differential cross-sections of the outgoing neutron and light charged particles for the proton-induced^(6) Li reaction.A significant difference is observed between the p+^(6) Li and p+^(7) Li reactions owing to the discrepancies in the energy-level structures of the targets.The reaction channels,including sequential and simultaneous emission processes,are analyzed in detail.Taking the double-differential cross-sections of the outgoing proton as an example,the influence of contaminations(such as^(1) H,^(7)Li,^(12)C,and^(16)O)on the target is identified in terms of the kinetic energy of the first emitted particles.The optical potential parameters of the proton are obtained by fitting the elastic scattering differential cross-sections.The calculated total double-differential cross-sections of the outgoing proton and deuteron at E_(p)=14 MeV agree well with the experimental data for different outgoing angles.Simultaneously,the mixed double differential cross-sections of^(3) He andαare in good agreement with the measurements.The agreement between the measured data and calculated results indicates that the two-body and three-body breakup reactions need to be considered,and the pre-equilibrium reaction mechanism dominates the reaction processes.Based on the STLN model,a PLUNF code for the p+^(6) Li reaction is developed to obtain an ENDF-6-formatted file of the double-differential cross-sections of the nucleon and light composite charged particles.
基金supported by the National Natural Science Foundation of China (Grant No. 12302238)the National Key Research and Development Program of China (Grant Nos. 2021YFB3400701, 2022YFB3402904)。
文摘The dynamic load distribution within in-service axlebox bearings of high-speed trains is crucial for the fatigue reliability assessment and forward design of axlebox bearings. This paper presents an in situ measurement of the dynamic load distribution in the four rows of two axlebox bearings on a bogie wheelset of a high-speed train under polygonal wheel–rail excitation. The measurement employed an improved strain-based method to measure the dynamic radial load distribution of roller bearings. The four rows of two axlebox bearings on a wheelset exhibited different ranges of loaded zones and different means of distributed loads. Besides, the mean value and standard deviation of measured roller–raceway contact loads showed non-monotonic variations with the frequency of wheel–rail excitation. The fatigue life of the four bearing rows under polygonal wheel–rail excitation was quantitatively predicted by compiling the measured roller–raceway contact load spectra of the most loaded position and considering the load spectra as input.
文摘Double differential cross section (DDCS) of First-Born approximation is calcu-lated for the ionization of metastable 3d-state hydrogen atoms by electron impact energy at 150 eV and 250 eV. A multiple scattering theory is applied in the present study. The present results are compared with the other related the-oretical results for the ionization of hydrogen atoms from different metastable states and ground-state experimental results. The findings demonstrate a strong qualitative agreement with the existing results. The obtained results have an extensive scope for further study of such an ionization process.
文摘Objective:To study the prevalence of anemia,the proportion of hemoglobin(Hb)levels,the treatment methods,and the influencing factors of Hb levels in maintenance hemodialysis(MHD)and peritoneal dialysis patients.Methods:In this study,602 patients with maintenance hemodialysis and continuous ambulatory peritoneal dialysis were enrolled from December 2020 to December 2022 in our hospital,and their medical records were collected and summarized.The main contents included the patient’s gender,age,primary disease,dialysis duration,dialysis method,the use of erythropoietic stimulating agents(ESA),intravenous iron,and laboratory tests.A Hb index exceeding 110 g/L was set as the standard for the prevalence of anemia.Results:The rate of anemia in patients undergoing blood purification was 83%.The proportion of ESA use was 84.1%,and the proportion of iron use was 76.7%,of which the proportion of intravenous iron used was 17.0%,and the proportion of folic acid used was 28.3%.Conclusion:The incidence of anemia in MHD patients was relatively high,with a low proportion of patients reaching the standard Hb levels.Risk factors include albumin(ALB)levels,iron storage,white blood cells,C-reactive protein,cholesterol,etc.Nutritional support,iron supplementation,and prevention of micro-inflammatory reactions can effectively promote the improvement of Hb indicators in dialysis patients to prevent anemia.
文摘BACKGROUND Neuropathy is a common complication of diabetes mellitus resulting from direct damage by hyperglycemia to the nerves and/or ischemia by microvascular injury to the endoneurial vessels which supply the nerves. Median nerve is one of the peripheral nerves commonly affected in diabetic neuropathy. The median nerve size has been studied in non-Nigerian diabetic populations. In attempt to contribute to existing literature, a study in a Nigerian population is needed.AIM To evaluate the cross-sectional area(CSA) of the median nerve using B-mode ultrasonography(USS) and the presence of peripheral neuropathy(PN) in a cohort of adult diabetic Nigerians.METHODS Demographic and anthropometric data of 85 adult diabetes mellitus(DM) and 85 age-and sex-matched apparently healthy control(HC) subjects were taken. A complete physical examination was performed on all study subjects to determine the presence of PN and modified Michigan Neuropathy Screening Instrument(MNSI) was used to grade its severity. Venous blood was taken from the study subjects for fasting lipid profile(FLP), fasting blood glucose(FBG) and glycated haemoglobin(HbA1 c) while their MN CSA was evaluated at a point 5 cm proximal to(5 cmCATL) and at the carpal tunnel(CATL) by high-resolution Bmode USS. Data was analysed using SPSS version 22.RESULTS The mean MN CSA was significantly thicker in DM subjects compared to the HC at 5 cmCATL(P < 0.01) and at the CATL(P < 0.01) on both sides. The presence of diabetic peripheral neuropathy(DPN) further increased the MN CSA at the CATL(P < 0.05) but not at 5 cmCATL(P > 0.05). However, the severity of DPN had no additional effect on MN CSA 5 cm proximal to and at the CATL. There was no significant association between MN CSA and duration of DM and glycemic control.CONCLUSION Thickening of the MN CSA at 5 cmCATL and CATL is seen in DM. Presence of DPN is associated with worse thickening of the MN CSA at the CATL but not at5 cmCATL. Severity of DPN, duration of DM, and glycemic control had no additional effect on the MN CSA.
