AIM:To evaluate and compare alterations in the effective lens position(ELP)and refractive outcomes among three distinct intraocular lens(IOL)types.METHODS:Patients with cataracts were enrolled and allocated to 3 group...AIM:To evaluate and compare alterations in the effective lens position(ELP)and refractive outcomes among three distinct intraocular lens(IOL)types.METHODS:Patients with cataracts were enrolled and allocated to 3 groups:Group A(implanted with the SN6CWS),Group B(implanted with the MI60),and Group C(implanted with the Aspira-aA).ELP measurements were obtained with swept-source optical coherence tomography(SS-OCT)at 1d,1wk,1mo,and 3mo postoperatively.Subjective refraction assessments were conducted at 1wk,1mo,and 3mo following surgery.RESULTS:The study included 189 eyes of 150 cataract patients(66 males).There were 77 eyes in Group A,55 eyes in Group B,and 57 eyes in Group C.The root mean square of the ELP(ELPRMS)within the initial 3mo was significantly lower for Group A than for Groups B and C.Refractive changes within Group A were not significant across the time points of 1wk,1mo,and 3mo.Conversely,both Group B and Group C demonstrated statistically significant shifts toward hyperopia from 1wk to 3mo postsurgery.CONCLUSION:Among the three IOLs examined,the SN6CWS IOL showes the greatest stability during the first 3mo postoperatively.Between 1wk and 3mo after surgery,notable hyperopic shifts are evident in eyes implanted with the MI60 and Aspira-aA IOLs,whereas refractive outcomes remain relatively constant in eyes implanted with SN6CWS IOLs.展开更多
Background:While the treatment of metastatic renal cell carcinoma(mRCC)is evolving due to immune checkpoint inhibitors(ICIs),optimal strategies for later lines of therapy have yet to be defined.The combination of lenv...Background:While the treatment of metastatic renal cell carcinoma(mRCC)is evolving due to immune checkpoint inhibitors(ICIs),optimal strategies for later lines of therapy have yet to be defined.The combination of lenvatinib and everolimus represents a viable option,and the present review aimed to summarize its activity,effectiveness,and safety.Methods:A systematic review of the literature was conducted using PubMed,targeting studies published between 2018 and 2025.Eligible studies included English-language prospective and retrospective trials reporting survival outcomes in mRCC patients treated with lenvatinib and everolimus after at least one ICI-containing regimen.Results:Nine studies met the inclusion criteria,encompassing a total of 441 patients.The lenvatinib and everolimus combination was primarily used in the third and subsequent lines of therapy.Median overall survival ranged from 7.5 to 24.5 months,while median progression-free survival was more consistent,between 6.1 and 6.7 months,except for one study reporting 12.9 months.Objective response rates varied widely(14.0%–55.7%).Adverse events of grade≥3 did not exceed the expected rate,with diarrhoea and proteinuria as the most reported events.Dose reductions and treatment discontinuations due to toxicity occurred but were generally lower than in prior pivotal trials.Conclusions:Real-world evidence suggests that lenvatinib and everolimus represent an effective and safe option after ICI failure in mRCC patients.Nevertheless,the lack of randomized phase III trials and the heterogeneity of existing studies highlight the need for more robust prospective research to guide post-ICI therapeutic strategies.展开更多
As the proportion of composite materials used in aircraft continues to increase, the electromagnetic Shielding Effectiveness (SE) of these materials becomes a critical factor in the electromagnetic safety design of ai...As the proportion of composite materials used in aircraft continues to increase, the electromagnetic Shielding Effectiveness (SE) of these materials becomes a critical factor in the electromagnetic safety design of aircraft structures. The assessment of electromagnetic SE for Slotted Composite Structures(SCSs) is particularly challenging due to their complex geometries and there remains a lack of suitable models for accurately predicting the SE performance of these intricate configurations. To address this issue, this paper introduces SCS-Net, a Deep Neural Network (DNN) method designed to accurately predict the SE of SCS. This method considers the impacts of various structural parameters, material properties and incident wave parameters on the SE of SCSs. In order to better model the SCS, an improved Nicolson-Ross-Weir (NRW) method is introduced in this paper to provide an equivalent flat structure for the SCS and to calculate the electromagnetic parameters of the equivalent structure. Additionally, the prediction of SE via DNNs is limited by insufficient test data, which hinders support for large-sample training. To address the issue of limited measured data, this paper develops a Measurement-Computation Fusion (MCF) dataset construction method. The predictions based on the simulation results show that the proposed method maintains an error of less than 0.07 dB within the 8–10 GHz frequency range. Furthermore, a new loss function based on the weighted L1-norm is established to improve the prediction accuracy for these parameters. Compared with traditional loss functions, the new loss function reduces the maximum prediction error for equivalent electromagnetic parameters by 47%. This method significantly improves the prediction accuracy of SCS-Net for measured data, with a maximum improvement of 23.88%. These findings demonstrate that the proposed method enables precise SE prediction and design for composite structures while reducing the number of test samples needed.展开更多
Evaluation of hydromechanical shear behavior of unsaturated soils is still a challenging issue. The time and cost needed for conducting precise experimental investigation on shear behavior of unsaturated soils have en...Evaluation of hydromechanical shear behavior of unsaturated soils is still a challenging issue. The time and cost needed for conducting precise experimental investigation on shear behavior of unsaturated soils have encouraged several investigators to develop analytical, empirical, or semi-empirical models for predicting the shear behavior of unsaturated soils. However, most of the previously proposed models are for specimens subjected to the isotropic state of stress, without considering the effect of initial shear stress. In this study, a hydromechanical constitutive model is proposed for unsaturated collapsible soils during shearing, with consideration of the effect of the initial shear stress. The model implements an effective stress-based disturbed state concept (DSC) to predict the stress-strain behavior of the soil. Accordingly, material/state variables were defined for both the start of the shearing stage and the critical state of the soil. A series of laboratory tests was performed using a fully automated unsaturated triaxial device to verify the proposed model. The experimental program included 23 suction-controlled unsaturated triaxial shear tests on reconstituted specimens of Gorgan clayey loess wetted to different levels of suctions under both isotropic and anisotropic stress states. The results show excellent agreement between the prediction by the proposed model and the experimental results.展开更多
Africa can draw inspiration from China’s multi-pronged approach to fighting poverty.Without a doubt,China’s poverty alleviation is a success that has not been achieved by any country I can think of.There is so much ...Africa can draw inspiration from China’s multi-pronged approach to fighting poverty.Without a doubt,China’s poverty alleviation is a success that has not been achieved by any country I can think of.There is so much that Africa can learn from China in this regard.African nations can draw inspiration from the effectiveness of China’s governance in delivering results.展开更多
