交互式数字叙事:加拿大Writing New Body Worlds阅读治疗新探索

文章基于相关研究文献与语料,对加拿大WNB阅读治疗实践进行梳理与归纳。WNB首次使用交互式数字叙事技术,构建面向公众的阅读治疗平台,以其交互式特征,融合了阅读和治疗引导两个过程,提供可访问的非临床方式,可面向大规模人群实现预防性健康干预。基于数据与计算的精准化阅读治疗是数字人文视角下的新变革,更具推广应用价值;以在线阅读平台建设为依托,推进实施平台化的阅读和治疗应成为未来发展方向之一;基于阅读形态与体验因技术赋能而改变的现状,图书馆应发挥引领作用,积极收集、创建或协助创建数字故事,推进阅读推广、服务与治疗的融合性发展,成为社区建设促进者、历史欣赏者和社区参与倡导者,也使阅读借助交互式数字叙事这一新载体,更好地发挥变革的力量,促进健康与幸福。

Longitudinal changes in body weight of breastfeeding mothers in the first year after delivery and its relationship with human milk composition:a combined longitudinal and cross-sectional cohort study

Objective:Postpartum weight retention(PPWR)is a common problem among women after childbirth.The main objectives of this study are to understand the changes in body weight of breastfeeding mothers during long-term follow-up and preliminarily explore the relationship between maternal body weight and human milk composition,including macronutrients,leptin,and adiponectin.Methods:The study included a longitudinal cohort(122 mothers),and a cross-sectional cohort(37 mothers).The human milk,maternal weight,and dietary surveys were collected in the longitudinal cohort at different follow-up time points(1-14 days postpartum,2-4 months postpartum,5-7 months postpartum,and 12-17 months postpartum).The maternal body weight was analyzed using the responses in the survey questionnaires.A milk analyzer based on the mid-infrared spectroscopy(MIRS)was used to determine milk composition,and nutrition analysis software evaluated dietary intakes.In the cross-sectional cohort,participating mothers were asked to provide blood and human milk samples and pertinent information related to maternal body composition.Maternal body composition was measured by bioelectrical impedance analysis(BIA),while ELISA analyzed leptin and adiponectin in milk and serum.Results:At 5-7 months postpartum,the PPWR of breastfeeding mothers was(2.46±3.59)kg.At 12-17 months postpartum,the PPWR was(0.98±4.06)kg.PPWR was found to be negatively correlated with milk fat content within 14 days postpartum and positively correlated at 2-4 months postpartum.In addition,the maternal weight and body muscle mass were positively correlated with leptin and adiponectin in milk.Plasma leptin was positively correlated with the mother’s body weight,body mass index(BMI),FAT percentage,and body fat mass,while plasma adiponectin did not correlate with any parameter.The results also indicate that the PPWR did not correlate with leptin and adiponectin in plasma or milk.Conclusions:Breastfeeding mothers may retain considerable weight gain one year after delivery.Human milk composition may be related to changes in maternal body weight.Leptin and adiponectin in breast milk and leptin in plasma are associated with the maternal body composition.This study supports the notion that maternal nutritional status may affect offspring health through lactation,and future research should focus on exploring weight management of postpartum mothers.

Ecological Remediation Technology of Urban Landscape Water Body

Urban landscape water body is not only an important part of urban landscape construction,but also an important way to maintain landscape diversity and biodiversity,carrying the beautiful yearning of urban residents for natural life.A good state of urban landscape water body is crucial to the ecological environment of the city.However,due to the poor kinetic energy of urban landscape water body and the influence of various human factors,the quality of urban landscape water body often declines,and urban population is threatened by water security problems.Through the study of several water body ecological remediation technologies,relevant suggestions are put forward,in order to provide a reference for water pollution restoration and treatment in urban human settlement environment.

