Purpose-In order to solve the problem of inaccurate calculation of index weights,subjectivity and uncertainty of index assessment in the risk assessment process,this study aims to propose a scientific and reasonable c...Purpose-In order to solve the problem of inaccurate calculation of index weights,subjectivity and uncertainty of index assessment in the risk assessment process,this study aims to propose a scientific and reasonable centralized traffic control(CTC)system risk assessment method.Design/methodologylapproach-First,system-theoretic process analysis(STPA)is used to conduct risk analysis on the CTC system and constructs risk assessment indexes based on this analysis.Then,to enhance the accuracy of weight calculation,the fuzzy analytical hierarchy process(FAHP),fuzzy decision-making trial and evaluation laboratory(FDEMATEL)and entropy weight method are employed to calculate the subjective weight,relative weight and objective weight of each index.These three types of weights are combined using game theory to obtain the combined weight for each index.To reduce subjectivity and uncertainty in the assessment process,the backward cloud generator method is utilized to obtain the numerical character(NC)of the cloud model for each index.The NCs of the indexes are then weighted to derive the comprehensive cloud for risk assessment of the CTC system.This cloud model is used to obtain the CTC system's comprehensive risk assessment.The model's similarity measurement method gauges the likeness between the comprehensive risk assessment cloud and the risk standard cloud.Finally,this process yields the risk assessment results for the CTC system.Findings-The cloud model can handle the subjectivity and fuzziness in the risk assessment process well.The cloud model-based risk assessment method was applied to the CTC system risk assessment of a railway group and achieved good results.Originality/value-This study provides a cloud model-based method for risk assessment of CTC systems,which accurately calculates the weight of risk indexes and uses cloud models to reduce uncertainty and subjectivity in the assessment,achieving effective risk assessment of CTC systems.It can provide a reference and theoretical basis for risk management of the CTC system.展开更多
The main hazard-causing factors of tropical cyclones are strong wind,heavy rainfall,and storm surge.Evaluation of the hazard-causing degree of a tropical cyclone requires a joint intensity analysis of these hazard-cau...The main hazard-causing factors of tropical cyclones are strong wind,heavy rainfall,and storm surge.Evaluation of the hazard-causing degree of a tropical cyclone requires a joint intensity analysis of these hazard-causing factors.According to the maximum hourly mean wind speed,total rainfall,and maximum tide level at various observation stations in Hong Kong during these tropical cyclones,three hazard-causing indices for tropical cyclones are introduced:the strong-wind index(VI),total-rainfall index(RI),and tide-level index(LI).Through a joint probability analysis of VI,RI,and LI for a tropical cyclone affecting Hong Kong,the joint return period is calculated to evaluate its joint hazard-causing intensity.A limit state function of Hong Kong’s resistance to tropical cyclones is developed and used to evaluate the regional risk of tropical cyclones affecting Hong Kong.The results indicate that the joint return period of VI,RI,and LI can reflect the joint hazard-causing intensity of strong wind,heavy rain,and storm surge caused by tropical cyclones;if the overall design return periods of the regional structures decrease,the regional ability to defend against tropical cyclone disasters is degraded.展开更多
BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective pr...BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.展开更多
In traditional finite-temperature Kohn–Sham density functional theory(KSDFT),the partial occupation of a large number of high-energy KS eigenstates restricts the use of first-principles molecular dynamics methods at ...In traditional finite-temperature Kohn–Sham density functional theory(KSDFT),the partial occupation of a large number of high-energy KS eigenstates restricts the use of first-principles molecular dynamics methods at extremely high temperatures.However,stochastic density functional theory(SDFT)can overcome this limitation.Recently,SDFT and the related mixed stochastic–deterministic density functional theory,based on a plane-wave basis set,have been implemented in the first-principles electronic structure software ABACUS[Q.Liu and M.Chen,Phys.Rev.B 106,125132(2022)].In this study,we combine SDFT with the Born–Oppenheimer molecular dynamics method to investigate systems with temperatures ranging from a few tens of eV to 1000 eV.Importantly,we train machine-learning-based interatomic models using the SDFT data and employ these deep potential models to simulate large-scale systems with long trajectories.Subsequently,we compute and analyze the structural properties,dynamic properties,and transport coefficients of warm dense matter.展开更多
The Yellow River Basin(YRB)has experienced severe floods and continuous riverbed elevation throughout history.Global climate change has been suggested to be driving a worldwide increase in flooding risk.However,owing ...The Yellow River Basin(YRB)has experienced severe floods and continuous riverbed elevation throughout history.Global climate change has been suggested to be driving a worldwide increase in flooding risk.However,owing to insufficient evidence,the quantitative correlation between flooding and climate change remains illdefined.We present a long time series of maximum flood discharge in the YRB dating back to 1843 compiled from historical documents and instrument measurements.Variations in yearly maximum flood discharge show distinct periods:a dramatic decreasing period from 1843 to 1950,and an oscillating gentle decreasing from 1950 to 2021,with the latter period also showing increasing more extreme floods.A Mann-Kendall test analysis suggests that the latter period can be further split into two distinct sub-periods:an oscillating gentle decreasing period from 1950 to 2000,and a clear recent increasing period from 2000 to 2021.We further predict that climate change will cause an ongoing remarkable increase in future flooding risk and an∼44.4 billion US dollars loss of floods in the YRB in 2100.展开更多
Due to the high potential risk and many influencing factors of subsea horizontal X-tree installation,to guarantee the successful completion of sea trials of domestic subsea horizontal X-trees,this paper established a ...Due to the high potential risk and many influencing factors of subsea horizontal X-tree installation,to guarantee the successful completion of sea trials of domestic subsea horizontal X-trees,this paper established a modular risk evaluation model based on a fuzzy fault tree.First,through the analysis of the main process oftree down and combining the Offshore&Onshore Reliability Data(OREDA)failure statistics and the operation procedure and the data provided by the job,the fault tree model of risk analysis of the tree down installation was established.Then,by introducing the natural language of expert comprehensive evaluation and combining fuzzy principles,quantitative analysis was carried out,and the fuzzy number was used to calculate the failure probability of a basic event and the occurrence probability of a top event.Finally,through a sensitivity analysis of basic events,the basic events of top events significantly affected were determined,and risk control and prevention measures for the corresponding high-risk factors were proposed for subsea horizontal X-tree down installation.展开更多
Natural disaster risk monitoring is an important task for disaster prevention and reduction.In the case of immovable cultural relics,however,the feedback mechanism,risk factors,monitoring logic,and monitoring indicato...Natural disaster risk monitoring is an important task for disaster prevention and reduction.In the case of immovable cultural relics,however,the feedback mechanism,risk factors,monitoring logic,and monitoring indicators of natural disaster risk monitoring are complex.How to achieve intelligent perception and monitoring of natural disaster risk for immovable cultural relics has always been a focus and a challenge for researchers.Based on the analysis of the concepts and issues related to the natural disaster risk of immovable cultural relics,this paper proposes a framework for natural disaster risk monitoring for immovable cultural relics based on the digital twin.This framework focuses on risk monitoring,including the physical entities of natural disaster risk for immovable cultural relics,monitoring indicators,and virtual entity construction.A platform for monitoring the natural disaster risk of immovable cultural relics is proposed.Using the Puzhou Ancient City Site as a test bed,the proposed concept can be used for monitoring the natural disaster risk of immovable cultural relics at different scales.展开更多
