BACKGROUND Pain in the back or pelvis or fear of back pain may affect the timing or cocontraction of the core muscles.In both static and dynamic movements,the Sahrmann core stability test provides an assessment of cor...BACKGROUND Pain in the back or pelvis or fear of back pain may affect the timing or cocontraction of the core muscles.In both static and dynamic movements,the Sahrmann core stability test provides an assessment of core muscle activation and a person's ability to stabilize the lumbopelvic complex.Preparatory cues and images can be used to increase the activation of these muscles.To attain optimal movement patterns,it will be necessary to determine what cueing will give the most effective results for core stability.AIM To investigate the effects of external and internal cues on core muscle activation during the Sahrmann five-level core stability test.METHODS Total 68 participants(21.83±3.47 years)were randomly allocated to an external(n=35)or internal cue group(n=33).Participants performed the Sahrmann fivelevel core stability test without a cue as baseline and the five-level stability exercises with an internal or external cue.External cue group received a pressure biofeedback unit(PBU),and the internal cue group received an audio cue.A Delsys Trigno^(TM)surface electromyography unit was used for muscle activation from the rectus abdominis,external oblique,and transverse abdominis/internal oblique muscles.RESULTS Linear mixed effects model analysis showed that cueing had a significant effect on core muscle activation(P=0.001);however,there was no significant difference between cue types(internal or external)(P=0.130).CONCLUSION Both external and internal cueing have significant effects on core muscle activation during the Sahrmann five-level core stability test and the PBU does not create higher muscle activation than internal cueing.展开更多
Since the mid-20th century,the Mongolian Plateau(MP)has experienced decadal droughts coupled with extreme heatwaves,severely affecting regional ecology and social development.However,the mechanisms behind these decada...Since the mid-20th century,the Mongolian Plateau(MP)has experienced decadal droughts coupled with extreme heatwaves,severely affecting regional ecology and social development.However,the mechanisms behind these decadalscale compound heatwavedrought events remain debated.Here,using reconstructions and simulations from the Community Earth System Model Last Millennium Ensemble,we demonstrate that,over the last millennium,decadal droughts on the MP occurred under both warm and cold conditions,differing from recent compound heatwavedrought events.We found that by examining temperature changes during these drought periods,the distinct influences of external forcings and internal variability can be simply and effectively distinguished.Specifically,colddry events were primarily driven by volcanic eruptions that weakened the East Asian summer monsoon and midlatitude westerlies,reducing moisture transport to the MP.In contrast,warmdry events were predominantly induced by internal variability,notably the negative phase of the Atlantic Multidecadal Oscillation and the expansion of the Barents Sea ice extent.The recent extreme compound event was probably influenced by the combined effects of anthropogenic forcings and internal variability.These findings deepen our understanding of how external forcings and internal variability affect decadal drought events on the MP and highlight that recent compound events are unprecedented in the context of the last millennium.展开更多
BACKGROUND Postoperative pancreatic fistula(POPF)is the most frequent cause of morbimortality after pancreaticoduodenectomy,but the best technique to use to prevent its development is unclear.The choice of drainage me...BACKGROUND Postoperative pancreatic fistula(POPF)is the most frequent cause of morbimortality after pancreaticoduodenectomy,but the best technique to use to prevent its development is unclear.The choice of drainage method external duct stent(EDS),internal duct stent(IDS),or non-ductal stent(NDS)is also controversial.AIM To compare the three groups(EDS,IDS and NDS),analyzing the patient characteristics,perioperative examinations and survival.METHODS Patients who underwent pancreaticoduodenectomy and pancreaticojejunostomy between 2012 and 2020,were divided into the EDS,IDS and NDS groups.RESULTS Of the 244 patients included,129 were in the EDS group,71 in the IDS group,and 44 in the NDS group.Except for preoperative pancreatitis in the NDS patients,comorbidities were similar among the groups.Patients in the NDS group had a high caliber of the Wirsung duct and frequently presented with a hard pancreas(P<0.001).A lower rate of grade C POPF was observed in the EDS(1.6%)compared to the NDS(9.1%)and IDS group(14.1%)(P=0.009).The groups showed similar findings for delayed gastric emptying,postoperative hemorrhage,reoperation,and 5-year survivals.Ninety-day mortality rate was significantly higher in the IDS group(5.6%)compared to the EDS(1.6%)and NDS(4.5%)groups(P=0.046).Multivariate analysis showed that the use of EDS was a protective factor for grade B/C POPF(P=0.034),and 90-day mortality(P=0.018).Additionally,a Wirsung duct diameter<3 mm was the only risk factor for grade B/C POPF(P=0.001),and 90-day mortality(P=0.031).CONCLUSION The use of the EDS was a protective factor for grade B/C POPF and 90-day mortality,and the Wirsung duct<3 mm was a risk factor for grade B/C POPF and 90-day mortality.展开更多
OBJECTIVE:To explore the relationship between colorectal polyps and pulmonary nodules from the perspective of the lung and the large intestine being internally and externally connected,aiming to provide a theoretical ...OBJECTIVE:To explore the relationship between colorectal polyps and pulmonary nodules from the perspective of the lung and the large intestine being internally and externally connected,aiming to provide a theoretical basis for clinical diagnosis and treatment.METHODS:We retrospectively analyzed the data of patients who underwent electronic colonoscopy and were found to have colorectal polyps at the Gastrointestinal Endoscopy Center of Dongfang Hospital,Beijing University of Chinese Medicine,from January 1,2017,to December 31,2023.We also reviewed their lung CT results and used statistical software to analyze the recurrence,location,size,and pathology of colorectal polyps in relation to the presence,number,and size of pulmonary nodules.RESULTS:Both colorectal polyps and pulmonary nodules are more common in elderly males.Patients with recurrent colorectal polyps are more likely to have pulmonary nodules,which tend to be located in the left colon and are more likely to be adenomatous in nature;those without pulmonary nodules show no clear pattern in polyp distribution,with a tendency towards inflammatory and hyperplastic pathology;the data from this study suggests that the proportion of lung nodules larger than 0.5 cm in the recurrent group is higher than in the non-recurrent group,and the proportion of colorectal polyps larger than 1 cm in the recurrent group is also higher than in the non-recurrent group.CONCLUSION:There is a certain connection between the pathogenesis and treatment of colorectal polyps and pulmonary nodules.Cold,phlegm,dampness,blood stasis,and toxic coagulation are common pathogenic factors of the two diseases.Patients with larger colorectal polyps should be advised to undergo regular colonoscopy.Patients with recurrent polyps or those with left colon necrosis or cancer indicated by colonoscopy should be advised to complete lung related examinations to rule out the possibility of pulmonary nodules.展开更多
