Reevaluating health metrics:Unraveling the limitations of disabilityadjusted life years as an indicator in disease burden assessment

In 1993,the World Bank released a global report on the efficacy of health promotion,introducing the disability-adjusted life years(DALY)as a novel indicator.The DALY,a composite metric incorporating temporal and qualitative data,is grounded in preferences regarding disability status.This review delineates the algorithm used to calculate the value of the proposed DALY synthetic indicator and elucidates key methodological challenges associated with its application.In contrast to the quality-adjusted life years approach,derived from multi-attribute utility theory,the DALY stands as an independent synthetic indicator that adopts the assumptions of the Time Trade Off utility technique to define Disability Weights.Claiming to rely on no mathematical or economic theory,DALY users appear to have exempted themselves from verifying whether this indicator meets the classical properties required of all indicators,notably content validity,reliability,specificity,and sensitivity.The DALY concept emerged primarily to facilitate comparisons of the health impacts of various diseases globally within the framework of the Global Burden of Disease initiative,leading to numerous publications in international literature.Despite widespread adoption,the DALY synthetic indicator has prompted significant methodological concerns since its inception,manifesting in inconsistent and non-reproducible results.Given the substantial diffusion of the DALY indicator and its critical role in health impact assessments,a reassessment is warranted.This reconsideration is imperative for enhancing the robustness and reliability of public health decisionmaking processes.

Development, Translation and Validation of the Circle of Life (CoL) Satisfaction Scale Assessment Tool: An Integrative Nutrition Approach

Objectives: This study was designed to validate, test and translate a newly developed assessment tool for health coaches to assess client’s satisfaction rates of the Circle of Life (CoL), as a guide for weight management and also to monitor clients’ health and wellbeing improvements. This includes development of the assessment content, content validity, translating and pretesting the tool among potential clients. Method: 18 participants enrolled in a telenutrition weight loss program was and received a hypocaloric diet that was supported with monthly telemonitoring and health coaching sessions remotely for 6 months. Thus, we developed content of the assessment tool and created a rating scale of three levels of satisfaction (completely satisfied, slightly satisfied and not satisfied). The process of validation included content and language validity by experts in the field and language. Results: High scores according to the content validity rating were seen on both English and language versions of the CoL assessment tool by experts. Followed by a pre-testing process by participants, which showed reliability and consistency of the (CoL) variables using a multilevel analysis seeks across all individuals and all individuals had similar correlational pattern. Conclusions: The new (CoL) satisfaction scale have demonstrated a good capacity for identifying lifestyle factors associated with participants weight, which is a useful tool for integrative nutrition practice in weight management interventions. Future studies must be directed towards using the tool in assessing different populations and cultures to understand the main root of obesity in relation to behavior and day to day life factors.

Investigation of the quality of life,mental status in patients with gynecological cancer and its influencing factors

BACKGROUND Having a gynecological tumor or undergoing treatment can be a traumatic experience for women,as it affects their self-image and sexual relationships and can lead to psychological reactions.Psychological adjustment following cancer occurrence remains a key issue among the survivors.AIM To examine the current status of quality of life(QoL),anxiety,and depression in patients with gynecological cancer and to analyze the factors associated with it.METHODS Data for 160 patients with gynecological malignancies treated at Shanxi Bethune Hospital from June 2020 to June 2023 were collected and analyzed retrospectively.Patients’QoL was assessed using the European Organization for Research on Treatment of Cancer Quality of Life Questionnaire Core 30 and the Functional Assessment of Cancer Therapy-General Questionnaire.Their emotional status was evaluated using the Self-Rating Anxiety/Depression Scale.The associated factors of anxiety and depression were analyzed.RESULTS The overall QoL score of the patients 6 months after surgery was 76.39±3.63 points.This included low levels of social and emotional function and severe fatigue and pain.The scores for physiological,functional,emotional,social,and family well-being exhibited an upward trend following surgery compared with those before surgery.One month after surgery,some patients experienced anxiety and depression,with an incidence of 18.75%and 18.13%,respectively.Logistic analysis revealed that good sleep was a protective factor against anxiety and depression in patients with gynecological tumors,whereas physical pain was a risk factor.CONCLUSION Patients with gynecological malignancies often experience anxiety and depression.By analyzing the factors that affect patients’QoL,effective nursing measures can be administered.