BACKGROUND Blonanserin,a novel antipsychotic,has demonstrated efficacy in treating both positive and negative symptoms.However,limited research exists on its dose-dependent effectiveness and safety in patients with an...BACKGROUND Blonanserin,a novel antipsychotic,has demonstrated efficacy in treating both positive and negative symptoms.However,limited research exists on its dose-dependent effectiveness and safety in patients with and without prominent nega-tive symptoms(PNS).AIM To evaluate the effectiveness and safety of blonanserin monotherapy for first-episode schizophrenia in real-world clinical settings and to explore the efficacy and safety of different doses of blonanserin for patients with PNS and without PNS.METHODS A 12-week,multicenter,prospective post-marketing surveillance was conducted.In this study,we included patients with first-episode schizophrenia who received blonanserin monotherapy.Patients were divided into those with PNS and without PNS,based on the Brief Psychiatric Rating Scale(BPRS)negative symptoms subscale scores.Additionally,patients were labeled as high-dose and low-dose was evaluated through the incidence of adverse drug reactions(ADRs).RESULTS A total of 653 patients were included in the analysis,with 613 completing the study.The BPRS total score decreased significantly from 47.94±16.31 at baseline to 26.88±9.47 at 12 weeks(P<0.001).A significant interaction of PNS×dose×time was observed for BPRS total scores(F=3.47,P=0.040)and negative symptom subscale scores(F=6.76,P=0.002).In the PNS group,the high-dose group showed greater reductions in BPRS total scores(P=0.001)and negative symptom subscale scores(P=0.003)than the low-dose group in week 12.In the without PNS group,no significant difference was observed between the high-dose and low-dose groups at any visit.Most adverse reactions were mild or moderate,with extrapyramidal symptoms(9.3%)being most common;1.5%of patients gained≥7%body weight at 12 weeks.CONCLUSION Blonanserin effectively alleviated the clinical symptoms of first-episode schizophrenia with an acceptable safety profile.High-dose blonanserin is particularly beneficial for patients with PNS in the acute phase of first-episode schizophrenia.However,due to the limitation of ADR reporting the real world,the ADR incidence observed in this study may be underestimated.展开更多
In the vast field of medical education,systematic anatomy serves as a solid cornerstone,firmly supporting medical students in their journey towards clinical professional knowledge.It is not just a course but also a ke...In the vast field of medical education,systematic anatomy serves as a solid cornerstone,firmly supporting medical students in their journey towards clinical professional knowledge.It is not just a course but also a key to unlocking the mysteries of medicine.This course is as rich as a vast treasure trove of knowledge,covering the fine structures and functions of various human body systems.Each knowledge point is like a bright pearl in the treasure trove.It is the foundation of clinical professional courses.Many subsequent clinical courses,such as diagnostics and surgery,rely on the basic understanding provided by systematic anatomy.Its professional vocabulary is also an important source of medical field terminologies,acting as the root of medical language and constructing the entire edifice of medical communication.Although the vocabulary of this course is rich,it is not complex.It is like a set of orderly-arranged jigsaw puzzles.As long as the correct methods are mastered,it is easy to piece them together.However,in the current teaching environment,the traditional cramming-style teaching method is like an old-fashioned carriage,showing obvious disadvantages on the road of the times.The pre-study link is like a rehearsal for a wonderful performance,having a direct and crucial impact on students’listening efficiency in class.Nevertheless,such an important teaching link is often overlooked,like a precious treasure forgotten in the corner.High-quality pre-study,for lecturers,is like giving wings to classroom teaching,which can greatly improve the efficiency of classroom teaching and make the teaching process smoother and more efficient.For students,it is like a magnifying glass that can deepen their understanding of knowledge points and their impression of the text,making the knowledge more clearly engraved in their minds.This article will focus on exploring the methods to achieve effective pre-study for systematic anatomy,hoping to contribute to the development of medical education.展开更多
Objective:To evaluate the value of humanistic nursing care during pediatric nebulization treatment.Methods:From January 2024 to June 2024,250 pediatric patients receiving nebulization treatment were given routine care...Objective:To evaluate the value of humanistic nursing care during pediatric nebulization treatment.Methods:From January 2024 to June 2024,250 pediatric patients receiving nebulization treatment were given routine care and included in the control group.From July 2024 to December 2024,250 pediatric patients receiving nebulization treatment were given full humanistic care by nurses and included in the observation group.The differences in patient compliance,symptom resolution time,parental satisfaction,and emotional scores were compared.Results:The compliance of pediatric nebulization patients in the observation group was higher than that in the control group(P<0.05).The disappearance time of inflammation,cough,expectoration,fever,and hospital stay in the observation group were shorter than those in the control group(P<0.05).Parental satisfaction with pediatric nebulization in the observation group was higher than that in the control group(P<0.05).The scores of anxiety(SAS)and depression(SDS)among parents of pediatric nebulization patients in the observation group were lower than those in the control group(P<0.05).Conclusion:The application of nurses’full humanistic care in pediatric nebulization treatment can promote the resolution of respiratory system symptoms,optimize patients’lung function,improve patient cooperation,and is highly effective and feasible.展开更多
Introduction:This study examined the application of targeted education strategies for nursing students of different MBTI types to enhance students’theoretical and practical grades.Nursing students have different pers...Introduction:This study examined the application of targeted education strategies for nursing students of different MBTI types to enhance students’theoretical and practical grades.Nursing students have different personalities,therefore learning behaviors are significantly different.It is worth exploring whether teaching methods influence these differences and can be improved through specific education strategies.Methods:Experimental research methods and Questionnaire survey methods were used to test the effect of MBTI with different personality types on the implementation of targeted education strategies.Results:There was a significant correlation between MBTI and teaching effect(p<0.005).Targeted changes in education strategies could effectively improve teaching effect(p<0.005),improve teaching quality(p<0.005),and improve nursing students’professional identity(p<0.005).Conclusion:The results showed that targeted changes in education strategies can effectively improve teaching effectiveness,teaching quality,and nursing students’sense of occupational identity.展开更多
