Effectiveness of Co-Testing in Cervical Cancer Screening Program in Macao SAR

Background: Cervical cancer remains a significant public health concern in Macao SAR despite the implementation of a cervical cancer screening program and HPV vaccination. To improve early detection, Macao SAR introduced HPV DNA testing alongside cytology (co-testing) as the primary screening method in 2019. This study evaluates the effectiveness of co-testing in identifying cervical precancerous lesions (CIN2+) compared to cytology alone. Methods: We conducted a retrospective analysis of women aged 30 - 65 years who participated in the routine cervical cancer screening program in Macao SAR Primary Healthcare Centers from 2019 to 2022. Data from over 70,000 women were analyzed, comparing the detection rates of CIN2+ through co-testing and cytology alone. Women with abnormal cytology or positive HPV results were referred for colposcopy. Results: The introduction of co-testing led to a significant increase in the detection of CIN2+, particularly in women with atypical squamous cells of undetermined significance (ASCUS) or negative for intraepithelial lesion or malignancy (NILM) cytology results. Between 2019 and 2022, the percentage of women with ASCUS/NILM and any high-risk HPV (hrHPV) positive who were diagnosed with CIN2+ after colposcopy were 24%, 13%, 10% and 7.5% respectively. This highlights the ability of co-testing to identify high-risk individuals who would have been missed by cytology alone. Discussion: Our findings demonstrate the effectiveness of co-testing in improving the sensitivity of cervical cancer screening in Macao SAR. The inclusion of HPV DNA testing allows for better risk stratification of women with ASCUS/NILM cytology, leading to more targeted referrals for colposcopy and timely detection of precancerous lesions. The initial high positive rate in 2019 (24%) might be attributed to the small sample size and potentially reflects a backlog of undiagnosed cases prior to co-testing implementation. Conclusion: The implementation of co-testing in Macao SAR’s cervical cancer screening program significantly improves the early detection of precancerous lesions, particularly in women with ambiguous cytology results. This proactive approach contributes to reducing cervical cancer morbidity and mortality and improving women’s health outcomes in Macao SAR.

Comprehensive Analysis of Diabetes Mellitus-Associated Visual Impairment: Insights from Ophthalmological Screening Program in Libya

Purpose: Diabetes Mellitus (DM) is a prevalent metabolic disorder associated with significant complications, including visual impairment. This study aimed to assess the prevalence and severity of visual impairment and its associated factors in diabetic patients in Libya. Methods: This cross-sectional study included 2365 DM patients (4730 eyes). Most participants were aged 30 - 49 (38.3%) and 50 - 69 (50.8%) with a nearly equal gender distribution (47.8% males, 52.2% females). Type 2 diabetes was predominant (92.6%), and 62.9% had HbA1c levels of 7.5% or higher. Results: Diabetic retinopathy (DR) was present in 2068 eyes (43.8%), with mild non-proliferative diabetic retinopathy (NPDR) affecting 1178 eyes (25%), moderate NPDR 476 eyes (10.1%), severe NPDR 228 eyes (4.8%), and proliferative diabetic retinopathy (PDR) 186 eyes (3.9%). Diabetic maculopathy was observed in 621 eyes (13.1%), with CSME in 287 eyes (6.07%) and non-CSME in 334 eyes (7.06%). Non-retinal conditions included cataracts in 1938 eyes (41%) and glaucoma in 252 eyes (5.3%). Visual impairment was observed in 1159 patients (49%), with 534 (23%) experiencing mild impairment, 382 (18%) moderate impairment, and 243 (12%) severe impairment;142 patients (6%) were classified as legally blind. DR showed a strong association with visual impairment severity (p Conclusions: These findings underscore the urgency for targeted public health interventions to mitigate visual impairment in Libyan individuals with DM.