Artificial Intelligence(AI),as a strategic technology leading the new round of scientific and technological revolution and industrial transformation,is reshaping the global power dynamics.Major countries are accelerat...Artificial Intelligence(AI),as a strategic technology leading the new round of scientific and technological revolution and industrial transformation,is reshaping the global power dynamics.Major countries are accelerating their strategic deployment around technological innovation,standard-setting,and rule-building,making technology increasingly intertwined with geopolitics.Since the U.S.released Preparing for the Future of Artificial Intelligence in 2016,it has integrated AI into its national strategic system and continuously upgraded it,aiming to maintain its dominance in the global competition.Meanwhile,the internal and external tensions of the U.S.AI strategy have become increasingly prominent,profoundly influencing its global strategy and future trajectory.展开更多
Background:Given the heightened risk of developmental challenges associated with preterm birth,it is crucial to explore interventions that may ameliorate potential adverse outcomes.This study aimed to examine whether ...Background:Given the heightened risk of developmental challenges associated with preterm birth,it is crucial to explore interventions that may ameliorate potential adverse outcomes.This study aimed to examine whether meeting the 24-h movement behavior(24-HMB)guidelines,which include recommendations on physical activity(PA),screen time(ST),and sleep(SL),is related to indicators of cognitive difficulties,internalizing problems(e.g.,depression and anxiety),and externalizing problems(e.g.,difficulties in making friends and arguing)in a sample of preterm youth(children and adolescents born preterm).Methods:In this cross-sectional study,data from 3410 preterm youth(aged 6 to 17 years)were included for data analyses.Multivariable logistic regression was used to investigate associations between meeting the 24-HMB guidelines and the above-mentioned health outcomes,while controlling for sociodemographic and health-related factors.Results:The prevalence of meeting 24-HMB guidelines varied across independent and integrated components of the 24-HMB guidelines.Meeting the ST guideline alone(p<0.05)and integrated guidelines(i.e.,ST+SL and ST+SL+PA)were associated with fewer cognitive difficulties and reduced internalizing and externalizing problems(p<0.05).Specifically,meeting the SL guideline alone and integrated guidelines(i.e.,SL+ST)were associated with lower odds of depression and anxiety(p<0.01).Additionally,meeting independent,and integrated(PA and/or ST)guidelines were associated with less pronounced difficulties in making friends and arguing(p<0.05).Meeting 24-HMB guidelines in an isolated and integrated manner are linked to better cognitive performance and fewer internalizing and externalizing problems in preterm youth.Conclusion:Results suggest that advocating for the implementation of the 24-HMB guidelines may reduce cognitive challenges and behavioral issues,which is of high relevance for improving public health.Future longitudinal studies in preterm youth should investigate how modifying specific 24-HMB behaviors,especially ST,influence cognitive difficulties,internalizing and externalizing problems in this vulnerable population.展开更多
School-based universal screening for behavioral/emotional risk is a necessary first step to providing services in an educational setting for students with emotional and behavioral disorders (EBDs). Psychometric proper...School-based universal screening for behavioral/emotional risk is a necessary first step to providing services in an educational setting for students with emotional and behavioral disorders (EBDs). Psychometric properties are critical to making decisions about choosing a screening instrument. The purpose of the present study was to examine the psychometric properties of the student risk screening scale for internalizing and externalizing behaviors (SRSS-IE). Participants included 3145 students and their teachers. Item-level analyses of the current sample supported the retention of all items. The internal consistency of the SRSS items ranged from 0.83 to 0.85. Convergent validity between the SRSS-IE and a well-established screening tool, the strength and difficulties questionnaire (SDQ), was found for the total score (r = 0.70). Additionally, the results of this study demonstrate strong social validity, suggesting the SRSS-IE to be a useful and functional screening tool. We conclude that the SRSS-IE is a valid and reliable instrument for assessing the level of emotional and behavioral difficulties among elementary students.展开更多
BACKGROUND Internal hernia(IH)is a rare culprit of small bowel obstruction(SBO)with an incidence of<1%.It poses a considerable diagnostic challenge requiring a high index of suspicion to prevent misdiagnosis,improp...BACKGROUND Internal hernia(IH)is a rare culprit of small bowel obstruction(SBO)with an incidence of<1%.It poses a considerable diagnostic challenge requiring a high index of suspicion to prevent misdiagnosis,improper treatment,and subsequent morbidity and mortality.AIM To determine the clinico-demographic profile,radiological and operative findings,and postoperative course of patients with IH and its association with SBO.METHODS Medical records of 586 patients with features of SBO presenting at a tertiary care centre at Lucknow,India between September 2010 and August 2023 were reviewed.RESULTS Out of 586 patients,7(1.2%)were diagnosed with IH.Among these,4 had congenital IH and 3 had acquired IH.The male-to-female ratio was 4:3.The median age at presentation was 32 years.Contrast-enhanced computed tomography(CECT)was the most reliable investigation for preoperative identification,demonstrating mesenteric whirling and clumped-up bowel loops.Left paraduodenal hernia and transmesenteric hernia occurred with an equal frequency(approximately 43%each).Intraoperatively,one patient was found to have bowel ischemia and one had associated malrotation of gut.During follow-up,no recurrences were reported.CONCLUSION IH,being a rare cause,must be considered as a differential diagnosis for SBO,especially in young patients in their 30s or with unexplained abdominal pain or discomfort post-surgery.A rapid imaging evaluation,preferably with CECT,is necessary to aid in an early diagnosis and prompt intervention,thereby reducing financial burden related to unnecessary investigations and preventing the morbidity and mortality associated with closed-loop obstruction and strangulation of the bowel.展开更多
High pressure die casting(HPDC)AlSi10Mn Mg alloy castings are widely used in the automobile industry.Mg can optimize the mechanical properties of castings through heat treatment,while the release of thermal stress aro...High pressure die casting(HPDC)AlSi10Mn Mg alloy castings are widely used in the automobile industry.Mg can optimize the mechanical properties of castings through heat treatment,while the release of thermal stress arouses the deformation of large integrated die-castings.Herein,the development of non-heat treatment Al alloys is becoming the hot topic.In addition,HPDC contains externally solidified crystals(ESCs),which are detrimental to the mechanical properties of castings.To achieve high strength and toughness of non-heat treatment die-casting Al-Si alloy,we used AlSi9Mn alloy as matrix with the introduction of Zr,Ti,Nb,and Ce.Their influences on ESCs and mechanical properties were systematically investigated through three-dimensional reconstruction and thermodynamic simulation.Our results reveal that the addition of Ti increased ESCs'size and porosity,while the introduction of Nb refined ESCs and decreased porosity.Meanwhile,large-sized Al_3(Zr,Ti)phases formed and degraded the mechanical properties.Subsequent introduction of Ce resulted in the poisoning effect and reduced mechanical properties.展开更多