Objective:This study aims to determine the effectiveness of giving a combination of Fe tablets and beetroot juice in increasing hemoglobin(Hb)levels of pregnant women with anemia in the Mataram City area.Methods:This ...Objective:This study aims to determine the effectiveness of giving a combination of Fe tablets and beetroot juice in increasing hemoglobin(Hb)levels of pregnant women with anemia in the Mataram City area.Methods:This study was designed with quasi-experimental design with pre-test and post-test with control design.The location of this study was conducted in the city of Mataram on pregnant women with anemia.The sample of this study was pregnant women with mild anemia based on inclusion and exclusion criteria,divided into 2 groups:a control group and a treatment group of 15 respondents each,bringing the total respondents to 30 people.Analysis of Hb level measurement results was carried out using the independent sample t-test.Results:The results obtained in the treatment group(combination of beet juice and Fe tablets)were the mean pre-test of 9.93 mg/dL and post-test of 11.90 mg/dL(P-value=0.000),which means there is effectiveness in increasing hemoglobin levels while in the control group.Comparison of increased Hb levels of the control group and significantly different treatments marked by a P value of 0.001.Conclusions:the combination of Fe tablets and beetroot juice is effective in increasing Hb levels of pregnant women with anemia in the Mataram City area.展开更多
The Shan-Shui Initiative has attracted global attention in massively contained ecological deterioration and restored millions of hectares of land in China.There are high hopes for this new combination of protection,re...The Shan-Shui Initiative has attracted global attention in massively contained ecological deterioration and restored millions of hectares of land in China.There are high hopes for this new combination of protection,restoration,and management of ecosystems,its overall benefits,however,remain uncertain.Here,we employed ecosystem service(ES)indicators to quantitatively evaluate the effectiveness of all pilot projects since 2016 at the national scale.Results show that after the implementation of Shan-Shui Initiative,ES have significantly improved,with increases in water yield(14.3%),carbon sequestration(13.7%),soil conservation(6.5%),windbreak sand fixation(5.0%),and habitat quality(0.7%).The changes in ES were driven by both the Shan-Shui Initiative and climate change.Projects with longer implementation periods showed a more pronounced trend of growth in ESs,particularly evident in the ecological space.The spillover effects were widely present and the prevalence of positive spillover effects was notably greater than that of negative ones.Furthermore,the diverse interventions implemented in the Shan-Shui project had varying impacts on ES across different regions.Overall,these interventions showed a positive influence on ESs,although the degree of trade-off showed a south-high and north-low pattern.This highlights the necessity for ecological restoration efforts to carefully consider regional differences.This study may provide policy guidance for optimizing the layout and sustainable management of Shan-Shui ecological restoration projects.展开更多
This study focused on investigating the effects of various factors on the mechanical properties of superconducting matrix composites reinforced with ferromagnetic particles and interface phases when exposed to externa...This study focused on investigating the effects of various factors on the mechanical properties of superconducting matrix composites reinforced with ferromagnetic particles and interface phases when exposed to external magnetic fields.A micromechanical model was created by simplifying the basic properties and composition of the interface,utilizing principles such as Eshelby’s equivalent inclusion theory and Hooke’s law,as well as applying uniform stress boundary conditions.Through the development of equations,the study predicted changes in effective mechanical properties,highlighting the significant influence of parameters like the interface phase,inclusions,and magnetic field on the effective elastic modulus and magnetostriction of the composite material.By shedding light on these relationships,the research offers valuable insights for the manufacture and application of ferromagnetic particle-reinforced superconducting matrix composites with interface phases,providing a foundation for future research in this area.展开更多
Surgical nursing education has long grappled with a tension between traditional lecture-based models and actual practice needs.Students have difficulty converting theory into functional nursing skills in the passive f...Surgical nursing education has long grappled with a tension between traditional lecture-based models and actual practice needs.Students have difficulty converting theory into functional nursing skills in the passive format of knowledge acquisition.As medical education concepts have been renewed,the goals of educating nursing talents with independent judgment and adaptability to clinical practice have evolved into a significant direction of teaching reform.To this end,the“flipped classroom”model that blends lecture with discussion,through the mechanism of“internalized absorption”and“discussion”in the classroom,represents both a new teaching model that meets the need for integration of surgical nursing knowledge and an approach to skill application.This model reconstructs the teaching and learning process by providing a bridge for students to transfer from understanding knowledge to clinical thinking,thus providing a path forward for the dilemma of the separation of theory and practice in surgical nursing education.展开更多
During nearly 200 years of development in the knowledge of Brownian motion,the Janus sphere,as a typical Brownian particle with special surface properties,has been widely studied in the past few decades.A standard Jan...During nearly 200 years of development in the knowledge of Brownian motion,the Janus sphere,as a typical Brownian particle with special surface properties,has been widely studied in the past few decades.A standard Janus sphere possesses two distinct surfaces.These two surfaces elicit different hydrodynamic interactions with ambient fluids or other interactions in response to environmental stimuli,such as chemical gradients,magnetic fields,and even light.The diffusion of Janus spheres,particularly when controlled by a remotely applied field,has inspired various applications,ranging from the design of micro-swimmers and novel procedures for probing the mechanical properties of suspensions to the fabrication of composites with enhanced performance.In this work,we report a systematic analysis of field-controlled diffusion of Janus spheres.Commencing with stochastic differential equations of motion at the microscale,we derive a coarse-grained Fokker-Planck equation at the macroscale,describing the evolution of the probability distribution function of the Janus sphere in terms of its position and orientation.Leveraging the concept of the hydrodynamic center,we derive,for the first time,explicit generalized Stokes-Einstein relations for long-time effective diffusivity,incorporating the effects of both the surface discontinuity of the Janus sphere and the external fields.The formulae enable predictions of the effective diffusivity as it varies with the slip length and characteristic angle of Janus spheres,and reveal the impact of an aligning potential field on the diffusion coefficients both parallel and perpendicular to the direction of the field.This work not only deepens the understanding of field-controlled diffusion of Janus particles,but also holds a meaningful impact on the future applications in microfluidics and related fields.展开更多