Flexible bronchoscopy for foreign body aspiration in children:A single-centre experience

BACKGROUND The technological evolution of bronchoscopy has led to the widespread adoption of flexible techniques and their use for both diagnostic and therapeutic purposes.Currently,there is an active debate regarding the comparative efficacy and safety of rigid vs flexible bronchoscopy in the treatment of foreign body aspiration.AIM To evaluate our experience with tracheobronchial foreign body extraction using flexible bronchoscopy and provide a literature overview.METHODS This was a single-centre retrospective study.Twenty-four patients were enrolled between January 2017 and January 2023.Medical records of patients aged below 18 years who were admitted to authors’affiliated institution with a suspected diagnosis of foreign body aspiration were collected from hospital’s database to Microsoft Excel 2019.Data were analysed using MedCalc Statistical Software.RESULTS Patient ages varied from 9 months to 11 years.The median age was 23.5 months,95%confidence interval(CI)19.49-44.77.We observed age clustering in children with foreign body aspiration at our institution with three age subgroups:(1)0-25 months;(2)40-60 months;and(3)120-140 months.We expectancy of an organic tracheobronchial foreign body was significantly higher in 0-25 months subgroup than that in older ones when subgroups 40-60 and 120-140 months were combined together(odds ratio=10.0,95%CI:1.44-29.26,P=0.0197).Successful foreign body extraction was performed in all cases.Conversion to a rigid bronchoscope was not required in any of the cases.No major complications(massive bleeding,tracheobronchial tree perforation,or asphyxia)were observed.CONCLUSION Flexible bronchoscopy is an effective and safe method for tracheobronchial foreign body extraction in children.

Experiencing the Abject Female Body and Writing the Female Self:Body Narrative of In the Heart of the Country

In the Heart of the Country,the second novel by J.M.Coetzee,has been traditionally read as a disembodied writing that focuses on the problem of writing per se instead of the reality.This paper contends that the work is actually a body narrative that explores the visceral pain suffered by Magda whose infertile body impedes her being a qualified subject.As the heroine in a postcolonial novel,Magda is not just a body that is restricted and constructed by the politics of the body,but also a thinking and writing body that consciously questions and resists the gendered bodily norms under whose yardstick her subjecthood is barred.Written in the metafictional manner,Magda’s narrative of the body is not just a record of her corporeal experience,but also a self-conscious negotiation with,and challenge of,the bodily norms under whose yardstick her body has been debased or,in terms of Judith Butler,abjected.Taking her female bodily experience as the starting point,Magda writes a feminine text that values passion,fluidity and non-linearity to disrupt the patriarchal discourse underpinned with logical reasoning.The feminine body narrative endeavors to achieve a new way of communication through which a reciprocal cross race/gender relationship might be established.

3D body解剖软件联合PACS系统在骨科临床实践教学中的应用

目的探讨3D body解剖软件结合医学影像存档与通信系统(PACS)在骨科临床实践教学中的应用效果。方法选择2023年1月至2023年12月在浙江大学医学院附属邵逸夫医院骨科轮转的60名实习生,按照随机数字表法分成实验组和对照组,每组30名。对照组采用传统线上结合线下的混合式教学方法,实验组采用3D body解剖软件联合PACS系统带教模式。在实习期结束时,对两组实习生进行闭卷理论考试与临床实践操作考核,并采用问卷调查方式评估实习生对课程的满意度。结果实验组实习生的理论考试与临床实践操作成绩均高于对照组,差异均有统计学意义(t分别=6.59、4.22,P均<0.05)。实验组实习生在学习兴趣、教学难度、专业能力以及医患沟通能力提升方面的满意度均高于对照组,差异均有统计学意义(χ^(2)分别=9.93、3.77、6.94、8.52,P均<0.05)。结论3D body解剖软件联合PACS系统带教模式运用到骨科实习生的临床教学中,能帮助实习生提高学习兴趣以及医患沟通能力,加强对骨科知识的掌握,降低知识的理解难度,对于提升临床医学教学质量具有重要意义。

