比较YEARS评分与简化Wells联合年龄校正D-二聚体评分用于疑似肺栓塞患者的诊断价值

目的通过前瞻性研究比较YEARS评分与简化Wells联合年龄校正D-二聚体评分(sWells-Age)用于疑似肺栓塞患者的诊断价值。方法纳入2021年3月3日到2022年4月30日于宜宾市第二人民医院就诊且符合纳排标准的可疑肺栓塞病人522名,采用前瞻性观察研究,由临床医师对照YEARS评分收集患者基线信息,计算患者YEARS评分及sWells-Age评分判断其目前肺栓塞临床可能性。所有排除肺栓塞且未进行抗凝治疗的患者进行3个月随访。以CTPA检查结果作为诊断金标准,分别计算YEARS评分及sWells-Age评分敏感度、特异度、κ值等指标,绘制两者ROC曲线并计算AUC值。结果sWells-Age评分及YEARS评分灵敏度分别为85.71%、93.41%(P<0.001),特异度分别为69.23%、56.92%(P<0.001),AUC值分别为0.775(95%CI 0.688~0.816)、0.752(95%CI 0.711~0.838),与CTPA的κ值分别为0.526、0.465,均>0.410,结果一致性均属于中等,两者灵敏度比较(χ^(2)=5.143,P<0.025),差异具有统计学意义,两者特异度比较(χ^(2)=12.500,P<0.001),差异具有显著统计学意义。结论sWells-Age评分优于YEARS评分,但YEARS评分项目少,灵敏度及安全性高,可应用于早期肺栓塞患者的筛查。

Evolutionary Decision-Making and Planning for Autonomous Driving Based on Safe and Rational Exploration and Exploitation

Decision-making and motion planning are extremely important in autonomous driving to ensure safe driving in a real-world environment.This study proposes an online evolutionary decision-making and motion planning framework for autonomous driving based on a hybrid data-and model-driven method.First,a data-driven decision-making module based on deep reinforcement learning(DRL)is developed to pursue a rational driving performance as much as possible.Then,model predictive control(MPC)is employed to execute both longitudinal and lateral motion planning tasks.Multiple constraints are defined according to the vehicle’s physical limit to meet the driving task requirements.Finally,two principles of safety and rationality for the self-evolution of autonomous driving are proposed.A motion envelope is established and embedded into a rational exploration and exploitation scheme,which filters out unreasonable experiences by masking unsafe actions so as to collect high-quality training data for the DRL agent.Experiments with a high-fidelity vehicle model and MATLAB/Simulink co-simulation environment are conducted,and the results show that the proposed online-evolution framework is able to generate safer,more rational,and more efficient driving action in a real-world environment.

Motion Planning for Autonomous Driving with Real Traffic Data Validation

Accurate trajectory prediction of surrounding road users is the fundamental input for motion planning,which enables safe autonomous driving on public roads.In this paper,a safe motion planning approach is proposed based on the deep learning-based trajectory prediction method.To begin with,a trajectory prediction model is established based on the graph neural network(GNN)that is trained utilizing the INTERACTION dataset.Then,the validated trajectory prediction model is used to predict the future trajectories of surrounding road users,including pedestrians and vehicles.In addition,a GNN prediction model-enabled motion planner is developed based on the model predictive control technique.Furthermore,two driving scenarios are extracted from the INTERACTION dataset to validate and evaluate the effectiveness of the proposed motion planning approach,i.e.,merging and roundabout scenarios.The results demonstrate that the proposed method can lower the risk and improve driving safety compared with the baseline method.

