Development and Validation of an Automatic Ultrawide-Field Fundus Imaging Enhancement System for Facilitating Clinical Diagnosis:A Cross-Sectional Multicenter Study

In ophthalmology,the quality of fundus images is critical for accurate diagnosis,both in clinical practice and in artificial intelligence(AI)-assisted diagnostics.Despite the broad view provided by ultrawide-field(UWF)imaging,pseudocolor images may conceal critical lesions necessary for precise diagnosis.To address this,we introduce UWF-Net,a sophisticated image enhancement algorithm that takes disease characteristics into consideration.Using the Fudan University ultra-wide-field image(FDUWI)dataset,which includes 11294 Optos pseudocolor and 2415 Zeiss true-color UWF images,each of which is rigorously annotated,UWF-Net combines global style modeling with feature-level lesion enhancement.Pathological consistency loss is also applied to maintain fundus feature integrity,significantly improving image quality.Quantitative and qualitative evaluations demonstrated that UWF-Net outperforms existing methods such as contrast limited adaptive histogram equalization(CLAHE)and structure and illumination constrained generative adversarial network(StillGAN),delivering superior retinal image quality,higher quality scores,and preserved feature details after enhancement.In disease classification tasks,images enhanced by UWF-Net showed notable improvements when processed with existing classification systems over those enhanced by StillGAN,demonstrating a 4.62%increase in sensitivity(SEN)and a 3.97%increase in accuracy(ACC).In a multicenter clinical setting,UWF-Net-enhanced images were preferred by ophthalmologic technicians and doctors,and yielded a significant reduction in diagnostic time((13.17±8.40)s for UWF-Net enhanced images vs(19.54±12.40)s for original images)and an increase in diagnostic accuracy(87.71%for UWF-Net enhanced images vs 80.40%for original images).Our research verifies that UWF-Net markedly improves the quality of UWF imaging,facilitating better clinical outcomes and more reliable AI-assisted disease classification.The clinical integration of UWF-Net holds great promise for enhancing diagnostic processes and patient care in ophthalmology.

Violence study of healthcare workers and systems in the Caribbean:ViSHWaS-Caribbean study

BACKGROUND Violence against healthcare workers(HCWs)in the Caribbean continues to prevail yet remains underreported.Our aim is to determine the cause,traits,and consequences of violence on HCWs in the Caribbean.AIM To determine the cause,traits,and consequences of violence on HCWs in the Caribbean.METHODS This research adopted an online cross-sectional survey approach,spanning over eight weeks(between June 6th and August 9th,2022).The survey was generated using Research Electronic Data Capture forms and followed a snowballing strategy to contact individuals using emails,social media,text messages,etc.Logistic regression analysis was performed to evaluate the variables that influence violence,including gender,age,years of experience,institution type,and night shift frequency.RESULTS The survey was completed by 225 HCWs.Females comprised 61%.Over 51%of respondents belonged to the 21 to 35 age group.Dominica(n=61),Haiti(n=50),and Grenada(n=31)had the most responses.Most HCWs(49%)worked for government academic institutions,followed by community hospitals(23%).Medical students(32%),followed by attending physicians(22%),and others(16%)comprised the most common cadre of respondents.About 39%of the participants reported experiencing violence themselves,and 18%reported violence against colleague(s).Verbal violence(48%),emotional abuse(24%),and physical misconduct(14%)were the most common types of violence.Nearly 63%of respondents identified patients or their relatives as the most frequent aggressors.Univariate logistic regression analyses demonstrated that female gender(OR=2.08;95%CI:1.16-3.76,P=0.014)and higher frequency of night shifts(OR=2.22;95%CI:1.08-4.58,P=0.030)were associated with significantly higher odds of experiencing violence.More than 50%of HCWs felt less motivated and had decreased job satisfaction post-violent conduct.CONCLUSION A large proportion of HCWS in the Caribbean are exposed to violence,yet the phenomenon remains underreported.As a result,HCWs’job satisfaction has diminished.