BACKGROUND Cancer patients often suffer from severe stress reactions psychologically,such as anxiety and depression.Prostate cancer(PC)is one of the common cancer types,with most patients diagnosed at advanced stages ...BACKGROUND Cancer patients often suffer from severe stress reactions psychologically,such as anxiety and depression.Prostate cancer(PC)is one of the common cancer types,with most patients diagnosed at advanced stages that cannot be treated by radical surgery and which are accompanied by complications such as bodily pain and bone metastasis.Therefore,attention should be given to the mental health status of PC patients as well as physical adverse events in the course of clinical treatment.AIM To analyze the risk factors leading to anxiety and depression in PC patients after castration and build a risk prediction model.METHODS A retrospective analysis was performed on the data of 120 PC cases treated in Xi'an People's Hospital between January 2019 and January 2022.The patient cohort was divided into a training group(n=84)and a validation group(n=36)at a ratio of 7:3.The patients’anxiety symptoms and depression levels were assessed 2 wk after surgery with the Self-Rating Anxiety Scale(SAS)and the Selfrating Depression Scale(SDS),respectively.Logistic regression was used to analyze the risk factors affecting negative mood,and a risk prediction model was constructed.RESULTS In the training group,35 patients and 37 patients had an SAS score and an SDS score greater than or equal to 50,respectively.Based on the scores,we further subclassified patients into two groups:a bad mood group(n=35)and an emotional stability group(n=49).Multivariate logistic regression analysis showed that marital status,castration scheme,and postoperative Visual Analogue Scale(VAS)score were independent risk factors affecting a patient's bad mood(P<0.05).In the training and validation groups,patients with adverse emotions exhibited significantly higher risk scores than emotionally stable patients(P<0.0001).The area under the curve(AUC)of the risk prediction model for predicting bad mood in the training group was 0.743,the specificity was 70.96%,and the sensitivity was 66.03%,while in the validation group,the AUC,specificity,and sensitivity were 0.755,66.67%,and 76.19%,respectively.The Hosmer-Lemeshow test showed aχ^(2) of 4.2856,a P value of 0.830,and a C-index of 0.773(0.692-0.854).The calibration curve revealed that the predicted curve was basically consistent with the actual curve,and the calibration curve showed that the prediction model had good discrimination and accuracy.Decision curve analysis showed that the model had a high net profit.CONCLUSION In PC patients,marital status,castration scheme,and postoperative pain(VAS)score are important factors affecting postoperative anxiety and depression.The logistic regression model can be used to successfully predict the risk of adverse psychological emotions.展开更多
BACKGROUND Age is a significant risk factor of diabetes mellitus(DM).With the develop of population aging,the incidence of DM remains increasing.Understanding the epidemiology of DM among elderly individuals in a cert...BACKGROUND Age is a significant risk factor of diabetes mellitus(DM).With the develop of population aging,the incidence of DM remains increasing.Understanding the epidemiology of DM among elderly individuals in a certain area contributes to the DM interventions for the local elderly individuals with high risk of DM.AIM To explore the prevalence of DM among elderly individuals in the Lugu community and analyze the related risk factors to provide a valid scientific basis for the health management of elderly individuals.METHODS A total of 4816 elderly people who came to the community for physical examination were retrospectively analyzed.The prevalence of DM among the elderly was calculated.The individuals were divided into a DM group and a non-DM group according to the diagnosis of DM to compare the differences in diastolic blood pressure(DBP)and systolic blood pressure(SBP),fasting blood glucose,body mass index(BMI),waist-to-hip ratio(WHR)and incidence of hypertension(HT),coronary heart disease(CHD),and chronic kidney disease(CKD).RESULTS DM was diagnosed in 32.70%of the 4816 elderly people.The BMI of the DM group(25.16±3.35)was greater than that of the non-DM group(24.61±3.78).The WHR was 0.90±0.04 in the non-DM group and 0.90±0.03 in the DM group,with no significant difference.The left SBP and SBP in the DM group were 137.9 mmHg±11.92 mmHg and 69.95 mmHg±7.75 mmHg,respectively,while they were 126.6 mmHg±12.44 mmHg and 71.15 mmHg±12.55 mmHg,respectively,in the non-DM group.These findings indicate higher SBP and lower DBP in DM patients than in those without DM.In the DM group,1274 patients were diagnosed with HT,accounting for 80.89%.Among the 3241 non-DM patients,1743(53.78%)were hypertensive and 1498(46.22%)were nonhypertensive.The DM group had more cases of HT than did the non-DM group.There were more patients with CHD or CKD in the DM group than in the non-DM group.There were more patients who drank alcohol more frequently(≥3 times)in the DM group than in the non-DM group.CONCLUSION Older adults in the Lugu community are at a greater risk of DM.In elderly individuals,DM is closely related to high BMI and HT,CHD,and CKD.Physical examinations should be actively carried out for elderly people to determine their BMI,SBP,DBP,and other signs,and sufficient attention should be given to abnormalities in the above signs before further diagnosis.展开更多
Cardiovascular disease(CVD)has gradually become one of the main causes of harm to the life and health of residents.Exploring the influencing factors and risk assessment methods of CVD has become a general trend.In thi...Cardiovascular disease(CVD)has gradually become one of the main causes of harm to the life and health of residents.Exploring the influencing factors and risk assessment methods of CVD has become a general trend.In this paper,a machine learning-based decision-making mechanism for risk assessment of CVD is designed.In this mechanism,the logistics regression analysismethod and factor analysismodel are used to select age,obesity degree,blood pressure,blood fat,blood sugar,smoking status,drinking status,and exercise status as the main pathogenic factors of CVD,and an index systemof risk assessment for CVD is established.Then,a two-stage model combining K-means cluster analysis and random forest(RF)is proposed to evaluate and predict the risk of CVD,and the predicted results are compared with the methods of Bayesian discrimination,K-means cluster analysis and RF.The results show that thepredictioneffect of theproposedtwo-stagemodel is better than that of the comparedmethods.Moreover,several suggestions for the government,the medical industry and the public are provided based on the research results.展开更多
BACKGROUND Many studies have explored the relationship between depression and metabolic syndrome(MetS),especially in older people.China has entered an aging society.However,there are still few studies on the elderly i...BACKGROUND Many studies have explored the relationship between depression and metabolic syndrome(MetS),especially in older people.China has entered an aging society.However,there are still few studies on the elderly in Chinese communities.AIM To investigate the incidence and risk factors of depression in MetS patients in China's Mainland and to construct a predictive model.METHODS Data from four waves of the China Health and Retirement Longitudinal Study were selected,and middle-aged and elderly patients with MetS(n=2533)were included based on the first wave.According to the center for epidemiological survey-depression scale(CESD),participants with MetS were divided into depression(n=938)and non-depression groups(n=1595),and factors related to depression were screened out.Subsequently,the 2-,4-,and 7-year follow-up data were analyzed,and a prediction model for depression in MetS patients was constructed.RESULTS The prevalence of depression in middle-aged and elderly patients with MetS was 37.02%.The prevalence of depression at the 2-,4-,and 7-year follow-up was 29.55%,34.53%,and 38.15%,respectively.The prediction model,constructed using baseline CESD and Physical Self-Maintenance Scale scores,average sleep duration,number of chronic diseases,age,and weight had a good predictive effect on the risk of depression in MetS patients at the 2-year follow-up(area under the curve=0.775,95%confidence interval:0.750-0.800,P<0.001),with a sensitivity of 68%and a specificity of 74%.CONCLUSION The prevalence of depression in middle-aged and elderly patients with MetS has increased over time.The early identification of and intervention for depressive symptoms requires greater attention in MetS patients.展开更多