Effects of Different Planting Years on Physicochemical Properties and Enzyme Activities in Soil of Rice-Cherry Tomato Rotation

Crop rotation periodicity has always been one of the research focuses currently. In this study, the physicochemical properties, nutrient contents and enzyme activities were investigated in soils from rice-cherry tomato rotation for one year (1a), three years (3a), five years (5a), seven years (7a) and ten years (10a), respectively. The major objective was to analyze the optimal rotation years of rice-cherry tomato from soil perspective, so as to provide theoretical basis for effectively avoiding continuous cropping obstacles of cherry tomato via studying the response characteristics of soil physicochemical properties, nutrient contents and enzyme activities to planting years of rice-cherry tomato rotation system. The results were as follows: 1) Soil pH value was increased year by year during 1a to 5a, reached the highest value 5.32 at 5a. However, soil acidity was sharply enhanced during 7a to 10a (P P •kg-1 at 5a. 3) The content of soil available phosphorus was increased year by year with increasing of crop rotation years, and increased by 110% to 173% during 3a to 10a (P P P < 0.05). In conclusion, long-term single rotation pattern of rice-cherry tomato would aggravate soil acidification, prompt soil nutrient imbalance and reduce soil enzyme activity. 5a to 7a would be the appropriate rotation period for rice-cherry tomato, or else it would reduce soil quality, resulting in a new continuous cropping obstacle of cherry tomato.

Bowel preparation protocol for hospitalized patients ages 50 years or older:A randomized controlled trial

BACKGROUND The incidence and mortality rate of colorectal cancer progressively increase with age and become particularly prominent after the age of 50 years.Therefore,the population that is≥50 years in age requires long-term and regular colonoscopies.Uncomfortable bowel preparation is the main reason preventing patients from undergoing regular colonoscopies.The standard bowel preparation regimen of 4-L polyethylene glycol(PEG)is effective but poorly tolerated.AIM To investigate an effective and comfortable bowel preparation regimen for hospitalized patients≥50 years in age.METHODS Patients were randomly assigned to group 1(2-L PEG+30-mL lactulose+a lowresidue diet)or group 2(4-L PEG).Adequate bowel preparation was defined as a Boston bowel preparation scale(BBPS)score of≥6,with a score of≥2 for each segment.Non-inferiority was prespecified with a margin of 10%.Additionally,the degree of comfort was assessed based on the comfort questionnaire.RESULTS The proportion of patients with a BBPS score of≥6 in group 1 was not significantly different from that in group 2,as demonstrated by intention-to-treat(91.2%vs 91.0%,P=0.953)and per-protocol(91.8%vs 91.0%,P=0.802)analyses.Furthermore,in patients≥75 years in age,the proportion of BBPS scores of≥6 in group 1 was not significantly different from that in group 2(90.9%vs 97.0%,P=0.716).Group 1 had higher comfort scores(8.85±1.162 vs 7.59±1.735,P<0.001),longer sleep duration(6.86±1.204 h vs 5.80±1.730 h,P<0.001),and fewer awakenings(1.42±1.183 vs 2.04±1.835,P=0.026)than group 2.CONCLUSION For hospitalized patients≥50 years in age,the bowel preparation regimen comprising 2-L PEG+30-mL lactulose+a low-residue diet produced a cleanse that was as effective as the 4-L PEG regimen and even provided better comfort.

Epidemiology of Cardiovascular Mortality in Patients under 60 Years Old in a Cardiology Department in West Africa, Dakar-Senegal

Background: Our study aimed to examine cardiovascular mortality within the working-age population, exploring epidemiological, clinical, and paraclinical features, complications, and identifying etiological factors linked to mortality. Methods: We conducted a descriptive and analytical retrospective study from September 2019 to August 2022 at the General Hospital Idrissa POUYE in Dakar, we reviewed all the medical records of patients from 15 to 60 years old who died while admitted in the cardiology department. Data collected were socioeconomic status, clinical history, type of cardiovascular disaese, length of hospitalization, circumstances and timing of death. The data were analyzed with R. Studio version 2022.12.0 + 353 and Excel 2019, with a P-value Results: The study included 73 patients, indicating a specific mortality rate of 8.8% and a proportional mortality of 39%. Predominantly male (sex ratio 1.2), the average age was 44. Key cardiovascular risk factors identified were sedentarism (76.7%), hypertension (28.8%), and smoking (21.9%). The leading cause for consultation was dyspnea (72.6%). Notable findings included a majority of patients presenting with general condition deterioration (90%) and cardiovascular collapse upon admission (23.3%). Physical exam revealed signs of heart failure in 63%. Echocardiography showed left ventricular ejection fraction impairment (81%) and pulmonary hypertension (78%). Immediate causes of death were primarily cardiogenic shock (45.2%) and septic shock (37%). The analytical study indicates that the data most closely associated with mortality were age, socio-economic level, ischemic heart disease (p = 0.034), rheumatic valvulopathies, pulmonary embolism (p = 0.034), hypertension (HTA) (p = 0.009), smoking (p = 0.011), diabetes (p = 0.011), dyslipidemias, prolonged bedrest (p = 0.001), morbid obesity (p = 0.001), and COVID-19 infection (p = 0.017). Conclusion: The prevalence of ischemic heart diseases, pulmonary embolisms, and valvulopathies in premature mortality statistics underscores the need for enhanced cardiovascular prevention efforts.

