Optimization Design of the Multi-Layer Cross-Sectional Layout of An Umbilical Based on the GA-GLM

Marine umbilical is one of the key equipment for subsea oil and gas exploitation,which is usually integrated by a great number of different functional components with multi-layers.The layout of these components directly affects manufacturing,operation and storage performances of the umbilical.For the multi-layer cross-sectional layout design of the umbilical,a quantifiable multi-objective optimization model is established according to the operation and storage requirements.Considering the manufacturing factors,the multi-layering strategy based on contact point identification is introduced for a great number of functional components.Then,the GA-GLM global optimization algorithm is proposed combining the genetic algorithm and the generalized multiplier method,and the selection operator of the genetic algorithm is improved based on the steepest descent method.Genetic algorithm is used to find the optimal solution in the global space,which can converge from any initial layout to the feasible layout solution.The feasible layout solution is taken as the initial value of the generalized multiplier method for fast and accurate solution.Finally,taking umbilicals with a great number of components as examples,the results show that the cross-sectional performance of the umbilical obtained by optimization algorithm is better and the solution efficiency is higher.Meanwhile,the multi-layering strategy is effective and feasible.The design method proposed in this paper can quickly obtain the optimal multi-layer cross-sectional layout,which replaces the manual design,and provides useful reference and guidance for the umbilical industry.

Wideband radar cross-section reduction by a double-layer-plasma-based metasurface

Reduction of the radar cross-section(RCS) is the key to stealth technology. To improve the RCS reduction effect of the designed checkerboard metasurface and overcome the limitation of thinlayer plasma in RCS reduction technology, a double-layer-plasma-based metasurface—composed of a checkerboard metasurface, a double-layer plasma and an air gap between them—was investigated. Based on the principle of backscattering cancellation, we designed a checkerboard metasurface composed of different artificial magnetic conductor units;the checkerboard metasurface can reflect vertically incident electromagnetic(EM) waves in four different inclined directions to reduce the RCS. Full-wave simulations confirm that the doublelayer-plasma-based metasurface can improve the RCS reduction effect of the metasurface and the plasma. This is because in a band lower than the working band of the metasurface, the RCS reduction effect is mainly improved by the plasma layer. In the working band of the metasurface,impedance mismatching between the air gap and first plasma layer and between first and second plasma layers cause the scattered waves to become more dispersed, so the propagation path of the EM waves in the plasma becomes longer, increasing the absorption of the EM waves by the plasma. Thus, the RCS reduction effect is enhanced. The double-layer-plasma-based metasurface can be insensitive to the polarization of the incoming EM waves, and can also maintain a satisfactory RCS reduction band when the incident waves are oblique.

Spatial pattern recognition for near-surface high temperature increases in mountain areas using MODIS and SRTM DEM

Abrupt near-surface temperature changes in mountainous areas are a special component of the mountain climate system.Fast and accurate measurements of the locations,intensity,and width of the near-surface changes are necessary but highly difficult due to the complicated environmental conditions and instrumental issues.This paper develops a spatial pattern recognition method to measure the near-surface high temperature increase(NSHTI),one of the lesser-attended changes.First,raster window measurement was proposed to calculate the temperature lapse rate using MODIS land surface temperature and SRTM DEM data.It fully considers the terrain heights of two neighboring cells on opposite or adjacent slopes with a moving window of 3×3 cell size.Second,a threshold selection was performed to identify the NSHTI cells using a threshold of-0.65℃/100 m.Then,the NSHTI strips were parameterized through raster vectorization and spatial analysis.Taking Yunnan,a mountainous province in southwestern China,as the study area,the results indicate that the NSHTI cells concentrate in a strip-like pattern along the mountains and valleys,and the strips are almost parallel to the altitude contours with a slight northward uplift.Also,they are located mostly at a 3/5 height of high mountains or within 400 m from the valley floors,where the controlling topographic index is the altitude of the terrain trend surface but not the absolute elevation and the topographic uplift height and cutting depth.Additionally,the NSHTI intensity varies with the geographic locations and the proportions increase with an exponential trend,and the horizontal width has a mean of about 1000 m and a maximum of over 5000 m.The result demonstrates that the proposed method can effectively recognize NSHTI boundaries over mountains,providing support for the modeling of weather and climate systems and the development of mountain resources.