Shifting the Paradigm:A Fresh Look at Physical Activity Frequency and Its Impact on Mental Health,Life Satisfaction,and Self-Rated Health in Adolescents

As adolescent mental health problems are becoming a more serious issue globally,this paper explores the relationship of physical activity in adolescents and its frequency on mental health as well as examines the mediating effects of life satisfaction and self-rated health in order to provide a reference for the promotion of mental health in adolescents.A sample of 3578 Chinese high school students completed questionnaires assessing their mental health,physical activity frequency,life satisfaction,and self-rated health.The mean SCL-90 value for adolescents was found to be 1.629%,and 24.73%of adolescents had varying degrees of mental health issue.Increased physical activity frequency is positively associated with improved mental health(p<0.001).Additionally,life satisfaction and self-rated health were found to play significant mediating roles in the relationship between physical activity frequency and mental health.Specifically,low-frequency physical activity had the most pronounced mediating effect on mental health through life satisfaction,while high-frequency physical activity exerted the most significant mediating effect on mental health through self-rated health.These findings underscore the importance of promoting physical activity among adolescents and highlight the distinct pathways through which physical activity frequency can influence mental health outcomes.Further research is needed to explore these relationships in diverse populations and settings,as well as to develop targeted intervention.

Effect of comprehensive nursing on the quality of life and swallowing function in individuals diagnosed with ischemic stroke

BACKGROUND Ischemic stroke(IS)is a widely recognized disease characterized by high preva-lence,mortality,morbidity,disability,and recurrence rates.It ranks prominently in terms of mortality,constituting 60%-80%of stroke cases.AIM To explore the impact of comprehensive nursing care on the quality of life and swallowing function in individuals diagnosed with IS.METHODS This study comprised 172 patients with IS admitted to our hospital between February 2018 to March 2021.The participants were divided into two groups,namely the control group(n=80)receiving routine care and the research group(n=92)receiving comprehensive care.Various assessment scales,including the standard swallowing function assessment scale(SSA),National Institutes of Health Stroke scale(NIHSS),European stroke scale(ESS),self-rating anxiety scale(SAS),self-rating depression scale(SDS),Barthel index(BI),and the motor func-tion assessment scale(MAS),were employed to evaluate the improvement in swallowing function,neurological deficits,clinical outcomes,anxiety,depression,daily living activities,and motor function before and after care.Furthermore,the study compared the occurrence of adverse reactions during the nursing period,life quality before and after the intervention,rehabilitation compliance,and nursing satisfaction between the two groups.RESULTS After the nursing intervention,the research group exhibited significantly improved SSA and NIHSS scores compared to the control group(P<0.05).Moreover,both groups demonstrated significant reductions in SAS and SDS scores(P<0.05),with the research group showing more obvious advantages(P<0.05).Compared to the control group,the research group displayed significantly better ESS,BI,and MAS scores(P<0.05),coupled with a lower incidence of adverse reactions(P<0.05).Additionally,the research group demonstrated markedly higher levels of life quality,rehabilitation compliance,and nursing satisfaction compared to the control group(P<0.05).CONCLUSION Comprehensive nursing effectively improved swallowing function,quality of life,and patient satisfaction,high-lighting its clinical significance.

The early life immune dynamics and cellular drivers at single-cell resolution in lamb forestomachs and abomasum