Selection of media tools for community planning:A study from the perspective of communicative planning

In community planning,due to the lack of evidence regarding the selection of media tools,this study examines how a common but differentiated ideal speech situation can be created as well as how more appropriate media tools can be defined and selected in the community planning process.First,this study describes the concept and theoretical basis of media used in community planning from the perspectives of the multiple effects of media evolution on communicative planning.Second,the classification criteria and typical characteristics of media tools used to support community planning are clarified from three dimensions:acceptability,cost effectiveness,and applicability.Third,strategies for applying media tools in the four phases of communicative planning-namely,state analysis,problem identification,contradictory solution and optimization-are described.Finally,trends in the development of media tools for community planning are explored in terms of multistakeholder engagement,supporting scientific decision-making and multiple-type media integration.The results provide a reference for developing more inclusive,effective,and appropriate media tools for enhancing decision-making capacity and modernizing governance in community planning and policy-making processes.

Development Trend of Energy and Key Points of Ecological Environment Protection in China's "14^(th) Five-Year Plan" Period

From the changes of total primary energy consumption and primary energy consumption structure,installed capacity and power generation of secondary energy(electricity),etc.,the development characteristics of China's energy structure in the"13^(th) Five-Year Plan"period was comprehensively studied.Combined with the complexity of the international situation,the diversification of the domestic energy system,the intelligence of the energy industry,etc.,the situation and challenges faced by China's energy development were deeply discussed in the four aspects of energy security,energy low-carbon transformation,energy system efficiency,and energy technology level.From the angle of ecological environment protection,the development of energy in the"14^(th) Five-Year Plan"period in China was analyzed,and some policies and measures were put forward.

Influence of a diet meal plan on pepsinogen I and II,gastrin-17,and nutritional status in gastric ulcer patients

BACKGROUND Gastric ulcers(GUs)have a high risk of clinical morbidity and recurrence,and further exploration is needed for the prevention,diagnosis,and treatment of the disease.AIM To investigated the effects of a diet plan on pepsinogen(PG)I,PG II,gastrin-17(G-17)levels and nutritional status in patients with GUs.METHODS A total of 100 patients with GUs treated between May 2022 and May 2023 were enrolled,with 47 patients in the control group receiving routine nursing and 53 patients in the experimental group receiving dietary nursing intervention based on a diet plan.The study compared the two groups in terms of nursing efficacy,adverse events(vomiting,acid reflux,and celialgia),time to symptom improvement(burning sensation,acid reflux,and celialgia),gastric function(PG I,PG II,and G-17 levels),and nutritional status[prealbumin(PA)and albumin(ALB)levels].RESULTS The experimental group showed a markedly higher total effective rate of nursing,a significantly lower incidence of adverse events,and a shorter time to symptom improvement than the control group.Additionally,the experimental group’s post-intervention PG I,PG II,and G-17 levels were significantly lower than preintervention or control group levels,whereas PA and ALB levels were significantly higher.CONCLUSION The diet plan significantly reduced PG I,PG II,and G-17 levels in patients with GUs and significantly improved their nutritional status.