Hydraulic fracturing techniques are commonly used to enhance the production of tight reservoirs.Generally,the effect of hydraulic fracturing can be appraised through hydraulic fracturing experiments in the laboratory,...Hydraulic fracturing techniques are commonly used to enhance the production of tight reservoirs.Generally,the effect of hydraulic fracturing can be appraised through hydraulic fracturing experiments in the laboratory,in which acoustic emission(AE)is often used to monitor the fracturing process.At present,the number of AE events and spatial distribution of AE locations are the two main factors commonly conside red in hydraulic fracturing effectiveness evaluatio n.Howeve r,these commonly used evaluation methods overlook two crucial aspects:the connectivity among fractures and the tensile and shear properties of fractures induced by hydraulic fracturing.In this technical note,we consider the influence of these two previously overlooked aspects on the evaluation of hydraulic fracturing effectiveness by establishing a connected fracture model using AE data.The proposed approach links up AE events based on their spatio-temporal relationship and builds a fracture network called the connection model.Then,the characteristic of the fracture network is represented by the fractal dimension to reveal the complexity of fractures in the network.We extract the tensile-shear properties of each fracture based on the inversion of AE events'focal mechanism.Finally,based on the pre-known fracturing effectiveness of a fracture network,we compare the connection model of AE events in several triaxial hydraulic experiments.Our findings indicate that a comprehensive evaluation of hydraulic fracturing effectiveness can be achieved by considering both the connectivity of AE locations and the tensile-shear properties of AE events.This work aims to provide a more rational method for characterizing rock fracture networks and evaluating rock fracturing effects using AE data.展开更多
As the enlightenment stage of students’Chinese learning,primary school Chinese education plays a key role in cultivating students’language ability,thinking development,and humanistic literacy.Value-added evaluation,...As the enlightenment stage of students’Chinese learning,primary school Chinese education plays a key role in cultivating students’language ability,thinking development,and humanistic literacy.Value-added evaluation,as an evaluation method that focuses on the changes in students’individual development and attaches importance to the learning process,has gradually attracted attention in the application of primary school Chinese education.This paper first analyzes the problems existing in the current implementation of value-added evaluation in primary school Chinese,and then explores the countermeasures to improve the effectiveness of value-added evaluation in primary school Chinese from the aspects of evaluation concept,evaluation content,evaluation method,evaluation subject,and application of evaluation results.The purpose is to provide strong support for the improvement of primary school Chinese teaching quality and the all-round development of students.展开更多
With the evolution of society,education reform continues to progress,and increasing attention is being paid to the learning outcomes and overall academic quality of junior high school students.As a core subject at thi...With the evolution of society,education reform continues to progress,and increasing attention is being paid to the learning outcomes and overall academic quality of junior high school students.As a core subject at this stage,the effectiveness of Chinese language teaching directly influences students’overall academic performance.Therefore,enhancing the effectiveness of junior high school Chinese classroom teaching has become a key focus for educators.Against this backdrop,this paper explores the significance of building an effective classroom environment in junior high school Chinese teaching and provides an in-depth analysis of strategies to improve teaching effectiveness.The goal is to assist teachers in creating efficient classrooms,fostering students’interest in learning,enhancing their overall competence in Chinese,and ultimately improving teaching quality to contribute to the overall advancement of Chinese language education.展开更多
Chronic obstructive pulmonary disease(COPD)is a common chronic respiratory disease that severely affects patients’quality of life.Current clinical treatments primarily rely on medication,with limited rehabilitation o...Chronic obstructive pulmonary disease(COPD)is a common chronic respiratory disease that severely affects patients’quality of life.Current clinical treatments primarily rely on medication,with limited rehabilitation options and uncertain efficacy.Home-based exercise rehabilitation,as a non-pharmacological therapy,can promote the improvement of respiratory muscle function and cardiopulmonary endurance,exerting a positive preventive effect on COPD.However,due to factors such as the home environment and lack of health knowledge,COPD patients face numerous difficulties in accepting home-based exercise rehabilitation.This article reviews domestic and international research on the feasibility and effectiveness of home-based exercise rehabilitation for COPD,aiming to provide references for medical workers to better implement home-based exercise rehabilitation for COPD,assist patients in performing rehabilitation exercises at home,improve their quality of life,reduce hospitalization rates,and lower medical costs.展开更多
Objective The objective of our study was to evaluate the vaccine effectiveness(VE)of the pentavalent rotavirus vaccine(RV5)among<5-year-old children in three provinces of China during 2020-2024 via a propensity sco...Objective The objective of our study was to evaluate the vaccine effectiveness(VE)of the pentavalent rotavirus vaccine(RV5)among<5-year-old children in three provinces of China during 2020-2024 via a propensity score-matched test-negative case-control study.Methods Electronic health records and immunization information systems were used to obtain data on acute gastroenteritis(AGE)cases tested for rotavirus(RV)infection.RV-positive cases were propensity score matched with RV-negative controls for age,visit month,and province.Results The study included 27,472 children with AGE aged 8 weeks to 4 years at the time of AGE diagnosis;7.98%(2,192)were RV-positive.The VE(95%confidence interval,CI)of 1-2 and 3 doses of RV5 against any medically attended RV infection(inpatient or outpatient)was 57.6%(39.8%,70.2%)and 67.2%(60.3%,72.9%),respectively.Among children who received the 3rd dose before turning 5 months of age,3-dose VE decreased from 70.4%(53.9%,81.1%)(<5 months since the 3rd dose)to 63.0%(49.1%,73.0%)(≥1 year since the 3rd dose).The three-dose VE rate was 69.4%(41.3%,84.0%)for RVGE hospitalization and 57.5%(38.9%,70.5%)for outpatient-only medically attended RVGE.Conclusion Three-dose RV5 VE against rotavirus gastroenteritis(RVGE)in children aged<5 years was higher than 1-2-dose VE.Three-dose VE decreased with time since the 3rd dose in children who received the 3rd dose before turning five months of age,but remained above 60%for at least one year.VE was higher for RVGE hospitalizations than for medically attended outpatient visits.展开更多
基金Supported by the Zhejiang Medical Health Science and Technology Project(No.2021KY217)the Basic Public Welfare Research Project of Wenzhou Municipal Science and Technology Bureau(No.2024Y1221).