Benefits of Dielectric Oil Regeneration Systems in Power Transmission Networks: A Case Study

The criticality of transformers and reactors in the power transmission network and the paramount importance of ensuring their reliability through maintenance of the insulating oil is known. This paper presents a comprehensive examination of the efficacy and economic viability of a dielectric oil regeneration system, as implemented by the Transmission System Maintenance Department (TSMD) of the Independent Power Transmission Operator (IPTO), Greece’s sole transmission operator. Through a detailed chemical analysis and performance evaluation, we assess the impact of the regeneration system on treated insulating oil quality over multiple cycles. The study reveals that the electrical properties of the insulating oil are fully restored after regeneration, negating the need to fully replace it, while the investment becomes cost-neutral within weeks from the commissioning of the regeneration system. This economic analysis, coupled with the system’s environmental benefits of reducing waste oil generation, positions the dielectric oil regeneration system as a compelling solution for the maintenance of power transmission assets.

Comparative Study of the Reliability and Complexity of Symmetrical and Asymmetrical Cryptosystems for the Protection of Academic Data in the Democratic Republic of Congo

In the digital age, the data exchanged within a company is a wealth of knowledge. The survival, growth and influence of a company in the short, medium and long term depend on it. Indeed, it is the lifeblood of any modern company. A companys operational and historical data contains strategic and operational knowledge of ever-increasing added value. The emergence of a new paradigm: big data. Today, the value of the data scattered throughout this mother of knowledge is calculated in billions of dollars, depending on its size, scope and area of intervention. With the rise of computer networks and distributed systems, the threats to these sensitive resources have steadily increased, jeopardizing the existence of the company itself by drying up production and losing the interest of customers and suppliers. These threats range from sabotage to bankruptcy. For several decades now, most companies have been using encryption algorithms to protect and secure their information systems against the threats and dangers posed by the inherent vulnerabilities of their infrastructure and the current economic climate. This vulnerability requires companies to make the right choice of algorithms to implement in their management systems. For this reason, the present work aims to carry out a comparative study of the reliability and effectiveness of symmetrical and asymmetrical cryptosystems, in order to identify one or more suitable for securing academic data in the DRC. The analysis of the robustness of commonly used symmetric and asymmetric cryptosystems will be the subject of simulations in this article.

Promoting Ethical Sensitivity in Nursing Education:A Systematic Review of Case Study-Based Health Education

Introduction: Nursing ethical sensitivity refers to a nurse’s capacity for thoughtful consideration of ethical issues when faced with dilemmas. In the nursing domain, ethical dilemmas arise when nurses face challenges in making sound ethical decisions during clinical practice. These challenges may stem from conflicts between personal values and professional responsibilities. Methodology: Articles downloaded from Pub Med, CNKI, and Google Scholar were reviewed. Results: After rigorous screening, a meticulous analysis was conducted, encompassing 10 articles and involving a substantial cohort of 2863 participants. Existing literature revealed variations in the ethical dilemmas faced by nurses across different departments. The ethical sensitivity of nurses also varies, with higher ethical sensitivity correlating with stronger empathetic abilities. Zhen et al. classified the causes of ethical dilemmas into four main categories: (1) Ethical dilemmas arising from personal reasons of nursing students;(2) Ethical dilemmas stemming from the actions of teachers;(3) Ethical dilemmas triggered by patients;(4) Ethical dilemmas resulting from miscellaneous reasons. Conclusion: According to literature findings, nursing ethical sensitivity was positively linked to the nurse’s ethical decision-making ability. A case study-oriented teaching program has proven effective in enhancing ethical sensitivity among nursing students.

Performance of a Combined Energy System Consisting of Solar Collector, Biogas Dry Reforming and Solid Oxide Fuel Cell: An Indian Case Study

An energy production system consisting of a solar collector, biogas dry reforming reactor and solid oxide fuel cell (SOFC) was assumed to be installed in Kolkata, India. This study aims to understand the impact of climate conditions on the performance of solar collectors with different lengths of parabolic trough solar collector (dx) and mass flow rate of heat transfer fluid (m). In addition, this study has evaluated the amount of H2 produced by biogas dry reforming (GH2), the amount of power generated by SOFC (PSOFC) and the maximum number of possible households (N) whose electricity demand could be met by the energy system proposed, considering the performance of solar collector with the different dx and m. As a result, the optimum dx was found to be 4 m. This study revealed that the temperature of heat transfer fluid (Tfb) decreased with the increase in m. Tfb in March, April and May was higher than that in other months, while Tfb from June to December was the lowest. GH2, PSOFC and N in March, April and May were higher than those in other months, irrespective of m. The optimum m was 0.030 kg/s.