With the implementation of the Belt and Road Initiative, China is deepening its cooperation in oil and gas resources with countries along the Initiative. In order to better mitigate risks and enhance the safety of inv...With the implementation of the Belt and Road Initiative, China is deepening its cooperation in oil and gas resources with countries along the Initiative. In order to better mitigate risks and enhance the safety of investments, it is of significant importance to research the oil and gas investment environment in these countries for China's overseas investment macro-layout. This paper proposes an indicator system including 27 indicators from 6 dimensions. On this basis, game theory models combined with global entropy method and analytic hierarchy process are applied to determine the combined weights, and the TOPSIS-GRA model is utilized to assess the risks of oil and gas investment in 76 countries along the Initiative from 2014 to 2021. Finally, the GM(1,1) model is employed to predict risk values for 2022-2025. In conclusion, oil and gas resources and political factors have the greatest impact on investment environment risk, and 12 countries with greater investment potential are selected through cluster analysis in conjunction with the predicted results. The research findings may provide scientific decisionmaking recommendations for the Chinese government and oil enterprises to strengthen oil and gas investment cooperation with countries along the Belt and Road Initiative.展开更多
Adolescents are considered one of the most vulnerable groups affected by suicide.Rapid changes in adolescents’physical and mental states,as well as in their lives,significantly and undeniably increase the risk of sui...Adolescents are considered one of the most vulnerable groups affected by suicide.Rapid changes in adolescents’physical and mental states,as well as in their lives,significantly and undeniably increase the risk of suicide.Psychological,social,family,individual,and environmental factors are important risk factors for suicidal behavior among teenagers and may contribute to suicide risk through various direct,indirect,or combined pathways.Social-emotional learning is considered a powerful intervention measure for addressing the crisis of adolescent suicide.When deliberately cultivated,fostered,and enhanced,selfawareness,self-management,social awareness,interpersonal skills,and responsible decision-making,as the five core competencies of social-emotional learning,can be used to effectively target various risk factors for adolescent suicide and provide necessary mental and interpersonal support.Among numerous suicide intervention methods,school-based interventions based on social-emotional competence have shown great potential in preventing and addressing suicide risk factors in adolescents.The characteristics of school-based interventions based on social-emotional competence,including their appropriateness,necessity,cost-effectiveness,comprehensiveness,and effectiveness,make these interventions an important means of addressing the crisis of adolescent suicide.To further determine the potential of school-based interventions based on social-emotional competence and better address the issue of adolescent suicide,additional financial support should be provided,the combination of socialemotional learning and other suicide prevention programs within schools should be fully leveraged,and cooperation between schools and families,society,and other environments should be maximized.These efforts should be considered future research directions.展开更多
BACKGROUND Prediabetes is a well-established risk factor for major adverse cardiac and cerebrovascular events(MACCE).However,the relationship between prediabetes and MACCE in atrial fibrillation(AF)patients has not be...BACKGROUND Prediabetes is a well-established risk factor for major adverse cardiac and cerebrovascular events(MACCE).However,the relationship between prediabetes and MACCE in atrial fibrillation(AF)patients has not been extensively studied.Therefore,this study aimed to establish a link between prediabetes and MACCE in AF patients.AIM To investigate a link between prediabetes and MACCE in AF patients.METHODS We used the National Inpatient Sample(2019)and relevant ICD-10 CM codes to identify hospitalizations with AF and categorized them into groups with and without prediabetes,excluding diabetics.The primary outcome was MACCE(all-cause inpatient mortality,cardiac arrest including ventricular fibrillation,and stroke)in AF-related hospitalizations.RESULTS Of the 2965875 AF-related hospitalizations for MACCE,47505(1.6%)were among patients with prediabetes.The prediabetes cohort was relatively younger(median 75 vs 78 years),and often consisted of males(56.3%vs 51.4%),blacks(9.8%vs 7.9%),Hispanics(7.3%vs 4.3%),and Asians(4.7%vs 1.6%)than the non-prediabetic cohort(P<0.001).The prediabetes group had significantly higher rates of hypertension,hyperlipidemia,smoking,obesity,drug abuse,prior myocardial infarction,peripheral vascular disease,and hyperthyroidism(all P<0.05).The prediabetes cohort was often discharged routinely(51.1%vs 41.1%),but more frequently required home health care(23.6%vs 21.0%)and had higher costs.After adjusting for baseline characteristics or comorbidities,the prediabetes cohort with AF admissions showed a higher rate and significantly higher odds of MACCE compared to the non-prediabetic cohort[18.6%vs 14.7%,odds ratio(OR)1.34,95%confidence interval 1.26-1.42,P<0.001].On subgroup analyses,males had a stronger association(aOR 1.43)compared to females(aOR 1.22),whereas on the race-wise comparison,Hispanics(aOR 1.43)and Asians(aOR 1.36)had a stronger association with MACCE with prediabetes vs whites(aOR 1.33)and blacks(aOR 1.21).CONCLUSION This population-based study found a significant association between prediabetes and MACCE in AF patients.Therefore,there is a need for further research to actively screen and manage prediabetes in AF to prevent MACCE.展开更多
Objective: Patients with radioactive iodine-refractory differentiated thyroid cancer(RAIR-DTC) are often diagnosed with delay and constrained to limited treatment options. The correlation between RAI refractoriness an...Objective: Patients with radioactive iodine-refractory differentiated thyroid cancer(RAIR-DTC) are often diagnosed with delay and constrained to limited treatment options. The correlation between RAI refractoriness and the underlying genetic characteristics has not been extensively studied.Methods: Adult patients with distant metastatic DTC were enrolled and assigned to undergo next-generation sequencing of a customized 26-gene panel(Thyro Lead). Patients were classified into RAIR-DTC or non-RAIR groups to determine the differences in clinicopathological and molecular characteristics. Molecular risk stratification(MRS) was constructed based on the association between molecular alterations identified and RAI refractoriness, and the results were classified as high, intermediate or low MRS.Results: A total of 220 patients with distant metastases were included, 63.2% of whom were identified as RAIRDTC. Genetic alterations were identified in 90% of all the patients, with BRAF(59.7% vs. 17.3%), TERT promoter(43.9% vs. 7.4%), and TP53 mutations(11.5% vs. 3.7%) being more prevalent in the RAIR-DTC group than in the non-RAIR group, except for RET fusions(15.8% vs. 39.5%), which had the opposite pattern. BRAF and TERT promoter are independent predictors of RAIR-DTC, accounting for 67.6% of patients with RAIR-DTC. MRS was strongly associated with RAI refractoriness(P<0.001), with an odds ratio(OR) of high to low MRS of 7.52 [95%confidence interval(95% CI), 3.96-14.28;P<0.001] and an OR of intermediate to low MRS of 3.20(95% CI,1.01-10.14;P=0.041).Conclusions: Molecular alterations were associated with RAI refractoriness, with BRAF and TERT promoter mutations being the predominant contributors, followed by TP53 and DICER1 mutations. MRS might serve as a valuable tool for both prognosticating clinical outcomes and directing precision-based therapeutic interventions.展开更多
