Printable and low-cost perfect terahertz absorber realized by a laser-induced graphene metasurface.

Terahertz (THz) absorbers are highly desired with the rapid development of THz technology. Although metasurface-based absorbers can realize perfect absorption, their fabrication often requires complicated micro-nano-processing with a high cost. In this paper, fast printable and low-cost metasurface absorbers based on a laser-induced graphene (LIG) technique are proposed. Experimental results demonstrate that these two metasurfaces can achieve maximum absorptions of 99.3% and 99.9% at their resonant frequencies in an incident angle range of ±55°. Fabrication of a metasurface with a size of 1 × 1 cm costs only 11 s. The absorbers may be applied in THz dichroism and communications.

Secular trends and urban-rural disparities in the median age at menarche among Chinese han girls from 1985 to 2019.

BACKGROUND: Menarche is a substantial milestone of female puberty. Timing of age at menarche is considered the key to understanding the potential linkages with women's health outcomes later in life. This study aimed to explore the secular trends and urban‒rural disparities in the median age at menarche among Chinese Han girls from 1985 to 2019. METHODS: Data were extracted from the 1985, 1995, 2005, 2014, and 2019 Chinese National Surveys on Students' Constitution and Health, which were nationally representative cross-sectional studies, and a total of 173,535 Han girls aged 9-18 years were examined. Girls were asked whether menarche had occurred. The median age at menarche was estimated by probit analysis. Z tests were used to compare the differences between survey years and between urban and rural areas. RESULTS: The median age at menarche among Chinese Han girls decreased from 13.37 years in 1985 to 12.00 years in 2019, and the overall decrease was more significant in rural areas (1.77 years) than in urban areas (0.99 years). The average five-year change in the decrease in the median age at menarche showed an accelerating and then slowing pace; and it was observed similarly in both urban and rural areas. The urban‒rural disparities shrank from 0.64 years in 1985 to 0.44 years in 1995, then to 0.27 years in 2005, 0.24 years in 2014, and finally to - 0.14 years in 2019. CONCLUSIONS: The median age at menarche among Chinese Han girls continued to decline from 1985 to 2019 but at a slowing pace in the last five years. Urban‒rural disparities gradually narrowed. Sexual and reproductive health education and interventions to prevent the decline in the age of menarche are needed, especially in rural areas.

An Analysis of Injury Trends and Disease Burden From Three Surveillance Hospitals in Urumqi From 2006 to 2018.

Objective: To investigate injury trends, injury distribution, and disease burden from three surveillance hospitals in Urumqi from 2006 to 2018. Method: Injury data from the National Injury Surveillance System (NISS) from three hospitals in Urumqi (2006 to 2018) were collected to analyze changes in the characteristics of outpatient injury cases. Years of potential life lost (YPLL) were calculated to determine the disease burden of the injury cases. Results: A total of 161,400 injury cases were recorded over 13 years, and the average age of the patient seeking medical attention was 32.4 years old. Male patients outnumbered female patients with a ratio of 1.6:1, but the proportion of female patients was greater after 45 years of age. The highest number of cases occurred in patients 15-29 years of age, accounting for 26.8% of all injury cases. Injury in females occurred most frequently in the home. A total of 41.4% of injury cases occurred while doing housework. The top three causes of injury were falls (49.7%), blunt force of an object, (13.7%), and motor vehicle accidents (MVA) (13.5%). Years of potential life lost from injury accounted for 7.39% of the total YPLL in the three hospitals. Conclusion: Males should be targeted for injury prevention and intervention in Urumqi. The prevention of falls, blunt force of objects, and MVA should be made a priority. Injury prevention strategies and targeted projects should be developed to reduce the disease burden of injury.

Benefit-Risk Assessment of Galcanezumab Versus Placebo for the Treatment of Episodic and Chronic Migraine Using the Metrics of Number Needed to Treat and Number Needed to Harm.