Cohort study on the treatment of BRAF V600E mutant metastatic colorectal cancer with integrated Chinese and western medicine

BACKGROUND Patients with BRAF V600E mutant metastatic colorectal cancer(mCRC)have a low incidence rate,poor biological activity,suboptimal response to conventional treatments,and a poor prognosis.In the previous cohort study on mCRC conducted by our team,it was observed that integrated Chinese and Western medicine treatment could significantly prolong the overall survival(OS)of patients with colorectal cancer.Therefore,we further explored the survival benefits in the population with BRAF V600E mutant mCRC.AIM To evaluate the efficacy of integrated Chinese and Western medicine in the treatment of BRAF V600E mutant metastatic colorectal cancer.METHODS A cohort study was conducted on patients with BRAF V600E mutant metastatic colorectal cancer admitted to Xiyuan Hospital of China Academy of Chinese Medical Sciences and Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region from January 2016 to December 2022.The patients were divided into two cohorts.RESULTS A total of 34 cases were included,with 23 in Chinese-Western medicine cohort(cohort A)and 11 in Western medicine cohort(cohort B).The median overall survival was 19.9 months in cohort A and 14.2 months in cohort B,with a statistically significant difference(P=0.038,hazard ratio=0.46).The 1-3-year survival rates were 95.65%(22/23),39.13%(9/23),and 26.09%(6/23)in cohort A,and 63.64%(7/11),18.18%(2/11),and 9.09%(1/11)in cohort B,respectively.Subgroup analysis showed statistically significant differences in median OS between the two cohorts in the right colon,liver metastasis,chemotherapy,and first-line treatment subgroups(P<0.05).CONCLUSION Integrated Chinese and Western medicine can prolong the survival and reduce the risk of death in patients with BRAF V600E mutant metastatic colorectal cancer,with more pronounced benefits observed in patients with right colon involvement,liver metastasis,combined chemotherapy,and first-line treatment.

Clinical study of ultrasound and microbubbles for enhancing chemotherapeutic sensitivity of malignant tumors in digestive system

Objective： To explore the safety of ultrasound and microbubbles for enhancing the chemotherapeutic sensitivity of malignant tumors in the digestive system in a clinical trial, as well as its efficacy.Methods： From October 2014 to June 2016, twelve patients volunteered to participate in this study. Eleven patients had hepatic metastases from tumors of the digestive system, and one patient had pancreatic carcinoma. According to the mechanical index （MI） in the ultrasound field, patients were classified into four groups with MIs of 0.4, 0.6, 0.8 and 1.0. Within half an hour after chemotherapy, patients underwent ultrasound scanning with ultrasound microbubbles （SonoVue） to enhance the efficacy of chemotherapy. All adverse reactions were recorded and were classified in 4 grades according to the Common Terminology Criteria for Adverse Events version 4.03 （CTCAE V4.03）. Tumor responses were evaluated by the Response Evaluation Criteria in Solid Tumors version 1.1 criteria. All the patients were followed up until progression.Results： All the adverse reactions recorded were level 1 or level 2. No local pain occurred in any of the patients. Among all the adverse reactions, fever might be related to the treatment with ultrasound combined with microbubbles. Six patients had stable disease （SD）, and one patient had a partial response （PR） after the first cycle of treatment. At the end of follow-up, tumor progression was restricted to the original sites, and no new lesions had appeared.Conclusions： Our preliminary data showed the potential role of a combined treatment with ultrasound and microbubbles in enhancing the chemotherapeutic sensitivity of malignant tumors of the digestive system. This technique is safe when the MI is no greater than 1.0.

Design and Experimental Study of an 80C196KC-Based SRD System Controller

Aim To design and experimentally study an 80C196KC-based SRD (switched re- luctance motor drive drive sytem) controller,Methods with the guidelines of the digitized SRD system controller,the circuit design and software programming were completed,and a relevantexperimental system was PUT forward to test the newly designed controller.Result The experi-mental study showed that the newlydesigned controller had good speed-adjusting characteristicfor a switched reluctance motor ,its stable error was less than 5% and its full-load startingtime was shorter than 1.8s .Conclusion The new controller has reasonable circuit design and suitable controlling algorithm,and it is a feasible SRD system controller design scheme.