Investigating natural-inspired applications is a perennially appealing subject for scientists. The current increase in the speed of natural-origin structure growth may be linked to their superior mechanical properties...Investigating natural-inspired applications is a perennially appealing subject for scientists. The current increase in the speed of natural-origin structure growth may be linked to their superior mechanical properties and environmental resilience. Biological composite structures with helicoidal schemes and designs have remarkable capacities to absorb impact energy and withstand damage. However, there is a dearth of extensive study on the influence of fiber redirection and reorientation inside the matrix of a helicoid structure on its mechanical performance and reactivity. The present study aimed to explore the static and transient responses of a bio-inspired helicoid laminated composite(B-iHLC) shell under the influence of an explosive load using an isomorphic method. The structural integrity of the shell is maintained by a viscoelastic basis known as the Pasternak foundation, which encompasses two coefficients of stiffness and one coefficient of damping. The equilibrium equations governing shell dynamics are obtained by using Hamilton's principle and including the modified first-order shear theory,therefore obviating the need to employ a shear correction factor. The paper's model and approach are validated by doing numerical comparisons with respected publications. The findings of this study may be used in the construction of military and civilian infrastructure in situations when the structure is subjected to severe stresses that might potentially result in catastrophic collapse. The findings of this paper serve as the foundation for several other issues, including geometric optimization and the dynamic response of similar mechanical structures.展开更多
BACKGROUND Deep learning provides an efficient automatic image recognition method for small bowel(SB)capsule endoscopy(CE)that can assist physicians in diagnosis.However,the existing deep learning models present some ...BACKGROUND Deep learning provides an efficient automatic image recognition method for small bowel(SB)capsule endoscopy(CE)that can assist physicians in diagnosis.However,the existing deep learning models present some unresolved challenges.AIM To propose a novel and effective classification and detection model to automatically identify various SB lesions and their bleeding risks,and label the lesions accurately so as to enhance the diagnostic efficiency of physicians and the ability to identify high-risk bleeding groups.METHODS The proposed model represents a two-stage method that combined image classification with object detection.First,we utilized the improved ResNet-50 classification model to classify endoscopic images into SB lesion images,normal SB mucosa images,and invalid images.Then,the improved YOLO-V5 detection model was utilized to detect the type of lesion and its risk of bleeding,and the location of the lesion was marked.We constructed training and testing sets and compared model-assisted reading with physician reading.RESULTS The accuracy of the model constructed in this study reached 98.96%,which was higher than the accuracy of other systems using only a single module.The sensitivity,specificity,and accuracy of the model-assisted reading detection of all images were 99.17%,99.92%,and 99.86%,which were significantly higher than those of the endoscopists’diagnoses.The image processing time of the model was 48 ms/image,and the image processing time of the physicians was 0.40±0.24 s/image(P<0.001).CONCLUSION The deep learning model of image classification combined with object detection exhibits a satisfactory diagnostic effect on a variety of SB lesions and their bleeding risks in CE images,which enhances the diagnostic efficiency of physicians and improves the ability of physicians to identify high-risk bleeding groups.展开更多
Malicious attacks against data are unavoidable in the interconnected,open and shared Energy Internet(EI),Intrusion tolerant techniques are critical to the data security of EI.Existing intrusion tolerant techniques suf...Malicious attacks against data are unavoidable in the interconnected,open and shared Energy Internet(EI),Intrusion tolerant techniques are critical to the data security of EI.Existing intrusion tolerant techniques suffered from problems such as low adaptability,policy lag,and difficulty in determining the degree of tolerance.To address these issues,we propose a novel adaptive intrusion tolerance model based on game theory that enjoys two-fold ideas:(1)it constructs an improved replica of the intrusion tolerance model of the dynamic equation evolution game to induce incentive weights;and (2)it combines a tournament competition model with incentive weights to obtain optimal strategies for each stage of the game process.Extensive experiments are conducted in the IEEE 39-bus system,whose results demonstrate the feasibility of the incentive weights,confirm the proposed strategy strengthens the system’s ability to tolerate aggression,and improves the dynamic adaptability and response efficiency of the aggression-tolerant system in the case of limited resources.展开更多
BACKGROUND The comprehension and utilization of timing theory and behavior change can offer a more extensive and individualized provision of support and treatment alternatives for primipara.This has the potential to e...BACKGROUND The comprehension and utilization of timing theory and behavior change can offer a more extensive and individualized provision of support and treatment alternatives for primipara.This has the potential to enhance the psychological well-being and overall quality of life for primipara,while also furnishing healthcare providers with efficacious interventions to tackle the psychological and physiological obstacles encountered during the stages of pregnancy and postpartum.AIM To explore the effect of timing theory combined with behavior change on selfefficacy,negative emotions and quality of life in patients with primipara.METHODS A total of 80 primipara cases were selected and admitted to our hospital between August 2020 and May 2022.These cases were divided into two groups,namely the observation group and the control group,with 40 cases in each group.The nursing interventions differed between the two groups,with the control group receiving routine nursing and the observation group receiving integrated nursing based on the timing theory and behavior change.The study aimed to compare the pre-and post-nursing scores of Chinese Perceived Stress Scale(CPSS),Edinburgh Postpartum Depression Scale(EPDS),Self-rating Anxiety Scale(SAS),breast milk knowledge,self-efficacy,and SF-36 quality of life in both groups.RESULTS After nursing,the CPSS,EPDS,and SAS scores of the two groups was significantly lower than that before nursing,and the CPSS,EPDS,and SAS scores of the observation group was significantly lower than that of the control group(P=0.002,P=0.011,and P=0.001 respectively).After nursing,the breastfeeding knowledge mastery,selfefficacy,and SF-36 quality of life scores was significantly higher than that before nursing,and the breastfeeding knowledge mastery(P=0.013),self-efficacy(P=0.008),and SF-36 quality of life(P=0.011)scores of the observation group was significantly higher than that of the control group.CONCLUSION The integration of timing theory and behavior change integrated theory has been found to be an effective approach in alleviating negative mood and stress experienced by primipara individuals,while also enhancing their selfefficacy and overall quality of life.This study focuses on the key concepts of timing theory,behavior change,primipara individuals,negative mood,and quality of life.展开更多
基金National Natural Science Foundation of China under Grant 62203468Technological Research and Development Program of China State Railway Group Co.,Ltd.under Grant J2023G007+2 种基金Young Elite Scientist Sponsorship Program by China Association for Science and Technology(CAST)under Grant 2022QNRC001Youth Talent Program Supported by China Railway SocietyResearch Program of Beijing Hua-Tie Information Technology Corporation Limited under Grant 2023HT02.