文摘AIM:To evaluate and compare alterations in the effective lens position(ELP)and refractive outcomes among three distinct intraocular lens(IOL)types.METHODS:Patients with cataracts were enrolled and allocated to 3 groups:Group A(implanted with the SN6CWS),Group B(implanted with the MI60),and Group C(implanted with the Aspira-aA).ELP measurements were obtained with swept-source optical coherence tomography(SS-OCT)at 1d,1wk,1mo,and 3mo postoperatively.Subjective refraction assessments were conducted at 1wk,1mo,and 3mo following surgery.RESULTS:The study included 189 eyes of 150 cataract patients(66 males).There were 77 eyes in Group A,55 eyes in Group B,and 57 eyes in Group C.The root mean square of the ELP(ELPRMS)within the initial 3mo was significantly lower for Group A than for Groups B and C.Refractive changes within Group A were not significant across the time points of 1wk,1mo,and 3mo.Conversely,both Group B and Group C demonstrated statistically significant shifts toward hyperopia from 1wk to 3mo postsurgery.CONCLUSION:Among the three IOLs examined,the SN6CWS IOL showes the greatest stability during the first 3mo postoperatively.Between 1wk and 3mo after surgery,notable hyperopic shifts are evident in eyes implanted with the MI60 and Aspira-aA IOLs,whereas refractive outcomes remain relatively constant in eyes implanted with SN6CWS IOLs.
文摘Background:While the treatment of metastatic renal cell carcinoma(mRCC)is evolving due to immune checkpoint inhibitors(ICIs),optimal strategies for later lines of therapy have yet to be defined.The combination of lenvatinib and everolimus represents a viable option,and the present review aimed to summarize its activity,effectiveness,and safety.Methods:A systematic review of the literature was conducted using PubMed,targeting studies published between 2018 and 2025.Eligible studies included English-language prospective and retrospective trials reporting survival outcomes in mRCC patients treated with lenvatinib and everolimus after at least one ICI-containing regimen.Results:Nine studies met the inclusion criteria,encompassing a total of 441 patients.The lenvatinib and everolimus combination was primarily used in the third and subsequent lines of therapy.Median overall survival ranged from 7.5 to 24.5 months,while median progression-free survival was more consistent,between 6.1 and 6.7 months,except for one study reporting 12.9 months.Objective response rates varied widely(14.0%–55.7%).Adverse events of grade≥3 did not exceed the expected rate,with diarrhoea and proteinuria as the most reported events.Dose reductions and treatment discontinuations due to toxicity occurred but were generally lower than in prior pivotal trials.Conclusions:Real-world evidence suggests that lenvatinib and everolimus represent an effective and safe option after ICI failure in mRCC patients.Nevertheless,the lack of randomized phase III trials and the heterogeneity of existing studies highlight the need for more robust prospective research to guide post-ICI therapeutic strategies.
基金supported by the National Natural Science Foundation of China(Nos.62101020 and 62141405)the Special Scientific Research Project of Civil Aircraft,China(No.MJZ5-2N22).
文摘As the proportion of composite materials used in aircraft continues to increase, the electromagnetic Shielding Effectiveness (SE) of these materials becomes a critical factor in the electromagnetic safety design of aircraft structures. The assessment of electromagnetic SE for Slotted Composite Structures(SCSs) is particularly challenging due to their complex geometries and there remains a lack of suitable models for accurately predicting the SE performance of these intricate configurations. To address this issue, this paper introduces SCS-Net, a Deep Neural Network (DNN) method designed to accurately predict the SE of SCS. This method considers the impacts of various structural parameters, material properties and incident wave parameters on the SE of SCSs. In order to better model the SCS, an improved Nicolson-Ross-Weir (NRW) method is introduced in this paper to provide an equivalent flat structure for the SCS and to calculate the electromagnetic parameters of the equivalent structure. Additionally, the prediction of SE via DNNs is limited by insufficient test data, which hinders support for large-sample training. To address the issue of limited measured data, this paper develops a Measurement-Computation Fusion (MCF) dataset construction method. The predictions based on the simulation results show that the proposed method maintains an error of less than 0.07 dB within the 8–10 GHz frequency range. Furthermore, a new loss function based on the weighted L1-norm is established to improve the prediction accuracy for these parameters. Compared with traditional loss functions, the new loss function reduces the maximum prediction error for equivalent electromagnetic parameters by 47%. This method significantly improves the prediction accuracy of SCS-Net for measured data, with a maximum improvement of 23.88%. These findings demonstrate that the proposed method enables precise SE prediction and design for composite structures while reducing the number of test samples needed.