Body composition and metabolic syndrome in patients with type 1 diabetes

BACKGROUND In recent years,the prevalence of obesity and metabolic syndrome in type 1 diabetes(T1DM)patients has gradually increased.Insulin resistance in T1DM deserves attention.It is necessary to clarify the relationship between body composition,metabolic syndrome and insulin resistance in T1DM to guide clinical treatment and intervention.AIM To assess body composition(BC)in T1DM patients and evaluate the relationship between BC,metabolic syndrome(MS),and insulin resistance in these indi-viduals.METHODS A total of 101 subjects with T1DM,aged 10 years or older,and with a disease duration of over 1 year were included.Bioelectrical impedance analysis using the Tsinghua-Tongfang BC Analyzer BCA-1B was employed to measure various BC parameters.Clinical and laboratory data were collected,and insulin resistance was calculated using the estimated glucose disposal rate(eGDR).RESULTS MS was diagnosed in 16/101 patients(15.84%),overweight in 16/101 patients(15.84%),obesity in 4/101(3.96%),hypertension in 34/101(33.66%%)and dyslip-idemia in 16/101 patients(15.84%).Visceral fat index(VFI)and trunk fat mass were significantly and negatively correlated with eGDR(both P<0.001).Female patients exhibited higher body fat percentage and visceral fat ratio compared to male patients.Binary logistic regression analysis revealed that significant factors for MS included eGDR[P=0.017,odds ratio(OR)=0.109],VFI(P=0.030,OR=3.529),and a family history of diabetes(P=0.004,OR=0.228).Significant factors for hypertension included eGDR(P<0.001,OR=0.488)and skeletal muscle mass(P=0.003,OR=1.111).Significant factors for dyslipidemia included trunk fat mass(P=0.033,OR=1.202)and eGDR(P=0.037,OR=0.708).CONCLUSION Visceral fat was found to be a superior predictor of MS compared to conventional measures such as body mass index and waist-to-hip ratio in Chinese individuals with T1DM.BC analysis,specifically identifying visceral fat(trunk fat),may play an important role in identifying the increased risk of MS in non-obese patients with T1DM.

Soft,body conformable electronics for thermoregulation enabled by kirigami

The application of thermoelectric devices(TEDs)for personalized thermoregulation is attractive for saving energy while balancing the quality of life.TEDs that directly attach to human skin remarkably minimized the energy wasted for cooling the entire environment.However,facing the extreme dynamic geometry change and strain of human skin,conventional TEDs cannot align with the contour of our bodies for the best thermoregulation effect.Hence,we designed a kirigami-based wearable TED with excellent water vapor permeability,flexibility,and conformability.Numerical analysis and experimental results reveal that our product can withstand various types of large mechanical deformation without circuit rupture.The stated outcome and proposed facile approach not only reinforce the development of wearable TEDs but also offer an innovative opportunity for different electronics that require high conformability.

Association of daily sitting time and leisure-time physical activity with body fat among U.S.adults

Background:Prolonged sitting and reduced physical activity lead to low energy expenditures.However,little is known about the joint impact of daily sitting time and physical activity on body fat distribution.We investigated the independent and joint associations of daily sitting time and physical activity with body fat among adults.Methods:This was a cross-sectional analysis of U.S.nationally representative data from the National Health and Nutrition Examination Survey2011-2018 among adults aged 20 years or older.Daily sitting time and leisure-time physical activity(LTPA)were self-reported using the Global Physical Activity Questionnaire.Body fat(total and trunk fat percentage)was determined via dual X-ray absorptiometry.Results:Among 10,808 adults,about 54.6%spent 6 h/day or more sitting;more than one-half reported no LTPA(inactive)or less than 150 min/week LTPA(insufficiently active)with only 43.3%reported 150 min/week or more LTPA(active)in the past week.After fully adjusting for sociodemographic data,lifestyle behaviors,and chronic conditions,prolonged sitting time and low levels of LTPA were associated with higher total and trunk fat percentages in both sexes.When stratifying by LTPA,the association between daily sitting time and body fat appeared to be stronger in those who were inactive/insuufficiently active.In the joint analyses,inactive/insuufficiently active adults who reported sitting more than 8 h/day had the highest total(female:3.99%(95%confidence interval(95%CI):3.09%-4.88%);male:3.79%(95%CI:2.75%-4.82%))and trunk body fat percentages(female:4.21%(95%CI:3.09%-5.32%);male:4.07%(95%CI:2.95%-5.19%))when compared with those who were active and sitting less than 4 h/day.Conclusion:Prolonged daily sitting time was associated with increased body fat among U.S.adults.The higher body fat associated with 6 h/day sitting may not be offset by achieving recommended levels of physical activity.