文摘Purpose-In order to solve the problem of inaccurate calculation of index weights,subjectivity and uncertainty of index assessment in the risk assessment process,this study aims to propose a scientific and reasonable centralized traffic control(CTC)system risk assessment method.Design/methodologylapproach-First,system-theoretic process analysis(STPA)is used to conduct risk analysis on the CTC system and constructs risk assessment indexes based on this analysis.Then,to enhance the accuracy of weight calculation,the fuzzy analytical hierarchy process(FAHP),fuzzy decision-making trial and evaluation laboratory(FDEMATEL)and entropy weight method are employed to calculate the subjective weight,relative weight and objective weight of each index.These three types of weights are combined using game theory to obtain the combined weight for each index.To reduce subjectivity and uncertainty in the assessment process,the backward cloud generator method is utilized to obtain the numerical character(NC)of the cloud model for each index.The NCs of the indexes are then weighted to derive the comprehensive cloud for risk assessment of the CTC system.This cloud model is used to obtain the CTC system's comprehensive risk assessment.The model's similarity measurement method gauges the likeness between the comprehensive risk assessment cloud and the risk standard cloud.Finally,this process yields the risk assessment results for the CTC system.Findings-The cloud model can handle the subjectivity and fuzziness in the risk assessment process well.The cloud model-based risk assessment method was applied to the CTC system risk assessment of a railway group and achieved good results.Originality/value-This study provides a cloud model-based method for risk assessment of CTC systems,which accurately calculates the weight of risk indexes and uses cloud models to reduce uncertainty and subjectivity in the assessment,achieving effective risk assessment of CTC systems.It can provide a reference and theoretical basis for risk management of the CTC system.
基金The National Natural Science Foundation of China—Shandong Joint Fund under contract No.U1706226the National Natural Science Foundation of China under contract No.52171284。
文摘The main hazard-causing factors of tropical cyclones are strong wind,heavy rainfall,and storm surge.Evaluation of the hazard-causing degree of a tropical cyclone requires a joint intensity analysis of these hazard-causing factors.According to the maximum hourly mean wind speed,total rainfall,and maximum tide level at various observation stations in Hong Kong during these tropical cyclones,three hazard-causing indices for tropical cyclones are introduced:the strong-wind index(VI),total-rainfall index(RI),and tide-level index(LI).Through a joint probability analysis of VI,RI,and LI for a tropical cyclone affecting Hong Kong,the joint return period is calculated to evaluate its joint hazard-causing intensity.A limit state function of Hong Kong’s resistance to tropical cyclones is developed and used to evaluate the regional risk of tropical cyclones affecting Hong Kong.The results indicate that the joint return period of VI,RI,and LI can reflect the joint hazard-causing intensity of strong wind,heavy rain,and storm surge caused by tropical cyclones;if the overall design return periods of the regional structures decrease,the regional ability to defend against tropical cyclone disasters is degraded.
基金Supported by Science and Technology Support Program of Qiandongnan Prefecture,No.Qiandongnan Sci-Tech Support[2021]12Guizhou Province High-Level Innovative Talent Training Program,No.Qiannan Thousand Talents[2022]201701.
文摘BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.
基金supported by the National Natural Science Foundation of China under Grant Nos.12122401 and 12074007.
文摘In traditional finite-temperature Kohn–Sham density functional theory(KSDFT),the partial occupation of a large number of high-energy KS eigenstates restricts the use of first-principles molecular dynamics methods at extremely high temperatures.However,stochastic density functional theory(SDFT)can overcome this limitation.Recently,SDFT and the related mixed stochastic–deterministic density functional theory,based on a plane-wave basis set,have been implemented in the first-principles electronic structure software ABACUS[Q.Liu and M.Chen,Phys.Rev.B 106,125132(2022)].In this study,we combine SDFT with the Born–Oppenheimer molecular dynamics method to investigate systems with temperatures ranging from a few tens of eV to 1000 eV.Importantly,we train machine-learning-based interatomic models using the SDFT data and employ these deep potential models to simulate large-scale systems with long trajectories.Subsequently,we compute and analyze the structural properties,dynamic properties,and transport coefficients of warm dense matter.
基金the National Natural Science Foundation of China(Grants No.42041006,41790443 and 41927806).
文摘The Yellow River Basin(YRB)has experienced severe floods and continuous riverbed elevation throughout history.Global climate change has been suggested to be driving a worldwide increase in flooding risk.However,owing to insufficient evidence,the quantitative correlation between flooding and climate change remains illdefined.We present a long time series of maximum flood discharge in the YRB dating back to 1843 compiled from historical documents and instrument measurements.Variations in yearly maximum flood discharge show distinct periods:a dramatic decreasing period from 1843 to 1950,and an oscillating gentle decreasing from 1950 to 2021,with the latter period also showing increasing more extreme floods.A Mann-Kendall test analysis suggests that the latter period can be further split into two distinct sub-periods:an oscillating gentle decreasing period from 1950 to 2000,and a clear recent increasing period from 2000 to 2021.We further predict that climate change will cause an ongoing remarkable increase in future flooding risk and an∼44.4 billion US dollars loss of floods in the YRB in 2100.
基金financially supported by the National Ministry of Industry and Information Technology Innovation Special Project-Engineering Demonstration Application of Subsea Production System,Topic 4:Research on Subsea X-Tree and Wellhead Offshore Testing Technology(Grant No.MC-201901-S01-04)the Key Research and Development Program of Shandong Province(Major Innovation Project)(Grant Nos.2022CXGC020405,2023CXGC010415)。
文摘Due to the high potential risk and many influencing factors of subsea horizontal X-tree installation,to guarantee the successful completion of sea trials of domestic subsea horizontal X-trees,this paper established a modular risk evaluation model based on a fuzzy fault tree.First,through the analysis of the main process oftree down and combining the Offshore&Onshore Reliability Data(OREDA)failure statistics and the operation procedure and the data provided by the job,the fault tree model of risk analysis of the tree down installation was established.Then,by introducing the natural language of expert comprehensive evaluation and combining fuzzy principles,quantitative analysis was carried out,and the fuzzy number was used to calculate the failure probability of a basic event and the occurrence probability of a top event.Finally,through a sensitivity analysis of basic events,the basic events of top events significantly affected were determined,and risk control and prevention measures for the corresponding high-risk factors were proposed for subsea horizontal X-tree down installation.