文摘Evaluation of hydromechanical shear behavior of unsaturated soils is still a challenging issue. The time and cost needed for conducting precise experimental investigation on shear behavior of unsaturated soils have encouraged several investigators to develop analytical, empirical, or semi-empirical models for predicting the shear behavior of unsaturated soils. However, most of the previously proposed models are for specimens subjected to the isotropic state of stress, without considering the effect of initial shear stress. In this study, a hydromechanical constitutive model is proposed for unsaturated collapsible soils during shearing, with consideration of the effect of the initial shear stress. The model implements an effective stress-based disturbed state concept (DSC) to predict the stress-strain behavior of the soil. Accordingly, material/state variables were defined for both the start of the shearing stage and the critical state of the soil. A series of laboratory tests was performed using a fully automated unsaturated triaxial device to verify the proposed model. The experimental program included 23 suction-controlled unsaturated triaxial shear tests on reconstituted specimens of Gorgan clayey loess wetted to different levels of suctions under both isotropic and anisotropic stress states. The results show excellent agreement between the prediction by the proposed model and the experimental results.
文摘Africa can draw inspiration from China’s multi-pronged approach to fighting poverty.Without a doubt,China’s poverty alleviation is a success that has not been achieved by any country I can think of.There is so much that Africa can learn from China in this regard.African nations can draw inspiration from the effectiveness of China’s governance in delivering results.
文摘BACKGROUND Blonanserin,a novel antipsychotic,has demonstrated efficacy in treating both positive and negative symptoms.However,limited research exists on its dose-dependent effectiveness and safety in patients with and without prominent nega-tive symptoms(PNS).AIM To evaluate the effectiveness and safety of blonanserin monotherapy for first-episode schizophrenia in real-world clinical settings and to explore the efficacy and safety of different doses of blonanserin for patients with PNS and without PNS.METHODS A 12-week,multicenter,prospective post-marketing surveillance was conducted.In this study,we included patients with first-episode schizophrenia who received blonanserin monotherapy.Patients were divided into those with PNS and without PNS,based on the Brief Psychiatric Rating Scale(BPRS)negative symptoms subscale scores.Additionally,patients were labeled as high-dose and low-dose was evaluated through the incidence of adverse drug reactions(ADRs).RESULTS A total of 653 patients were included in the analysis,with 613 completing the study.The BPRS total score decreased significantly from 47.94±16.31 at baseline to 26.88±9.47 at 12 weeks(P<0.001).A significant interaction of PNS×dose×time was observed for BPRS total scores(F=3.47,P=0.040)and negative symptom subscale scores(F=6.76,P=0.002).In the PNS group,the high-dose group showed greater reductions in BPRS total scores(P=0.001)and negative symptom subscale scores(P=0.003)than the low-dose group in week 12.In the without PNS group,no significant difference was observed between the high-dose and low-dose groups at any visit.Most adverse reactions were mild or moderate,with extrapyramidal symptoms(9.3%)being most common;1.5%of patients gained≥7%body weight at 12 weeks.CONCLUSION Blonanserin effectively alleviated the clinical symptoms of first-episode schizophrenia with an acceptable safety profile.High-dose blonanserin is particularly beneficial for patients with PNS in the acute phase of first-episode schizophrenia.However,due to the limitation of ADR reporting the real world,the ADR incidence observed in this study may be underestimated.
文摘In the vast field of medical education,systematic anatomy serves as a solid cornerstone,firmly supporting medical students in their journey towards clinical professional knowledge.It is not just a course but also a key to unlocking the mysteries of medicine.This course is as rich as a vast treasure trove of knowledge,covering the fine structures and functions of various human body systems.Each knowledge point is like a bright pearl in the treasure trove.It is the foundation of clinical professional courses.Many subsequent clinical courses,such as diagnostics and surgery,rely on the basic understanding provided by systematic anatomy.Its professional vocabulary is also an important source of medical field terminologies,acting as the root of medical language and constructing the entire edifice of medical communication.Although the vocabulary of this course is rich,it is not complex.It is like a set of orderly-arranged jigsaw puzzles.As long as the correct methods are mastered,it is easy to piece them together.However,in the current teaching environment,the traditional cramming-style teaching method is like an old-fashioned carriage,showing obvious disadvantages on the road of the times.The pre-study link is like a rehearsal for a wonderful performance,having a direct and crucial impact on students’listening efficiency in class.Nevertheless,such an important teaching link is often overlooked,like a precious treasure forgotten in the corner.High-quality pre-study,for lecturers,is like giving wings to classroom teaching,which can greatly improve the efficiency of classroom teaching and make the teaching process smoother and more efficient.For students,it is like a magnifying glass that can deepen their understanding of knowledge points and their impression of the text,making the knowledge more clearly engraved in their minds.This article will focus on exploring the methods to achieve effective pre-study for systematic anatomy,hoping to contribute to the development of medical education.
文摘Objective:To evaluate the value of humanistic nursing care during pediatric nebulization treatment.Methods:From January 2024 to June 2024,250 pediatric patients receiving nebulization treatment were given routine care and included in the control group.From July 2024 to December 2024,250 pediatric patients receiving nebulization treatment were given full humanistic care by nurses and included in the observation group.The differences in patient compliance,symptom resolution time,parental satisfaction,and emotional scores were compared.Results:The compliance of pediatric nebulization patients in the observation group was higher than that in the control group(P<0.05).The disappearance time of inflammation,cough,expectoration,fever,and hospital stay in the observation group were shorter than those in the control group(P<0.05).Parental satisfaction with pediatric nebulization in the observation group was higher than that in the control group(P<0.05).The scores of anxiety(SAS)and depression(SDS)among parents of pediatric nebulization patients in the observation group were lower than those in the control group(P<0.05).Conclusion:The application of nurses’full humanistic care in pediatric nebulization treatment can promote the resolution of respiratory system symptoms,optimize patients’lung function,improve patient cooperation,and is highly effective and feasible.