文摘This study was designed to measure the performance of county health systems in central and western China utilizing routine healthcare data.Drawing on a literature review and expert consultation,the study established a theoretical framework and an indicator system for performance review.Questionnaires were designed and disseminated to collect empirical data on health system performance in four counties of two central and western provinces.Quantitative data were subjected to descriptive statistical analysis through SPSS12.0.Three dimensions were introduced in the performance review framework—health outcomes,financial risk protection and consumer and provider satisfaction.Health outcomes were assessed from four secondary indicators：infant mortality rate;maternal mortality rate;under-5 child mortality rate;and the incidence of Class A and Class B notifiable diseases.Financial risk was assessed using two secondary indicators：the proportion of the cost of inpatient care that was reimbursed under the New Cooperative Medical System（NCMS） insurance scheme,and the rate of NCMS funds utilization.The assessment of satisfaction was made using two secondary indicators：the overall satisfaction of local residents with healthcare services,and the satisfaction of health practitioners at the township and village level.The study indicated better health system performance in the two counties in Chongqing than those in Shanxi.It was concluded that outcome framework scores can fairly reveal performance differences among county health systems in central and western China,and can provide practical evidence for optimizing the operation and inputs of county health systems.Caution needs to be exercised in generalizing such performance outcomes as many factors such as spending and organization that contribute to county health system performance were not included in the study.
基金supported by National Natural Science Foundation of China(No.U1966211)National Key R&D Program of China(No.2021YFB2401400)。
文摘Prediction models were proposed to estimate the reduced Townsend ionization coefficient and ionization cross-section.A shape function of the reduced Townsend ionization coefficient curves was derived from the ionization collision probability model.The function had three parameters:the first ionization potential energy,A_(α),and B_(α).A_(α)and B_(α)were related to the molecule symmetry and size.The polarization of molecules could characterize the molecule symmetry.The multi-layer molecular cross-section(MMCS)was proposed to describe the contributions of electrons and molecule radius on different molecule surfaces to collisions.A prediction model of the ionization cross-section was also proposed based on Aα.The molecule parameters were calculated by the Becke3–Lee–Yang–Parr(B3LYP)method and the 6–311G**basis set.We used available data of 30 and 23 gases,respectively,to build the prediction models of reduced Townsend ionization coefficients and ionization cross-sections.The relationships between the molecular parameters Aαand Bαand the ionization cross-section were built up via nonlinear fittings.The determination coefficients R^(2)of Aα,Bα,and the ionization cross-section were 0.877,0.887,and 0.838,respectively.The results showed that the accuracy of models was positively correlated with the molecule symmetry and reduced electric field.This was mainly related to the accuracy of the MMCS model in predicting Aα.The MMCS model needed to be improved to describe the collision direction selectivity caused by the molecule asymmetry.Under a high reduced electric field,that error of Aαhad less influence on the prediction results.However,the prediction results for single atoms with high symmetry were poor.This may be due to the absolute error of the model close to single atoms’reduced Townsend ionization coefficients.The models could provide the basis for gas insulation prediction and discharge calculations,especially for symmetric molecules under a high electric field.
基金supported by the National Natural Science Foundation of China(82073160).