Dyslipidemia in Adults with Type 2 Diabetes in a Rural Community in Ganadougou, Mali: A Cross-Sectional Study

Dyslipidemia is a disorder where abnormally lipid concentrations circulate in the bloodstream. The disorder is common in type 2 diabetics (T2D) and is linked with T2D comorbidities, particularly cardiovascular disease. Dyslipidemia in T2D is typically characterized by elevated plasma triglyceride and low high-density lipoprotein cholesterol (HDL-C) levels. There is a significant gap in the literature regarding dyslipidemia in rural parts of Africa, where lipid profiles may not be captured through routine surveillance. This study aimed to characterize the prevalence and demo-graphic profile of dyslipidemia in T2D in the rural community of Ganadougou, Mali. We performed a cross-sectional study of 104 subjects with T2D in Ganadougou between November 2021 and March 2022. Demographic and lipid profiles were collected through cross-sectional surveys and serological analyses. The overall prevalence of dyslipidemia in T2D patients was 87.5% (91/104), which did not differ by sex (P = .368). High low-density lipoprotein cholesterol (LDL-C) was the most common lipid abnormality (78.9%, [82/104]). Dyslipidemia was associated with age and hypertension status (P = .013 and.036, respectively). High total and high LDL-C parameters were significantly associated with hypertension (P = .029 and .006, respectively). In low-resource settings such as rural Mali, there is a critical need to improve infrastructure for routine dyslipidemia screening to guide its prevention and intervention approaches. The high rates of dyslipidemia observed in Gandadougou, consistent with concomitant increases in cardiovascular diseases in Africa suggest that lipid profile assessments should be incorporated into routine medical care for T2D patients in African rural settings.

Association between triglyceride-glucose index and colorectal polyps:A retrospective cross-sectional study

BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses metabolic health and insulin resistance,and has been linked to gastrointestinal cancers.AIM To investigate the potential association between the TyG index and CPs,as the relation between them has not been documented.METHODS A total of 2537 persons undergoing a routine health physical examination and colonoscopy at The First People's Hospital of Kunshan,Jiangsu Province,China,between January 2020 and December 2022 were included in this retrospective cross-sectional study.After excluding individuals who did not meet the eligibility criteria,descriptive statistics were used to compare characteristics between patients with and without CPs.Logistic regression analyses were conducted to determine the associations between the TyG index and the prevalence of CPs.The TyG index was calculated using the following formula:Ln[triglyceride(mg/dL)×glucose(mg/dL)/2].The presence and types of CPs was determined based on data from colonoscopy reports and pathology reports.RESULTS A nonlinear relation between the TyG index and the prevalence of CPs was identified,and exhibited a curvilinear pattern with a cut-off point of 2.31.A significant association was observed before the turning point,with an odds ratio(95% confidence interval)of 1.70(1.40,2.06),P<0.0001.However,the association between the TyG index and CPs was not significant after the cut-off point,with an odds ratio(95% confidence interval)of 0.57(0.27,1.23),P=0.1521.CONCLUSION Our study revealed a curvilinear association between the TyG index and CPs in Chinese individuals,suggesting its potential utility in developing colonoscopy screening strategies for preventing CRC.

