Background: The human gut microbiome is an important target for disease treatment and prevention. Various microbial species within the complex ecosystem of the microbiome have been shown to play important roles in dis...Background: The human gut microbiome is an important target for disease treatment and prevention. Various microbial species within the complex ecosystem of the microbiome have been shown to play important roles in disease. Identification of bioactive materials capable of altering the abundances of these species both safely and effectively is a major goal in microbiome research. Many traditional Chinese medicines (TCMs) have been reported to affect the composition of the gut microbiome. Here, we summarize studies that have used TCMs to alter the gut microbiome and discuss the response relationship between TCMs and gut microbial species. Methods: We searched the PubMed, Web of Science, and Knowledge Network databases using the terms “traditional Chinese medicine,” “gut microbiome,” and specific system disease names (endocrine, immune, nervous, cardiovascular, and digestive). Studies were excluded if irrelevant or if the experimental procedures were unclear. Results: TCMs have been reported to affect a wide range of gut microbial taxa spanning major phyla, including Firmicutes, Bacteroidetes, Proteobacteria, Verrucomicrobiota, Actinobacteria, and Fusobacteria. In all, 54 TCMs including compounds and extracts have been tested in rodents and 30 have been examined in human trials. Almost all studies have reported positive results in regulating the gut microbiome as well as modulating corresponding phenotypes, spanning diseases of the endocrine, immune, nervous, cardiovascular, and digestive systems. Gut species, including Akkermansia, Bacteroides, Fusobacterium, Faecalibacterium, and E. coli, were found to be regulated by 19 TCMs. A network was constructed to visualize the interactions between TCMs and these taxa. Conclusion: There exists a complex and close relationship between intestinal microflora and diseases. Sufficient experimental data and studies have proved that the imbalance of intestinal microflora affects health by mediating metabolism, immune regulation, inflammation and signal transduction. Many characteristic alterations of intestinal microflora are positively correlated with diseases, so intestinal microflora has become a potential risk index and treatment target for many diseases. Many TCMs affect the relative abundances of microbial species in the gut, and therefore may be useful for modulating the gut microbiome. This review provides a reference for prioritizing candidate TCMs from the enormous repertoire of such medicines to test which specific gut microbes are targeted.展开更多
Budding yeast (Saccharomyces cerevisiae) is a single cell model organism that is amenable to genome wide experimental interrogation using high-throughput genomics, proteomics
In the scenario of a steam generator tube rupture accident in a lead-cooled fast reactor,secondary circuit subcooled water under high pressure is injected into an ordinary-pressure primary vessel,where a molten lead-b...In the scenario of a steam generator tube rupture accident in a lead-cooled fast reactor,secondary circuit subcooled water under high pressure is injected into an ordinary-pressure primary vessel,where a molten lead-based alloy(typically pure lead or lead-bismuth eutectic(LBE))is used as the coolant.To clarify the pressure build-up characteristics under water-jet injection,this study conducted several experiments by injecting pressurized water into a molten LBE pool at Sun Yat-sen University.To obtain a further understanding,several new experimental parameters were adopted,including the melt temperature,water subcooling,injection pressure,injection duration,and nozzle diameter.Through detailed analyses,it was found that the pressure and temperature during the water-melt interaction exhibited a consistent variation trend with our previous water-droplet injection mode LBE experiment.Similarly,the existence of a steam explosion was confirmed,which typically results in a much stronger pressure build-up.For the non-explosion cases,increasing the injection pressure,melt-pool temperature,nozzle diameter,and water subcooling promoted pressure build-up in the melt pool.However,a limited enhancement effect was observed when increasing the injection duration,which may be owing to the continually rising pressure in the interaction vessel or the isolation effect of the generated steam cavity.Regardless of whether a steam explosion occurred,the calculated mechanical and kinetic energy conversion efficiencies of the melt were relatively small(not exceeding 4.1%and 0.7%,respectively).Moreover,the range of the conversion efficiency was similar to that of previous water-droplet experiments,although the upper limit of the jet mode was slightly lower.展开更多
BACKGROUND Despite therapeutic benefits,discontinuation of tirzepatide is common in randomized controlled trials(RCTs)due to adverse events(AEs)and other causes.No previous systematic reviews have explored the reasons...BACKGROUND Despite therapeutic benefits,discontinuation of tirzepatide is common in randomized controlled trials(RCTs)due to adverse events(AEs)and other causes.No previous systematic reviews have explored the reasons for discontinuing tirzepatide in the RCTs.AIM To explore the reasons for permanent discontinuation of tirzepatide vs controls[placebo,insulin,and glucagon-like peptide-1 receptor agonists(GLP-1Ras)]in RCTs.METHODS Relevant RCTs were systematically searched using related terms through multiple databases such as MEDLINE(via PubMed),Scopus,Cochrane Central Register,and ClinicalTrials.gov from their inception until June 20,2024.RevMan web was used to conduct meta-analysis using random-effects models.Outcomes were presented as risk ratios(RR)with 95%confidence intervals(CI).RESULTS Seventeen RCTs(n=14645),mostly having low risks of bias,were analyzed.Compared to placebo,the risk of permanent discontinuation of the study drug was substantially lower with tirzepatide 10 mg(RR:0.69,95%CI:0.51-0.93,P=0.02)and similar with tirzepatide 5 mg(RR:0.74,95%CI:0.47-1.17,P=0.20)and 15 mg(RR:0.94,95%CI:0.68-1.31,P=0.71).Tirzepatide had identical discontinuation risks when compared to insulin at 5 mg(RR:0.96,95%CI:0.75-1.24,P=0.77)and 10 mg(RR:1.19,95%CI:0.77-1.82,P=0.44)doses,whereas such risk was higher with tirzepatide 15 mg than insulin(RR:1.31,95%CI:1.03-1.67,P=0.03).Compared to GLP-1RA,the permanent discontinuation risk was similar with tirzepatide 5 mg(RR:0.98,95%CI:0.70-1.37,P=0.90)but was higher with tirzepatide 10 mg(RR:1.40,95%CI:1.03-1.90,P=0.03)and 15 mg(RR:1.70,95%CI:1.27-2.27,P=0.0004).Tirzepatide,at all doses,had higher risks of AE-related discontinuation than insulin;such risks were only greater with higher doses of tirzepatide than with placebo or GLP-1RA.Discontinuation risk due to withdrawal by the study subjects was lower with tirzepatide than with placebo or insulin.Compared to the placebo,tirzepatide(all doses)conferred a lower risk of study drug discontinuation due to other causes not specifically mentioned.CONCLUSION The discontinuation risk is not higher in tirzepatide group than in the placebo arm.Many factors other than AEs led to drug discontinuation in the included RCTs.展开更多
Resilience studies for water distribution systems(WDS)coupled with other interdependent infrastructure systems attract increasing attention from stakeholders and researchers.However,most existing large-scale WDS model...Resilience studies for water distribution systems(WDS)coupled with other interdependent infrastructure systems attract increasing attention from stakeholders and researchers.However,most existing large-scale WDS models are single infrastructure-based without consideration of other infrastructure systems.This is due to a lack of needed information on systems coupling,the structure of the simulator used,and the computation load involved.To address these gaps,this paper presents a synthetic modeling framework for a real-world WDS as coordinating with other infrastructure systems via a building-mediated clustering approach through consideration of physical distance and node capacity.First,the WDS network topology and operation parameters are inferred via bulk open-source information.A building-mediated clustering approach is designed to systematically derive the interdependence between the WDS and the power system similarly created as a case study.Second,a novel linearization method is developed in formulating the WDS model that can relieve computation load while maintaining accuracy.Finally,a disruption-recovery framework is developed to demonstrate the proposed methodology in modelling WDS resilience.The framework is applied to a neighborhood in Queenstown,Singapore,an area of 20.43 km^(2) and 96,000 population.The near-real-time simulations on the coupled system involving 308 nodes and 384 links showcase the effectiveness and application of the proposed synthetic modeling and formulation.展开更多