Assessing the Effectiveness of a Cervical Cancer Screening Program in a Hospital-based Study

This study compared HPV testing and liquid-based cytology （LCT） as performance indicators for cervical cancer screening in a hospital-based study. A total of 61,193 outpatients were screened initially by LCT. Samples with screening results showing atypical squamous cells of undetermined significance （ASC-US） or worse were referred for colposcopy, and some samples were tested for high-risk HPV types with the Hybrid Capture II system （HC II）. Data on LCT （n=61,193） and HC II （n=1056） results were analysed. Overall test positivity for LCT was 2.53% using an ASC-US threshold, 3.11% using a low-grade squamous intraepithelial lesion （LSIL） threshold, and 0.67% using a high-grade squamous intraepithelial lesion （HSIL） threshold. A total of 1839 women （84% of the 3893 patients with abnormal cytology） underwent colposcopy-directed biopsy. HPV was positive in 80.3% of women with cervical intraepithelial neoplasia 1 （CIN1）, 88.3% of those with CIN2, 79.2% of women with CIN3 and 50% （2 of 4） of women with invasive cancer. There was a significant increase in the detection of CIN2 or worse with adjunct HPV testing of women with ASC-US and LSIL However, there were detection of CIN2＋ cases no differences in the with adjunct HPV testing of women with HSlI.. The results indicate that HPV testing for HSlL triage should not be recommended in cervical cancer screening.

Effectiveness of gastric cancer screening programs in South Korea:Organized vs opportunistic models

AIM:To investigate the outcome and effectiveness of two screening programs,National Cancer Screening Program(NCSP)and opportunistic screening(OS),for the detection of gastric cancer. METHODS:A total of 45 654 subjects underwent upper endoscopy as part of the NCSP or OS at the Chung-Ang University Healthcare System in Korea between January 2007 and December 2010.The study population was comprised of subjects over the age of 40 years.More specifically,subjects who took part in the NCSP were Medicaid recipients and beneficiaries of the National Health Insurance Corporation.Still photo-graphs from the endoscopies diagnosed as gastric cancer were reviewed by two experienced endoscopists. RESULTS:The mean age of the screened subjects was 55 years for men and 54 years for women.A total of 126 cases(0.28%)of gastric cancer were detected from both screening programs;100 cases(0.3%)from NCSP and in 26 cases(0.2%)from OS.The proportion of early gastric cancer(EGC)detected in NCSP was higher than that in OS(74.0%vs 53.8%,P=0.046). Among the 34 416 screenees in NCSP,6585(19.1%) underwent upper endoscopy every other year as scheduled.Among the 11 238 screenees in OS,3050(27.1%) underwent upper endoscopy at least once every two years during the study period.The detection rate of gastric cancer was found to be significantly higher during irregular follow-up than during regular follow-up in both screening programs(0.3%vs 0.2%,P=0.036).A higher incidence of EGC than advanced gastric cancer was observed during regular follow-up compared with irregular follow-up. CONCLUSION:Compliance to the screening program is more important than the type of screening system used.

Results of National Colorectal Cancer Screening Program in Croatia(2007-2011)