Patterns of Infertility and Abortion in Saudi Arabia: A Cross-Sectional Study

Background: Infertility and abortion are significant reproductive health concerns globally, impacting individuals' well-being and healthcare systems. In Saudi Arabia, cultural, social, and religious factors influence perceptions and management of these issues, necessitating research to understand the patterns and associated factors. Study Aim: This cross-sectional study aimed to investigate the patterns of infertility and abortion among 458 women in Saudi Arabia, focusing on demographic profiles, reproductive histories, medical conditions, and lifestyle factors. Methodology: Participants were recruited from healthcare facilities, and data on age, BMI, reproductive history, medical conditions, assisted reproduction methods, and lifestyle behaviors were collected. Statistical analyses, including chi-square tests, were conducted to examine associations between variables. Results: The majority of participants were aged 30 - 39 years (47.4%), with 76.9% experiencing secondary infertility. Among those with offspring (76.9%), 31% reported using assisted reproduction methods, primarily ovarian stimulators (54.2%). Abortion history was reported by 39.5% of participants. Significant associations were found between age and infertility type (X2 = 5.8, p = 0.054), having offspring and infertility type (X2 = 458.0, p = 0.001), menstrual irregularity and infertility type (X2 = 11.4, p = 0.001), and abortion history and delayed fertility (X2 = 10.4, p = 0.001). Conclusion: Our study reveals significant associations between demographic, medical, and lifestyle factors with infertility patterns and abortion history among Saudi women. These findings emphasize the need for tailored interventions addressing medical conditions, age-related factors, and access to reproductive healthcare services.

Theoretical analysis of the double-differential cross-sections of neutron,proton,deuteron,^(3)He,andαfor the p+^(6) Li reaction

Based on the unified Hauser–Feshbach and exciton model,which can describe the particle emission processes between discrete energy levels with energy,angular momentum,and parity conservations,a statistical theory of light nucleus reaction(STLN)is developed to calculate the double-differential cross-sections of the outgoing neutron and light charged particles for the proton-induced^(6) Li reaction.A significant difference is observed between the p+^(6) Li and p+^(7) Li reactions owing to the discrepancies in the energy-level structures of the targets.The reaction channels,including sequential and simultaneous emission processes,are analyzed in detail.Taking the double-differential cross-sections of the outgoing proton as an example,the influence of contaminations(such as^(1) H,^(7)Li,^(12)C,and^(16)O)on the target is identified in terms of the kinetic energy of the first emitted particles.The optical potential parameters of the proton are obtained by fitting the elastic scattering differential cross-sections.The calculated total double-differential cross-sections of the outgoing proton and deuteron at E_(p)=14 MeV agree well with the experimental data for different outgoing angles.Simultaneously,the mixed double differential cross-sections of^(3) He andαare in good agreement with the measurements.The agreement between the measured data and calculated results indicates that the two-body and three-body breakup reactions need to be considered,and the pre-equilibrium reaction mechanism dominates the reaction processes.Based on the STLN model,a PLUNF code for the p+^(6) Li reaction is developed to obtain an ENDF-6-formatted file of the double-differential cross-sections of the nucleon and light composite charged particles.

First Born Double Differential Cross-Section for Ionization of H (3d) by Incident Electron Impact

Double differential cross section (DDCS) of First-Born approximation is calcu-lated for the ionization of metastable 3d-state hydrogen atoms by electron impact energy at 150 eV and 250 eV. A multiple scattering theory is applied in the present study. The present results are compared with the other related the-oretical results for the ionization of hydrogen atoms from different metastable states and ground-state experimental results. The findings demonstrate a strong qualitative agreement with the existing results. The obtained results have an extensive scope for further study of such an ionization process.

A Cross-Sectional Study on The Prevalence of Anemia in Maintenance Hemodialysis and Peritoneal Dialysis Patients and Its Related Factors

Objective:To study the prevalence of anemia,the proportion of hemoglobin(Hb)levels,the treatment methods,and the influencing factors of Hb levels in maintenance hemodialysis(MHD)and peritoneal dialysis patients.Methods:In this study,602 patients with maintenance hemodialysis and continuous ambulatory peritoneal dialysis were enrolled from December 2020 to December 2022 in our hospital,and their medical records were collected and summarized.The main contents included the patient’s gender,age,primary disease,dialysis duration,dialysis method,the use of erythropoietic stimulating agents(ESA),intravenous iron,and laboratory tests.A Hb index exceeding 110 g/L was set as the standard for the prevalence of anemia.Results:The rate of anemia in patients undergoing blood purification was 83%.The proportion of ESA use was 84.1%,and the proportion of iron use was 76.7%,of which the proportion of intravenous iron used was 17.0%,and the proportion of folic acid used was 28.3%.Conclusion:The incidence of anemia in MHD patients was relatively high,with a low proportion of patients reaching the standard Hb levels.Risk factors include albumin(ALB)levels,iron storage,white blood cells,C-reactive protein,cholesterol,etc.Nutritional support,iron supplementation,and prevention of micro-inflammatory reactions can effectively promote the improvement of Hb indicators in dialysis patients to prevent anemia.