Background:Cardiorespiratory fitness(CRF)is a powerful health marker recommended by the American Heart Association as a clinical vital sign.Comparing the predictive validity of objectively measured CRF(the"gold s...Background:Cardiorespiratory fitness(CRF)is a powerful health marker recommended by the American Heart Association as a clinical vital sign.Comparing the predictive validity of objectively measured CRF(the"gold standara")and estimated CRF is clinically relevant because estimated CRF is more feasible.Our objective was to meta-analyze cohort studies to compare the associations of objectively measured,exerciseestimated,and non-exercise-estimated CRF with all-cause and cardiovascular disease(CVD)mortality in adults.Methods:Systematic searches were conducted in 9 databases(MEDLINE,SPORTDiscus,Embase,Scopus,PsycINFO,Web of Science,PubMed,CINAHL,and the Cochrane Library)up to April 11,2024.We included full-text refereed cohort studies published in English that quantified the association(using risk estimates with 95%confidence intervals(95%CIs))of objectively measured,exercise-estimated,and non-exercise-estimated CRF with all-cause and CVD mortality in adults.CRF was expressed as metabolic equivalents(METs)of task.Pooled relative risks(RR)for all-cause and CVD mortality per 1-MET(3.5 mL/kg/min)higher level of CRF were quantified using random-effects models.Results:Forty-two studies representing 35 cohorts and 3,813,484 observations(81%male)(362,771 all-cause and 56,471 CVD deaths)were included.The pooled RRs for all-cause and CVD mortality per higher MET were 0.86(95%CI:0.83-0.88)and 0.84(95%CI:0.80-0.87),respectively.For both all-cause and CVD mortality,there were no statistically significant differences in RR per higher MET between objectively measured(RR range:0.86-0.90)and maximal exercise-estimated(RR range:0.85-0.86),submaximal exercise-estimated(RR range:0.91-0.94),and non-exercise-estimated CRF(RR range:0.81-0.85).Conclusion:Objectively measured and estimated CRF showed similar dose-response associations for all-cause and CVD mortality in adults.Estimated CRF could provide a practical and robust alternative to objectively measured CRF for assessing mortality risk across diverse populations.Our findings underscore the health-related benefits of higher CRF and advocate for its integration into clinical practice to enhance risk stratification.展开更多
BACKGROUND Lifestyle factors are closely associated with the onset and progression of inflammatory bowel disease(IBD).Studies have demonstrated the positive effects of exercise on clinical outcomes and quality of life...BACKGROUND Lifestyle factors are closely associated with the onset and progression of inflammatory bowel disease(IBD).Studies have demonstrated the positive effects of exercise on clinical outcomes and quality of life in individuals with IBD.Despite the well-documented role of exercise in improving IBD outcomes,the underlying mechanisms remain unclear.AIM To compare the efficacy of different exercise modalities and explore their potential physiological mechanisms in rodent models of colitis.METHODS We conducted a comprehensive search of five databases from inception to September 24,2024,which yielded 19 animal studies in rodent colitis models.We compared the efficacy of various forms of exercise and explored the possible physiological mechanisms.The effects of different exercise modalities,namely forced treadmill running(FTR),voluntary wheel running(VWR),swimming,climbing,and jumping,on both macroscopic symptoms(e.g.,body weight,disease activity,and colon length)and microscopic parameters(e.g.,histopathology,immune markers,oxidative/antioxidant balance,and gut microbiota)in colitis models were compared.RESULTS VWR(simulated recreational physical activity),swimming(aerobic exercise),and strength training(climbing and jumping)consistently promoted overall health in animal colitis models.However,evidence for FTR remains inconsistent,with a notable number of studies suggesting potential exacerbation of colitis symptoms,possibly due to stress or fatigue resulting from its coercive nature.Overall,various exercise(e.g.,VWR,swimming,strength training)ameliorates colitis symptoms possibly by suppressing immune hyperactivation,enhancing antioxidant defenses,and modulating gut microbiota composition.In contrast,FTR was inconsistent,with several studies indicating a potential exacerbation of colitis symptoms,possibly due to stress or fatigue induced by its coercive nature.CONCLUSION Exercise modality is critical in influencing colitis outcomes,with voluntary and low-stress forms generally being beneficial,while forced exercise may yield adverse effects.These findings highlight the importance of exercise type and individual tolerance in designing therapeutic exercise interventions for IBD.Further research is warranted to establish a robust therapeutic framework for exercise-based interventions in IBD management.展开更多
The effect of prenatal exposure to ambient particulate matter(PM)on birth weight varies considerably across studies,and the findings remain inconclusive.In this study,we conducted a meta-analysis to assess the associa...The effect of prenatal exposure to ambient particulate matter(PM)on birth weight varies considerably across studies,and the findings remain inconclusive.In this study,we conducted a meta-analysis to assess the associations between exposure to PM_(2.5) and PM10 and birth weight.A total of 74 studies were identified through searches in Web of Science,PubMed,Embase,and Ovid Medline,as well as manual searches,up to October 2024.We found that for each 10μg/m^(3) increase in PM_(2.5),the risk of low birth weight(LBW)increased significantly during the entire pregnancy(odds ratio[OR]=2.41,95%confidence interval[CI]:1.99–2.91)and in all trimesters.Similarly,for every 10μg/m^(3) increase in PM10 concentration,the risk of LBW increased significantly during the entire pregnancy(OR=1.46,95%CI:1.16–1.84).Subgroup analysis by maternal age for PM_(2.5) showed that mothers aged 30 and above had a significantly higher risk of LBW(OR=3.69,95%CI:2.81–4.84),compared with those under 30.In conclusion,maternal exposure to PM_(2.5) and PM_(10) is associated with an increased risk of LBW across all trimesters.Additionally,mothers aged 30 and above are at a higher risk of LBW,compared with younger mothers.Further research is needed to clarify the biological mechanisms by which PM pollution may contribute to LBW.展开更多
With the development of vocational education,cultural study courses play an increasingly important role in cultivating students’overall competence and professional skills.However,many vocational colleges face challen...With the development of vocational education,cultural study courses play an increasingly important role in cultivating students’overall competence and professional skills.However,many vocational colleges face challenges such as outdated teaching content,low student engagement,and insufficient learning outcomes in their cultural study courses.To address these issues,this study introduces the Assurance of Learning(AOL)system,aiming to enhance course quality through a systematic approach.Using Shanghai Zhongqiao University of Technology and Vocational Education as a case study,this research explores the specific pathways for designing and implementing cultural study courses based on the AOL system.During the course design phase,specific and measurable learning objectives are set,and corresponding teaching content and assessment tools are developed to enhance the controllability of the study process.In the implementation phase,various teaching strategies such as project-based learning,case analysis,and field visits are adopted to promote active student participation and effective learning.Additionally,continuous monitoring and feedback mechanisms are employed to continuously adjust and optimize the course content and teaching methods.This study not only provides specific pathways for course improvement in vocational colleges but also verifies the effectiveness of the AOL system in enhancing the quality of cultural study courses.The research findings offer valuable references for other vocational colleges in curriculum reform and quality improvement.展开更多
The learning of English academic vocabulary has been the focus of numerous studies from the time Coxhead(2000)developed the academic word list to the present day.Various researchers have emphasized the importance of p...The learning of English academic vocabulary has been the focus of numerous studies from the time Coxhead(2000)developed the academic word list to the present day.Various researchers have emphasized the importance of possessing academic vocabulary knowledge for academic success.Recognizing this importance,it is crucial for researchers,teachers,and learners to understand the progress made in academic word lists.This systematic review first identifies,describes,appraises,and synthesizes the development of academic word lists from 2000 to 2020.It then examines the methods used by researchers in developing academic word lists among 56 studies that meet the pre-established criteria.The word lists were classified based on some criteria such as word counting units,corpora types/sizes,and exclusion criteria.Limitations,suggestions for further study,and implications are also discussed.Additionally,recommendations for future word list establishment are provided to help advance the field of word list development.展开更多