文摘Introduction:This study examined the application of targeted education strategies for nursing students of different MBTI types to enhance students’theoretical and practical grades.Nursing students have different personalities,therefore learning behaviors are significantly different.It is worth exploring whether teaching methods influence these differences and can be improved through specific education strategies.Methods:Experimental research methods and Questionnaire survey methods were used to test the effect of MBTI with different personality types on the implementation of targeted education strategies.Results:There was a significant correlation between MBTI and teaching effect(p<0.005).Targeted changes in education strategies could effectively improve teaching effect(p<0.005),improve teaching quality(p<0.005),and improve nursing students’professional identity(p<0.005).Conclusion:The results showed that targeted changes in education strategies can effectively improve teaching effectiveness,teaching quality,and nursing students’sense of occupational identity.
基金supported by Muhammadiyah Research Grant (RisetMu) Batch Ⅵ (No. 1687.186/PD/I.3/D/2022)
文摘Objective:This study aims to determine the effectiveness of giving a combination of Fe tablets and beetroot juice in increasing hemoglobin(Hb)levels of pregnant women with anemia in the Mataram City area.Methods:This study was designed with quasi-experimental design with pre-test and post-test with control design.The location of this study was conducted in the city of Mataram on pregnant women with anemia.The sample of this study was pregnant women with mild anemia based on inclusion and exclusion criteria,divided into 2 groups:a control group and a treatment group of 15 respondents each,bringing the total respondents to 30 people.Analysis of Hb level measurement results was carried out using the independent sample t-test.Results:The results obtained in the treatment group(combination of beet juice and Fe tablets)were the mean pre-test of 9.93 mg/dL and post-test of 11.90 mg/dL(P-value=0.000),which means there is effectiveness in increasing hemoglobin levels while in the control group.Comparison of increased Hb levels of the control group and significantly different treatments marked by a P value of 0.001.Conclusions:the combination of Fe tablets and beetroot juice is effective in increasing Hb levels of pregnant women with anemia in the Mataram City area.
基金supported by the National Key Research and Development Program of China(Grant No.2022YFF1303205)the Fundamental Research Funds for the Central Universities(Grant No.2652022005)。
文摘The Shan-Shui Initiative has attracted global attention in massively contained ecological deterioration and restored millions of hectares of land in China.There are high hopes for this new combination of protection,restoration,and management of ecosystems,its overall benefits,however,remain uncertain.Here,we employed ecosystem service(ES)indicators to quantitatively evaluate the effectiveness of all pilot projects since 2016 at the national scale.Results show that after the implementation of Shan-Shui Initiative,ES have significantly improved,with increases in water yield(14.3%),carbon sequestration(13.7%),soil conservation(6.5%),windbreak sand fixation(5.0%),and habitat quality(0.7%).The changes in ES were driven by both the Shan-Shui Initiative and climate change.Projects with longer implementation periods showed a more pronounced trend of growth in ESs,particularly evident in the ecological space.The spillover effects were widely present and the prevalence of positive spillover effects was notably greater than that of negative ones.Furthermore,the diverse interventions implemented in the Shan-Shui project had varying impacts on ES across different regions.Overall,these interventions showed a positive influence on ESs,although the degree of trade-off showed a south-high and north-low pattern.This highlights the necessity for ecological restoration efforts to carefully consider regional differences.This study may provide policy guidance for optimizing the layout and sustainable management of Shan-Shui ecological restoration projects.
基金supported by the National Natural Science Foundation of China(No.12262020).
文摘This study focused on investigating the effects of various factors on the mechanical properties of superconducting matrix composites reinforced with ferromagnetic particles and interface phases when exposed to external magnetic fields.A micromechanical model was created by simplifying the basic properties and composition of the interface,utilizing principles such as Eshelby’s equivalent inclusion theory and Hooke’s law,as well as applying uniform stress boundary conditions.Through the development of equations,the study predicted changes in effective mechanical properties,highlighting the significant influence of parameters like the interface phase,inclusions,and magnetic field on the effective elastic modulus and magnetostriction of the composite material.By shedding light on these relationships,the research offers valuable insights for the manufacture and application of ferromagnetic particle-reinforced superconducting matrix composites with interface phases,providing a foundation for future research in this area.
文摘Surgical nursing education has long grappled with a tension between traditional lecture-based models and actual practice needs.Students have difficulty converting theory into functional nursing skills in the passive format of knowledge acquisition.As medical education concepts have been renewed,the goals of educating nursing talents with independent judgment and adaptability to clinical practice have evolved into a significant direction of teaching reform.To this end,the“flipped classroom”model that blends lecture with discussion,through the mechanism of“internalized absorption”and“discussion”in the classroom,represents both a new teaching model that meets the need for integration of surgical nursing knowledge and an approach to skill application.This model reconstructs the teaching and learning process by providing a bridge for students to transfer from understanding knowledge to clinical thinking,thus providing a path forward for the dilemma of the separation of theory and practice in surgical nursing education.
基金Project supported by the National Natural Science Foundation of China(Nos.12302079 and 11521202)the National Natural Science Foundation of U.S.A.(No.DMS-2306254)。
文摘During nearly 200 years of development in the knowledge of Brownian motion,the Janus sphere,as a typical Brownian particle with special surface properties,has been widely studied in the past few decades.A standard Janus sphere possesses two distinct surfaces.These two surfaces elicit different hydrodynamic interactions with ambient fluids or other interactions in response to environmental stimuli,such as chemical gradients,magnetic fields,and even light.The diffusion of Janus spheres,particularly when controlled by a remotely applied field,has inspired various applications,ranging from the design of micro-swimmers and novel procedures for probing the mechanical properties of suspensions to the fabrication of composites with enhanced performance.In this work,we report a systematic analysis of field-controlled diffusion of Janus spheres.Commencing with stochastic differential equations of motion at the microscale,we derive a coarse-grained Fokker-Planck equation at the macroscale,describing the evolution of the probability distribution function of the Janus sphere in terms of its position and orientation.Leveraging the concept of the hydrodynamic center,we derive,for the first time,explicit generalized Stokes-Einstein relations for long-time effective diffusivity,incorporating the effects of both the surface discontinuity of the Janus sphere and the external fields.The formulae enable predictions of the effective diffusivity as it varies with the slip length and characteristic angle of Janus spheres,and reveal the impact of an aligning potential field on the diffusion coefficients both parallel and perpendicular to the direction of the field.This work not only deepens the understanding of field-controlled diffusion of Janus particles,but also holds a meaningful impact on the future applications in microfluidics and related fields.