AIM:To study the epidemiologic indicators of uptake and characteristic colonoscopic findings in the Croatian National Colorectal Cancer Screening Program.METHODS:Colorectal cancer(CRC) was the second leading cause of cancer mortality in men(n = 1063,49.77/100 000),as well as women(n = 803,34.89/100 000) in Croatia in 2009.The Croatian National CRC Screening Program was established by the Ministry of Health and Social Welfare,and its implementation started in September,2007.The coordinators were recruited in each county institute of public health with an obligation to provide fecal occult blood testing(FOBT) to the participants,followed by colonoscopy in all positive cases.The FOBT was performed by hypersensitive guaiac-based Hemognost card test(Biognost,Zagreb).The test and short questionnaire were delivered to the home addresses of all citizens aged 50-74 years consecutively during a 3-year period.Each participant was required to complete the questionnaire and send it together with the stool specimen on three test cards back to the institute for further analysis.About 4% FOBT positive cases are expected in normal risk populations.A descriptive analysis was performed.RESULTS:A total of 1 056 694 individuals(born between 1933-1945 and 1952-1957) were invited to screening by the end of September 2011.In total,210 239(19.9%) persons returned the envelope with a completed questionnaire,and 181 102 of them returned it with a correctly placed stool specimen on FOBT cards.Until now,12 477(6.9%),FOBT-positive patients have been found,which is at the upper limit of the expected values in European Guidelines for Quality Assurance in CRC Screening and Diagnosis [European Union(EU) Guidelines].Colonoscopy was performed in 8541 cases(uptake 66%).Screening has identified CRC in 472 patients(5.5% of colonoscopied,3.8% of FOBT-positive,and 0.26% of all screened individuals).This is also in the expected range according to EU Guidelines.Polyps were found and removed in 3329(39% of colonoscopied) patients.The largest number of polyps were found in the left half of the colon:64%(19%,37% and 8% in the rectum,sigma,and descendens,respectively).The other 36% were detected in the proximal part(17% in the transverse colon and 19% in ceco-ascending colon).Small polyps in the rectum(5-10 mm in diameter),sigmoid and descending colon were histologically found to be tubular adenomas in 60% of cases,with a low degree of dysplasia,and 40% were classified as hyperplastic.Polyps of this size in the transverse or ceco-ascending colon in almost 20% had a histologically villous component,but still had a low degree of dysplasia.Polyps sized 10-20 mm in diameter were in 43% cases tubulovillous,and among them,32% had areas with a high degree of dysplasia,especially those polyps in the cecoascending or transverse part.The characteristics of the Croatian CRC Screening National Program in the first 3 years were as follows:relatively low percentage of returned FOBT,higher number of FOBT-positive persons but still in the range for population-based programs,and higher number of pathologic findings(polyps and cancers).CONCLUSION:These results suggest a need for intervention strategies that include organizational changes and educational activities to improve awareness of CRC screening usefulness and increase participation rates.

Two Singapore public healthcare AI applications for national screening programs and other examples

This article explains how two AI systems have been incorporated into the everyday operations of two Singapore public healthcare nation‐wide screening programs.The first example is embedded within the setting of a national level population health screening program for diabetes related eye diseases,targeting the rapidly increasing number of adults in the country with diabetes.In the second example,the AI assisted screening is done shortly after a person is admitted to one of the public hospitals to identify which inpatients—especially which elderly patients with complex conditions—have a high risk of being readmitted as an inpatient multiple times in the months following discharge.Ways in which healthcare needs and the clinical operations context influenced the approach to designing or deploying the AI systems are highlighted,illustrating the multiplicity of factors that shape the requirements for successful large‐scale deployments of AI systems that are deeply embedded within clinical workflows.In the first example,the choice was made to use the system in a semi‐automated(vs.fully automated)mode as this was assessed to be more cost‐effective,though still offering substantial productivity improvement.In the second example,machine learning algorithm design and model execution trade-offs were made that prioritized key aspects of patient engagement and inclusion over higher levels of predictive accuracy.The article concludes with several lessons learned related to deploying AI systems within healthcare settings,and also lists several other AI efforts already in deployment and in the pipeline for Singapore's public healthcare system.

A Screening Program for Overweight Status Among Schoolgirls in Saudi Arabia： A Proposed Co-design Project to Tackle the Problem

The paper realizes the importance of communicating with schools to conduct nutritional screening, assessment and intervention programs for obesity and related risk factors to tackle the problem at earlier stage. The screening program was conducted by dietetics＇ students ＂under supervision＂ as part of their practice and community services to apply some assessment method for mritional status. Two intermediate schools for girls in Jeddah city were involved in the screening stage, followed by a full nutritional assessment and implementation of a designed intervention program at one of the schools. At screening stage, interview questionnaires for diet histories and anthropometric measurements used to screen overweight status and related food patterns. National and international references data used for assessment and comparison. Following screening approach, a designed comprehensive nutritional assessment and intervention program was piloted at one of the screened schools for overweight status. For screening stage： the overall prevalence of overweight girls is 61% （n = 81 out of 133） of the population, 73% （n = 91） of girls were centrally obese. Almost 3/4 of all students reported no participations in any type of physical activities/exercises. Dietary behaviors included non-consumption of breakfast （83%） and low intake of fruit and vegetables （38%）. For intervention stage, the present report concentrates on data concerning post intervention changes in Body Mass Index （BMI） and Waist Circumference （WC）. By the 30 days of intervention there were significant changes in values for BMI according to Saudi growth chart （p value = 0.009） with no changes among the control group. No statistically significant difference in the mean WC of the group. Study＇s results suggest that approaching young girls through schools to screen, assess and intervene overweight status and risk factors is vital. Although the non-random selection of only two schools for screening the prevalence of overweight status among school girls prevent the geralizability of the study findings to wider population, previous studies used random selection of schools and large sample sizes showed a high prevalence of overweight status among Saudi students Therefore, designing and piloting of an intervention program for implementation at a national level is useful to tackle theproblem.