基金National Natural Science Foundation of China(Nos.42171444,42301516)Beijing Natural Science Foundation Project-Municipal Education Commission Joint Fund Project(No.KZ202110016021)Beijing Municipal Education Commission Scientific Research Project-Science and Technology Plan General Project(No.KM202110016005).
文摘Natural disaster risk monitoring is an important task for disaster prevention and reduction.In the case of immovable cultural relics,however,the feedback mechanism,risk factors,monitoring logic,and monitoring indicators of natural disaster risk monitoring are complex.How to achieve intelligent perception and monitoring of natural disaster risk for immovable cultural relics has always been a focus and a challenge for researchers.Based on the analysis of the concepts and issues related to the natural disaster risk of immovable cultural relics,this paper proposes a framework for natural disaster risk monitoring for immovable cultural relics based on the digital twin.This framework focuses on risk monitoring,including the physical entities of natural disaster risk for immovable cultural relics,monitoring indicators,and virtual entity construction.A platform for monitoring the natural disaster risk of immovable cultural relics is proposed.Using the Puzhou Ancient City Site as a test bed,the proposed concept can be used for monitoring the natural disaster risk of immovable cultural relics at different scales.
文摘BACKGROUND Cancer patients often suffer from severe stress reactions psychologically,such as anxiety and depression.Prostate cancer(PC)is one of the common cancer types,with most patients diagnosed at advanced stages that cannot be treated by radical surgery and which are accompanied by complications such as bodily pain and bone metastasis.Therefore,attention should be given to the mental health status of PC patients as well as physical adverse events in the course of clinical treatment.AIM To analyze the risk factors leading to anxiety and depression in PC patients after castration and build a risk prediction model.METHODS A retrospective analysis was performed on the data of 120 PC cases treated in Xi'an People's Hospital between January 2019 and January 2022.The patient cohort was divided into a training group(n=84)and a validation group(n=36)at a ratio of 7:3.The patients’anxiety symptoms and depression levels were assessed 2 wk after surgery with the Self-Rating Anxiety Scale(SAS)and the Selfrating Depression Scale(SDS),respectively.Logistic regression was used to analyze the risk factors affecting negative mood,and a risk prediction model was constructed.RESULTS In the training group,35 patients and 37 patients had an SAS score and an SDS score greater than or equal to 50,respectively.Based on the scores,we further subclassified patients into two groups:a bad mood group(n=35)and an emotional stability group(n=49).Multivariate logistic regression analysis showed that marital status,castration scheme,and postoperative Visual Analogue Scale(VAS)score were independent risk factors affecting a patient's bad mood(P<0.05).In the training and validation groups,patients with adverse emotions exhibited significantly higher risk scores than emotionally stable patients(P<0.0001).The area under the curve(AUC)of the risk prediction model for predicting bad mood in the training group was 0.743,the specificity was 70.96%,and the sensitivity was 66.03%,while in the validation group,the AUC,specificity,and sensitivity were 0.755,66.67%,and 76.19%,respectively.The Hosmer-Lemeshow test showed aχ^(2) of 4.2856,a P value of 0.830,and a C-index of 0.773(0.692-0.854).The calibration curve revealed that the predicted curve was basically consistent with the actual curve,and the calibration curve showed that the prediction model had good discrimination and accuracy.Decision curve analysis showed that the model had a high net profit.CONCLUSION In PC patients,marital status,castration scheme,and postoperative pain(VAS)score are important factors affecting postoperative anxiety and depression.The logistic regression model can be used to successfully predict the risk of adverse psychological emotions.
基金Supported by the Capital’s Funds for Health Improvement and Research,No.2023-3S-002.
文摘BACKGROUND Age is a significant risk factor of diabetes mellitus(DM).With the develop of population aging,the incidence of DM remains increasing.Understanding the epidemiology of DM among elderly individuals in a certain area contributes to the DM interventions for the local elderly individuals with high risk of DM.AIM To explore the prevalence of DM among elderly individuals in the Lugu community and analyze the related risk factors to provide a valid scientific basis for the health management of elderly individuals.METHODS A total of 4816 elderly people who came to the community for physical examination were retrospectively analyzed.The prevalence of DM among the elderly was calculated.The individuals were divided into a DM group and a non-DM group according to the diagnosis of DM to compare the differences in diastolic blood pressure(DBP)and systolic blood pressure(SBP),fasting blood glucose,body mass index(BMI),waist-to-hip ratio(WHR)and incidence of hypertension(HT),coronary heart disease(CHD),and chronic kidney disease(CKD).RESULTS DM was diagnosed in 32.70%of the 4816 elderly people.The BMI of the DM group(25.16±3.35)was greater than that of the non-DM group(24.61±3.78).The WHR was 0.90±0.04 in the non-DM group and 0.90±0.03 in the DM group,with no significant difference.The left SBP and SBP in the DM group were 137.9 mmHg±11.92 mmHg and 69.95 mmHg±7.75 mmHg,respectively,while they were 126.6 mmHg±12.44 mmHg and 71.15 mmHg±12.55 mmHg,respectively,in the non-DM group.These findings indicate higher SBP and lower DBP in DM patients than in those without DM.In the DM group,1274 patients were diagnosed with HT,accounting for 80.89%.Among the 3241 non-DM patients,1743(53.78%)were hypertensive and 1498(46.22%)were nonhypertensive.The DM group had more cases of HT than did the non-DM group.There were more patients with CHD or CKD in the DM group than in the non-DM group.There were more patients who drank alcohol more frequently(≥3 times)in the DM group than in the non-DM group.CONCLUSION Older adults in the Lugu community are at a greater risk of DM.In elderly individuals,DM is closely related to high BMI and HT,CHD,and CKD.Physical examinations should be actively carried out for elderly people to determine their BMI,SBP,DBP,and other signs,and sufficient attention should be given to abnormalities in the above signs before further diagnosis.
基金This work is supported by the National Natural Science Foundation of China(Nos.72071150,71871174).
文摘Cardiovascular disease(CVD)has gradually become one of the main causes of harm to the life and health of residents.Exploring the influencing factors and risk assessment methods of CVD has become a general trend.In this paper,a machine learning-based decision-making mechanism for risk assessment of CVD is designed.In this mechanism,the logistics regression analysismethod and factor analysismodel are used to select age,obesity degree,blood pressure,blood fat,blood sugar,smoking status,drinking status,and exercise status as the main pathogenic factors of CVD,and an index systemof risk assessment for CVD is established.Then,a two-stage model combining K-means cluster analysis and random forest(RF)is proposed to evaluate and predict the risk of CVD,and the predicted results are compared with the methods of Bayesian discrimination,K-means cluster analysis and RF.The results show that thepredictioneffect of theproposedtwo-stagemodel is better than that of the comparedmethods.Moreover,several suggestions for the government,the medical industry and the public are provided based on the research results.