Optimal search path planning of UUV in battlefeld ambush scene

Aiming at the practical application of Unmanned Underwater Vehicle(UUV)in underwater combat,this paper proposes a battlefield ambush scene with UUV considering ocean current.Firstly,by establishing these mathematical models of ocean current environment,target movement,and sonar detection,the probability calculation methods of single UUV searching target and multiple UUV cooperatively searching target are given respectively.Then,based on the Hybrid Quantum-behaved Particle Swarm Optimization(HQPSO)algorithm,the path with the highest target search probability is found.Finally,through simulation calculations,the influence of different UUV parameters and target parameters on the target search probability is analyzed,and the minimum number of UUVs that need to be deployed to complete the ambush task is demonstrated,and the optimal search path scheme is obtained.The method proposed in this paper provides a theoretical basis for the practical application of UUV in the future combat.

Efficient Route Planning for Real-Time Demand-Responsive Transit

Demand Responsive Transit (DRT) responds to the dynamic users’ requests without any fixed routes and timetablesand determines the stop and the start according to the demands. This study explores the optimization of dynamicvehicle scheduling and real-time route planning in urban public transportation systems, with a focus on busservices. It addresses the limitations of current shared mobility routing algorithms, which are primarily designedfor simpler, single origin/destination scenarios, and do not meet the complex demands of bus transit systems. Theresearch introduces an route planning algorithm designed to dynamically accommodate passenger travel needsand enable real-time route modifications. Unlike traditional methods, this algorithm leverages a queue-based,multi-objective heuristic A∗ approach, offering a solution to the inflexibility and limited coverage of suburbanbus routes. Also, this study conducts a comparative analysis of the proposed algorithm with solutions based onGenetic Algorithm (GA) and Ant Colony Optimization Algorithm (ACO), focusing on calculation time, routelength, passenger waiting time, boarding time, and detour rate. The findings demonstrate that the proposedalgorithmsignificantly enhances route planning speed, achieving an 80–100-fold increase in efficiency over existingmodels, thereby supporting the real-time demands of Demand-Responsive Transportation (DRT) systems. Thestudy concludes that this algorithm not only optimizes route planning in bus transit but also presents a scalablesolution for improving urban mobility.

Characteristics of the HIV/AIDS Epidemic among People Aged≥50 Years in China during 2018–2021

Objective This study aimed to determine the current epidemiological status of PLWHA aged≥50 years in China from 2018 to 2021.It also aimed to recommend targeted interventions for the prevention and treatment of HIV/AIDS in elderly patients.Methods Data on newly reported cases of PLWHA,aged≥50 years in China from 2018 to 2021,were collected using the CRIMS.Trend tests and spatial analyses were also conducted.Results Between 2018 and 2021,237,724 HIV/AIDS cases were reported among patients aged≥50 years in China.The main transmission route was heterosexual transmission(91.24%).Commercial heterosexual transmission(CHC)was the primary mode of transmission among males,while non-marital non-CHC([NMNCHC];60.59%)was the prevalent route in women.The proportion of patients with CHC decreased over time(Z=67.716,P<0.01),while that of patients with NMNCHC increased(Z=153.05,P<0.01).The sex ratio varied among the different modes of infection,and it peaked at 17.65 for CHC.The spatial analysis indicated spatial clustering,and the high-high clustering areas were mainly distributed in the southwestern and central-southern provinces.Conclusion In China,PLWHA,aged≥50 years,were predominantly infected through heterosexual transmission.The primary modes of infection were CHC and NMNCHC.There were variations in the sex ratio among different age groups,infected through various sexual behaviors.HIV/AIDS cases exhibited spatial clustering.Based on these results,the expansion of HIV testing,treatment,and integrated behavioral interventions in high-risk populations is recommended to enhance disease detection in key regions.

Effect of a Nutrition Education Intervention on Food Safety Knowledge, Attitudes and Practices of Mothers of Children under 5 Years in the Peri-Urban Areas of Bobo-Dioulasso: Before and after Study