Tea Consumption is Associated with Increased Risk of Kidney Stones in Northern Chinese： A Cross-sectional Study

Kidney stones are a common urinary system condition that can progress to kidney disease. Previous studies on the association between tea consumption and kidney stones are inconsistent. A cross-sectional study to investigate the association between tea consumption and kidney stones was conducted from 2013 to 2014 and recruited 9,078 northern Chinese adults. A total of 8,807 participants were included in the final analysis. Participants＇ prevalence of kidney stones was 1.07%, 1.73%, and 2.25% based on their tea consumption frecluencv of never, occasionally,

Prediction models of the ionization coefficient and ionization cross-section based on multi-layer molecular parameters

Prediction models were proposed to estimate the reduced Townsend ionization coefficient and ionization cross-section.A shape function of the reduced Townsend ionization coefficient curves was derived from the ionization collision probability model.The function had three parameters:the first ionization potential energy,A_(α),and B_(α).A_(α)and B_(α)were related to the molecule symmetry and size.The polarization of molecules could characterize the molecule symmetry.The multi-layer molecular cross-section(MMCS)was proposed to describe the contributions of electrons and molecule radius on different molecule surfaces to collisions.A prediction model of the ionization cross-section was also proposed based on Aα.The molecule parameters were calculated by the Becke3–Lee–Yang–Parr(B3LYP)method and the 6–311G**basis set.We used available data of 30 and 23 gases,respectively,to build the prediction models of reduced Townsend ionization coefficients and ionization cross-sections.The relationships between the molecular parameters Aαand Bαand the ionization cross-section were built up via nonlinear fittings.The determination coefficients R^(2)of Aα,Bα,and the ionization cross-section were 0.877,0.887,and 0.838,respectively.The results showed that the accuracy of models was positively correlated with the molecule symmetry and reduced electric field.This was mainly related to the accuracy of the MMCS model in predicting Aα.The MMCS model needed to be improved to describe the collision direction selectivity caused by the molecule asymmetry.Under a high reduced electric field,that error of Aαhad less influence on the prediction results.However,the prediction results for single atoms with high symmetry were poor.This may be due to the absolute error of the model close to single atoms’reduced Townsend ionization coefficients.The models could provide the basis for gas insulation prediction and discharge calculations,especially for symmetric molecules under a high electric field.

Direct measurement of an energy-dependent single-event-upset cross-section with time-of-flight method at CSNS

To predict the soft error rate for applications, it is essential to study the energy dependence of the single-event-upset(SEU) cross-section. In this work, we present a direct measurement of the SEU cross-section with the Back-n white neutron source at the China Spallation Neutron Source. The measured cross section is consistent with the soft error data from the manufacturer and the result suggests that the threshold energy of the SEU is about 0.5 Me V, which confirms the statement in Iwashita’s report that the threshold energy for neutron soft error is much below that of the(n, α) cross-section of silicon.In addition, an index of the effective neutron energy is suggested to characterize the similarity between a spallation neutron beam and the standard atmospheric neutron environment.

Mulching broad ridges with a woven polypropylene fabric increases the growth and yield of young pear trees ‘Yuluxiang' in the North China Plain