Background Four-chambered stomach including the forestomachs(rumen,reticulum,and omasum)and abomasum allows ruminants convert plant fiber into high-quality animal products.The early development of this four-chambered stomach is crucial for the health and well-being of young ruminants,especially the immune development.However,the dynamics of immune development are poorly understood.Results We investigated the early gene expression patterns across the four-chambered stomach in Hu sheep,at 5,10,15,and 25 days of age.We found that forestomachs share similar gene expression patterns,all four stomachs underwent widespread activation of both innate and adaptive immune responses from d 5 to 25,whereas the metabolic function were significantly downregulated with age.We constructed a cell landscape of the four-chambered stomach using single-cell sequencing.Integrating transcriptomic and single-cell transcriptomic analyses revealed that the immune-associated module hub genes were highly expressed in T cells,monocytes and macrophages,as well as the defense-associated module hub genes were highly expressed in endothelial cells in the four-stomach tissues.Moreover,the non-immune cells such as epithelial cells play key roles in immune maturation.Cell communication analysis predicted that in addition to immune cells,non-immune cells recruit immune cells through macrophage migration inhibitory factor signaling in the forestomachs.Conclusions Our results demonstrate that the immune and defense responses of four stomachs are quickly developing with age in lamb's early life.We also identified the gene expression patterns and functional cells associated with immune development.Additionally,we identified some key receptors and signaling involved in immune regulation.These results help to understand the early life immune development at single-cell resolution,which has implications to develop nutritional manipulation and health management strategies based on specific targets including key receptors and signaling pathways.

Study on the Layout of 15-Minute Community-Life Circle in Third-Tier Cities Based on POI: Baoding City of Hebei Province

At present, the planning of 15-minute community-life circle is being actively promoted in China. Taking Baoding City as an example, the status quo of service facilities layout was analyzed based on the POI data. Using the spatial accessibility algorithm, the ranges of 15-minute life circle of more than 1000 communities in Baoding were determined. By calculating the up-to-standard rates of public service facilities in each district, it is found that the allocation of medical facilities and commercial facilities in urban community life circle is relatively perfect, but the allocation of public cultural facilities and pension facilities is obviously inadequate. Based on this, optimization suggestions on the layout of public service facilities in the 15-minute life circle were put forward from three aspects: facilities sharing, function mixing and population structure and activity characteristics differentiation. It not only provides data and technical support for the planning and construction of community life circle in Baoding city, but also provides referable examples and promotable models for the community planning of third-tier cities.

基于Childlife理念的叙事医学干预在隐睾患儿围手术期中的应用

目的探讨Child life理念的叙事医学干预在隐睾患儿围手术期中的应用效果。方法选取2021年1月至2023年8月安徽医科大学第一附属医院收治的120例住院择期手术的隐睾患儿作为研究对象,采用随机数字表法分为观察组和对照组,各60例。对照组采用泌尿外科常规围手术期干预,观察组在对照组基础上采用Child life理念的叙事医学干预。比较两组患儿和家长入院时、术后1 d和出院时的焦虑状态,以及患儿术后疼痛和家长满意度。结果两组患儿和家长焦虑评分组间、时间及交互比较,差异均具有统计学意义(P<0.001);对照组患儿和家长出院时焦虑评分均低于入院时、术后1 d,差异具有统计学意义(P<0.05);观察组患儿和家长术后1 d焦虑评分均低于入院时,出院时低于入院时、术后1 d,差异具有统计学意义(P<0.05);观察组患儿和家长术后1 d、出院时焦虑评分均低于对照组,差异具有统计学意义(P<0.05)。观察组患儿术后疼痛评分显著低于对照组,差异具有统计学意义(P<0.001)。观察组家长满意度显著高于对照组,差异具有统计学意义(P<0.001)。结论基于Child life理念的叙事医学干预可有效减轻隐睾患儿和家长围手术期的焦虑情绪,降低患儿术后疼痛感,提高家长满意度。

Consequences of early life stress on the structure and function of the adult mouse retina

Early-life stress(ELS)refers to a period of environmental/social deprivation,physica l,sexual or emotional abuse,neglect,severe and/or chronic trauma in the prenatal/early postnatal stage,which is closely related to many adverse psychiatric disorders later in life,such as depressive disorder,substance abuse,dysthymia,panic,anxiety,and suicidal behavior in adulthood(Waters and Gould,2022).