The paper presents experimental investigation results of crack pattern change in cement pastes caused by external sulfate attack(ESA).To visualize the formation and development of cracks in cement pastes under ESA,an ...The paper presents experimental investigation results of crack pattern change in cement pastes caused by external sulfate attack(ESA).To visualize the formation and development of cracks in cement pastes under ESA,an X-ray computed tomography(X-ray CT)was used,i e,the tomography system of Zeiss Xradia 510 versa.The results indicate that X-CT can monitor the development process and distribution characteristics of the internal cracks of cement pastes under ESA with attack time.In addition,the C3A content in the cement significantly affects the damage mode of cement paste specimens during sulfate erosion.The damage of ordinary Portland cement(OPC)pastes subjected to sulfate attack with high C3A content are severe,while the damage of sulfate resistant Portland cement(SRPC)pastes is much smaller than that of OPC pastes.Furthermore,a quadratic function describes the correlation between the crack volume fraction and development depth for two cement pastes immermed in sulfate solution.展开更多
An internal state variable(ISV)model was established according to the experimental results of hot plane strain compression(PSC)to predict the microstructure evolution during hot spinning of ZK61 alloy.The effects of t...An internal state variable(ISV)model was established according to the experimental results of hot plane strain compression(PSC)to predict the microstructure evolution during hot spinning of ZK61 alloy.The effects of the internal variables were considered in this ISV model,and the parameters were optimized by genetic algorithm.After validation,the ISV model was used to simulate the evolution of grain size(GS)and dynamic recrystallization(DRX)fraction during hot spinning via Abaqus and its subroutine Vumat.By comparing the simulated results with the experimental results,the application of the ISV model was proven to be reliable.Meanwhile,the strength of the thin-walled spun ZK61 tube increased from 303 to 334 MPa due to grain refinement by DRX and texture strengthening.Besides,some ultrafine grains(0.5μm)that played an important role in mechanical properties were formed due to the proliferation,movement,and entanglement of dislocations during the spinning process.展开更多
Internal learning-based video inpainting methods have shown promising results by exploiting the intrinsic properties of the video to fill in the missing region without external dataset supervision.However,existing int...Internal learning-based video inpainting methods have shown promising results by exploiting the intrinsic properties of the video to fill in the missing region without external dataset supervision.However,existing internal learning-based video inpainting methods would produce inconsistent structures or blurry textures due to the insufficient utilisation of motion priors within the video sequence.In this paper,the authors propose a new internal learning-based video inpainting model called appearance consistency and motion coherence network(ACMC-Net),which can not only learn the recurrence of appearance prior but can also capture motion coherence prior to improve the quality of the inpainting results.In ACMC-Net,a transformer-based appearance network is developed to capture global context information within the video frame for representing appearance consistency accurately.Additionally,a novel motion coherence learning scheme is proposed to learn the motion prior in a video sequence effectively.Finally,the learnt internal appearance consistency and motion coherence are implicitly propagated to the missing regions to achieve inpainting well.Extensive experiments conducted on the DAVIS dataset show that the proposed model obtains the superior performance in terms of quantitative measurements and produces more visually plausible results compared with the state-of-the-art methods.展开更多
Using real fields instead of complex ones, it was recently claimed, that all fermions are made of pairs of coupled fields (strings) with an internal tension related to mutual attraction forces, related to Planck’s co...Using real fields instead of complex ones, it was recently claimed, that all fermions are made of pairs of coupled fields (strings) with an internal tension related to mutual attraction forces, related to Planck’s constant. The solution to Dirac equation gives four, real, 2-vectors solutions ψ1=(U1D1)ψ2=(U2D2)ψ3=(U3D3)ψ4=(U4D4)where (ψ1,ψ4) are coupled via linear combinations to yield spin-up and spin-down fermions. Likewise, (ψ2,ψ3) are coupled via linear combinations to represent spin-up and spin-down anti-fermions. Here, a deeper investigation of the free fermion internal frequency is discussed, hinting to an exchange interaction between the two components of which a fermion is made of. An upper limit estimate is given to the strength of this interaction.展开更多
This study explores whether the current external quality assessment(EQA)level and acceptable bias for basic semen analysis in China are clinically useful.We collected data of semen EQA from Andrology laboratories in t...This study explores whether the current external quality assessment(EQA)level and acceptable bias for basic semen analysis in China are clinically useful.We collected data of semen EQA from Andrology laboratories in the Hunan Province(China)in 2022 and searched for data in the published literature from January2000 to December 2023 in China.On the basis of these data,we analyzed the coefficients of variation and acceptable biases of different quality control materials for basic semen analysis through robust statistics.We compared these findings with quality specifications based on biological variation from optimal,desirable,and minimum levels of bias to seek a unified and more suitable semen EQAbias evaluation standard for China's national conditions.Different sources of semen quality control material exhibited considerable variation in acceptable biases among laboratories,ranging from 8.2%to 56.9%.A total of 50.0% of the laboratories met the minimum quality specifications for progressive motility(PR),whereas 100.0%and 75.0%of laboratories met only the minimum quality specifications for sperm concentration and total motility(nonprogressive[NP]+PR),respectively.The Z value for sperm concentration and PR+NP was equivalent to the desirable performance specification,whereas the Z value for PR was equivalent only to the minimum performance specification.This study highlights the feasibility of operating external quality assessment schemes for basic semen analysis using quality specifications based on biological variation.These specifications should be unified among external quality control(EQC)centers based on biological variation.展开更多