Unlike traditional ridging, mulching broad ridges with a woven polypropylene fabric (WPF) can reduce soil evaporation during the drought season and avoid long saturation time in the root zone of pear trees during the rainy season. In this study, field experiments were conducted from 2017 to 2020 in a pear orchard in the North China Plain to investigate the effects of mulching broad ridges (0.3 m in height and 2 m in width) with WPF on soil temperature and moisture, nitrogen leaching, vegetative and reproductive growth of young pear trees(Pyrus bretschneideri Rehd.‘Yuluxiang’). The experiments involved two treatments, namely, control (traditional no-ridge planting without mulching) and mulching broad ridges with WPF (RM treatment). The results showed that the RM treatment increased soil moisture and temperature and decreased nitrogen leaching, resulting in vigorous growth of the young pear trees. Moreover, the RM treatment increased the tree trunk cross-sectional area and height of the young pear trees by 37%and 8%in 2020, respectively. The nitrate nitrogen content at the soil layer depth of 0-30 cm was significantly higher in the RM than that in control. Furthermore, the RM treatment significantly increased the fruit yield due to larger tree size. In addition, compared with control, significantly higher fruit soluble solid content of RM treatment was detected in 2020. High precipitation (423 mm) occurred during fruit enlargement stage in 2020, RM treatment decreased the rainfall infiltration in the ridge and the soil moisture in root region, resulting in the improvement of fruit quality, compared with control.Therefore, mulching broad ridges with WPF can be implemented to increase soil moisture during drought season, soil temperature, and nitrate nitrogen content, thereby improving the growth and fruit yield of young pear trees. Additionally, it can reduce soil moisture in the root zone during the rainy season and improve the fruit quality of the trees. Finally, it can reduce nitrate nitrogen leaching, thereby reducing environmental pollution.

Large eddy simulation of supersonic flow in ducts with complex cross-sections

Large Eddy Simulation(LES)has been employed for the investigation of supersonic flow characteristics in five ducts with varying cross-sectional geometries.The numerical results reveal that flow channel configurations exert a considerable influence on the mainstream flow and the near-wall flow behavior.In contrast to straight ducts,square-to-circular and rectangular-to-circular ducts exhibit thicker boundary layers and a greater presence of vortex structures.Given the same inlet area,rectangular-to-circular ducts lead to higher flow drag force and total pressure loss than square-to-circular ducts.Characterized by the substantial flow separation and shock waves,the"S-shaped duct shows significant vertically-asymmetric characteristics.

Knowledge,attitude,and practice of patients living with inflammatory bowel disease:A cross-sectional study

BACKGROUND Patients with inflammatory bowel diseases(IBDs)generally have poor knowledge,attitude,and practice of their disease,while the data from China are lacking.AIM To address this knowledge disparity among Chinese patients with IBD.METHODS This web-based,cross-sectional study was conducted on a cohort of IBD patients who visited the Second Affiliated Hospital of Wenzhou Medical University between December 2022 and February 2023.Their socio-demographic information and the knowledge,attitude,and practice scores were collected and estimated using a self-designed questionnaire.Pearson’s correlation analysis was used to determine the pairwise correlations among knowledge,attitude,and practice scores.A multivariate logistic regression analysis was further performed to determine the independent factors associated with their knowledge,attitude,and practice scores.RESULTS A total of 353 patients(224 males)with IBD completed the questionnaires.The mean knowledge,attitude,and practice scores were 10.05±3.46(possible range:0-14),41.58±5.23(possible range:0-56),44.20±7.39(possible range:0-56),respectively,indicating good knowledge,positive attitude,and proactive practice toward IBD.Pearson’s correlation analysis showed that the knowledge score had significant positive correlations with the attitude score(r=0.371,P<0.001)and practice score(r=0.100,P<0.001).The attitude score had a significant positive correlation with the practice score(r=0.452,P<0.001).Moreover,multivariate logistic regression analysis showed that aged 30-40 years[odds ratio(OR)=4.06,95%confidence interval(CI):1.04-15.82,P=0.043],middle school education(OR=3.98,95%CI:1.29-12.33,P=0.017),high school/technical secondary school education(OR=14.06,95%CI:3.92-50.38,P<0.001),and junior college/bachelor’s degree and above education(OR=15.20,95%CI:4.15-55.650,P<0.001)were independently associated with good knowledge.The higher knowledge score was independently associated with a positive attitude(OR=1.23,95%CI:1.11-1.36,P<0.001).The higher attitude score was independently associated with proactive practice(OR=1.20,95%CI:1.11-1.30,P<0.001).CONCLUSION Chinese patients with IBD might have good knowledge,a positive attitude,and proactive practice toward their disease.However,a small number of specific items require education.