Healthy life expectancy with cardiovascular disease among Chinese rural population based on the prospective cohort study

BACKGROUND Limited research has explored the impact of cardiovascular disease(CVD)on healthy life expectancy(HLE)especially in resource-limited areas.This study aimed to investigate the association between CVD and HLE in Chinese rural population.METHODS This study included 11,994 participants aged 45 years and older from the baseline and follow-up surveys of the Henan rural cohort study.Healthy status was measured via a Visual Analogue Scale.The multistate Markov model was applied to estimate the association between CVD and transitions in health,unhealthiness and death.Gender-specific total life expectancy,HLE and unhealthy life expectancy were calculated by the multistate life table method.RESULTS During a mean follow-up time of 3.85(3.84–3.86)years,there were 588 deaths recorded.For individuals with CVD,the risk of switching from health to unhealthiness status was increased by 71%[hazard ratio(HR)=1.71,95%CI:1.42–2.07],the chance of recovery was reduced by 30%(HR=0.70,95%CI:0.60–0.82).Men aged 45 years without CVD could gain an extra 7.08(4.15–10.01)years of HLE and lose 4.00(1.60–6.40)years of unhealthy life expectancy compared to their peers with CVD,respectively.The corresponding estimates among women were 8.62(5.55–11.68)years and 5.82(2.59–9.04)years,respectively.CONCLUSIONS This study indicated that CVD was significantly associated with poorer health status and lower HLE among Chinese rural population.It is an important public health policy to adopt targeted measures to reduce the CVD burden and enhance the quality of life and HLE in resource-limited areas.

Investigating the Influence of Glaucoma on the Quality of Life among Adult Patients

Background: Research exploring the influence of glaucoma on quality of life has gained momentum in recent years. Numerous studies have investigated the multifaceted aspects of quality of life in glaucoma patients, utilizing various assessment tools and methodologies. Objective: To determine the influence that glaucoma has on the quality of life among adult patients. Study site: kitwe teaching eye hospital, Zambia. Method: It was a cross-sectional study that was conducted from 30th June 2022 to 17th April 2023. The study included 106 diagnosed glaucoma patients who were above the age of 55 years. Data was collected using validated 25-item national eye institute visual function Questionnaire (NEI VFQ-25). The data was analyzed using SPSS version 26 and Microsoft excel to present frequencies and percentages that generated graphical presentation. Results: 62% of the participants worry about their eye sight most of the time, 26% sometimes and 12% a little time. 9% of the participants had little difficulty to read ordinary prints, 14% moderate difficulties and 58% extremely difficult. 40% of the participants could drive despite glaucoma damaging their eyes while 60% could not. Majority of the patients said it was difficult noticing things around them while walking or sitted in one place. There was a significant difference between effects of glaucoma on patients and the existing relationship between glaucoma and quality of life (ANOVA, p = 0.019 and ANOVA, p = 0.023). Conclusion: This study has demonstrated the magnitude of impact that glaucoma has on the Quality of Life (QoL) in diagnosed patients and the relationship between glaucoma and the Quality of Life. Due to the progressive visual loss, the amount of activities these patients would perform is negatively affected especially where social and economic activities are concerned which also affects their monthly earnings for those living in middle to low-income countries. Therefore, social welfare and psycho-social institutions need to increase their support for these glaucoma patients.

Economic Stress, Precariousness and Risk of High Blood Pressure: A Descriptive Survey of Life Models within Households of the Central Region of Cameroon

Context/Objective: High blood pressure (HBP) currently represents the most widespread chronic non-communicable disease in Cameroon. The increase in its prevalence in the country is the result of multiple factors including economic stress imposed by precariousness, poor living conditions, sources of anxiety, anguish, depression and other behavioral disorders. Economic stress is a globalizing concept that integrates into a purely hermeneutic approach, a particular functioning of the nervous system of an individual who faces employment problems and precarious remuneration conditions. The non-satisfaction by an individual of his basic needs due to insufficient financial means can cause him to become irritable, aggressive, and socially and symbolically isolated, thereby increasing the desire to resort to morbid life models such as excessive consumption of narcotics and other psychoactive substances often associated with high blood pressure. The fight against the emergence of BPH is a complex, multifaceted and multifactorial reality that requires taking into account economic stress. The main objective of this survey is to describe the situation of economic stress within the Cameroonian population, which imposes precariousness and life models at risk of high blood pressure. Specifically, we determined the level of household income and the sources of income. Methods: A cross-sectional survey with a descriptive aim among five hundred households in the Central Region of Cameroon was conducted. A probabilistic technique called simple randomness was used. The number of households to be surveyed was determined indirectly using the Cochrane formula. Data collection in face-to-face mode using a physical questionnaire took place from July 1 to August 31, 2023, after obtaining ethical clearance from the Regional Health Research Ethics Committee, Human from the Center and an administrative authorization for data collection. Regarding their processing, the data was grouped during processing in Excel sheets. Normality and reliability tests of the collected data were carried out. For this, the Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value. Descriptive analysis was possible using R software version 3.2, SPSS version 25.0, XLSTAT 2016, PAST and EXCEL programs from Microsoft Office 2013. Results: The main results highlight economic stress, with 45.60% of households surveyed earning less than US$154 per month;55% of household heads were women in single-parent families;14% of household heads were unemployed, 22% worked in the private sector and 19% were self-employed. This general economic situation leads to precarious living conditions, thereby increasing the risk of high blood pressure among the Cameroonian population.