Dear Editor,We aimed to describe the management of the intraoperative injury of the right external iliac artery that occurred during robot-assisted right nephroureterectomy with bladder cuff excision.Surgery was sched...Dear Editor,We aimed to describe the management of the intraoperative injury of the right external iliac artery that occurred during robot-assisted right nephroureterectomy with bladder cuff excision.Surgery was scheduled for suspected urothelial carcinoma of the distal ureter in a 60-year-old woman.The patient involved in the present research signed a dedicated form to consent to the publication of images and/or information about her.Past medical history included Brugada syndrome diagnosed in 2015,and hypercholesterolemia.Past surgical history included one cesarean section only.Family history included ovarian cancer(sister),colorectal cancer(mother),and kidney cancer(father).展开更多
Obesity is a common chronic metabolic disease affecting populations in multiple countries and regions worldwide.Traditional Chinese medicine(TCM)external treatments have garnered increasing attention due to their uniq...Obesity is a common chronic metabolic disease affecting populations in multiple countries and regions worldwide.Traditional Chinese medicine(TCM)external treatments have garnered increasing attention due to their unique therapeutic advantages,such as simplicity of operation,proven efficacy,and minimal side effects.In recent years,research on the application of TCM external treatments in obesity treatment has deepened,involving various methods such as acupuncture,tuina(massage),acupoint catgut embedding,and acupoint herbal patching.This article reviews relevant studies to provide new insights for enhancing clinical efficacy and safety.展开更多
In clinical environments,the prolonged utilization of polarization equipment can result in theaccumulation of errors over extended periods.The absence of expeditious calibration techniques in clinical practice present...In clinical environments,the prolonged utilization of polarization equipment can result in theaccumulation of errors over extended periods.The absence of expeditious calibration techniques in clinical practice presents a significant obstacle in preserving the precision and dependability of these instruments.To address this challenge,we propose an innovative research study that presents a comprebersive calibration system specifically designed for the calibration of the backscattering Muellet matrix measurement system,enabling swift online calibration acroes various scenarios.This system employs an external calibration framework for rmal-time adjust-ment of the polarizer's initial angle,oversecing the rotation of PSG and PSA motors through position measurement and control procedures,with light intensity monitored by a camera.By incorporating moment um concepts and the Adam optimization algorithm,we enhance conver-gence speed,mitigate noise,and improve calibration accuracy.Experimental results showcase the exceptional precision,speed,and robustness of oрroposed method,achieving high acсuracy and minimal error,thereby offering a promising solution for maintaining the reliabilit y of polarization equipment in clinical settings.展开更多
The metamaterial based on external meshing gears(MEG)is designed based on the principle of external meshing gear transmission.Based on the meshing transmission principle of external meshing gears and planetary gear tr...The metamaterial based on external meshing gears(MEG)is designed based on the principle of external meshing gear transmission.Based on the meshing transmission principle of external meshing gears and planetary gear trains,the internal and external gear rings are designed.Based on the internal and external gear rings,the metamaterial based on inner and outer planetary gear trains(MIP)is designed to study the shear modulus,Young's modulus,and amplitude-frequency characteristics of the metamaterial based on gears at different angles.The effects of the number of planetary gears on the physical characteristics of the MIP are studied.The results show that the MEG can be continuously adjusted by adjusting the shear modulus and Young's modulus due to its meshing characteristics.With the same number of gears,the adjustment range of the MIP is larger than the adjustment range of the MEG.When the number of planetary gears increases,the adjustment range of the MIP decreases.Moreover,when the metamaterial based on gears rotates,the harmonic response changes with the change of the angle.展开更多
Basic life support for cardiac arrest associates cardiopulmonary resuscitation(CPR)and defibrillation.CPR relies on chest compressions(CC)and ventilation.Current guidelines on CPR recommend a depth of 5-6 cm at a rhyt...Basic life support for cardiac arrest associates cardiopulmonary resuscitation(CPR)and defibrillation.CPR relies on chest compressions(CC)and ventilation.Current guidelines on CPR recommend a depth of 5-6 cm at a rhythm of 100-120 times/min for CC.[1,2]Interruptions of the CC must be as short as possible and are related to ventilation,defibrillation and turnover of the rescuers.Most of the automated external defibrillators(AEDs)require interruptions of the CC to perform rhythm analysis.Among the numerous marketed models of AEDs,some provide real-time feedback about the quality of the CC.展开更多
The authors(Cai et al.,2022)claim that their proposed machine learning(ML)models,which are based on three typical ML algorithms and are trained to predict the burst capacity of pitting corroded pipelines,perform bette...The authors(Cai et al.,2022)claim that their proposed machine learning(ML)models,which are based on three typical ML algorithms and are trained to predict the burst capacity of pitting corroded pipelines,perform better than the existing semi-empirical formulas recommended by the international engineering code developers,DNV and ASME.The authors’assessments of the semi-empiri‐cal burst capacity formulas in Figure 10(a)and Table 8(Cai et al.,2022)incorrectly indicate that DNVGL-RP F101,ASME B31G,and modified ASME B31G are dan‐gerously unsafe due to significantly overestimating burst pressures in several cases.In contrast to the results and conclusions in Cai et al.展开更多
文摘BACKGROUND Pain in the back or pelvis or fear of back pain may affect the timing or cocontraction of the core muscles.In both static and dynamic movements,the Sahrmann core stability test provides an assessment of core muscle activation and a person's ability to stabilize the lumbopelvic complex.Preparatory cues and images can be used to increase the activation of these muscles.To attain optimal movement patterns,it will be necessary to determine what cueing will give the most effective results for core stability.AIM To investigate the effects of external and internal cues on core muscle activation during the Sahrmann five-level core stability test.METHODS Total 68 participants(21.83±3.47 years)were randomly allocated to an external(n=35)or internal cue group(n=33).Participants performed the Sahrmann fivelevel core stability test without a cue as baseline and the five-level stability exercises with an internal or external cue.External cue group received a pressure biofeedback unit(PBU),and the internal cue group received an audio cue.A Delsys Trigno^(TM)surface electromyography unit was used for muscle activation from the rectus abdominis,external oblique,and transverse abdominis/internal oblique muscles.RESULTS Linear mixed effects model analysis showed that cueing had a significant effect on core muscle activation(P=0.001);however,there was no significant difference between cue types(internal or external)(P=0.130).CONCLUSION Both external and internal cueing have significant effects on core muscle activation during the Sahrmann five-level core stability test and the PBU does not create higher muscle activation than internal cueing.