Patient Satisfaction in Croatian Nationwide Mammography Screening Program

Mammographic screening programs are essential in timely detection and effective treatment of breast cancer. Since 2006, Croatia implemented a national MSP which asks for a regular biannual mammography for all women 50 - 69 years of age. First-visit screening attendance in the country is estimated at 58.3% with the trend of gradually decreasing re-attendance rates. Since patient satisfaction with the screening procedure may influence subsequent adherence, this study aimed to assess patient satisfaction in order to predict and improve patient re-attendance rate, a first-time effort of such kind in Croatia. 201 random patients undergoing mammography screening procedure at four facilities in Croatia were asked to complete an anonymous questionnaire which specifically evaluated the following aspects of patient experience: patient attitude, facility surroundings, staff attitude and pre-examination information transfer, associated physical pain, psychological discomfort, and finally overall patient impressions and satisfaction. The majority of our examinees expressed high satisfaction with MSP and an intention to re-screen;patient attitude, facility environment and staff attitude were deemed overly positive, whereas the majority of patients estimated the physical and psychological pain associated tolerable. These results suggest that patient satisfaction is not a critical factor influencing future adherence rate in MSP, and other components of the program should be evaluated and improved.

Who should be screened for colorectal cancer and how can it be prevented more effectively?

In this editorial,we comment on the article published by Agatsuma et al in a recent issue of the World J Gastroenterol(2024;30:1368-1376).We firmly concur with Agatsuma et al regarding the vital significance of colorectal cancer(CRC)screening as a public health strategy to diminish disease burden.Individuals exposed to risk factors for CRC,those with comorbid conditions,and those with limited health literacy should undergo screening.However,we believe that more regular screenings should be accompanied by a greater focus on primary prevention(PP)of CRC.CRC remains a significant global health challenge,and its incidence is strongly linked to age,lifestyle,and socioeconomic factors.It is particularly noteworthy that the majority of CRC patients are diagnosed outside of established screening pathways and frequently at an advanced stage of the disease,and the majority of patients possess inadequate or even nonexistent knowledge regarding CRC,which significantly impacts the prognosis and imposes a substantial economic burden.This study revealed that CRC identified during hospital visits for comorbid conditions was typically diagnosed at an earlier stage than detected via symptomatic pathways.Remarkably,early incidental detection of CRC aligns closely with the timing of discovery through routine cancer screenings.This suggests that by adopting more inclusive screening protocols that combine opportunistic testing with traditional screening methods,health care systems can create a more comprehensive safety net for individuals at risk of CRC.However,before maximizing the health benefits of screening programs,it is essential to make additional efforts prior to screening,such as raising awareness via public education,risk assessment,and personalized recommendations,enhancing the knowledge and skills of health care professionals,optimizing the accessibility and convenience of screening processes,ensuring the quality and safety of screening services,strengthening follow-up and support systems,and providing policy support and financial investment.The establishment of a comprehensive screening system often requires substantial investment in human,material,and financial resources,which can be challenging to achieve in regions with limited health care resources.Strengthening PP strategies can reduce the disease burden by targeting the cause,representing a more cost-effective and impactful approach.Establishing a comprehensive cancer PP service platform that integrates authoritative public education on malignant tumor PP,individualized malignant tumor risk assessment,and self-health management assistance accessible to the entire population will significantly enhance the overall effectiveness of CRC PP strategies.