Exercise, Depression, and Anxiety in Young People: A Cross-Sectional Survey

Background:Depression and anxiety are highly prevalent among adolescents and have multiple negative effects on their physical and mental health.While exercise can reduce the symptoms of depression and anxiety,the rela-tionship between mental disorders among American university students has been rarely reported.Accordingly,this study aimed to explore the association between exercise,depression and anxiety among American university students in the 2018–2019 academic year.Methods:In this cross-sectional study,the association between exercise,depression and anxiety was investigated in a large representative sample of American university students.In the 2018–2019 academic year,university students aged 18+years old from 79 institutions participated in this school-based study.The questionnaire included measurements of demographic characteristics,exercise,and validated screen instructions for depression(PHQ-9)and anxiety(GAD-7).The multivariable logistic regression model was applied to explore the association between exercise,depression and anxiety.Results:A total of 62026 indivi-duals(31.9%males)participated in this survey,and the prevalence of exercising at least 5 h each day was 24.6%.The prevalence of depression and anxiety was 25.7%and 22.3%,respectively.In the multivariable logistic regres-sion model,compared to exercise at least 5 h daily,participants whose exercise less than 1 h daily(OR=1.31[1.29,1.33],p<0.05),2 to 3 h daily(OR=1.13[1.11,1.15],p<0.05),3 to 4 h daily(OR=1.04[1.02,1.06],p<0.05),were correlated with greater odds of depression,while exercise less than 1 h daily(OR=1.23[1.21,1.25],p<0.05),2 to 3 h daily(OR=1.10[1.08,1.12],p<0.05)were significantly correlated with great-er odds of anxiety.Conclusion:Higher levels of exercise are associated with lower risk of depression and anxiety among American university students.Community and school interventions should focus on increasing exercise participation in university populations to promote both physical and mental health.

Numerical Analysis of Flow-Induced Vibration and Noise Generation in a Variable Cross-Section Channel

Flow channels with a variable cross-section are important components of piping system and are widely used in variousfields of engineering.Using afinite element method and modal analysis theory,flow-induced noise,mode shapes,and structure-borne noise in such systems are investigated in this study.The results demonstrate that the maximum displacement and equivalent stress are located in the part with variable cross-sectional area.The aver-age excitation force on theflow channel wall increases with theflow velocity.The maximum excitation force occurs in the range of 0–20 Hz,and then it decreases gradually in the range of 20–1000 Hz.Additionally,as theflow velocity rises from 1 to 3 m/s,the overall sound pressure level associated with theflow-induced noise grows from 49.37 to 66.37 dB.Similarly,the overall sound pressure level associated with the structure-borne noise rises from 40.27 to 72.20 dB.When theflow velocity is increased,the increment of the structure-borne noise is higher than that of theflow-induced noise.

Concept Analysis: Emergency Department Crowding and Length of Stay before and after an Increase in Catchment Area

Several notable issues arise from overcrowding in an emergency department (ED) for both patients and staff. Longer wait times, higher ambulance diversion rates, longer stays, higher incidence of medical errors, higher rates of patient mortality, and greater harm to hospitals due to financial losses are some of these problems. Collaboration is crucial in the healthcare industry since it determines the team’s hourly performance in managing patient care. By using Walker and Avant’s (2011) concept analysis method, the author reviewed the literature to better understand ED crowding, to ensure that patients receive safe treatment in a timely manner, and to highlight best practices that can be identified through concept analysis and practice evaluations. In conducting this concept analysis, Walker and Avant’s framework was applied to examine the nature of the findings selected for the advancement of the concept. Everyone working in the ED, from those who determine policy to those on the front lines continually encounter new obstacles, but has little or no time to formulate fresh concepts or reconsider how ED treatment is provided. Overcrowding occurs when the number of patients requiring attention, awaiting transfer, or undergoing diagnosis and treatment exceeds the physical capacity of ED staff. If a clear plan is not in place to increase and improve services in proportion to a growing population, this situation will persist.