基金supported by the National Natural Science Foundation of China(Grant Nos.42130604)the National Key Research and Development Program of China(Grant No.2023YFF0804704)+2 种基金the National Natural Science Foundation of China(Grant Nos.42105044)Swedish STINT(Grant No.CH2019-8377)the Priority Academic Program Development of Jiangsu Higher Education Institutions(Grant No.164320H116)。
文摘Since the mid-20th century,the Mongolian Plateau(MP)has experienced decadal droughts coupled with extreme heatwaves,severely affecting regional ecology and social development.However,the mechanisms behind these decadalscale compound heatwavedrought events remain debated.Here,using reconstructions and simulations from the Community Earth System Model Last Millennium Ensemble,we demonstrate that,over the last millennium,decadal droughts on the MP occurred under both warm and cold conditions,differing from recent compound heatwavedrought events.We found that by examining temperature changes during these drought periods,the distinct influences of external forcings and internal variability can be simply and effectively distinguished.Specifically,colddry events were primarily driven by volcanic eruptions that weakened the East Asian summer monsoon and midlatitude westerlies,reducing moisture transport to the MP.In contrast,warmdry events were predominantly induced by internal variability,notably the negative phase of the Atlantic Multidecadal Oscillation and the expansion of the Barents Sea ice extent.The recent extreme compound event was probably influenced by the combined effects of anthropogenic forcings and internal variability.These findings deepen our understanding of how external forcings and internal variability affect decadal drought events on the MP and highlight that recent compound events are unprecedented in the context of the last millennium.
文摘BACKGROUND Postoperative pancreatic fistula(POPF)is the most frequent cause of morbimortality after pancreaticoduodenectomy,but the best technique to use to prevent its development is unclear.The choice of drainage method external duct stent(EDS),internal duct stent(IDS),or non-ductal stent(NDS)is also controversial.AIM To compare the three groups(EDS,IDS and NDS),analyzing the patient characteristics,perioperative examinations and survival.METHODS Patients who underwent pancreaticoduodenectomy and pancreaticojejunostomy between 2012 and 2020,were divided into the EDS,IDS and NDS groups.RESULTS Of the 244 patients included,129 were in the EDS group,71 in the IDS group,and 44 in the NDS group.Except for preoperative pancreatitis in the NDS patients,comorbidities were similar among the groups.Patients in the NDS group had a high caliber of the Wirsung duct and frequently presented with a hard pancreas(P<0.001).A lower rate of grade C POPF was observed in the EDS(1.6%)compared to the NDS(9.1%)and IDS group(14.1%)(P=0.009).The groups showed similar findings for delayed gastric emptying,postoperative hemorrhage,reoperation,and 5-year survivals.Ninety-day mortality rate was significantly higher in the IDS group(5.6%)compared to the EDS(1.6%)and NDS(4.5%)groups(P=0.046).Multivariate analysis showed that the use of EDS was a protective factor for grade B/C POPF(P=0.034),and 90-day mortality(P=0.018).Additionally,a Wirsung duct diameter<3 mm was the only risk factor for grade B/C POPF(P=0.001),and 90-day mortality(P=0.031).CONCLUSION The use of the EDS was a protective factor for grade B/C POPF and 90-day mortality,and the Wirsung duct<3 mm was a risk factor for grade B/C POPF and 90-day mortality.
基金Beijing Natural Science Foundation:Research on the Mechanism of Chaiqi Decoction in Improving Vascular Endothelial Injury in Metabolic Syndrome by Regulating Pyroptosis via miR-21(No.7212181)。
文摘OBJECTIVE:To explore the relationship between colorectal polyps and pulmonary nodules from the perspective of the lung and the large intestine being internally and externally connected,aiming to provide a theoretical basis for clinical diagnosis and treatment.METHODS:We retrospectively analyzed the data of patients who underwent electronic colonoscopy and were found to have colorectal polyps at the Gastrointestinal Endoscopy Center of Dongfang Hospital,Beijing University of Chinese Medicine,from January 1,2017,to December 31,2023.We also reviewed their lung CT results and used statistical software to analyze the recurrence,location,size,and pathology of colorectal polyps in relation to the presence,number,and size of pulmonary nodules.RESULTS:Both colorectal polyps and pulmonary nodules are more common in elderly males.Patients with recurrent colorectal polyps are more likely to have pulmonary nodules,which tend to be located in the left colon and are more likely to be adenomatous in nature;those without pulmonary nodules show no clear pattern in polyp distribution,with a tendency towards inflammatory and hyperplastic pathology;the data from this study suggests that the proportion of lung nodules larger than 0.5 cm in the recurrent group is higher than in the non-recurrent group,and the proportion of colorectal polyps larger than 1 cm in the recurrent group is also higher than in the non-recurrent group.CONCLUSION:There is a certain connection between the pathogenesis and treatment of colorectal polyps and pulmonary nodules.Cold,phlegm,dampness,blood stasis,and toxic coagulation are common pathogenic factors of the two diseases.Patients with larger colorectal polyps should be advised to undergo regular colonoscopy.Patients with recurrent polyps or those with left colon necrosis or cancer indicated by colonoscopy should be advised to complete lung related examinations to rule out the possibility of pulmonary nodules.