Development of Preparation Systems with K_2CsSb Photocathodes and Study on the Preparation Process

The next generation of advanced light sources requires photons with large average flux and high brightness,which needs advanced electron gun matched with excellent photocathode materials. K_2CsSb photocathode has the advantages of high quantum efficiency, long lifetime and instantaneous response. This study introduces the design of a set of K_2CsSb photocathode preparation systems and detailed preparation process of K_2CsSb photocathodes, including sequential deposition process and co-deposition process, and finally develops a K_2CsSb photocathode. The influence of laser power on the quantum efficiency is also investigated.

A Study of the Kunlun-Qilian-Qinling Suture System

The Late Neoproterozoic-Early Palaeozoic suture zones within the Central Orogenic Belt of China can be considered a system—the Kunlun-Qilian-Qinling suture system (KQQ suture system). It is basically divided into the western, central and eastern sectors. The western sector consists of the Küda-Subashi suture zone, the Mazar-Kangxiwar suture and the central West Kunlun microblock. The central sector covers the following five suture zones: the Altun, North Qilian, Qaidam northern marginal, Qimantag-Wutuo and East Kunlun southern marginal sutures, in addition to some microblocks such as the mid-south Qilian, Qaidam, Ayakkum and Maqen microblocks. The eastern sector is composed of the Shangdan suture zone, Mianlüe suture zone and central Qinling-Dabie microblock. The KQQ suture system experienced (1) extending-rifting of the Rodinia super-continent in the early-middle Sinian (～780–600 Ma); (2) the formation and evolution of the KQQ archipelagic ocean during the Late Sinian-Ordovician (～600–440 Ma), and (3) closing of the KQQ ocean and forming of the KQQ suture system during the Late Ordovician—early Silurian (～440–400 Ma). As a system comprising many suture zones and microblocks, the KQQ suture system constitutes the foundation of the Central Orogenic Belt of China.

Experimental Study on Aerodynamic Characteristics of the Model Wind Rotor System and on Characterization of A Wind Generation System

In order to investigate the aerodynamic characteristics of 6-MW wind turbine, experimental study on the aerodynamic characteristics of the model rotor system and on characterization of a wind generation system is carried out. In the test, a thrust-matched rotor system and a geometry-matched rotor system, which utilize redesigned thrustmatched and original geometry-matched blades, respectively, are applied. The 6-MW wind turbine system is introduced briefly. The proper scaling laws for model tests are established in the paper, which are then implemented in the construction of a model wind turbine with optimally designed blades. And the parameters of the model are provided. The aerodynamic characteristics of the proposed 6-MW wind rotor system are explored by testing a 1:65.3 scale model at the State Key Laboratory of Ocean Engineering at Shanghai Jiao Tong University. Before carrying out the wind rotor system test, the turbulence intensity and spatial uniformity of the wind generation system are tested and results demonstrate that the characterization of the wind generation system is satisfied and the average turbulence intensity of less than 10% within the wind rotor plane is proved in the test. And then, the aerodynamic characteristics of 6-MW wind rotor system are investigated. The response characteristic differences between the thrust-matched rotor system and the geometry-matched rotor system are presented. Results indicate that the aerodynamic characteristics of 6-MW wind rotor with the thrust-matched rotor system are satisfied. The conclusion is that the thrust-matched rotor system can better reflect the characteristics of the prototype wind turbine. A set of model test method is proposed in the work and preparations for further model basin test of the 6-MW SPAR-type floating offshore wind turbine system are made.