基金financial support from the subprojects of the Natural Science Foundation of China(No.42302326)the Shenzhen Science and Technology Program(JCYJ20220530113612028)+1 种基金the National Key Research and Development Program of China(Grant No.2023YFC3707905)the Fundamental Research Funds for the Central Universities(JZ2025HGTB0191)。
文摘Hydraulic fracturing techniques are commonly used to enhance the production of tight reservoirs.Generally,the effect of hydraulic fracturing can be appraised through hydraulic fracturing experiments in the laboratory,in which acoustic emission(AE)is often used to monitor the fracturing process.At present,the number of AE events and spatial distribution of AE locations are the two main factors commonly conside red in hydraulic fracturing effectiveness evaluatio n.Howeve r,these commonly used evaluation methods overlook two crucial aspects:the connectivity among fractures and the tensile and shear properties of fractures induced by hydraulic fracturing.In this technical note,we consider the influence of these two previously overlooked aspects on the evaluation of hydraulic fracturing effectiveness by establishing a connected fracture model using AE data.The proposed approach links up AE events based on their spatio-temporal relationship and builds a fracture network called the connection model.Then,the characteristic of the fracture network is represented by the fractal dimension to reveal the complexity of fractures in the network.We extract the tensile-shear properties of each fracture based on the inversion of AE events'focal mechanism.Finally,based on the pre-known fracturing effectiveness of a fracture network,we compare the connection model of AE events in several triaxial hydraulic experiments.Our findings indicate that a comprehensive evaluation of hydraulic fracturing effectiveness can be achieved by considering both the connectivity of AE locations and the tensile-shear properties of AE events.This work aims to provide a more rational method for characterizing rock fracture networks and evaluating rock fracturing effects using AE data.
基金Shandong Provincial Education and Teaching Research Topic“Research on Student Value-Added Evaluation for Promoting Deep Learning”(2023JXY500)。
文摘As the enlightenment stage of students’Chinese learning,primary school Chinese education plays a key role in cultivating students’language ability,thinking development,and humanistic literacy.Value-added evaluation,as an evaluation method that focuses on the changes in students’individual development and attaches importance to the learning process,has gradually attracted attention in the application of primary school Chinese education.This paper first analyzes the problems existing in the current implementation of value-added evaluation in primary school Chinese,and then explores the countermeasures to improve the effectiveness of value-added evaluation in primary school Chinese from the aspects of evaluation concept,evaluation content,evaluation method,evaluation subject,and application of evaluation results.The purpose is to provide strong support for the improvement of primary school Chinese teaching quality and the all-round development of students.
文摘With the evolution of society,education reform continues to progress,and increasing attention is being paid to the learning outcomes and overall academic quality of junior high school students.As a core subject at this stage,the effectiveness of Chinese language teaching directly influences students’overall academic performance.Therefore,enhancing the effectiveness of junior high school Chinese classroom teaching has become a key focus for educators.Against this backdrop,this paper explores the significance of building an effective classroom environment in junior high school Chinese teaching and provides an in-depth analysis of strategies to improve teaching effectiveness.The goal is to assist teachers in creating efficient classrooms,fostering students’interest in learning,enhancing their overall competence in Chinese,and ultimately improving teaching quality to contribute to the overall advancement of Chinese language education.
文摘Chronic obstructive pulmonary disease(COPD)is a common chronic respiratory disease that severely affects patients’quality of life.Current clinical treatments primarily rely on medication,with limited rehabilitation options and uncertain efficacy.Home-based exercise rehabilitation,as a non-pharmacological therapy,can promote the improvement of respiratory muscle function and cardiopulmonary endurance,exerting a positive preventive effect on COPD.However,due to factors such as the home environment and lack of health knowledge,COPD patients face numerous difficulties in accepting home-based exercise rehabilitation.This article reviews domestic and international research on the feasibility and effectiveness of home-based exercise rehabilitation for COPD,aiming to provide references for medical workers to better implement home-based exercise rehabilitation for COPD,assist patients in performing rehabilitation exercises at home,improve their quality of life,reduce hospitalization rates,and lower medical costs.
基金the Study on Vaccine Application Evaluation Strategies and Capacity Building (INV-006373)the National Key R&D Program of China(2024YFC2310604)
文摘Objective The objective of our study was to evaluate the vaccine effectiveness(VE)of the pentavalent rotavirus vaccine(RV5)among<5-year-old children in three provinces of China during 2020-2024 via a propensity score-matched test-negative case-control study.Methods Electronic health records and immunization information systems were used to obtain data on acute gastroenteritis(AGE)cases tested for rotavirus(RV)infection.RV-positive cases were propensity score matched with RV-negative controls for age,visit month,and province.Results The study included 27,472 children with AGE aged 8 weeks to 4 years at the time of AGE diagnosis;7.98%(2,192)were RV-positive.The VE(95%confidence interval,CI)of 1-2 and 3 doses of RV5 against any medically attended RV infection(inpatient or outpatient)was 57.6%(39.8%,70.2%)and 67.2%(60.3%,72.9%),respectively.Among children who received the 3rd dose before turning 5 months of age,3-dose VE decreased from 70.4%(53.9%,81.1%)(<5 months since the 3rd dose)to 63.0%(49.1%,73.0%)(≥1 year since the 3rd dose).The three-dose VE rate was 69.4%(41.3%,84.0%)for RVGE hospitalization and 57.5%(38.9%,70.5%)for outpatient-only medically attended RVGE.Conclusion Three-dose RV5 VE against rotavirus gastroenteritis(RVGE)in children aged<5 years was higher than 1-2-dose VE.Three-dose VE decreased with time since the 3rd dose in children who received the 3rd dose before turning five months of age,but remained above 60%for at least one year.VE was higher for RVGE hospitalizations than for medically attended outpatient visits.