Background:Foreign Language Anxiety(FLA)represents a substantial affective barrier that undermines cognitive performance,motivation,and retention in language learners.Emerging evidence highlights mindfulness-based int...Background:Foreign Language Anxiety(FLA)represents a substantial affective barrier that undermines cognitive performance,motivation,and retention in language learners.Emerging evidence highlights mindfulness-based interventions as promising strategies for enhancing emotional regulation and reducing anxiety across educational contexts.This review synthesizes current research on mindfulness as a psychological intervention,aims to evaluate its efficacy in alleviating FLA,and discusses its broader implications for health-focused educational policy and practice.Methods:Following PRISMA guidelines,we systematically reviewed studies examining the relationships between mindfulness and FLA.Our search of four major databases(November 2023)initially identified 346 articles using terms like“mindfulness AND language anxiety.”After screening,14 studies met our criteria:(1)empirical research in English on mindfulness-FLA relationships;(2)no publication date restrictions.Two independent reviewers selected studies,excluding two due to methodological limitations.We conducted a narrative synthesis given the study heterogeneity(9 correlational and 5 intervention studies).Results:9 non-intervention studies demonstrated that mindfulness is negatively associated with FLA,with 3 studies highlighting the mediating roles of self-efficacy and resilience.5 intervention studies reported inconsistent results regarding the efficacy of mindfulness-based interventions in reducing FLA.Conclusions:The findings suggest that while mindfulness holds promise as a tool to address FLA,its mechanisms and effectiveness require further investigation.This study underscores the need for rigorous research,including Randomized Controlled Trials(RCTs),to inform evidence-based integration of mindfulness into foreign language curricula.For educational policymakers and practitioners,these insights highlight the importance of adopting mindfulness interventions cautiously,ensuring they are tailored to students’needs and supported by evidence.展开更多
This paper deals with reduction of losses in electric power distribution system through a dynamic reconfiguration case study of a grid in the city of Mostar,Bosnia and Herzegovina.The proposed solution is based on a n...This paper deals with reduction of losses in electric power distribution system through a dynamic reconfiguration case study of a grid in the city of Mostar,Bosnia and Herzegovina.The proposed solution is based on a nonlinear model predictive control algorithm which determines the optimal switching operations of the distribution system.The goal of the control algorithm is to find the optimal radial network topology which minimizes cumulative active power losses and maximizes voltages across the network while simultaneously satisfying all system constraints.The optimization results are validated through multiple simulations(using real power demand data collected for a few characteristic days during winter and summer)which demonstrate the efficiency and usefulness of the developed control algorithm in reducing the grid losses by up to 14%.展开更多
Background:Lenvatinib is primarily utilized for the treatment of inoperable or advanced hepatocellular carcinoma,radioiodine-refractory differentiated thyroid cancer,and advanced renal cell carcinoma.Primary informati...Background:Lenvatinib is primarily utilized for the treatment of inoperable or advanced hepatocellular carcinoma,radioiodine-refractory differentiated thyroid cancer,and advanced renal cell carcinoma.Primary information about adverse reactions is principally derived from clinical trials;however,there is a notable dearth of substantial real-world studies.Methods:In this research,an examination of the U.S.Food and Drug Administration(FDA)Adverse Event Reporting System(FAERS)database was performed to evaluate the potential side effects of lenvatinib.The FAERS database revealed a total of 20,290 reported adverse events associated with lenvatinib.Different algorithms for repeated measure analysis were employed to ascertain the significance of these adverse reactions.Results:The study identified 170 instances of adverse events(AEs)induced by lenvatinib,incorporating several significant adverse reactions that the product label does not mention.The investigation also evaluated the onset periods of the adverse reactions,pinpointing a median time of 43 days.The majority of adverse reactions manifested within the initial month of lenvatinib use.Sex-specific analysis revealed disparities in high risk adverse reactions between females(vascular and lymphatic diseases,and neuronal organ diseases)and males(death and infectious diseases).Our data mining has unveiled adverse reactions beyond those mentioned within the instructions,such as osteonecrosis of the jaw,cholecystitis,cholangitis,dehydration,tumor lysis syndrome,type 1 diabetes,hyperammonemia,liver abscess,interstitial lung disease,pneumothorax,sudden death,and aortic dissection.Conclusion:The insights derived from these findings contribute significant nuances for optimizing lenvatinib use,enhancing its efficacy,and substantially mitigating potential side effects.These data elements will substantially enhance the implementation of the drug in a clinical environment.展开更多
Around the world,there has been a notable shift toward the use of renewable energy technology due to the growing demand for energy and the ongoing depletion of conventional resources,such as fossil fuels.Following thi...Around the world,there has been a notable shift toward the use of renewable energy technology due to the growing demand for energy and the ongoing depletion of conventional resources,such as fossil fuels.Following this worldwide trend,Brunei’s government has initiated several strategic programs aimed at encouraging the establishment of energy from renewable sources in the nation’s energy mix.These initiatives are designed not only to support environmental sustainability but also to make energy from renewable sources increasingly competitive in comparison to more conventional energy sources like gas and oil,which have historically dominated Brunei’s energy market.The optimization of a hybrid energy system that combines diesel generators,solar photovoltaic(PV)panels,and the national power grid is the focus of this study.The objective is to identify the most cost-effective and environmentally sustainable configuration that can reliably meet local energy demands.During optimization,several configuration was tried and tested,including only grid,PV and Grid and PV-generator.HOMER(Hybrid Optimization of Multiple Energy Resources)software,a popular simulation tool that makes it possible to simulate and analyze hybrid energy systems,is utilized in the optimization process.Inside the HOMER Pro optimization,various system configuration is taken into account for the optimization.While simulating,it takes into account different combinations of components such as solar panels,wind turbines and batteries.Later on,it is being ranked by different factors such as net present cost(NPC),Cost of Energy(COE),etc.A comprehensive techno-economic research is carried out to evaluate various system configurations,considering key performance indicators such as total energy generation cost,operational expenditure,and greenhouse gas emissions.The results provide valuable insights into how renewable-based hybrid systems can reduce environmental impact while maintaining economic viability,supporting Brunei’s broader goals of energy diversification and sustainability.The study also emphasizes how such hybrid systems could be scaled for off-grid and rural populations in Brunei,where a dependable electricity supply is still a problem.Furthermore,sensitivity analyses were performed to evaluate the effects of variations in solar irradiation,load demand,and fuel prices on the overall system performance.Policymakers and energy planners can use these insights to help them make data-driven decisions about future investments in infrastructure for renewable energy.展开更多