文摘Artificial Intelligence(AI),as a strategic technology leading the new round of scientific and technological revolution and industrial transformation,is reshaping the global power dynamics.Major countries are accelerating their strategic deployment around technological innovation,standard-setting,and rule-building,making technology increasingly intertwined with geopolitics.Since the U.S.released Preparing for the Future of Artificial Intelligence in 2016,it has integrated AI into its national strategic system and continuously upgraded it,aiming to maintain its dominance in the global competition.Meanwhile,the internal and external tensions of the U.S.AI strategy have become increasingly prominent,profoundly influencing its global strategy and future trajectory.
基金supported by the Shenzhen Educational Research Funding(Grant No.zdzb2014)the Shenzhen Science and Technology Innovation Commission(Grant No.202307313000096)+3 种基金the Social Science Foundation from China’s Ministry of Education(Grant No.23YJA880093)a Post-Doctoral Fellowship(Grant No.2022M711174)the National Center for Mental Health(Grant No.Z014)a Research Excellence Scholarship of Shenzhen University(Grant No.ZYZD2305).
文摘Background:Given the heightened risk of developmental challenges associated with preterm birth,it is crucial to explore interventions that may ameliorate potential adverse outcomes.This study aimed to examine whether meeting the 24-h movement behavior(24-HMB)guidelines,which include recommendations on physical activity(PA),screen time(ST),and sleep(SL),is related to indicators of cognitive difficulties,internalizing problems(e.g.,depression and anxiety),and externalizing problems(e.g.,difficulties in making friends and arguing)in a sample of preterm youth(children and adolescents born preterm).Methods:In this cross-sectional study,data from 3410 preterm youth(aged 6 to 17 years)were included for data analyses.Multivariable logistic regression was used to investigate associations between meeting the 24-HMB guidelines and the above-mentioned health outcomes,while controlling for sociodemographic and health-related factors.Results:The prevalence of meeting 24-HMB guidelines varied across independent and integrated components of the 24-HMB guidelines.Meeting the ST guideline alone(p<0.05)and integrated guidelines(i.e.,ST+SL and ST+SL+PA)were associated with fewer cognitive difficulties and reduced internalizing and externalizing problems(p<0.05).Specifically,meeting the SL guideline alone and integrated guidelines(i.e.,SL+ST)were associated with lower odds of depression and anxiety(p<0.01).Additionally,meeting independent,and integrated(PA and/or ST)guidelines were associated with less pronounced difficulties in making friends and arguing(p<0.05).Meeting 24-HMB guidelines in an isolated and integrated manner are linked to better cognitive performance and fewer internalizing and externalizing problems in preterm youth.Conclusion:Results suggest that advocating for the implementation of the 24-HMB guidelines may reduce cognitive challenges and behavioral issues,which is of high relevance for improving public health.Future longitudinal studies in preterm youth should investigate how modifying specific 24-HMB behaviors,especially ST,influence cognitive difficulties,internalizing and externalizing problems in this vulnerable population.
文摘School-based universal screening for behavioral/emotional risk is a necessary first step to providing services in an educational setting for students with emotional and behavioral disorders (EBDs). Psychometric properties are critical to making decisions about choosing a screening instrument. The purpose of the present study was to examine the psychometric properties of the student risk screening scale for internalizing and externalizing behaviors (SRSS-IE). Participants included 3145 students and their teachers. Item-level analyses of the current sample supported the retention of all items. The internal consistency of the SRSS items ranged from 0.83 to 0.85. Convergent validity between the SRSS-IE and a well-established screening tool, the strength and difficulties questionnaire (SDQ), was found for the total score (r = 0.70). Additionally, the results of this study demonstrate strong social validity, suggesting the SRSS-IE to be a useful and functional screening tool. We conclude that the SRSS-IE is a valid and reliable instrument for assessing the level of emotional and behavioral difficulties among elementary students.
文摘BACKGROUND Internal hernia(IH)is a rare culprit of small bowel obstruction(SBO)with an incidence of<1%.It poses a considerable diagnostic challenge requiring a high index of suspicion to prevent misdiagnosis,improper treatment,and subsequent morbidity and mortality.AIM To determine the clinico-demographic profile,radiological and operative findings,and postoperative course of patients with IH and its association with SBO.METHODS Medical records of 586 patients with features of SBO presenting at a tertiary care centre at Lucknow,India between September 2010 and August 2023 were reviewed.RESULTS Out of 586 patients,7(1.2%)were diagnosed with IH.Among these,4 had congenital IH and 3 had acquired IH.The male-to-female ratio was 4:3.The median age at presentation was 32 years.Contrast-enhanced computed tomography(CECT)was the most reliable investigation for preoperative identification,demonstrating mesenteric whirling and clumped-up bowel loops.Left paraduodenal hernia and transmesenteric hernia occurred with an equal frequency(approximately 43%each).Intraoperatively,one patient was found to have bowel ischemia and one had associated malrotation of gut.During follow-up,no recurrences were reported.CONCLUSION IH,being a rare cause,must be considered as a differential diagnosis for SBO,especially in young patients in their 30s or with unexplained abdominal pain or discomfort post-surgery.A rapid imaging evaluation,preferably with CECT,is necessary to aid in an early diagnosis and prompt intervention,thereby reducing financial burden related to unnecessary investigations and preventing the morbidity and mortality associated with closed-loop obstruction and strangulation of the bowel.