Life Review the Impact of Combined Watson Care Theory Intervention on Psychological Status and Quality of Life in Patients with Terminal Lung Cancer

Objective: To analyze the impact of combined Watson care theory intervention on the psychological state and quality of life in patients with terminal lung cancer. Methods: 72 patients with terminal lung cancer admitted from March 2021 to January 2024 were selected, which were divided into research group (life review combined with Watson care theory intervention) and control group (conventional intervention), with 36 cases each. Compare the nursing effect between the two groups. Results: The anxiety self-rating scale (SAS) and depression self-rating scale (SDS) scores were significantly lower than those of the control group, and the quality of life score was significantly higher than that of the control group (P < 0.05). Conclusion: Life review combined with Watson care theory intervention can improve the psychological state and improve the quality of life of patients with terminal lung cancer.

Quality-adjusted life years and surgical waiting list:Systematic review of the literature

BACKGROUND The quality-adjusted life year(QALY)is a metric that is increasingly used today in the field of health economics to evaluate the value of different medical treatments and procedures.Surgical waiting lists(SWLs)represent a pressing problem in public healthcare.The QALY measure has rarely been used in the context of surgery.It would be interesting to know how many QALYs are lost by patients on SWLs.AIM To investigate the relationship between QALYs and SWLs in a systematic review of the scientific literature.METHODS The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement.An unlimited search was carried out in PubMed,updated on January 19,2024.Data on the following variables were investigated and analyzed:Specialty,country of study,procedure under study,scale used to measure QALYs,the use of a theoretical or real-life model,objectives of the study and items measured,the economic value assigned to the QALY in the country in question,and the results and conclusions published.RESULTS Forty-eight articles were selected for the study.No data were found regarding QALYs lost on SWLs.The specialties in which QALYs were studied the most in relation to the waiting list were urology and general surgery,with 15 articles each.The country in which the most studies of QALYs were carried out was the United States(n=21),followed by the United Kingdom(n=9)and Canada(n=7).The most studied procedure was organ transplantation(n=39),including 15 kidney,14 liver,5 heart,4 lung,and 1 intestinal.Arthroplasty(n=4),cataract surgery(n=2),bariatric surgery(n=1),mosaicplasty(n=1),and septoplasty(n=1)completed the surgical interventions included.Thirty-nine of the models used were theoretical(the most frequently applied being the Markov model,n=34),and nine were real-life.The survey used to measure quality of life in 11 articles was the European Quality of Life-5 dimensions,but in 32 articles the survey was not specified.The willingness-to-pay per QALY gained ranged from$100000 in the United States to€20000 in Spain.CONCLUSION The relationship between QALYs and SWLs has only rarely been studied in the literature.The rate of QALYs lost on SWLs has not been determined.Future research is warranted to address this issue.