This study aimed to evaluate the feasibility,safety,and efficacy of a noveltranscatheter suture closure system(HaloStitch^(®))for patent foramen ovale(PFO)closure in a swine model.Methods:Thirteen swine underwent...This study aimed to evaluate the feasibility,safety,and efficacy of a noveltranscatheter suture closure system(HaloStitch^(®))for patent foramen ovale(PFO)closure in a swine model.Methods:Thirteen swine underwentexperimental PF0 model creation.All animals received implantationof the transcatheter suture closure system to evaluate procedural success.Comprehensive follow-up over sixmonths included serial ultrasound imaging,histopathological analysis,and gross anatomical exaninationof cardiac specimens.Results:Successful HaloStitch^(®)device implantation was adhieved in 11 of 13 swine.Gross anatomical examination confirrned secure positioning of all sutures in the atrial septum,with noredundancy or thrombus formation.Postoperative ultrasound demonstrated stable suture and staplepositions throughout follow-up,with no evidence of suture breakage,displacement,or thrombus.Stapleswere clearly visualized under ultrasound imaging,Both the atrial septal defect orifice diameter and residualseptal shunt flow velocity decreased significantly during the observation period.Histopathological analysisrevealed partially organized thrombi at the implant head and fibrous connective tissue encapsulation withlocalized inflammatory cell infiltration surrounding the polymer material.Conclsions:The transcathetersuture closure system(HaloStitch^(®))demonstrated feasibility,safety,and biocompatib ility for PFO closure ina swine model,supporting its potential for clinical translation.展开更多
This paper focuses on the issue of nurses’job burnout and conducts an in-depth analysis of its contributing factors from multiple dimensions,including organizational management,job characteristics,and individual attr...This paper focuses on the issue of nurses’job burnout and conducts an in-depth analysis of its contributing factors from multiple dimensions,including organizational management,job characteristics,and individual attributes.These factors include shortages in nursing human resources,lack of management support,excessive workload,and differences in coping strategies.Based on this analysis,targeted human resource management strategies are proposed,covering aspects such as optimizing human resource allocation,leadership development and organizational support,humanized management practices,and competency development with supporting systems.The aim is to alleviate nurses’job burnout,improve the quality of nursing work and nurses’professional well-being,and provide theoretical reference and practical guidance for human resource management in the nursing industry.展开更多
Urban traffic is a complex system composed of users,drivers,vehicles,roads,the environment,and information and management strategies,characterized by dynamics,randomness,openness,and complexity.Traditional traffic sci...Urban traffic is a complex system composed of users,drivers,vehicles,roads,the environment,and information and management strategies,characterized by dynamics,randomness,openness,and complexity.Traditional traffic science and engineering research usually focuses on specific traffic subsystems[1,2],such as drivers(i.e.,driving behavior),vehicles(i.e.,traffic flow),or traffic control(i.e.,signal systems),and significant progress has been achieved in these areas.展开更多
Background The association of systemic inflammatory response index(SIRI)with prognosis of coronary artery disease(CAD)patients has never been investigated in a large sample with long-term follow-up.This study aimed to...Background The association of systemic inflammatory response index(SIRI)with prognosis of coronary artery disease(CAD)patients has never been investigated in a large sample with long-term follow-up.This study aimed to explore the association of SIRI with all-cause and cause-specific mortality in a nationally representative sample of CAD patients from United States.Methods A total of 3386 participants with CAD from the National Health and Nutrition Examination Survey(NHANES)1999-2018 were included in this study.Cox proportional hazards model,restricted cubic spline(RCS),and receiver operating characteristic curve(ROC)were performed to investigate the association of SIRI with all-cause and cause-specific mortality.Piecewise linear regression and sensitivity analyses were also performed.Results During a median follow-up of 7.7 years,1454 all-cause mortality occurred.After adjusting for confounding factors,higher lnSIRI was significantly associated with higher risk of all-cause(HR=1.16,95%CI:1.09-1.23)and CVD mortality(HR=1.17,95%CI:1.05-1.30)but not cancer mortality(HR=1.17,95%CI:0.99-1.38).The associations of SIRI with all-cause and CVD mortality were detected as J-shaped with threshold values of 1.05935 and 1.122946 for SIRI,respectively.ROC curves showed that lnSIRI had robust predictive effect both in short and long terms.Conclusions SIRI was independently associated with all-cause and CVD mortality,and the dose-response relationship was Jshaped.SIRI might serve as a valid predictor for all-cause and CVD mortality both in the short and long terms.展开更多
Background Ischemic heart disease(IHD) represents the most significant disease burden among all cardiovascular diseases(CVDs). The increasing prevalence of metabolic risks in the 21st century has a profound impact on ...Background Ischemic heart disease(IHD) represents the most significant disease burden among all cardiovascular diseases(CVDs). The increasing prevalence of metabolic risks in the 21st century has a profound impact on the disease burden associated with IHD. We analyzed the global, regional, and national burdens of IHD attributable to metabolic risks from 1990 to 2021.Methods The data were taken from Global Burden of Disease(GBD) study 2021. Deaths, disability-adjusted life years(DALYs),the average annual percent change(AAPC), age-standardized death rates per 100,000 persons(ASDR) and age-standardized rate per 100,000 persons(ASR) of DALYs ranging from 1990 to 2021, were extracted and stratified according to region, nationality, socio-demographic index(SDI), sex, and age. Additionally, the global future trends were predicted using Nordpred prediction model.Results Compared to 1990, in 2021, the number of death and DALYs from metabolic risk-attributed IHD increased globally by67.35% and 59.91%, respectively;whereas ASDR and ASR of DALYs showed a decreasing trend and the most severe impact was observed in male and elderly populations. In addition, the burden of disease showed an inverted V-shaped relationship with SDI from 1990 to 2021. AAPC showed a significant increase in developing countries and a decrease in developed countries. We also analyzed the effects of different risk factors including metabolic risk factors on IHD in different SDI regions and genders. The prediction of future disease burden showed that the number of death and DALYs will keep rising, while ASDR and ASR of DALYs will maintain a certain downward trend.Conclusions The results of this study highlighted the need for screening and intervention for metabolic risk factors in specific regions and populations, this should call for increased collaboration between developing and developed countries to reduce the burden of disease and improve the prognosis of patients with IHD.展开更多
BACKGROUND The rising global prevalence of gastroesophageal reflux disease(GERD)has been closely linked to lifestyle changes driven by globalization.GERD imposes a substantial public health burden,affecting quality of...BACKGROUND The rising global prevalence of gastroesophageal reflux disease(GERD)has been closely linked to lifestyle changes driven by globalization.GERD imposes a substantial public health burden,affecting quality of life and leading to potential complications.Early intervention through lifestyle modification can prevent disease onset;however,there is a lack of effective risk prediction models that emphasize primary prevention.AIM To develop and validate a GERD Risk Scoring System(GRSS)aimed at identifying high-risk individuals and promoting primary prevention strategies.METHODS A 45-item questionnaire encompassing major lifestyle and demographic risk factors was developed and validated.It was administered to healthy controls and GERD patients.Two regression models-one using continuous variables and another using categorized variables-were used to develop a computational prediction equation and a clinically applicable scoring scale.An independent validation cohort of 355 participants was used to assess model performance in terms of discrimination(C-index),calibration,sensitivity,specificity,internal consistency(Cronbach's alpha),and test-retest reliability(intraclass correlation coefficient,Bland-Altman analysis).RESULTS Significant associations were observed between GERD and key lifestyle factors.The derived GRSS equation and scoring scale demonstrated strong discriminative ability,with high sensitivity and specificity.The scoring system exhibited excellent internal consistency(Cronbach’s alpha)and strong test-retest reliability.The C-index indicated excellent predictive accuracy in both derivation and validation cohorts.CONCLUSION GRSS offers a novel and validated approach to GERD risk prediction,combining a robust equation for digital applications and a practical scale for clinical use.Its ability to accurately identify at-risk individuals supports a paradigm shift toward primary prevention,underscoring its significance in addressing the growing burden of GERD at the population level.展开更多
基金funding by National Natural Science Foundation of China(No.82174492)National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion Project(N o.ZJJBGS2024002-1).