文摘Objective The popularization of gastroenteroscopy and the introduction of comfortable medical care have further promoted the growth of people's demand,especially the demand for painless endoscopy.This cross-sectional study aims to investigate the current situation and change in county people's demand for endoscopy to promote the development of endoscopy centers in county hospitals in southeast China.Methods From October to December 2021,patients and their family members who came to the Gastroenterology Department in Suichang County People's Hospital of Zhejiang Province were randomly selected to complete the questionnaire.A total of 838 valid questionnaires were collected.Additionally,the original software data of the Endoscopy Center were sampled and retrieved(from October to December every year from 2018 to 2021)for statistical analysis of real-world data.Those who would choose painless endoscopy the next time in the valid questionnaires were included in the painless endoscopy group,while those who would choose ordinary endoscopy the next time were included in the ordinary endoscopy group.Results The stepwise forward binary logistic regression model analysis showed that,patients with“secondhand smoke exposure”were more willing to choose painless endoscopy(OR=1.459,95%CI:1.050-2.028,p=0.025).However,patients with an education level of“primary and below”and“junior high school”,and patients who are suffering from“currently experiencing abdominal distension”,were more willing to choose ordinary endoscopy(OR=0.270,95%CI:0.149-0.488,p<0.001;OR=0.528,95%CI:0.330-0.845,p=0.008;OR=0.536,95%CI:0.334-0.861,p=0.010).Patients with previous experience in painless endoscopy tended to choose painless endoscopy the next time,while patients with previous experience in ordinary endoscopy tended to choose ordinary endoscopy the next time(χ^(2)=140.97,p<0.001).From 2018 to 2021,the proportion of painless endoscopy has increased yearly(p<0.001).Most patients indicated that they would“regularly review gastroenteroscopy”(477/838,56.9%).Conclusions With Suichang County of Zhejiang Province as the representative,the demand for painless endoscopy for people's gastrointestinal cancer detection in southeast China has been increasing yearly.The development of endoscopy centers in county-level hospitals can basically meet the demand growth.Meanwhile,advanced concepts such as comfortable medical care and regular follow-up are gradually popularized at the grassroots level in southeast China.
基金supported by the Spark Program from The First Hospital of Hebei Medical University(No.XH202316)the Innovation Funding Program for postgraduate students of Hebei Medical University(No.22034100684).
文摘Background:To examine the correlation between the dietary mineral intake and the nutritional status of patients suffering from malignan-cies.Methods:This multi-center cross-sectional study included a total of 866 patients with malignant tumors recruited from seven hospitals throughout China.The information of socio-demographic characteristics and biochemical indicators were obtained from electronic medical records of inpatients.Dietary data were collected using a 3-day 24-hour dietary recall questionnaire.The intake of energy,dietary calcium(Ca),phosphorus(P),potassium(K),sodium(Na),magnesium(Mg),iron(Fe),zinc(Zn),selenium(Se),copper(Cu)and manganese(Mn)were estimated according to the Chinese Food Composition Tables standard edition.The weight and height of patients were measured,and the body mass index(BMI)was calculated.Nutritional risk and malnutrition were assessed by the Nutritional Screening 2002(NRS 2002)and Global Leadership Initiative on Malnutrition(GLIM)diagnostic criteria.We used a multivariable logistic regression model to estimate the asso-ciations between dietary minerals and malnutrition.Results:The patients had an average age of 61.98(±15.49)years,and 40.6%(n=352)were female.Slightly less than half(44.5%)of the patients were at nutritional risk(NRS 2002≥3),and 32.7%were diagnosed with malnutrition(using the GUM criteria).Univariate analy-ses revealed that there was a statistically significant relationship between dietary mineral intake and the occurrence of nutritional risk(P<0.001).After adjusting the collinearity,we found that higher levels of P,Mn and Se intake were negatively associated with nutritional risk as-sessed by the NRS 2002 score.Moderate intake of Ca and high intake of Zn might also decrease the nutritional risk(Ca:OR,0.53,95%CI,0.32-0.88;Zn:OR,0.36,95%CI,0.19-0.68).However,no significant relationships were observed between any dietary mineral intake and malnutrition identified by the GUM criteria.Conclusions:Dietary minerals,especially P,Se,and Mn,may have a protective effect on the occurrence of nutritional risk in patients with malignant tumors.In addition,patients should maintain appropriate levels of Ca and Zn.
基金supported by the National Key Research and Development Program of China(No.2023YFC2907600)the National Natural Science Foundation of China(Nos.42077267,42277174 and 52074164)+2 种基金the Natural Science Foundation of Shandong Province,China(No.ZR2020JQ23)the Opening Project of State Key Laboratory of Explosion Science and Technology,Beijing Institute of Technology(No.KFJJ21-02Z)the Fundamental Research Funds for the Central Universities,China(No.2022JCCXSB03).
文摘The technology of drilling tests makes it possible to obtain the strength parameter of rock accurately in situ. In this paper, a new rock cutting analysis model that considers the influence of the rock crushing zone(RCZ) is built. The formula for an ultimate cutting force is established based on the limit equilibrium principle. The relationship between digital drilling parameters(DDP) and the c-φ parameter(DDP-cφ formula, where c refers to the cohesion and φ refers to the internal friction angle) is derived, and the response of drilling parameters and cutting ratio to the strength parameters is analyzed. The drillingbased measuring method for the c-φ parameter of rock is constructed. The laboratory verification test is then completed, and the difference in results between the drilling test and the compression test is less than 6%. On this basis, in-situ rock drilling tests in a traffic tunnel and a coal mine roadway are carried out, and the strength parameters of the surrounding rock are effectively tested. The average difference ratio of the results is less than 11%, which verifies the effectiveness of the proposed method for obtaining the strength parameters based on digital drilling. This study provides methodological support for field testing of rock strength parameters.