Verifying the Effects of an Education Program Leveraging Information Technology to Promote Cervical Cancer Screening in Women Aged 20 - 29—A One-Year Longitudinal Study

The purpose of this research is to implement an IT-based education program in order to promote cervical cancer screenings for women aged 20 - 29 years, as well as to examine the results of said program. This is a longitudinal/comparative study of two groups, one for which the program was implemented (the intervention group), and the other for which it was not (the control group). The program consisted of attending a health lecture and encouragement to be screened one month, six months, and one year later sent through IT-based methods. The target was unmarried women aged 20 - 29 who had neither previously given birth nor had been screened for cervical cancer in a period one year prior. They were divided into two groups, the intervention group (n = 142) and control group (n = 145). The effectiveness of the program was assessed via an initial survey and further surveys six months and one year later. Results were based on the Japanese version of the Health Belief Model Scale for Cervical Cancer and the Pap Smear Test (HBMSCCPST), knowledge scores in the categories of Healthy Lifestyles, Cervical Cancer, Cervical Cancer Screening, and screening behavior. A two-way ANOVA of the HBMSCCPST subscales and knowledge scores in the initial, six-month, and one-year surveys was performed, showing interaction in Cervical Cancer (p = 0.00). Main effects were observed in Cervical Cancer Screening (p = 0.00) and Healthy Lifestyles (p = 0.00). Regarding the amount of change from the initial survey, knowledge scores in the Cervical Cancer (p = 0.027) and Cervical Cancer Screening (p = 0.016) categories were significantly higher in the intervention group than in the control group. There was no significant difference in cervical cancer screening rates (p = 0.26) between the two groups. However, a small-degree effect size was observed for Benefits, Seriousness, and Susceptibility subscales in both examinees and non-examinees. Although the educational program of this study was effective in improving the knowledge of women in their twenties, there was little improvement in HBMSCCPST and it did not lead to the promotion of cervical cancer screening. In order to raise interest in cervical cancer screening, it is necessary to consider useful content to guide women to consult with healthcare professionals, a long-term population approach, and organizational structure of consultation.

FoxPro Screen Wizard生成程序的改进与汉化工具

FoxPro Screen Wizard是一种开发数据管理程序的有效工具.但是,直接用Screen Wizard生成的程序需要保做一些必要的改进.本文讨论FoxPro Screen Wizard生成程序的改进方法,并介绍我们设计的一个汉化工具.

Colorectal cancer screening:20 years of development and recent progress

Colorectal cancer(CRC)is the second most common cancer in Europe and its incidence is steadily increasing.This trend could be reversed through timely secondary prevention(screening).In the last twenty years,CRC screening programs across Europe have experienced considerable improvements(fecal occult blood testing;transition from opportunistic to population based program settings).The Czech Republic is a typical example of a country with a long history of nationwide CRC screening programs in the face of very high CRC incidence and mortality rates.Each year,approximately 8000 people are diagnosed with CRC and some 4000 die from this malignancy.Twenty years ago,the first pilot studies on CRC screening led to the introduction of the opportunistic Czech National Colorectal Cancer Screening Program in 2000.Originally,this program was based on the guaiac fecal occult blood test(FOBT)offered by general practitioners,followed by colonoscopy in cases of FOBT positivity.The program has continuously evolved,namely with the implementation of immunochemical FOBTs and screening colonoscopy,as well as the involvement of gynecologists.Since the establishment of the Czech CRC Screening Registry in 2006,2405850 FOBTs have been performed and 104565 preventive colonoscopies recorded within the screening program.The overall program expanded to cover 25.0%of the target population by 2011.However,stagnation in the annual number of performed FOBTs lately has led to switching to the option of a population-based program with personal invitation,which is currently being prepared.