文摘Background: The human gut microbiome is an important target for disease treatment and prevention. Various microbial species within the complex ecosystem of the microbiome have been shown to play important roles in disease. Identification of bioactive materials capable of altering the abundances of these species both safely and effectively is a major goal in microbiome research. Many traditional Chinese medicines (TCMs) have been reported to affect the composition of the gut microbiome. Here, we summarize studies that have used TCMs to alter the gut microbiome and discuss the response relationship between TCMs and gut microbial species. Methods: We searched the PubMed, Web of Science, and Knowledge Network databases using the terms “traditional Chinese medicine,” “gut microbiome,” and specific system disease names (endocrine, immune, nervous, cardiovascular, and digestive). Studies were excluded if irrelevant or if the experimental procedures were unclear. Results: TCMs have been reported to affect a wide range of gut microbial taxa spanning major phyla, including Firmicutes, Bacteroidetes, Proteobacteria, Verrucomicrobiota, Actinobacteria, and Fusobacteria. In all, 54 TCMs including compounds and extracts have been tested in rodents and 30 have been examined in human trials. Almost all studies have reported positive results in regulating the gut microbiome as well as modulating corresponding phenotypes, spanning diseases of the endocrine, immune, nervous, cardiovascular, and digestive systems. Gut species, including Akkermansia, Bacteroides, Fusobacterium, Faecalibacterium, and E. coli, were found to be regulated by 19 TCMs. A network was constructed to visualize the interactions between TCMs and these taxa. Conclusion: There exists a complex and close relationship between intestinal microflora and diseases. Sufficient experimental data and studies have proved that the imbalance of intestinal microflora affects health by mediating metabolism, immune regulation, inflammation and signal transduction. Many characteristic alterations of intestinal microflora are positively correlated with diseases, so intestinal microflora has become a potential risk index and treatment target for many diseases. Many TCMs affect the relative abundances of microbial species in the gut, and therefore may be useful for modulating the gut microbiome. This review provides a reference for prioritizing candidate TCMs from the enormous repertoire of such medicines to test which specific gut microbes are targeted.
文摘Budding yeast (Saccharomyces cerevisiae) is a single cell model organism that is amenable to genome wide experimental interrogation using high-throughput genomics, proteomics
基金supported by Basic and Applied Basic research foundation of Guangdong province(Nos.2021A1515010343 and 2022A1515011582)the Science and Technology Program of Guangdong Province(Nos.2021A0505030026 and 2022A0505050029).
文摘In the scenario of a steam generator tube rupture accident in a lead-cooled fast reactor,secondary circuit subcooled water under high pressure is injected into an ordinary-pressure primary vessel,where a molten lead-based alloy(typically pure lead or lead-bismuth eutectic(LBE))is used as the coolant.To clarify the pressure build-up characteristics under water-jet injection,this study conducted several experiments by injecting pressurized water into a molten LBE pool at Sun Yat-sen University.To obtain a further understanding,several new experimental parameters were adopted,including the melt temperature,water subcooling,injection pressure,injection duration,and nozzle diameter.Through detailed analyses,it was found that the pressure and temperature during the water-melt interaction exhibited a consistent variation trend with our previous water-droplet injection mode LBE experiment.Similarly,the existence of a steam explosion was confirmed,which typically results in a much stronger pressure build-up.For the non-explosion cases,increasing the injection pressure,melt-pool temperature,nozzle diameter,and water subcooling promoted pressure build-up in the melt pool.However,a limited enhancement effect was observed when increasing the injection duration,which may be owing to the continually rising pressure in the interaction vessel or the isolation effect of the generated steam cavity.Regardless of whether a steam explosion occurred,the calculated mechanical and kinetic energy conversion efficiencies of the melt were relatively small(not exceeding 4.1%and 0.7%,respectively).Moreover,the range of the conversion efficiency was similar to that of previous water-droplet experiments,although the upper limit of the jet mode was slightly lower.
文摘BACKGROUND Despite therapeutic benefits,discontinuation of tirzepatide is common in randomized controlled trials(RCTs)due to adverse events(AEs)and other causes.No previous systematic reviews have explored the reasons for discontinuing tirzepatide in the RCTs.AIM To explore the reasons for permanent discontinuation of tirzepatide vs controls[placebo,insulin,and glucagon-like peptide-1 receptor agonists(GLP-1Ras)]in RCTs.METHODS Relevant RCTs were systematically searched using related terms through multiple databases such as MEDLINE(via PubMed),Scopus,Cochrane Central Register,and ClinicalTrials.gov from their inception until June 20,2024.RevMan web was used to conduct meta-analysis using random-effects models.Outcomes were presented as risk ratios(RR)with 95%confidence intervals(CI).RESULTS Seventeen RCTs(n=14645),mostly having low risks of bias,were analyzed.Compared to placebo,the risk of permanent discontinuation of the study drug was substantially lower with tirzepatide 10 mg(RR:0.69,95%CI:0.51-0.93,P=0.02)and similar with tirzepatide 5 mg(RR:0.74,95%CI:0.47-1.17,P=0.20)and 15 mg(RR:0.94,95%CI:0.68-1.31,P=0.71).Tirzepatide had identical discontinuation risks when compared to insulin at 5 mg(RR:0.96,95%CI:0.75-1.24,P=0.77)and 10 mg(RR:1.19,95%CI:0.77-1.82,P=0.44)doses,whereas such risk was higher with tirzepatide 15 mg than insulin(RR:1.31,95%CI:1.03-1.67,P=0.03).Compared to GLP-1RA,the permanent discontinuation risk was similar with tirzepatide 5 mg(RR:0.98,95%CI:0.70-1.37,P=0.90)but was higher with tirzepatide 10 mg(RR:1.40,95%CI:1.03-1.90,P=0.03)and 15 mg(RR:1.70,95%CI:1.27-2.27,P=0.0004).Tirzepatide,at all doses,had higher risks of AE-related discontinuation than insulin;such risks were only greater with higher doses of tirzepatide than with placebo or GLP-1RA.Discontinuation risk due to withdrawal by the study subjects was lower with tirzepatide than with placebo or insulin.Compared to the placebo,tirzepatide(all doses)conferred a lower risk of study drug discontinuation due to other causes not specifically mentioned.CONCLUSION The discontinuation risk is not higher in tirzepatide group than in the placebo arm.Many factors other than AEs led to drug discontinuation in the included RCTs.