基金financially supported by the National Natural Science Foundation of China(Nos.52175284 and 52474396)the National Key Research and Development Program of China(No.2022YFB3404201)。
文摘High pressure die casting(HPDC)AlSi10Mn Mg alloy castings are widely used in the automobile industry.Mg can optimize the mechanical properties of castings through heat treatment,while the release of thermal stress arouses the deformation of large integrated die-castings.Herein,the development of non-heat treatment Al alloys is becoming the hot topic.In addition,HPDC contains externally solidified crystals(ESCs),which are detrimental to the mechanical properties of castings.To achieve high strength and toughness of non-heat treatment die-casting Al-Si alloy,we used AlSi9Mn alloy as matrix with the introduction of Zr,Ti,Nb,and Ce.Their influences on ESCs and mechanical properties were systematically investigated through three-dimensional reconstruction and thermodynamic simulation.Our results reveal that the addition of Ti increased ESCs'size and porosity,while the introduction of Nb refined ESCs and decreased porosity.Meanwhile,large-sized Al_3(Zr,Ti)phases formed and degraded the mechanical properties.Subsequent introduction of Ce resulted in the poisoning effect and reduced mechanical properties.
基金Funded by Chinese National Natural Science Foundation of China(No.U2006224)。
文摘The paper presents experimental investigation results of crack pattern change in cement pastes caused by external sulfate attack(ESA).To visualize the formation and development of cracks in cement pastes under ESA,an X-ray computed tomography(X-ray CT)was used,i e,the tomography system of Zeiss Xradia 510 versa.The results indicate that X-CT can monitor the development process and distribution characteristics of the internal cracks of cement pastes under ESA with attack time.In addition,the C3A content in the cement significantly affects the damage mode of cement paste specimens during sulfate erosion.The damage of ordinary Portland cement(OPC)pastes subjected to sulfate attack with high C3A content are severe,while the damage of sulfate resistant Portland cement(SRPC)pastes is much smaller than that of OPC pastes.Furthermore,a quadratic function describes the correlation between the crack volume fraction and development depth for two cement pastes immermed in sulfate solution.
基金supported by the National Natural Science Foundation of China(No.51905123)Major Scientific and Technological Innovation Program of Shandong Province,China(Nos.2020CXGC010303,2022ZLGX04)Key R&D Programme of Shandong Province,China(No.2022JMRH0308).
文摘An internal state variable(ISV)model was established according to the experimental results of hot plane strain compression(PSC)to predict the microstructure evolution during hot spinning of ZK61 alloy.The effects of the internal variables were considered in this ISV model,and the parameters were optimized by genetic algorithm.After validation,the ISV model was used to simulate the evolution of grain size(GS)and dynamic recrystallization(DRX)fraction during hot spinning via Abaqus and its subroutine Vumat.By comparing the simulated results with the experimental results,the application of the ISV model was proven to be reliable.Meanwhile,the strength of the thin-walled spun ZK61 tube increased from 303 to 334 MPa due to grain refinement by DRX and texture strengthening.Besides,some ultrafine grains(0.5μm)that played an important role in mechanical properties were formed due to the proliferation,movement,and entanglement of dislocations during the spinning process.
基金Shenzhen Science and Technology Programme,Grant/Award Number:JCYJ202308071208000012023 Shenzhen sustainable supporting funds for colleges and universities,Grant/Award Number:20231121165240001Guangdong Provincial Key Laboratory of Ultra High Definition Immersive Media Technology,Grant/Award Number:2024B1212010006。
文摘Internal learning-based video inpainting methods have shown promising results by exploiting the intrinsic properties of the video to fill in the missing region without external dataset supervision.However,existing internal learning-based video inpainting methods would produce inconsistent structures or blurry textures due to the insufficient utilisation of motion priors within the video sequence.In this paper,the authors propose a new internal learning-based video inpainting model called appearance consistency and motion coherence network(ACMC-Net),which can not only learn the recurrence of appearance prior but can also capture motion coherence prior to improve the quality of the inpainting results.In ACMC-Net,a transformer-based appearance network is developed to capture global context information within the video frame for representing appearance consistency accurately.Additionally,a novel motion coherence learning scheme is proposed to learn the motion prior in a video sequence effectively.Finally,the learnt internal appearance consistency and motion coherence are implicitly propagated to the missing regions to achieve inpainting well.Extensive experiments conducted on the DAVIS dataset show that the proposed model obtains the superior performance in terms of quantitative measurements and produces more visually plausible results compared with the state-of-the-art methods.
文摘Using real fields instead of complex ones, it was recently claimed, that all fermions are made of pairs of coupled fields (strings) with an internal tension related to mutual attraction forces, related to Planck’s constant. The solution to Dirac equation gives four, real, 2-vectors solutions ψ1=(U1D1)ψ2=(U2D2)ψ3=(U3D3)ψ4=(U4D4)where (ψ1,ψ4) are coupled via linear combinations to yield spin-up and spin-down fermions. Likewise, (ψ2,ψ3) are coupled via linear combinations to represent spin-up and spin-down anti-fermions. Here, a deeper investigation of the free fermion internal frequency is discussed, hinting to an exchange interaction between the two components of which a fermion is made of. An upper limit estimate is given to the strength of this interaction.
基金supported by the Hunan Province Municipal Natural Science Foundation(2022JJ30018)the Hunan Province Health Commission Science Foundation(B202301037899)to WNL。
文摘This study explores whether the current external quality assessment(EQA)level and acceptable bias for basic semen analysis in China are clinically useful.We collected data of semen EQA from Andrology laboratories in the Hunan Province(China)in 2022 and searched for data in the published literature from January2000 to December 2023 in China.On the basis of these data,we analyzed the coefficients of variation and acceptable biases of different quality control materials for basic semen analysis through robust statistics.We compared these findings with quality specifications based on biological variation from optimal,desirable,and minimum levels of bias to seek a unified and more suitable semen EQAbias evaluation standard for China's national conditions.Different sources of semen quality control material exhibited considerable variation in acceptable biases among laboratories,ranging from 8.2%to 56.9%.A total of 50.0% of the laboratories met the minimum quality specifications for progressive motility(PR),whereas 100.0%and 75.0%of laboratories met only the minimum quality specifications for sperm concentration and total motility(nonprogressive[NP]+PR),respectively.The Z value for sperm concentration and PR+NP was equivalent to the desirable performance specification,whereas the Z value for PR was equivalent only to the minimum performance specification.This study highlights the feasibility of operating external quality assessment schemes for basic semen analysis using quality specifications based on biological variation.These specifications should be unified among external quality control(EQC)centers based on biological variation.