Colorectal cancer screening in Europe

Colorectal cancer(CRC)is the second most frequent malignant disease in Europe.Every year,412 000people are diagnosed with this condition,and 207 000patients die of it.In 2003,recommendations forscreening programs were issued by the Council of the European Union(EU),and these currently serve as thebasis for the preparation of European guidelines forCRC screening.The manner in which CRC screening iscarried out varies significantly from country to countrywithin the EU,both in terms of organization and thescreening test chosen.A screening program of onesort or another has been implemented in 19 of 27 EUcountries.The most frequently applied method is testing stool for occult bleeding(fecal occult blood test,FOBT).In recent years,a screening colonoscopy hasbeen introduced,either as the only method(Poland)orthe method of choice(Germany,Czech Republic).

Stool DNA methylation assays in colorectal cancer screening

Colorectal cancer(CRC) is fourth most common cancer in men and third in women worldwide. Developing a diagnostic panel of sensitive and specific biomarkers for the early detection of CRC is recognised as to be crucial for early initial diagnosis, which in turn leads to better long term survival. Most of the research on novel potential CRC biomarkers in the last 2 decades has been focussed on stool DNA analysis. In this paper, we describe the recent advances in non-invasive CRC screening and more specifically in molecular assays for aberrantly methylated BMP3 and NDRG4 promoter regions. In several research papers these markers showed superior rates for sensitivity and specificity in comparison to previously described assays. These tests detected the majority of adenomas ≥ 1 cm in size and the detection rates progressively increased with larger adenomas. The methylation status of the BMP3 and NDRG4 promoters demonstrated effective detection of neoplasms at all sites throughout the colon and was not affected by common clinical variables. Recently, a multitarget stool DNA test consisting of molecular assays for aberrantly methylated BMP3 and NDRG4 promoter regions, mutant KRAS and immunochemical assay for human haemoglobin has been made commercially available and is currently reimbursed in the United States. Although this is the most sensitive noninvasive CRC screening test, there is the need for further research in several areas- establishment of the best timeframe for repeated DNA stool testing; validation of the results in populations outside of North America; usefulness for surveillance and prognosis of patients; cost-effectiveness of DNA stool testing in real-life populations.

Colorectal cancer screening in the COVID-19 era

Colorectal cancer(CRC)is the third most diagnosed form of cancer and second most deadly cancer worldwide.Introduction of better screening has improved both incidence and mortality.However,as the coronavirus disease 2019(COVID-19)pandemic began,healthcare resources were shunted away from cancer screening services resulting in a sharp decrease in CRC screening and a backlog of patients awaiting screening tests.This may have significant effects on CRC cancer mortality,as delayed screening may lead to advanced cancer at diagnosis.Strategies to overcome COVID-19 related disruption include utilizing stool-based cancer tests,developing screening protocols based on individual risk factors,expanding telehealth,and increasing open access colonoscopies.In this review,we will summarize the effects of COVID-19 on CRC screening,the potential longoutcomes,and ways to adapt CRC screening during this global pandemic.

Amblyopia screening for first and second-grade children in Jordan

AIM:To share the results of a national screening program for amblyopia in school children in the north of Jordan.METHODS:This is a prospective national screening study for amblyopia.The program rolls first and second-grade children(6 to 7 years old) in the north of Jordan.The eye examination included:best-corrected visual acuity,cover-uncover test,and cycloplegic retinoscopy.Monocular visual acuity was tested using an ETDRS visual acuity chart without correction.Moreover,children were tested with full cycloplegic refraction when the test criteria were met.Unilateral amblyopia was defined as a best-corrected visual acuity difference of 2 or more lines.In comparison,bilateral amblyopia was defined as a best-corrected visual acuity of 20/40 or worse in the best eye.RESULTS:The prevalence of amblyopia for the total sample tested(n=17 203) was 2.78%(n=479).The most common cause of amblyopia was hypermetropia(64.45%),followed by previous ocular surgeries(15.1%),myopia(10.43%),strabismus(9.39%),and congenital cataract(0.63%).CONCLUSION:This is the first and only study,identifing modifiable risk factors in Jordanian children with amblyopia.In their first couple of years of elementary education,many Jordanian children are affected by amblyopia and pass unnoticed.A more governmental effort is needed into screening programs to improve vision in the Jordanian population.