Background: This study assessed the effect of a nutrition education intervention. This intervention aimed to improve the knowledge, attitudes, and practices of mothers on food safety in the peri-urban areas of Bobo-Dioulasso in Burkina Faso. Methods: A total of 243 mothers of children under 5 years in the peri-urban of Bobo-Dioulasso were administered the FAO questionnaire for food safety knowledge, attitudes, and practices assessment during two cross-sectional surveys, before and after the intervention, in January and October 2017. The intervention included two components consisting of a theoretical phase (counselling and discussion) and cooking demonstrations implemented for ten months. To account for the before-and-after design of the study, the McNemar’s test was used to assess the effect of the intervention on food safety KAP of mothers of children under 5 years. Results: The mean age of mothers was 29 ± 6.2 years and 50.6% of them were between 20 and 29 years old. One for knowledge (cooking thoroughly with, p-value = 0.0001) and another for attitudes (perceived benefits of reheating leftovers before eating them, p-value = 0.0001), significantly increased after the intervention. In terms of food safety practices, all the indicators (cleaning of dirty surfaces, plates and utensils and storage of perishable foods) significantly increased (all p = 0.0001 Conclusion: This study provided some evidence of an effective nutrition education intervention for improving maternal KAP on food safety for their child’s feeding.

Review of Two Years of Surgical Activities of the General Surgery Department of the Reference Health Center of Commune I of Bamako Mali

The objectives of this work were to evaluate the surgical activities carried out in the general surgery department of the Reference Health Center of Commune I of Bamako, to describe the sociodemographic characteristics of the operated patients, to determine the main pathologies encountered and to evaluate qualitatively the result of the treatment. In order to improve performance, and the quality of care, and to identify common pathologies in the surgical department, we undertook a retrospective study on surgical activities from January 2009 to December 2010. At the end of this study, out of 474 men and 187 women (equal sex ratio 2.53);we were able to determine the frequency of surgical pathologies. Farmers, housewives and pupils/students were the most represented with 25.9% respectively;20% and 13.3%. The most frequently observed pathologies were wall hernia (44.8%), prostate adenoma (12%) and acute appendicitis (10.5%). The average length of hospitalization was 3.43 days. Infectious complications affected 25 patients (3.8% of cases) and a death rate of 0.45% (i.e. 3 patients). The average cost of care was 53,500 FCFA. Indeed, the reality of surgical practice in health centers was not the same because of the level of skills of practicing surgeons.

Succession Plan for Nursing Academic Program Administrators

Leadership succession in nursing academic programs poses a significant challenge, primarily due to the limited availability of professionals with the competencies required for effective leadership [1]. This study aims to address this gap by investigating the critical factors in succession planning for nursing program administrators. The research objectives include identifying the competencies necessary for academic administrators, assessing the experience of current administrators, and developing a comprehensive succession plan framework. The research uses qualitative methods, including literature review, interviews with nursing administrators, and analysis of existing succession models. Results highlight the importance of integrating strategic planning into succession processes to ensure smooth transitions and organizational stability. Conclusions suggest that a formalized succession plan, incorporating mentorship and leadership development, can mitigate leadership gaps in nursing academia [2].

Exploration of Detailed Planning Practice of Chemical Industrial Parks under the Background of Territorial Space Planning

With the gradual completion of the overall planning of city and county land space,the detailed planning will be prepared according to the requirements of transmitting and refining the upper planning.Industrial parks are one of the“main forces”of local economic development,and the preparation of their detailed planning will escort their development.The key points of the Control Indicators of Construction Land in Industrial Projectsissued in 2008 and 2023 were compared,and the new requirements for detailed planning under the background of territorial space and the contradictions between the detailed planning of industrial parks and the overall planning of the upper territorial space were sorted out based on the summary of the existing problems in the development of chemical parks.It provides some ideas for the practice of detailed planning of chemical industrial parks under the background of territorial space.