The Impact of Binge Drinking among Brazilian University Students on Mental Health and Quality of Life: A Post-COVID-19 Pandemic Study

Background: The restrictive lockdown measures that were introduced as a response to the COVID-19 pandemic imposed constraints that affected university students’ drinking habits and mental health. Methods: The current study evaluated the rate of binge drinking among university students as they returned to normal life post-lockdown and whether binge drinking affected their mental health and quality of life. A cross-sectional study included 1382 university students (18 - 24 years) of one private Southwestern university in Brazil. Alcohol Use Disorders Identification, the Beck Depression Inventory-II, and the World Health Organization Quality of Life Brief were used. Data were collected after the COVID-19 pandemic lockdown period (from October 2021 to May 2022). Results: 52.6% of the students reported binge drinking, and 35.6% reported symptoms of depression. Binge drinkers were 1.41 times more likely to experience depressive symptoms when compared with non-binge drinkers, and binge drinking was a risk factor for lower quality of life in all three domains (physical, psychological and environmental). Conclusion: Our study highlights an increased prevalence of binge drinking in university students after the pandemic lockdown. The rise in binge drinking rates was linked to depressive symptoms and worsening of quality of life.

Correlation of personality with individual reproductive success in shrub-nesting birds depends on their life history style

Two questions in the research of animal personality—whether there is a correlation between a personality trait and individual reproductive success,and what is the genetic basis underlying a personality trait—remain unresolved.We addressed these two questions in three shrub-nesting birds,the Azure-winged Magpie(Cyanopica cyanus,AM),White-collared Blackbird(Turdus albocinctus,WB),and Brown-cheeked Laughingthrush(Trochalopteron henrici,BL).The personality type of an individual was first identified according to its response to a territorial intruder.Then,we compared the fleeing distance,breeding parameters,and differential expressed genes(DEGs) in the brain transcriptome between bold and shy breeders.In the three species,bold breeders exhibited more aggressiveness towards an intruder of their territory than did shy breeders.The reproductive success of bold breeders was significantly higher than that of shy breeders in AM but not in WB and BL.The three species shared one DEG,crabp1,which was up-regulated in bold relative to in shy individuals.By regulating the expression of corticotropin-releasing hormone,higher crabp1 gene expression can decrease cellular response to retinoic acid.Therefore,bold individuals are insensitive to external stresses and able to exhibit more aggressiveness to intruders than their shier counterparts.Aggressiveness is beneficial to bold individuals in AM but not in WB and BL because the former could evoke neighbors to make the same response of defending against intruders but the latter could not.Although a personality trait may have the same genetic basis across species,its correlation with reproductive success depends largely on the life history style of a species.

The impact of foliar application of calcium nitrate fertilizer on the yield,quality,and post harvest life of two varieties of roses(Rosa hybrida L.)in a soilless cultivation system

【Objectives】Rose(Rosa hybrida L.)is a beautiful and widely cultivated flowering plant around the world whose quality is of great commercial importance.The objective of this study was to investigate the impact of foliar application of calcium nitrate on the quality and postharvest life of two rose varieties(cvs.Samurai,and Jumilia)in a soilless culture system.【Methods】The research used a hydroponic culture method,the roses plants were grown in Hoagland nutrient solution containing 50%less Ca for a total span of 4 months.One month was dedicated to plant acclimatization,and 3 months for spray treatment.Two rose varieties(Rosa hybrida L.),cvs.Samurai and Jumilia plants were used as test materials and planted in pots containing 100%perlite(3-5 mm).After one month of culture,160 mg/kg CaNO3 solution was sprayed,and each treatment corresponded to the first,second,and third harvests,respectively.The plant and flower growth indicators and flower vase life were investigated after each harvesting immediately.【Results】A positive impact of foliar-applied Ca on stem characteristics,pedicel dimensions,corolla size,flower attributes,and vase life was found.Furthermore,a general trend was observed,wherein an increase in the number of harvesting stages led to improved traits.Notably,Jumilia rose consistently exhibited lower values for all studied traits,except for flower vase life,in comparison to the Samurai rose.While there were no significant differences in length values between Samurai and Jumilia roses due to calcium foliar application across the three harvesting stages.Duncan’s grouping revealed a specific effect on Jumilia roses during the third harvest stage.Calcium fertilizer significantly increased photosynthesis rates of of rose leaves in the calcium treatments compared with the control treatment.【Conclusions】Foliar spraying of calcium nitrate is an effective measure to promote the growth of roses and improve the yield,quality and bottle life of fresh cut flowers.