基金Supported by Shaanxi Provincial Key Research and Development Program,No.2023-YBSF-517and National Natural Science Foundation of China,No.82301737.
文摘BACKGROUND Many studies have explored the relationship between depression and metabolic syndrome(MetS),especially in older people.China has entered an aging society.However,there are still few studies on the elderly in Chinese communities.AIM To investigate the incidence and risk factors of depression in MetS patients in China's Mainland and to construct a predictive model.METHODS Data from four waves of the China Health and Retirement Longitudinal Study were selected,and middle-aged and elderly patients with MetS(n=2533)were included based on the first wave.According to the center for epidemiological survey-depression scale(CESD),participants with MetS were divided into depression(n=938)and non-depression groups(n=1595),and factors related to depression were screened out.Subsequently,the 2-,4-,and 7-year follow-up data were analyzed,and a prediction model for depression in MetS patients was constructed.RESULTS The prevalence of depression in middle-aged and elderly patients with MetS was 37.02%.The prevalence of depression at the 2-,4-,and 7-year follow-up was 29.55%,34.53%,and 38.15%,respectively.The prediction model,constructed using baseline CESD and Physical Self-Maintenance Scale scores,average sleep duration,number of chronic diseases,age,and weight had a good predictive effect on the risk of depression in MetS patients at the 2-year follow-up(area under the curve=0.775,95%confidence interval:0.750-0.800,P<0.001),with a sensitivity of 68%and a specificity of 74%.CONCLUSION The prevalence of depression in middle-aged and elderly patients with MetS has increased over time.The early identification of and intervention for depressive symptoms requires greater attention in MetS patients.
基金the financial support from the National Natural Science Foundation of China(71934004)Key Projects of the National Social Science Foundation(23AZD065)the Project of the CNOOC Energy Economics Institute(EEI-2022-IESA0009)。
文摘With the implementation of the Belt and Road Initiative, China is deepening its cooperation in oil and gas resources with countries along the Initiative. In order to better mitigate risks and enhance the safety of investments, it is of significant importance to research the oil and gas investment environment in these countries for China's overseas investment macro-layout. This paper proposes an indicator system including 27 indicators from 6 dimensions. On this basis, game theory models combined with global entropy method and analytic hierarchy process are applied to determine the combined weights, and the TOPSIS-GRA model is utilized to assess the risks of oil and gas investment in 76 countries along the Initiative from 2014 to 2021. Finally, the GM(1,1) model is employed to predict risk values for 2022-2025. In conclusion, oil and gas resources and political factors have the greatest impact on investment environment risk, and 12 countries with greater investment potential are selected through cluster analysis in conjunction with the predicted results. The research findings may provide scientific decisionmaking recommendations for the Chinese government and oil enterprises to strengthen oil and gas investment cooperation with countries along the Belt and Road Initiative.
文摘Adolescents are considered one of the most vulnerable groups affected by suicide.Rapid changes in adolescents’physical and mental states,as well as in their lives,significantly and undeniably increase the risk of suicide.Psychological,social,family,individual,and environmental factors are important risk factors for suicidal behavior among teenagers and may contribute to suicide risk through various direct,indirect,or combined pathways.Social-emotional learning is considered a powerful intervention measure for addressing the crisis of adolescent suicide.When deliberately cultivated,fostered,and enhanced,selfawareness,self-management,social awareness,interpersonal skills,and responsible decision-making,as the five core competencies of social-emotional learning,can be used to effectively target various risk factors for adolescent suicide and provide necessary mental and interpersonal support.Among numerous suicide intervention methods,school-based interventions based on social-emotional competence have shown great potential in preventing and addressing suicide risk factors in adolescents.The characteristics of school-based interventions based on social-emotional competence,including their appropriateness,necessity,cost-effectiveness,comprehensiveness,and effectiveness,make these interventions an important means of addressing the crisis of adolescent suicide.To further determine the potential of school-based interventions based on social-emotional competence and better address the issue of adolescent suicide,additional financial support should be provided,the combination of socialemotional learning and other suicide prevention programs within schools should be fully leveraged,and cooperation between schools and families,society,and other environments should be maximized.These efforts should be considered future research directions.
文摘BACKGROUND Prediabetes is a well-established risk factor for major adverse cardiac and cerebrovascular events(MACCE).However,the relationship between prediabetes and MACCE in atrial fibrillation(AF)patients has not been extensively studied.Therefore,this study aimed to establish a link between prediabetes and MACCE in AF patients.AIM To investigate a link between prediabetes and MACCE in AF patients.METHODS We used the National Inpatient Sample(2019)and relevant ICD-10 CM codes to identify hospitalizations with AF and categorized them into groups with and without prediabetes,excluding diabetics.The primary outcome was MACCE(all-cause inpatient mortality,cardiac arrest including ventricular fibrillation,and stroke)in AF-related hospitalizations.RESULTS Of the 2965875 AF-related hospitalizations for MACCE,47505(1.6%)were among patients with prediabetes.The prediabetes cohort was relatively younger(median 75 vs 78 years),and often consisted of males(56.3%vs 51.4%),blacks(9.8%vs 7.9%),Hispanics(7.3%vs 4.3%),and Asians(4.7%vs 1.6%)than the non-prediabetic cohort(P<0.001).The prediabetes group had significantly higher rates of hypertension,hyperlipidemia,smoking,obesity,drug abuse,prior myocardial infarction,peripheral vascular disease,and hyperthyroidism(all P<0.05).The prediabetes cohort was often discharged routinely(51.1%vs 41.1%),but more frequently required home health care(23.6%vs 21.0%)and had higher costs.After adjusting for baseline characteristics or comorbidities,the prediabetes cohort with AF admissions showed a higher rate and significantly higher odds of MACCE compared to the non-prediabetic cohort[18.6%vs 14.7%,odds ratio(OR)1.34,95%confidence interval 1.26-1.42,P<0.001].On subgroup analyses,males had a stronger association(aOR 1.43)compared to females(aOR 1.22),whereas on the race-wise comparison,Hispanics(aOR 1.43)and Asians(aOR 1.36)had a stronger association with MACCE with prediabetes vs whites(aOR 1.33)and blacks(aOR 1.21).CONCLUSION This population-based study found a significant association between prediabetes and MACCE in AF patients.Therefore,there is a need for further research to actively screen and manage prediabetes in AF to prevent MACCE.