A Double-Blind, Randomized, Placebo-Controlled Nutritional Study Using an Insoluble Yeast Beta-Glucan to Improve the Immune Defense System

Purpose: In a placebo-controlled, double-blind, randomized clinical trial, the effect of an insoluble yeast beta-glucan preparation on the incidences of common colds and its effect on common cold symptoms were compared to placebo. Methods: 100 healthy participants with recurring infections were randomly assigned to receive either placebo or yeast beta-glucan (Yestimun?;n = 50 each group) over a period of 26 weeks. The subjects had to document each common cold episode in a diary, and rate 6 predefined infections symptoms on a 3-point rating scale during an infection period, resulting in an infection score. The common cold episodes were confirmed by the investigators. Results: A total of 171 common cold episodes were documented. Of these, 76 were experienced by 38 subjects in the beta-glucan group and 96 were experienced by 48 subjects in the placebo group (p = 0.406). The beta-glucan group had significantly more subjects without incidences of common cold than the placebo group (15.6% vs 2.0%;p = 0.019). During the most intense infection season (first 13 weeks of the study), the beta-glucan group had significantly less infections compared to placebo (p = 0.02). Beta-glucan significantly reduced the typical cold symptoms (“sore throat and/or difficulty swallowing”, “hoarseness and/or cough” and “runny nose”) as opposed to placebo. Conclusion: The present study demonstrates a prophylactic effect of yeast beta-glucan on the occurrence of common colds as opposed to placebo. In addition, when these episodes occurred, they were from the beginning less pronounced and subsided faster.

Preclinical in vivo research of magnesium-based implants for fracture treatment: A systematic review of animal model selection and study design

Background:Degradable magnesium implants are promising for clinical fracture treatment,providing less stress-shielding mechanical support and superior bone-strengthening benefits to traditional materials.The quality of preclinical research is essential for developing Mg implants;however,there are considerable variations in the model selection and study design in published studies,posing challenges for safe and effective clinical translation of lab discoveries.Objective:The purpose of this systematic review is to investigate the current progress on in vivo research of Mg implants for fracture treatment,focusing on model selection,Mg materials,implant design,methodological and analyzing techniques,aiming to provide comprehensive guidance for future preclinical research.Materials and methods:Pub Med and Embase online databases were searched to identify researches investigating Mg implants in animal models of fracture from 1960 to December 2019,using a combination of keywords:magnesium and fracture.Eligible studies were included without language restriction.Data extraction was conducted for qualitative analysis.Meta-analysis was not performed due to extensive heterogeneities among studies.Results:Twenty studies published from 2014 to 2019 were included.Publication information,animal model,methodological quality,implants preparation,and evaluation techniques were extracted.The methodological assessment revealed low to high risk of bias among studies.Both rodent and non-rodent species were selected,and the anatomical sites for inducing fractures included both cranial-facial and limb bones.Pure Mg and alloys with or without surface modification were evaluated,covering implant designs of both intra-medullary and extra-medullary fixation.Radiological and histological evaluations were commonly conducted.Conclusions:Published in vivo evidence confirmed the role of Mg-based implants in promoting fracture healing.However,considering heterogeneity in animal selection,implant preparation,and evaluation methods,there still lacks a standardized reference model.By analyzing the information extracted from included studies,the systematic review may facilitate planning and conducting preclinical research with translational perspective.

Factors Affecting Patient Satisfaction with Community Health Service under the Gatekeeper System:A Cross-sectional Study in Nanjing,China

The gatekeeper policy has been implemented for approximately ten years on a pilot population in China. It is necessary to assess the satisfaction of patients utilizing community health service（CHS） under the gatekeeper system. Our study showed that the cognition of gatekeeper policy was associated with four dimensions including doctor‐patient relationships, information and support, organization of care, and accessibility（P 〈 0.001）. One or more factors such as gender and self‐perceived health scores also affected their satisfaction. General practitioners must be prepared to focus on these aspects of information and support, organization of care, and accessibility as indicators of potential opportunities for improvement. Additionally, policymakers can improve patients＇ satisfaction with CHS by strengthening their awareness of the gatekeeper policy.