Stereotactic body radiotherapy in pancreatic adenocarcinoma

Background:Stereotactic body radiotherapy(SBRT)in pancreatic cancer allows high delivery of radiation doses on tumors without affecting surrounding tissue.This review aimed at the SBRT application in the treatment of pancreatic cancer.Data sources:We retrieved articles published in MEDLINE/PubMed from January 2017 to December 2022.Keywords used in the search included:“pancreatic adenocarcinoma”OR“pancreatic cancer”AND“stereotactic ablative radiotherapy(SABR)”OR“stereotactic body radiotherapy(SBRT)”OR“chemoradiotherapy(CRT)”.English language articles with information on technical characteristics,doses and fractionation,indications,recurrence patterns,local control and toxicities of SBRT in pancreatic tumors were included.All articles were assessed for validity and relevant content.Results:Optimal doses and fractionation have not yet been defined.However,SBRT could be the standard treatment in patients with pancreatic adenocarcinoma in addition to CRT.Furthermore,the combination of SBRT with chemotherapy may have additive or synergic effect on pancreatic adenocarcinoma.Conclusions:SBRT is an effective modality for patients with pancreatic cancer,supported by clinical practice guidelines as it has demonstrated good tolerance and good disease control.SBRT opens a possibility of improving outcomes for these patients,both in neoadjuvant treatment and with radical intent.

3D Body解剖软件结合CBL教学法在骨科实习生临床带教中的应用

目的:探讨3D body解剖软件结合CBL教学法在骨科实习生临床带教中的应用效果。方法:随机选取2022年1月~2023年12月在我科室实习的36名骨科实习生为研究对象,随机分为观察组和对照组,对照组采用CBL教学模式,观察组在对照组的教学模式上运用3D body解剖软件。教学结束后,比较两组学生的理论知识考试成绩,PPT汇报成绩以及教学满意度。结果:观察组学生理论知识考核成绩、PPT汇报成绩、教学满意度明显高于对照组,差异具有显著性(P < 0.05)。结论:3D body解剖软件结合CBL教学法应用于骨科实习生临床带教,可以有效提高学生成绩,调动学生积极性及自主学习能力,提升教学满意度。

Energy Harvesting in the Wake of An Inverted C-Shaped Bluff Body

This paper proposes a novel wake-induced vibration(WIV)-based energy harvesting system consisting of two bluff bodies.An inverted C-shaped bluff body is stationary installed at the upstream position to generate an interference wake street,and a cylinder bluff body equipped with a transducer is elastically suspended at the downstream position to harness WIV energy.The hydrodynamics and energy harvesting(EH)performance of the proposed system are investigated via experimental studies.The reduced velocity(U*)ranging from 2 to 14(the corresponding Reynolds number ranging from 15100 to 106200)is considered in the present study.It is found that the wake generated by the inverted C-shaped bluff body significantly affects the EH performance.Enlarging the opening angle(α)of the C-shaped bluff body increases the vibration amplitude of the downstream cylinder,thereby increasing the harvested power.When the spacing(L)between two bluff bodies is two times the cylinder diameter(D),the wake-induced vibration(WIV)mode is observed,while the combined WIV and wake galloping(WG)mode occurs whenαis 150°,and L equals 3D or 4D.The average drag coefficient becomes negative when L is 2D,3D,or 4D.By carefully configuring a C-shaped bluff body,the wake generated by it can bring an augmenting effect on the vibration of the downstream EH cylinder.For example,the RMS power output of the proposed EH system reaches a maximum of 0.31 W at U*=8 and L=4D,which is 300%greater than that of its traditional counterpart.Furthermore,after a number of case stud-ies,it is identified that the proposed EH system can achieve the best performance whenαis 150°and L=2D.