文摘Resilience studies for water distribution systems(WDS)coupled with other interdependent infrastructure systems attract increasing attention from stakeholders and researchers.However,most existing large-scale WDS models are single infrastructure-based without consideration of other infrastructure systems.This is due to a lack of needed information on systems coupling,the structure of the simulator used,and the computation load involved.To address these gaps,this paper presents a synthetic modeling framework for a real-world WDS as coordinating with other infrastructure systems via a building-mediated clustering approach through consideration of physical distance and node capacity.First,the WDS network topology and operation parameters are inferred via bulk open-source information.A building-mediated clustering approach is designed to systematically derive the interdependence between the WDS and the power system similarly created as a case study.Second,a novel linearization method is developed in formulating the WDS model that can relieve computation load while maintaining accuracy.Finally,a disruption-recovery framework is developed to demonstrate the proposed methodology in modelling WDS resilience.The framework is applied to a neighborhood in Queenstown,Singapore,an area of 20.43 km^(2) and 96,000 population.The near-real-time simulations on the coupled system involving 308 nodes and 384 links showcase the effectiveness and application of the proposed synthetic modeling and formulation.
基金supported by a grant from the European Union's Horizon 2020 research and innovation programme under the Marie Sklodowska Curie(Grant agreement No.101028929)supported by an Investigator Grant from the Medical Research Future Fund(MRF1193862)supported by an Australian Government Research Training Program Scholarship.
文摘Background:Cardiorespiratory fitness(CRF)is a powerful health marker recommended by the American Heart Association as a clinical vital sign.Comparing the predictive validity of objectively measured CRF(the"gold standara")and estimated CRF is clinically relevant because estimated CRF is more feasible.Our objective was to meta-analyze cohort studies to compare the associations of objectively measured,exerciseestimated,and non-exercise-estimated CRF with all-cause and cardiovascular disease(CVD)mortality in adults.Methods:Systematic searches were conducted in 9 databases(MEDLINE,SPORTDiscus,Embase,Scopus,PsycINFO,Web of Science,PubMed,CINAHL,and the Cochrane Library)up to April 11,2024.We included full-text refereed cohort studies published in English that quantified the association(using risk estimates with 95%confidence intervals(95%CIs))of objectively measured,exercise-estimated,and non-exercise-estimated CRF with all-cause and CVD mortality in adults.CRF was expressed as metabolic equivalents(METs)of task.Pooled relative risks(RR)for all-cause and CVD mortality per 1-MET(3.5 mL/kg/min)higher level of CRF were quantified using random-effects models.Results:Forty-two studies representing 35 cohorts and 3,813,484 observations(81%male)(362,771 all-cause and 56,471 CVD deaths)were included.The pooled RRs for all-cause and CVD mortality per higher MET were 0.86(95%CI:0.83-0.88)and 0.84(95%CI:0.80-0.87),respectively.For both all-cause and CVD mortality,there were no statistically significant differences in RR per higher MET between objectively measured(RR range:0.86-0.90)and maximal exercise-estimated(RR range:0.85-0.86),submaximal exercise-estimated(RR range:0.91-0.94),and non-exercise-estimated CRF(RR range:0.81-0.85).Conclusion:Objectively measured and estimated CRF showed similar dose-response associations for all-cause and CVD mortality in adults.Estimated CRF could provide a practical and robust alternative to objectively measured CRF for assessing mortality risk across diverse populations.Our findings underscore the health-related benefits of higher CRF and advocate for its integration into clinical practice to enhance risk stratification.
基金Supported by the 2024 General Scientific Research Project of Zhejiang Provincial Department of Education-Special Project for Reform of Professional Degree Graduate Training Mode,No.Y202456174“Pioneer”and“Leading Goose”R and D Program of Zhejiang,No.2023C03050.
文摘BACKGROUND Lifestyle factors are closely associated with the onset and progression of inflammatory bowel disease(IBD).Studies have demonstrated the positive effects of exercise on clinical outcomes and quality of life in individuals with IBD.Despite the well-documented role of exercise in improving IBD outcomes,the underlying mechanisms remain unclear.AIM To compare the efficacy of different exercise modalities and explore their potential physiological mechanisms in rodent models of colitis.METHODS We conducted a comprehensive search of five databases from inception to September 24,2024,which yielded 19 animal studies in rodent colitis models.We compared the efficacy of various forms of exercise and explored the possible physiological mechanisms.The effects of different exercise modalities,namely forced treadmill running(FTR),voluntary wheel running(VWR),swimming,climbing,and jumping,on both macroscopic symptoms(e.g.,body weight,disease activity,and colon length)and microscopic parameters(e.g.,histopathology,immune markers,oxidative/antioxidant balance,and gut microbiota)in colitis models were compared.RESULTS VWR(simulated recreational physical activity),swimming(aerobic exercise),and strength training(climbing and jumping)consistently promoted overall health in animal colitis models.However,evidence for FTR remains inconsistent,with a notable number of studies suggesting potential exacerbation of colitis symptoms,possibly due to stress or fatigue resulting from its coercive nature.Overall,various exercise(e.g.,VWR,swimming,strength training)ameliorates colitis symptoms possibly by suppressing immune hyperactivation,enhancing antioxidant defenses,and modulating gut microbiota composition.In contrast,FTR was inconsistent,with several studies indicating a potential exacerbation of colitis symptoms,possibly due to stress or fatigue induced by its coercive nature.CONCLUSION Exercise modality is critical in influencing colitis outcomes,with voluntary and low-stress forms generally being beneficial,while forced exercise may yield adverse effects.These findings highlight the importance of exercise type and individual tolerance in designing therapeutic exercise interventions for IBD.Further research is warranted to establish a robust therapeutic framework for exercise-based interventions in IBD management.
文摘The effect of prenatal exposure to ambient particulate matter(PM)on birth weight varies considerably across studies,and the findings remain inconclusive.In this study,we conducted a meta-analysis to assess the associations between exposure to PM_(2.5) and PM10 and birth weight.A total of 74 studies were identified through searches in Web of Science,PubMed,Embase,and Ovid Medline,as well as manual searches,up to October 2024.We found that for each 10μg/m^(3) increase in PM_(2.5),the risk of low birth weight(LBW)increased significantly during the entire pregnancy(odds ratio[OR]=2.41,95%confidence interval[CI]:1.99–2.91)and in all trimesters.Similarly,for every 10μg/m^(3) increase in PM10 concentration,the risk of LBW increased significantly during the entire pregnancy(OR=1.46,95%CI:1.16–1.84).Subgroup analysis by maternal age for PM_(2.5) showed that mothers aged 30 and above had a significantly higher risk of LBW(OR=3.69,95%CI:2.81–4.84),compared with those under 30.In conclusion,maternal exposure to PM_(2.5) and PM_(10) is associated with an increased risk of LBW across all trimesters.Additionally,mothers aged 30 and above are at a higher risk of LBW,compared with younger mothers.Further research is needed to clarify the biological mechanisms by which PM pollution may contribute to LBW.
基金Phase achievements of the“Civilian Teacher Plan”project for Shanghai’s private universities in 2023Establishing the“Three Hundred Miles”Research and Learning Base to Promote Innovation in the“Great Ideological and Political Course”(2025 Private 06-01-15)。
文摘With the development of vocational education,cultural study courses play an increasingly important role in cultivating students’overall competence and professional skills.However,many vocational colleges face challenges such as outdated teaching content,low student engagement,and insufficient learning outcomes in their cultural study courses.To address these issues,this study introduces the Assurance of Learning(AOL)system,aiming to enhance course quality through a systematic approach.Using Shanghai Zhongqiao University of Technology and Vocational Education as a case study,this research explores the specific pathways for designing and implementing cultural study courses based on the AOL system.During the course design phase,specific and measurable learning objectives are set,and corresponding teaching content and assessment tools are developed to enhance the controllability of the study process.In the implementation phase,various teaching strategies such as project-based learning,case analysis,and field visits are adopted to promote active student participation and effective learning.Additionally,continuous monitoring and feedback mechanisms are employed to continuously adjust and optimize the course content and teaching methods.This study not only provides specific pathways for course improvement in vocational colleges but also verifies the effectiveness of the AOL system in enhancing the quality of cultural study courses.The research findings offer valuable references for other vocational colleges in curriculum reform and quality improvement.