Systemic study on the safety of immuno-deficient nude mice treated by atmospheric plasma-activated water

Cold atmospheric-pressure plasma is a new technology, widely used in many fields of biomedicine,especially in cancer treatment. Cold plasma can selectively kill a variety of tumor cells, and its biological safety in clinical trials is also very important. In many cases, the patient’s immune level is relatively low, so we first studied the safety assessment of plasma treatment in an immunocompromised animal model. In this study, we examined the safety of immuno-deficient nude mice by oral lavage treatment of plasma-activated water, and studied the growth status, main organs and blood biochemical indexes. Acute toxicity test results showed that the maximum dose of plasma treatment for 15 min had no lethal effect and other acute toxicity. There were no significant changes in body weight and survival status of mice after 2 min and 4 min of plasma-activated water(PAW)treatment for 2 weeks. After treatment, the major organs, including heart, liver, spleen, lung and kidney, were not significantly changed in organ coefficient and tissue structure. Blood biochemical markers showed that blood neutrophils and mononuclear cells were slightly increased, and the others remained unchanged. Liver function, renal function, electrolytes, glucose metabolism and lipid metabolism were not affected by different doses of PAW treatment. The above results indicate that PAW treatment can be used to treat immuno-deficient nude mice without significant safety problems.

Oderly accumulation theory of shale system petroleum resource and its prospecting significance-A case study of Chang 7 Member of Yanchang Formation in Ordos Basin

1 Introduction Shale formations bear abundant mineral resource and*unconventional petroleum resource,and the unconventional petroleum resource that contain in the shale formation should be integrated and researched.

Abnormal Activity of Sympathetic Nervous System in Girls with Adolescent Idiopathic Scoliosis： A Cross-sectional Study

The objective of this study was to characterize sympathetic nervous system （SNS） activity in girls with adolescent idiopathic scoliosis （AIS） and investigate the correlation of such activity with body weight and bone mass. Fifty-eight girls with AIS and 21 healthy controls were recruited. Abnormal growth pattern （lower weight, lower body mass index （BMI）, and longer arm span） and significantly increased adrenaline （AD） level, norepinephrine （NE） level, and low-frequency （LF） were found in girls with AIS. Circulating AD level, NE level, and LF power were negatively correlated with body weight and BMI but significantly correlated with bone quality.

A Comparative Study of Genetic Algorithm Parameters for the Inverse Problem-based Fault Diagnosis of Liquid Rocket Propulsion Systems

Fault diagnosis of liquid rocket propulsion systems （LRPSs） is a very important issue in space launch activities particularly when manned space missions are accompanied, since the safety and reliability can be significantly enhanced by exploiting an efficient fault diagnosis system. Currently, inverse problem-based diagnosis has attracted a great deal of research attention in fault diagnosis domain. This methodology provides a new strategy to model-based fault diagnosis for monitoring the health of propulsion systems. To solve the inverse problems arising from the fault diagnosis of LRPSs, GAs have been adopted in recent years as the first and effective choice of available numerical optimization tools. However, the GA has many control parameters to be chosen in advance and there still lack sound theoretical tools to analyze the effects of these parameters on diagnostic performance analytically. In this paper a comparative study of the influence of GA parameters on diagnostic results is conducted by performing a series of numerical experiments. The objective of this study is to investigate the contribution of individual algorithm parameter to final diagnostic result and provide reasonable estimates for choosing GA parameters in the inverse problem-based fault diagnosis of LRPSs. Some constructive remarks are made in conclusion and will be helpful for the implementation of GA to the fault diagnosis practice of LRPSs in the future.

A Comparative Study of the Economic Feasibility of Employing CHP Systems in Different Industrial Manufacturing Applications

Extensive research work including multiple methodologies and numerous simulations have been completed in order to determine the economic effectiveness of employing CHP at commercial and residential sites. In contrast to the above, very few attempts have been made to develop methodologies to study the feasibility of CHP systems at industrial manufacturing facilities. As a result, practical opportunities for CHP at industrial sites are often not realized or even investigated. It follows that there is a need in the CHP related literature for an analysis that is explicit and yet general enough to determine the economic viability and potential for success of CHP systems at industrial manufacturing facilities. Therefore, the purpose of this paper is to clearly outline a methodology to determine the economic effectiveness of installation and operation of a CHP system at industrial facilities that have a need for space or process heating in the form of steam. The effect on the CHP system economic performance of several parameters, such as the project payback, internal rate of return, net present value, etc., are considered in the proposed methodology. The applicability and generality of the methodology is illustrated by examples including four different manufacturing facilities. The effects of the variability of factors such as annual facility operational hours during which both process heat and electricity are needed, facility average hourly thermal load, cost of utility supplied electricity, and CHP fuel type and associated fuel cost, on the outcome of the economic analysis are also examined.