α-Synuclein pathology from the body to the brain:so many seeds so close to the central soil

α-Synuclein is a protein that mainly exists in the presynaptic terminals.Abnormal folding and accumulation of α-synuclein are found in several neurodegenerative diseases,including Parkinson’s disease.Aggregated and highly phospho rylated a-synuclein constitutes the main component of Lewy bodies in the brain,the pathological hallmark of Parkinson s disease.For decades,much attention has been focused on the accumulation of α-synuclein in the brain parenchyma rather than considering Parkinson s disease as a systemic disease.Recent evidence demonstrates that,at least in some patients,the initial α-synuclein pathology originates in the peripheral organs and spreads to the brain.Injection of α-synuclein preformed fibrils into the gastrointestinal tra ct trigge rs the gutto-brain propagation of α-synuclein pathology.However,whether α-synuclein pathology can occur spontaneously in peripheral organs independent of exogenous α-synuclein preformed fibrils or pathological α-synuclein leakage from the central nervous system remains under investigation.In this review,we aimed to summarize the role of peripheral α-synuclein pathology in the pathogenesis of Parkinson’s disease.We also discuss the pathways by which α-synuclein pathology spreads from the body to the brain.

First record of abnormal body coloration in a rockfish Sebastes koreanus(Scorpaenoidei:Sebastidae)from coastal water of China based on morphological characteristics and DNA barcoding

The first record of abnormal body coloration in Sebastes koreanus Kim and Lee,1994,from the Yellow Sea of China,was documented based on morphological characteristics and DNA barcoding.The two rockfish specimens were collected from the coastal waters of Qingdao,China,and the whole body and all fins of them were red.Of the two red-colored rockfish,there were tiny deep red spots on each fin,2 red radial stripes behind and below the eyes and 1 large deep red blotch on the opercula,while the similar stripe and spot patterns are also present in the S.koreanus specimens with normal body coloration.The countable characteristics of the two specimens are in the range of the morphometry of S.koreanus.To further clarify the species identity and taxonomic status of the two specimens,DNA barcode analysis was carried out.The genetic distance between the red-colored rockfish and S.koreanus was 0,and the minimum net genetic distances between the red-colored rockfish and other Sebastes species except for S.koreanus were 3.0%,which exceeds the threshold of species delimitation.The phylogenetic analysis showed that the DNA barcoding sequences of the two red-colored rockfish clustered with the S.koreanus sequences.The above results of DNA barcode analysis also support that the two red-colored rockfish could be identified as the species of S.koreanus.The mechanism of color variation in S.koreanus is desirable for further research and the species could be an ideal model to study the color-driven speciation of the rockfishes.

Parametric Optimization of Wheel Spoke Structure for Drag Reduction of an Ahmed Body

The wheels have a considerable influence on the aerodynamic properties and can contribute up to 25%of the total drag on modern vehicles.In this study,the effect of the wheel spoke structure on the aerodynamic performance of the isolated wheel is investigated.Subsequently,the 35°Ahmed body with an optimized spoke structure is used to analyze the flow behavior and the mechanism of drag reduction.The Fluent software is employed for this investigation,with an inlet velocity of 40 m/s.The accuracy of the numerical study is validated by comparing it with experimental results obtained from the classical Ahmed model.To gain a clearer understanding of the effects of the wheel spoke parameters on the aerodynamics of both the wheel and Ahmedmodel,and five design variables are proposed:the fillet angleα,the inside arc radius R1,the outside radius R2,and the same length of the chord L1 and L2.These variables characterize the wheel spoke structure.The Optimal Latin Hypercube designmethod is utilized to conduct the experimental design.Based on the simulation results of various wheel spoke designs,the Kriging model and the adaptive simulated annealing algorithm is selected to optimize the design parameters.The objective is to achieve the best combination for maximum drag reduction.It is indicated that the optimized spoke structure resulted in amaximum drag reduction of 5.7%and 4.7%for the drag coefficient of the isolated wheel and Ahmed body,respectively.The drag reduction is primarily attributed to changes in the flow state around the wheel,which suppressed separation bubbles.Additionally,it influenced the boundary layer thickness around the car body and reduced the turbulent kinetic energy in the wake flow.These effects collectively contributed to the observed drag reduction.