文摘The learning of English academic vocabulary has been the focus of numerous studies from the time Coxhead(2000)developed the academic word list to the present day.Various researchers have emphasized the importance of possessing academic vocabulary knowledge for academic success.Recognizing this importance,it is crucial for researchers,teachers,and learners to understand the progress made in academic word lists.This systematic review first identifies,describes,appraises,and synthesizes the development of academic word lists from 2000 to 2020.It then examines the methods used by researchers in developing academic word lists among 56 studies that meet the pre-established criteria.The word lists were classified based on some criteria such as word counting units,corpora types/sizes,and exclusion criteria.Limitations,suggestions for further study,and implications are also discussed.Additionally,recommendations for future word list establishment are provided to help advance the field of word list development.
文摘Background:Foreign Language Anxiety(FLA)represents a substantial affective barrier that undermines cognitive performance,motivation,and retention in language learners.Emerging evidence highlights mindfulness-based interventions as promising strategies for enhancing emotional regulation and reducing anxiety across educational contexts.This review synthesizes current research on mindfulness as a psychological intervention,aims to evaluate its efficacy in alleviating FLA,and discusses its broader implications for health-focused educational policy and practice.Methods:Following PRISMA guidelines,we systematically reviewed studies examining the relationships between mindfulness and FLA.Our search of four major databases(November 2023)initially identified 346 articles using terms like“mindfulness AND language anxiety.”After screening,14 studies met our criteria:(1)empirical research in English on mindfulness-FLA relationships;(2)no publication date restrictions.Two independent reviewers selected studies,excluding two due to methodological limitations.We conducted a narrative synthesis given the study heterogeneity(9 correlational and 5 intervention studies).Results:9 non-intervention studies demonstrated that mindfulness is negatively associated with FLA,with 3 studies highlighting the mediating roles of self-efficacy and resilience.5 intervention studies reported inconsistent results regarding the efficacy of mindfulness-based interventions in reducing FLA.Conclusions:The findings suggest that while mindfulness holds promise as a tool to address FLA,its mechanisms and effectiveness require further investigation.This study underscores the need for rigorous research,including Randomized Controlled Trials(RCTs),to inform evidence-based integration of mindfulness into foreign language curricula.For educational policymakers and practitioners,these insights highlight the importance of adopting mindfulness interventions cautiously,ensuring they are tailored to students’needs and supported by evidence.
基金supported in part by the European Regional Development Fund under Grant KK.01.1.1.01.0009(DATACROSS).
文摘This paper deals with reduction of losses in electric power distribution system through a dynamic reconfiguration case study of a grid in the city of Mostar,Bosnia and Herzegovina.The proposed solution is based on a nonlinear model predictive control algorithm which determines the optimal switching operations of the distribution system.The goal of the control algorithm is to find the optimal radial network topology which minimizes cumulative active power losses and maximizes voltages across the network while simultaneously satisfying all system constraints.The optimization results are validated through multiple simulations(using real power demand data collected for a few characteristic days during winter and summer)which demonstrate the efficiency and usefulness of the developed control algorithm in reducing the grid losses by up to 14%.
基金The 2022 Educational Teaching Reform and Research Project of Guangxi University of Traditional Chinese Medicine(2022C032).
文摘Background:Lenvatinib is primarily utilized for the treatment of inoperable or advanced hepatocellular carcinoma,radioiodine-refractory differentiated thyroid cancer,and advanced renal cell carcinoma.Primary information about adverse reactions is principally derived from clinical trials;however,there is a notable dearth of substantial real-world studies.Methods:In this research,an examination of the U.S.Food and Drug Administration(FDA)Adverse Event Reporting System(FAERS)database was performed to evaluate the potential side effects of lenvatinib.The FAERS database revealed a total of 20,290 reported adverse events associated with lenvatinib.Different algorithms for repeated measure analysis were employed to ascertain the significance of these adverse reactions.Results:The study identified 170 instances of adverse events(AEs)induced by lenvatinib,incorporating several significant adverse reactions that the product label does not mention.The investigation also evaluated the onset periods of the adverse reactions,pinpointing a median time of 43 days.The majority of adverse reactions manifested within the initial month of lenvatinib use.Sex-specific analysis revealed disparities in high risk adverse reactions between females(vascular and lymphatic diseases,and neuronal organ diseases)and males(death and infectious diseases).Our data mining has unveiled adverse reactions beyond those mentioned within the instructions,such as osteonecrosis of the jaw,cholecystitis,cholangitis,dehydration,tumor lysis syndrome,type 1 diabetes,hyperammonemia,liver abscess,interstitial lung disease,pneumothorax,sudden death,and aortic dissection.Conclusion:The insights derived from these findings contribute significant nuances for optimizing lenvatinib use,enhancing its efficacy,and substantially mitigating potential side effects.These data elements will substantially enhance the implementation of the drug in a clinical environment.
基金funded through Deanship of Scientific Research at Northern Border University,Arar,Saudi Arabia—project number“NBU-FFR-2025-3623-06”.
文摘Around the world,there has been a notable shift toward the use of renewable energy technology due to the growing demand for energy and the ongoing depletion of conventional resources,such as fossil fuels.Following this worldwide trend,Brunei’s government has initiated several strategic programs aimed at encouraging the establishment of energy from renewable sources in the nation’s energy mix.These initiatives are designed not only to support environmental sustainability but also to make energy from renewable sources increasingly competitive in comparison to more conventional energy sources like gas and oil,which have historically dominated Brunei’s energy market.The optimization of a hybrid energy system that combines diesel generators,solar photovoltaic(PV)panels,and the national power grid is the focus of this study.The objective is to identify the most cost-effective and environmentally sustainable configuration that can reliably meet local energy demands.During optimization,several configuration was tried and tested,including only grid,PV and Grid and PV-generator.HOMER(Hybrid Optimization of Multiple Energy Resources)software,a popular simulation tool that makes it possible to simulate and analyze hybrid energy systems,is utilized in the optimization process.Inside the HOMER Pro optimization,various system configuration is taken into account for the optimization.While simulating,it takes into account different combinations of components such as solar panels,wind turbines and batteries.Later on,it is being ranked by different factors such as net present cost(NPC),Cost of Energy(COE),etc.A comprehensive techno-economic research is carried out to evaluate various system configurations,considering key performance indicators such as total energy generation cost,operational expenditure,and greenhouse gas emissions.The results provide valuable insights into how renewable-based hybrid systems can reduce environmental impact while maintaining economic viability,supporting Brunei’s broader goals of energy diversification and sustainability.The study also emphasizes how such hybrid systems could be scaled for off-grid and rural populations in Brunei,where a dependable electricity supply is still a problem.Furthermore,sensitivity analyses were performed to evaluate the effects of variations in solar irradiation,load demand,and fuel prices on the overall system performance.Policymakers and energy planners can use these insights to help them make data-driven decisions about future investments in infrastructure for renewable energy.
基金supported by grants from National High-Level Hospital Clinical Research Funding(2023-GSP-RC-04).