Sociodemographic Characteristics Related to Resistance to Breast Cancer Screening

Objective: To describe the sociodemographic characteristics of women related to resistance to breast cancer. Methods: Cross-sectional study, with a quantitative approach, whose research took place in the Basic Family Health Units of the municipality of Mossoró. The study included 362 women aged between 40 and 69 years. One used a validated questionnaire with questions divided into five blocks. The data were entered in a spreadsheet, transferred to the SPSS software, and subsequently coded to perform the analysis. The Research Ethics Committee of the State University of Rio Grande do Norte, in Opinion No. 356958, approved the project. Results: Black women were two times more likely to be resistant when compared to white women (OR = 2.01, 95% CI = 1.12 - 3.69;p = 0.018). Women who have studied up to primary school 122 (58.1%) were two times more likely to be resistant when compared to those 14 (6.7%) who studied up to higher education (OR = 2.69;95% CI = 1.31 - 5.48;p = 0.012). Women who had first-degree relatives with breast cancer 153 (72.9%) were three times more likely to be resistant. Conclusions: The findings show the need for investments in educational practices with a view to public awareness and professionals’ training to disseminate information regarding tests used in practice directed to women’s health.

定向断裂控制爆破下层理页岩的致裂机理

为探究定向断裂控制爆破下层理页岩的爆破致裂机理,采用切缝药包,对四种切缝角度下的页岩立方体试件进行爆破试验,采用数字图像相关技术(DIC)对页岩试件表面应变场的演化过程进行监测,分析了微裂纹孕育至宏观裂纹贯通的内在机理,并基于盒维数理论计算了不同切缝角度下页岩试件表面裂纹的分形维数,采用Matlab软件对爆后块度的筛分方法进行了编程分析,开发了全自动的粒径分析程序,实现了粒径圈定的可视化。试验结果表明:试件在不同比例爆距内的裂纹总密度与比例爆距之间存在负相关的幂函数关系,切缝方向与层理弱面的夹角对微观损伤区域出现的位置影响显著,当层理弱面与切缝方向平行时,损伤区域多集中于层理弱面处,对宏观裂纹的扩展路径影响显著,易于形成单一裂纹;层理弱面处的能量泄漏是造成页岩爆破破碎效果较差的重要因素,当切缝方向与层理弱面一致时,试件爆后的大块占比较高,爆后块度的分形维数平均值在各组间最低,仅为0.7843,而当切缝方向与层理面垂直时,试件的爆后块度分布较为均匀,爆后块度的分形维数平均值达到了2.5233,爆破破碎效果相对较好。

可视化编程语言中small-screen与scaling-up问题解决方法探讨

由于目前可视化编程语言的设计工具主要集中于将其语素和数据应用二维图形对象来表示的范例来实现,针对其随之产生的sm all-screen与scaling-up问题,提出了一种在二维可视化编程环境下进行解决的方案。可以证明在解决实际问题中效果明显。

基于EPPM理论胃癌患者一级亲属胃癌筛查行为干预方案构建

目的构建基于拓展平行过程理论(extended parallel process model,EPPM)的胃癌患者一级亲属胃癌筛查行为干预方案。方法2023年3—11月,在文献回顾和小组讨论的基础上形成基于EPPM理论的胃癌患者一级亲属胃癌筛查行为干预方案初稿,采用德尔菲专家函询法对18名专家进行2轮函询,形成干预方案终稿。结果2轮专家函询共构建2个一级指标、4个二级指标和27个三级指标的筛查干预方案。专家权威系数分别为0.822、0.884;2轮函询的肯德尔协调系数分别为0.176、0.373,差异有统计学意义(P<0.001)。结论构建的基于EPPM理论的胃癌患者一级亲属胃癌筛查行为干预方案具有可靠性和实用性,以期为胃癌患者一级亲属胃癌筛查行为干预提供借鉴依据。