Heterogeneous information phase space reconstruction and stability prediction of filling body–surrounding rock combination

Traditional research believes that the filling body can effectively control stress concentration while ignoring the problems of unknown stability and the complex and changeable stress distribution of the filling body–surrounding rock combination under high-stress conditions.Current monitoring data processing methods cannot fully consider the complexity of monitoring objects,the diversity of monitoring methods,and the dynamics of monitoring data.To solve this problem,this paper proposes a phase space reconstruction and stability prediction method to process heterogeneous information of backfill–surrounding rock combinations.The three-dimensional monitoring system of a large-area filling body–surrounding rock combination in Longshou Mine was constructed by using drilling stress,multipoint displacement meter,and inclinometer.Varied information,such as the stress and displacement of the filling body–surrounding rock combination,was continuously obtained.Combined with the average mutual information method and the false nearest neighbor point method,the phase space of the heterogeneous information of the filling body–surrounding rock combination was then constructed.In this paper,the distance between the phase point and its nearest point was used as the index evaluation distance to evaluate the stability of the filling body–surrounding rock combination.The evaluated distances(ED)revealed a high sensitivity to the stability of the filling body–surrounding rock combination.The new method was then applied to calculate the time series of historically ED for 12 measuring points located at Longshou Mine.The moments of mutation in these time series were at least 3 months ahead of the roadway return dates.In the ED prediction experiments,the autoregressive integrated moving average model showed a higher prediction accuracy than the deep learning models(long short-term memory and Transformer).Furthermore,the root-mean-square error distribution of the prediction results peaked at 0.26,thus outperforming the no-prediction method in 70%of the cases.

Genetic mechanism of body size variation in groupers:Insights from phylotranscriptomics

Animal body size variation is of particular interest in evolutionary biology,but the genetic basis remains largely unknown.Previous studies have shown the presence of two parallel evolutionary genetic clusters within the fish genus Epinephelus with evident divergence in body size,providing an excellent opportunity to investigate the genetic basis of body size variation in vertebrates.Herein,we performed phylotranscriptomic analysis and reconstructed the phylogeny of 13 epinephelids originating from the South China Sea.Two genetic clades with an estimated divergence time of approximately 15.4 million years ago were correlated with large and small body size,respectively.A total of 180 rapidly evolving genes and two positively selected genes were identified between the two groups.Functional enrichment analyses of these candidate genes revealed distinct enrichment categories between the two groups.These pathways and genes may play important roles in body size variation in groupers through complex regulatory networks.Based on our results,we speculate that the ancestors of the two divergent groups of groupers may have adapted to different environments through habitat selection,leading to genetic variations in metabolic patterns,organ development,and lifespan,resulting in body size divergence between the two locally adapted populations.These findings provide important insights into the genetic mechanisms underlying body size variation in groupers and species differentiation.

Automated body composition analysis system based on chest CT for evaluating content of muscle and adipose

Objective To establish a body composition analysis system based on chest CT,and to observe its value for evaluating content of chest muscle and adipose.Methods T7—T8 layer CT images of 108 pneumonia patients were collected(segmented dataset),and chest CT data of 984 patients were screened from the COVID 19-CT dataset(10 cases were randomly selected as whole test dataset,the remaining 974 cases were selected as layer selection dataset).T7—T8 layer was classified based on convolutional neural network(CNN)derived networks,including ResNet,ResNeXt,MobileNet,ShuffleNet,DenseNet,EfficientNet and ConvNeXt,then the accuracy,precision,recall and specificity were used to evaluate the performance of layer selection dataset.The skeletal muscle(SM),subcutaneous adipose tissue(SAT),intermuscular adipose tissue(IMAT)and visceral adipose tissue(VAT)were segmented using classical fully CNN(FCN)derived network,including FCN,SegNet,UNet,Attention UNet,UNET++,nnUNet,UNeXt and CMUNeXt,then Dice similarity coefficient(DSC),intersection over union(IoU)and 95 Hausdorff distance(HD)were used to evaluate the performance of segmented dataset.The automatic body composition analysis system was constructed based on optimal layer selection network and segmentation network,the mean absolute error(MAE),root mean squared error(RMSE)and standard deviation(SD)of MAE were used to evaluate the performance of automatic system for testing the whole test dataset.Results The accuracy,precision,recall and specificity of DenseNet network for automatically classifying T7—T8 layer from chest CT images was 95.06%,84.83%,92.27%and 95.78%,respectively,which were all higher than those of the other layer selection networks.In segmentation of SM,SAT,IMAT and overall,DSC and IoU of UNet++network were all higher,while 95HD of UNet++network were all lower than those of the other segmentation networks.Using DenseNet as the layer selection network and UNet++as the segmentation network,MAE of the automatic body composition analysis system for predicting SM,SAT,IMAT,VAT and MAE was 27.09,6.95,6.65 and 3.35 cm 2,respectively.Conclusion The body composition analysis system based on chest CT could be used to assess content of chest muscle and adipose.Among them,the UNet++network had better segmentation performance in adipose tissue than SM.