文摘This study aimed to evaluate the feasibility,safety,and efficacy of a noveltranscatheter suture closure system(HaloStitch^(®))for patent foramen ovale(PFO)closure in a swine model.Methods:Thirteen swine underwentexperimental PF0 model creation.All animals received implantationof the transcatheter suture closure system to evaluate procedural success.Comprehensive follow-up over sixmonths included serial ultrasound imaging,histopathological analysis,and gross anatomical exaninationof cardiac specimens.Results:Successful HaloStitch^(®)device implantation was adhieved in 11 of 13 swine.Gross anatomical examination confirrned secure positioning of all sutures in the atrial septum,with noredundancy or thrombus formation.Postoperative ultrasound demonstrated stable suture and staplepositions throughout follow-up,with no evidence of suture breakage,displacement,or thrombus.Stapleswere clearly visualized under ultrasound imaging,Both the atrial septal defect orifice diameter and residualseptal shunt flow velocity decreased significantly during the observation period.Histopathological analysisrevealed partially organized thrombi at the implant head and fibrous connective tissue encapsulation withlocalized inflammatory cell infiltration surrounding the polymer material.Conclsions:The transcathetersuture closure system(HaloStitch^(®))demonstrated feasibility,safety,and biocompatib ility for PFO closure ina swine model,supporting its potential for clinical translation.
基金Zhejiang Provincial Medical and Health Science and Technology Projects(Project No:2024KY1339)。
文摘This paper focuses on the issue of nurses’job burnout and conducts an in-depth analysis of its contributing factors from multiple dimensions,including organizational management,job characteristics,and individual attributes.These factors include shortages in nursing human resources,lack of management support,excessive workload,and differences in coping strategies.Based on this analysis,targeted human resource management strategies are proposed,covering aspects such as optimizing human resource allocation,leadership development and organizational support,humanized management practices,and competency development with supporting systems.The aim is to alleviate nurses’job burnout,improve the quality of nursing work and nurses’professional well-being,and provide theoretical reference and practical guidance for human resource management in the nursing industry.
基金partially supported by the National Natural Science Foundation of China(72288101 and 72242102)。
文摘Urban traffic is a complex system composed of users,drivers,vehicles,roads,the environment,and information and management strategies,characterized by dynamics,randomness,openness,and complexity.Traditional traffic science and engineering research usually focuses on specific traffic subsystems[1,2],such as drivers(i.e.,driving behavior),vehicles(i.e.,traffic flow),or traffic control(i.e.,signal systems),and significant progress has been achieved in these areas.
基金National Key Research and Development Program of China(2022YFC2503500 and 2022YFC2503504)。
文摘Background The association of systemic inflammatory response index(SIRI)with prognosis of coronary artery disease(CAD)patients has never been investigated in a large sample with long-term follow-up.This study aimed to explore the association of SIRI with all-cause and cause-specific mortality in a nationally representative sample of CAD patients from United States.Methods A total of 3386 participants with CAD from the National Health and Nutrition Examination Survey(NHANES)1999-2018 were included in this study.Cox proportional hazards model,restricted cubic spline(RCS),and receiver operating characteristic curve(ROC)were performed to investigate the association of SIRI with all-cause and cause-specific mortality.Piecewise linear regression and sensitivity analyses were also performed.Results During a median follow-up of 7.7 years,1454 all-cause mortality occurred.After adjusting for confounding factors,higher lnSIRI was significantly associated with higher risk of all-cause(HR=1.16,95%CI:1.09-1.23)and CVD mortality(HR=1.17,95%CI:1.05-1.30)but not cancer mortality(HR=1.17,95%CI:0.99-1.38).The associations of SIRI with all-cause and CVD mortality were detected as J-shaped with threshold values of 1.05935 and 1.122946 for SIRI,respectively.ROC curves showed that lnSIRI had robust predictive effect both in short and long terms.Conclusions SIRI was independently associated with all-cause and CVD mortality,and the dose-response relationship was Jshaped.SIRI might serve as a valid predictor for all-cause and CVD mortality both in the short and long terms.
基金supported by the National Natural Science Foundation of China (82070055 and 82470054)the Project Program of National Clinical Research Center for Geriatric Disorders (Xiangya Hospital, Grant No.2023LNJJ18)。
文摘Background Ischemic heart disease(IHD) represents the most significant disease burden among all cardiovascular diseases(CVDs). The increasing prevalence of metabolic risks in the 21st century has a profound impact on the disease burden associated with IHD. We analyzed the global, regional, and national burdens of IHD attributable to metabolic risks from 1990 to 2021.Methods The data were taken from Global Burden of Disease(GBD) study 2021. Deaths, disability-adjusted life years(DALYs),the average annual percent change(AAPC), age-standardized death rates per 100,000 persons(ASDR) and age-standardized rate per 100,000 persons(ASR) of DALYs ranging from 1990 to 2021, were extracted and stratified according to region, nationality, socio-demographic index(SDI), sex, and age. Additionally, the global future trends were predicted using Nordpred prediction model.Results Compared to 1990, in 2021, the number of death and DALYs from metabolic risk-attributed IHD increased globally by67.35% and 59.91%, respectively;whereas ASDR and ASR of DALYs showed a decreasing trend and the most severe impact was observed in male and elderly populations. In addition, the burden of disease showed an inverted V-shaped relationship with SDI from 1990 to 2021. AAPC showed a significant increase in developing countries and a decrease in developed countries. We also analyzed the effects of different risk factors including metabolic risk factors on IHD in different SDI regions and genders. The prediction of future disease burden showed that the number of death and DALYs will keep rising, while ASDR and ASR of DALYs will maintain a certain downward trend.Conclusions The results of this study highlighted the need for screening and intervention for metabolic risk factors in specific regions and populations, this should call for increased collaboration between developing and developed countries to reduce the burden of disease and improve the prognosis of patients with IHD.
文摘BACKGROUND The rising global prevalence of gastroesophageal reflux disease(GERD)has been closely linked to lifestyle changes driven by globalization.GERD imposes a substantial public health burden,affecting quality of life and leading to potential complications.Early intervention through lifestyle modification can prevent disease onset;however,there is a lack of effective risk prediction models that emphasize primary prevention.AIM To develop and validate a GERD Risk Scoring System(GRSS)aimed at identifying high-risk individuals and promoting primary prevention strategies.METHODS A 45-item questionnaire encompassing major lifestyle and demographic risk factors was developed and validated.It was administered to healthy controls and GERD patients.Two regression models-one using continuous variables and another using categorized variables-were used to develop a computational prediction equation and a clinically applicable scoring scale.An independent validation cohort of 355 participants was used to assess model performance in terms of discrimination(C-index),calibration,sensitivity,specificity,internal consistency(Cronbach's alpha),and test-retest reliability(intraclass correlation coefficient,Bland-Altman analysis).RESULTS Significant associations were observed between GERD and key lifestyle factors.The derived GRSS equation and scoring scale demonstrated strong discriminative ability,with high sensitivity and specificity.The scoring system exhibited excellent internal consistency(Cronbach’s alpha)and strong test-retest reliability.The C-index indicated excellent predictive accuracy in both derivation and validation cohorts.CONCLUSION GRSS offers a novel and validated approach to GERD risk prediction,combining a robust equation for digital applications and a practical scale for clinical use.Its ability to accurately identify at-risk individuals supports a paradigm shift toward primary prevention,underscoring its significance in addressing the growing burden of GERD at the population level.