Investigation into the Methodology and Implementation of Life Cycle Engineering under China’s Carbon Reduction Target in the Process Industry

The industrial sector is the primary source of carbon emissions in China.In pursuit of meeting its carbon reduction targets,China aims to promote resource consumption sustainability,reduce energy consumption,and achieve carbon neutrality within its processing industries.An effective strategy to promote energy savings and carbon reduction throughout the life cycle of materials is by applying life cycle engineering technology.This strategy aims to attain an optimal solution for material performance,resource consumption,and environmental impact.In this study,five types of technologies were considered:raw material replacement,process reengineering,fuel replacement,energy recycling and reutilization,and material recycling and reutilization.The meaning,methodology,and development status of life cycle engineering technology abroad and domestically are discussed in detail.A multidimensional analysis of ecological design was conducted from the perspectives of resource and energy consumption,carbon emissions,product performance,and recycling of secondary resources in a manufacturing process.This coupled with an integrated method to analyze carbon emissions in the entire life cycle of a material process industry was applied to the nonferrous industry,as an example.The results provide effective ideas and solutions for achieving low or zero carbon emission production in the Chinese industry as recycled aluminum and primary aluminum based on advanced technologies had reduced resource consumption and emissions as compared to primary aluminum production.

Multi-Objective Optimization of the Ultrasonic Scalpel Rod and Tip with Improved Performance:Vibration Frequency,Amplitude,and Service Life

Ultrasonic scalpel design for minimally invasive surgical procedures is mainly focused on optimizing cutting performance.However,an important issue is the low fatigue life of traditional ultrasonic scalpels,which affects their long-term reliability and effectiveness and creates hidden dangers for surgery.In this study,a multi-objective optimal design for the cutting performance and fatigue life of ultrasonic scalpels was proposed using finite element analysis and fatigue simulation.The optimal design parameters of resonance frequency and amplitude were determined.By setting the transition fillet and keeping the gain structure away from the node position to enable the scalpel to have a high service life with excellent cutting performance.The frequency modulation method of setting the vibration node bosses at the node position and setting the vibration antinode grooves at the antinode position was compared.Then,the mechanism of the influence of various design elements,such as tip,shank,node position,and antinode position,on the resonance frequency,amplitude,and fatigue life of the ultrasonic scalpel was analyzed,and the optimal design principles of the ultrasonic scalpel were obtained.The proposed ultrasonic scalpel design was confirmed by simulations,impedance measurements,and liver tissue cutting experiments,demonstrating its feasibility and enhanced performance.This research introduces innovative design strategies to improve the fatigue life and performance of ultrasonic scalpels to address an important issue in minimally invasive surgery.

Mediating Effect of Mindfulness,Self-Esteem and Psychological Resilience in the Relation between Childhood Maltreatment and Life Satisfaction

Childhood maltreatment,as a typical early adverse environment,is known to have a negative impact on one’s life satisfaction.Mindfulness,on the other hand,may serve as a protective factor.This study explored the mediating role of mindfulness and its related variables–positive thoughts,psychological resilience and self-esteem.In order to testify the mechanism,we administered Childhood Trauma Questionnaire(CTQ),Satisfaction with Life Scale(SWLS),Mindful Attention Awareness Scale(MAAS),Connor–Davidson Resilience Scale(CD-RISC)and Rosenberg Self-Esteem Scale(RSES)to a non-clinical sample of Chinese university students(N=1021).The results indicated that positive thoughts did not mediate the relationship between childhood maltreatment and life satisfaction,but self-esteem(β=−0.194,95%CI=[−0.090,−0.040])and psychological resilience(β=−0.063,95%CI=[−0.059,−0.020])mediated the relationship,as well as the“mindfulness-selfesteem”(β=−0.061,95%CI=[−0.287,−0.126])and“mindfulness-psychological resilience”(β=−0.035,95%CI=[−0.115,−0.034]).The results of this study were helpful to understand the relationship between childhood maltreatment and life satisfaction and provided a theoretical basis for the development of mindfulness intervention programs from the perspective of positive psychology.