DNBP-CCA:A Novel Approach to Enhancing Heterogeneous Data Traffic and Reliable Data Transmission for Body Area Network

The increased adoption of Internet of Medical Things (IoMT) technologies has resulted in the widespread use ofBody Area Networks (BANs) in medical and non-medical domains. However, the performance of IEEE 802.15.4-based BANs is impacted by challenges related to heterogeneous data traffic requirements among nodes, includingcontention during finite backoff periods, association delays, and traffic channel access through clear channelassessment (CCA) algorithms. These challenges lead to increased packet collisions, queuing delays, retransmissions,and the neglect of critical traffic, thereby hindering performance indicators such as throughput, packet deliveryratio, packet drop rate, and packet delay. Therefore, we propose Dynamic Next Backoff Period and Clear ChannelAssessment (DNBP-CCA) schemes to address these issues. The DNBP-CCA schemes leverage a combination ofthe Dynamic Next Backoff Period (DNBP) scheme and the Dynamic Next Clear Channel Assessment (DNCCA)scheme. The DNBP scheme employs a fuzzy Takagi, Sugeno, and Kang (TSK) model’s inference system toquantitatively analyze backoff exponent, channel clearance, collision ratio, and data rate as input parameters. Onthe other hand, the DNCCA scheme dynamically adapts the CCA process based on requested data transmission tothe coordinator, considering input parameters such as buffer status ratio and acknowledgement ratio. As a result,simulations demonstrate that our proposed schemes are better than some existing representative approaches andenhance data transmission, reduce node collisions, improve average throughput, and packet delivery ratio, anddecrease average packet drop rate and packet delay.

Impact of body mass index on adverse kidney events in diabetes mellitus patients: A systematic-review and meta-analysis

BACKGROUND The incidence of chronic kidney disease among patients with diabetes mellitus(DM)remains a global concern.Long-term obesity is known to possibly influence the development of type 2 diabetes mellitus.However,no previous meta-analysis has assessed the effects of body mass index(BMI)on adverse kidney events in patients with DM.AIM To determine the impact of BMI on adverse kidney events in patients with DM.METHODS A systematic literature search was performed on the PubMed,ISI Web of Science,Scopus,Ovid,Google Scholar,EMBASE,and BMJ databases.We included trials with the following characteristics:(1)Type of study:Prospective,retrospective,randomized,and non-randomized in design;(2)participants:Restricted to patients with DM aged≥18 years;(3)intervention:No intervention;and(4)kidney adverse events:Onset of diabetic kidney disease[estimated glomerular filtration rate(eGFR)of<60 mL/min/1.73 m2 and/or microalbuminuria value of≥30 mg/g Cr],serum creatinine increase of more than double the baseline or end-stage renal disease(eGFR<15 mL/min/1.73 m2 or dialysis),or death.RESULTS Overall,11 studies involving 801 patients with DM were included.High BMI(≥25 kg/m2)was significantly associated with higher blood pressure(BP)[systolic BP by 0.20,95%confidence interval(CI):0.15–0.25,P<0.00001;diastolic BP by 0.21 mmHg,95%CI:0.04–0.37,P=0.010],serum albumin,triglycerides[standard mean difference(SMD)=0.35,95%CI:0.29–0.41,P<0.00001],low-density lipoprotein(SMD=0.12,95%CI:0.04–0.20,P=0.030),and lower high-density lipoprotein(SMD=–0.36,95%CI:–0.51 to–0.21,P<0.00001)in patients with DM compared with those with low BMIs(<25 kg/m2).Our analysis showed that high BMI was associated with a higher risk ratio of adverse kidney events than low BMI(RR:1.22,95%CI:1.01–1.43,P=0.036).CONCLUSION The present analysis suggested that high BMI was a risk factor for adverse kidney events in patients with DM.