文摘Dear Editor,We aimed to describe the management of the intraoperative injury of the right external iliac artery that occurred during robot-assisted right nephroureterectomy with bladder cuff excision.Surgery was scheduled for suspected urothelial carcinoma of the distal ureter in a 60-year-old woman.The patient involved in the present research signed a dedicated form to consent to the publication of images and/or information about her.Past medical history included Brugada syndrome diagnosed in 2015,and hypercholesterolemia.Past surgical history included one cesarean section only.Family history included ovarian cancer(sister),colorectal cancer(mother),and kidney cancer(father).
基金Supported by National Natural Science Foundation of China(82174525)Natural Science Foundation of Jilin Province(YDZJ202301ZYTS469)+1 种基金Science and Technology Research Project of Jilin Provincial Department of Education in 2022(JJKH20230966KJ)2023 Jilin College Student Innovation and Entrepreneurship Training Project(S202310199043).
文摘Obesity is a common chronic metabolic disease affecting populations in multiple countries and regions worldwide.Traditional Chinese medicine(TCM)external treatments have garnered increasing attention due to their unique therapeutic advantages,such as simplicity of operation,proven efficacy,and minimal side effects.In recent years,research on the application of TCM external treatments in obesity treatment has deepened,involving various methods such as acupuncture,tuina(massage),acupoint catgut embedding,and acupoint herbal patching.This article reviews relevant studies to provide new insights for enhancing clinical efficacy and safety.
基金the Knowledge Innovation Program of Basic Re-search Projects of Shenzhen for their support under Grant No.JCYJ20200109142805928the funding provided by the Basic and Applied Basic Research Foundation of Guangdong Provinæunder Grant No.2021A1515220113partially supported by the Guangzhou Municipal Science and Technology Project under Grant 202102010421.
文摘In clinical environments,the prolonged utilization of polarization equipment can result in theaccumulation of errors over extended periods.The absence of expeditious calibration techniques in clinical practice presents a significant obstacle in preserving the precision and dependability of these instruments.To address this challenge,we propose an innovative research study that presents a comprebersive calibration system specifically designed for the calibration of the backscattering Muellet matrix measurement system,enabling swift online calibration acroes various scenarios.This system employs an external calibration framework for rmal-time adjust-ment of the polarizer's initial angle,oversecing the rotation of PSG and PSA motors through position measurement and control procedures,with light intensity monitored by a camera.By incorporating moment um concepts and the Adam optimization algorithm,we enhance conver-gence speed,mitigate noise,and improve calibration accuracy.Experimental results showcase the exceptional precision,speed,and robustness of oрroposed method,achieving high acсuracy and minimal error,thereby offering a promising solution for maintaining the reliabilit y of polarization equipment in clinical settings.
基金supported by the Guangxi Science and Technology Major Program of China(Nos.AA23073019 and AA24263074)the National Natural Science Foundation of China(No.52265004)+7 种基金the Guangxi Natural Science Fund for Distinguished Young Scholars of China(No.2024JJG160014)the Innovation Project of Guangxi Graduate Education of China(No.YCSW2024119)the Open Fund of State Key Laboratory of Intelligent Manufacturing Equipment and Technology of China(No.IMETKF2025021)the Open Research Fund of State Key Laboratory of Precision Manufacturing for Extreme Service Performance-Central South University of China(No.Kfkt2023-06)the Open Fund of High-end Basic Component Innovation Station of China(No.KY01080030124001)the Open Fund for Academician Mao Ming's Workstation of China(No.XSJSFW-QNKXJ-202404-007)the Technology Innovation Platform Project of China Aviation Engine Group Corporation(No.CXPT-2023-044)the Open Fund for Innovation Workstation in the National Defense Science and Technology Innovation Special Zone(Xi'an Jiaotong University).
文摘The metamaterial based on external meshing gears(MEG)is designed based on the principle of external meshing gear transmission.Based on the meshing transmission principle of external meshing gears and planetary gear trains,the internal and external gear rings are designed.Based on the internal and external gear rings,the metamaterial based on inner and outer planetary gear trains(MIP)is designed to study the shear modulus,Young's modulus,and amplitude-frequency characteristics of the metamaterial based on gears at different angles.The effects of the number of planetary gears on the physical characteristics of the MIP are studied.The results show that the MEG can be continuously adjusted by adjusting the shear modulus and Young's modulus due to its meshing characteristics.With the same number of gears,the adjustment range of the MIP is larger than the adjustment range of the MEG.When the number of planetary gears increases,the adjustment range of the MIP decreases.Moreover,when the metamaterial based on gears rotates,the harmonic response changes with the change of the angle.
文摘Basic life support for cardiac arrest associates cardiopulmonary resuscitation(CPR)and defibrillation.CPR relies on chest compressions(CC)and ventilation.Current guidelines on CPR recommend a depth of 5-6 cm at a rhythm of 100-120 times/min for CC.[1,2]Interruptions of the CC must be as short as possible and are related to ventilation,defibrillation and turnover of the rescuers.Most of the automated external defibrillators(AEDs)require interruptions of the CC to perform rhythm analysis.Among the numerous marketed models of AEDs,some provide real-time feedback about the quality of the CC.
文摘The authors(Cai et al.,2022)claim that their proposed machine learning(ML)models,which are based on three typical ML algorithms and are trained to predict the burst capacity of pitting corroded pipelines,perform better than the existing semi-empirical formulas recommended by the international engineering code developers,DNV and ASME.The authors’assessments of the semi-empiri‐cal burst capacity formulas in Figure 10(a)and Table 8(Cai et al.,2022)incorrectly indicate that DNVGL-RP F101,ASME B31G,and modified ASME B31G are dan‐gerously unsafe due to significantly overestimating burst pressures in several cases.In contrast to the results and conclusions in Cai et al.