基金supported by the Project on InterGovernmental International Scientific and Technological Innovation Cooperation in National Key Projects of Research and Development Plan (No. 2019YFE0106400)the National Natural Science Foundation of China (No. 81771875)。
文摘Objective: Patients with radioactive iodine-refractory differentiated thyroid cancer(RAIR-DTC) are often diagnosed with delay and constrained to limited treatment options. The correlation between RAI refractoriness and the underlying genetic characteristics has not been extensively studied.Methods: Adult patients with distant metastatic DTC were enrolled and assigned to undergo next-generation sequencing of a customized 26-gene panel(Thyro Lead). Patients were classified into RAIR-DTC or non-RAIR groups to determine the differences in clinicopathological and molecular characteristics. Molecular risk stratification(MRS) was constructed based on the association between molecular alterations identified and RAI refractoriness, and the results were classified as high, intermediate or low MRS.Results: A total of 220 patients with distant metastases were included, 63.2% of whom were identified as RAIRDTC. Genetic alterations were identified in 90% of all the patients, with BRAF(59.7% vs. 17.3%), TERT promoter(43.9% vs. 7.4%), and TP53 mutations(11.5% vs. 3.7%) being more prevalent in the RAIR-DTC group than in the non-RAIR group, except for RET fusions(15.8% vs. 39.5%), which had the opposite pattern. BRAF and TERT promoter are independent predictors of RAIR-DTC, accounting for 67.6% of patients with RAIR-DTC. MRS was strongly associated with RAI refractoriness(P<0.001), with an odds ratio(OR) of high to low MRS of 7.52 [95%confidence interval(95% CI), 3.96-14.28;P<0.001] and an OR of intermediate to low MRS of 3.20(95% CI,1.01-10.14;P=0.041).Conclusions: Molecular alterations were associated with RAI refractoriness, with BRAF and TERT promoter mutations being the predominant contributors, followed by TP53 and DICER1 mutations. MRS might serve as a valuable tool for both prognosticating clinical outcomes and directing precision-based therapeutic interventions.
文摘Investigating natural-inspired applications is a perennially appealing subject for scientists. The current increase in the speed of natural-origin structure growth may be linked to their superior mechanical properties and environmental resilience. Biological composite structures with helicoidal schemes and designs have remarkable capacities to absorb impact energy and withstand damage. However, there is a dearth of extensive study on the influence of fiber redirection and reorientation inside the matrix of a helicoid structure on its mechanical performance and reactivity. The present study aimed to explore the static and transient responses of a bio-inspired helicoid laminated composite(B-iHLC) shell under the influence of an explosive load using an isomorphic method. The structural integrity of the shell is maintained by a viscoelastic basis known as the Pasternak foundation, which encompasses two coefficients of stiffness and one coefficient of damping. The equilibrium equations governing shell dynamics are obtained by using Hamilton's principle and including the modified first-order shear theory,therefore obviating the need to employ a shear correction factor. The paper's model and approach are validated by doing numerical comparisons with respected publications. The findings of this study may be used in the construction of military and civilian infrastructure in situations when the structure is subjected to severe stresses that might potentially result in catastrophic collapse. The findings of this paper serve as the foundation for several other issues, including geometric optimization and the dynamic response of similar mechanical structures.
基金The Shanxi Provincial Administration of Traditional Chinese Medicine,No.2023ZYYDA2005.
文摘BACKGROUND Deep learning provides an efficient automatic image recognition method for small bowel(SB)capsule endoscopy(CE)that can assist physicians in diagnosis.However,the existing deep learning models present some unresolved challenges.AIM To propose a novel and effective classification and detection model to automatically identify various SB lesions and their bleeding risks,and label the lesions accurately so as to enhance the diagnostic efficiency of physicians and the ability to identify high-risk bleeding groups.METHODS The proposed model represents a two-stage method that combined image classification with object detection.First,we utilized the improved ResNet-50 classification model to classify endoscopic images into SB lesion images,normal SB mucosa images,and invalid images.Then,the improved YOLO-V5 detection model was utilized to detect the type of lesion and its risk of bleeding,and the location of the lesion was marked.We constructed training and testing sets and compared model-assisted reading with physician reading.RESULTS The accuracy of the model constructed in this study reached 98.96%,which was higher than the accuracy of other systems using only a single module.The sensitivity,specificity,and accuracy of the model-assisted reading detection of all images were 99.17%,99.92%,and 99.86%,which were significantly higher than those of the endoscopists’diagnoses.The image processing time of the model was 48 ms/image,and the image processing time of the physicians was 0.40±0.24 s/image(P<0.001).CONCLUSION The deep learning model of image classification combined with object detection exhibits a satisfactory diagnostic effect on a variety of SB lesions and their bleeding risks in CE images,which enhances the diagnostic efficiency of physicians and improves the ability of physicians to identify high-risk bleeding groups.
基金supported by the National Natural Science Foundation of China(Nos.51977113,62293500,62293501 and 62293505).
文摘Malicious attacks against data are unavoidable in the interconnected,open and shared Energy Internet(EI),Intrusion tolerant techniques are critical to the data security of EI.Existing intrusion tolerant techniques suffered from problems such as low adaptability,policy lag,and difficulty in determining the degree of tolerance.To address these issues,we propose a novel adaptive intrusion tolerance model based on game theory that enjoys two-fold ideas:(1)it constructs an improved replica of the intrusion tolerance model of the dynamic equation evolution game to induce incentive weights;and (2)it combines a tournament competition model with incentive weights to obtain optimal strategies for each stage of the game process.Extensive experiments are conducted in the IEEE 39-bus system,whose results demonstrate the feasibility of the incentive weights,confirm the proposed strategy strengthens the system’s ability to tolerate aggression,and improves the dynamic adaptability and response efficiency of the aggression-tolerant system in the case of limited resources.
文摘BACKGROUND The comprehension and utilization of timing theory and behavior change can offer a more extensive and individualized provision of support and treatment alternatives for primipara.This has the potential to enhance the psychological well-being and overall quality of life for primipara,while also furnishing healthcare providers with efficacious interventions to tackle the psychological and physiological obstacles encountered during the stages of pregnancy and postpartum.AIM To explore the effect of timing theory combined with behavior change on selfefficacy,negative emotions and quality of life in patients with primipara.METHODS A total of 80 primipara cases were selected and admitted to our hospital between August 2020 and May 2022.These cases were divided into two groups,namely the observation group and the control group,with 40 cases in each group.The nursing interventions differed between the two groups,with the control group receiving routine nursing and the observation group receiving integrated nursing based on the timing theory and behavior change.The study aimed to compare the pre-and post-nursing scores of Chinese Perceived Stress Scale(CPSS),Edinburgh Postpartum Depression Scale(EPDS),Self-rating Anxiety Scale(SAS),breast milk knowledge,self-efficacy,and SF-36 quality of life in both groups.RESULTS After nursing,the CPSS,EPDS,and SAS scores of the two groups was significantly lower than that before nursing,and the CPSS,EPDS,and SAS scores of the observation group was significantly lower than that of the control group(P=0.002,P=0.011,and P=0.001 respectively).After nursing,the breastfeeding knowledge mastery,selfefficacy,and SF-36 quality of life scores was significantly higher than that before nursing,and the breastfeeding knowledge mastery(P=0.013),self-efficacy(P=0.008),and SF-36 quality of life(P=0.011)scores of the observation group was significantly higher than that of the control group.CONCLUSION The integration of timing theory and behavior change integrated theory has been found to be an effective approach in alleviating negative mood and stress experienced by primipara individuals,while also enhancing their selfefficacy and overall quality of life.This study focuses on the key concepts of timing theory,behavior change,primipara individuals,negative mood,and quality of life.