Postpartum Family Planning at the Timbuktu Hospital in Mali

Introduction: Postpartum family planning is the prevention of pregnancies during the 12 months following childbirth. Few studies have been devoted to postpartum family planning in Mali. Our work will contribute to reducing unmet need for family planning. Objective: To study the use of contraceptive methods in the postpartum period in the obstetrics and gynecology unit of Timbuktu hospital. Materials and Methods: This was a descriptive and analytical cross-sectional study with prospective collection of data from January 1, 2022 to December 31, 2023. All women who gave birth having chosen and benefited from a contraceptive method were included. The statistical test used was the Fisher test with a significance threshold fixed at 5%. Results: The frequency of contraception in the postpartum period was 17.03%. The average age of clients was 26.14% with extremes of 14 and 45 years. They were paupiparous at 56.4% with an inter-birth interval of less than 12 months at 12.3%. More than half of the counseling (58.5%) was done during postnatal visits. The methods chosen were implants at 48.1%, injectable progestins at 21.3%, intrauterine device at 14.7%, miro-progestin pills at 13.5%, tubal ligation at 1 .4% and condoms at 1%. The regular follow-up rate was 51.1% of cases and 25.6% had no follow-up. Conclusion: The overall rate of postpartum family planning of 17.08% remains low. Improving FP staff skills will reduce unmet needs and contribute to increasing contraceptive prevalence in Timbuktu.

Stochastic programming based coordinated expansion planning of generation,transmission,demand side resources,and energy storage considering the DC transmission system

With the increasing penetration of wind and solar energies,the accompanying uncertainty that propagates in the system places higher requirements on the expansion planning of power systems.A source-grid-load-storage coordinated expansion planning model based on stochastic programming was proposed to suppress the impact of wind and solar energy fluctuations.Multiple types of system components,including demand response service entities,converter stations,DC transmission systems,cascade hydropower stations,and other traditional components,have been extensively modeled.Moreover,energy storage systems are considered to improve the accommodation level of renewable energy and alleviate the influence of intermittence.Demand-response service entities from the load side are used to reduce and move the demand during peak load periods.The uncertainties in wind,solar energy,and loads were simulated using stochastic programming.Finally,the effectiveness of the proposed model is verified through numerical simulations.

Correlates of Mistimed Pregnancy and Unmet Need for Family Planning among Women of Reproductive Age in Sandema, Ghana

Background: Globally, an estimated 80 million unintended pregnancies comprising both mistimed and unwanted pregnancies are recorded yearly. Yet only half of the women at risk of mistimed pregnancy use contraceptives. In developing countries, over 100 million females have unmet need, and national surveys in Ghana indicate 23% unmet need rate. Methods: Using a cross-sectional community-based approach, a sample size of 300 women of reproductive age were selected using multi-step cluster sampling techniques. The study was quantitative, using structured interviewer-administered questionnaires. Results: Two-third (66%) of the women in reproductive age still had unmet need, 71% were currently pregnant, and more than a third (36%) confirmed ever having a mistimed pregnancy. Fifty-three percent (53%) of the women confirmed never communicating with their partners on family planning issues, a little below half (45%) took their own health care decisions. Seventy nine percent (79%) ever received family planning services from a health professional. Factors related to unmet needs included mistimed pregnancy, level of education, preferred birth/pregnancy interval, communication between partners and the autonomy to spend self-earnings. Conclusion: Considering that high rates of unmet need results in mistimed pregnancy, improved policies around the influence of unmet need on mistimed pregnancies are needed.

A Planning Method for Operational Test of UAV Swarm Based on Mission Reliability

The unmanned aerial vehicle(UAV)swarm plays an increasingly important role in the modern battlefield,and the UAV swarm operational test is a vital means to validate the combat effectiveness of the UAV swarm.Due to the high cost and long duration of operational tests,it is essential to plan the test in advance.To solve the problem of planning UAV swarm operational test,this study considers the multi-stage feature of a UAV swarm mission,composed of launch,flight and combat stages,and proposes a method to find test plans that can maximize mission reliability.Therefore,a multi-stage mission reliability model for a UAV swarm is proposed to ensure successful implementation of the mission.A multi-objective integer optimization method that considers both mission reliability and cost is then formulated to obtain the optimal test plans.This study first constructs a mission reliability model for the UAV swarm in the combat stage.Then,the launch stage and flight stage are integrated to develop a complete PMS(Phased Mission Systems)reliability model.Finally,the Binary Decision Diagrams(BDD)and Multi Objective Quantum Particle Swarm Optimization(MOQPSO)methods are proposed to solve the model.The optimal plans considering both reliability and cost are obtained.The proposed model supports the planning of UAV swarm operational tests and represents a meaningful exploration of UAV swarm test planning.