Endoscopy demand among county people in southeast China:A cross-sectional study

Objective The popularization of gastroenteroscopy and the introduction of comfortable medical care have further promoted the growth of people's demand,especially the demand for painless endoscopy.This cross-sectional study aims to investigate the current situation and change in county people's demand for endoscopy to promote the development of endoscopy centers in county hospitals in southeast China.Methods From October to December 2021,patients and their family members who came to the Gastroenterology Department in Suichang County People's Hospital of Zhejiang Province were randomly selected to complete the questionnaire.A total of 838 valid questionnaires were collected.Additionally,the original software data of the Endoscopy Center were sampled and retrieved(from October to December every year from 2018 to 2021)for statistical analysis of real-world data.Those who would choose painless endoscopy the next time in the valid questionnaires were included in the painless endoscopy group,while those who would choose ordinary endoscopy the next time were included in the ordinary endoscopy group.Results The stepwise forward binary logistic regression model analysis showed that,patients with“secondhand smoke exposure”were more willing to choose painless endoscopy(OR=1.459,95%CI:1.050-2.028,p=0.025).However,patients with an education level of“primary and below”and“junior high school”,and patients who are suffering from“currently experiencing abdominal distension”,were more willing to choose ordinary endoscopy(OR=0.270,95%CI:0.149-0.488,p<0.001;OR=0.528,95%CI:0.330-0.845,p=0.008;OR=0.536,95%CI:0.334-0.861,p=0.010).Patients with previous experience in painless endoscopy tended to choose painless endoscopy the next time,while patients with previous experience in ordinary endoscopy tended to choose ordinary endoscopy the next time(χ^(2)=140.97,p<0.001).From 2018 to 2021,the proportion of painless endoscopy has increased yearly(p<0.001).Most patients indicated that they would“regularly review gastroenteroscopy”(477/838,56.9%).Conclusions With Suichang County of Zhejiang Province as the representative,the demand for painless endoscopy for people's gastrointestinal cancer detection in southeast China has been increasing yearly.The development of endoscopy centers in county-level hospitals can basically meet the demand growth.Meanwhile,advanced concepts such as comfortable medical care and regular follow-up are gradually popularized at the grassroots level in southeast China.

Determinants of internet addiction among medical students in Casablanca: a cross-sectional study

Objective:This study aimed to estimate the prevalence and determinants of Internet addiction among medical students at the Faculty of Medicine and Pharmacy of Casablanca,Morocco.Methods:This was a cross-sectional study conducted among students at the Faculty of Medicine and Pharmacy in Casablanca between October and March 2020.An online questionnaire was administered to students to collect data and internet addiction was assessed by the Young questionnaire.A score threshold≥50 was adopted to define addiction.Univariate and multivariate logistic regression analyses were used to identify factors associated with internet addiction.Results:Out of a total of 4093 FMPC students enrolled in the 2020-2021 academic year,506 agreed to participate in this study,including 303 females and 203 males.The mean addiction score assessed on the Young scale was(49.08±16.11).The prevalence of Internet addiction was 44.5%(225/506,95% CI:40% to 49%).Multiple regression analysis showed that being older than 20 years(OR=0.17,95% CI:0.40 to 0.64),being female(OR=1.70,95% CI:1.04 to 2.78),being in the dissertation year(6th year)(OR=5.17,95% CI:2.23 to 11.44),having a history of psychiatric consultation(OR=2.64,95% CI:1.34 to 5.21),having divorced parents(OR=2.64,95% CI:1.05 to 5.87),use of sleeping medication(OR=2.9,95% CI:1.05 to 3.70),sleep disorders(OR=2.06,95% CI:1.25 to 3.79),sleep deprivation(OR=2.26,95% CI:1.39 to 3.65),excessive daytime sleepiness(OR=5.39,95% CI:2.19 to 13.24),anxiety disorders(OR=1.47,95% CI:1.18 to 2.30),duration of internet connection(>4 h)(OR=11.43,95% CI:4.85 to 27.66),and having frequent conflicts with parents(OR=2.37,95% CI:1.49 to 3.79)and friends(OR=0.26,95% CI:0.11 to 0.65)were independently associated with internet addiction.Conclusion:The prevalence of Internet addiction among medical students in Casablanca remains high.Targeted action on the determinants would be of great value in prevention.