INTRODUCTION: Subcutaneous galcanezumab was an effective, well-tolerated preventive treatment for adults with episodic (EM) or chronic migraine (CM) in 4 phase 3 randomized controlled trials: EVOLVE-1, EVOLVE-2, REGAIN, and CONQUER. Number needed to treat (NNT) and to harm (NNH) are metrics of effect size used to evaluate benefit-risk profiles. This study evaluated NNT, NNH, and benefit-risk profiles (measured as likelihood to be helped or harmed, LHH) of galcanezumab 120 mg versus placebo in patients with EM or CM. METHODS: Primary efficacy outcomes were responses defined as ≥ 30%, ≥ 50%, and ≥ 75% reductions from baseline in number of monthly migraine headache days in patients with EM (EVOLVE-1; EVOLVE-2; CONQUER) and CM (REGAIN; CONQUER); corresponding NNTs to achieve respective responses; and corresponding NNHs for discontinuations due to adverse events (DCAEs) among the safety population. Secondary efficacy outcomes were responses for patients with ≥ 2 failed prior preventive treatments due to lack of efficacy and/or for tolerability reasons. All LHHs were based on ≥ 50% response and DCAEs. RESULTS: During double-blind treatment periods with galcanezumab 120 mg, NNT to achieve ≥ 30% and ≥ 50% responses ranged from 4 to 10 and NNT to achieve ≥ 75% responses ranged from 5 to 23 in individual trials. NNH ranged from 93 to 1000, while LHH ranged from 18.6 to 104.6. NNTs were generally more robust among patients with EM than with CM; however, in patients with failure of ≥ 2 prior preventive treatments, NNTs to achieve ≥ 30% and ≥ 50% responses were similar between patients with CM and EM. NNHs were imputed as 1000 for both migraine types. Resulting LHHs were 178.8 (EM) and 127 (CM). CONCLUSION: Across 4 trials, galcanezumab 120 mg demonstrated a favorable benefit-risk profile versus placebo, based on low NNTs to achieve response and high NNHs associated with DCAEs. LHH values consistently far exceeded 1. TRIAL REGISTRATION NUMBERS: EVOLVE-1: ClinicalTrials.gov identifier, NCT02614183; EVOLVE-2: ClinicalTrials.gov identifier, NCT02614196; REGAIN: ClinicalTrials.gov identifier, NCT02614261; CONQUER: ClinicalTrials.gov identifier, NCT03559257.

Cross-walk of the Assessment of Spondyloarthritis International Society Health Index and Ankylosing Spondylitis Quality of Life Scores in Ankylosing Spondylitis and Non-radiographic Axial Spondyloarthritis Patients.

INTRODUCTION: Axial spondyloarthritis (axSpA) is a chronic rheumatic disease affecting the spine and sacroiliac joints, encompassing both ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA) patients. Patient quality of life (QoL) is assessed using the Ankylosing Spondylitis Quality of Life (ASQoL) (disease-specific measure) and the Assessment of SpondyloArthritis International Society Health Index (ASAS HI) (disease-specific measure). Both ASQoL and ASAS HI have similar parameters and scoring ranges, however, their performance relative to each other is unknown. We conducted a cross-walk analysis of the ASAS HI to the ASQoL in AS and nr-axSpA patients. METHODS: A cross-sectional survey using the Adelphi axSpA Disease Specific Programme™, conducted with rheumatologists and their consulting AS and nr-axSpA patients in the United States, was undertaken between Jun and Aug 2018. Rheumatologists provided confirmed diagnoses of AS and nr-axSpA alongside patients' demographic and clinical characteristics. Patients reported quality-of-life measures using the validated ASAS HI and ASQoL questionnaires. Model performance was assessed by comparing root-mean squared error (RMSE) from tenfold cross-validation to determine the best mapping from ASAS HI to ASQoL, and vice versa. RMSE was calculated overall, and for lower, middle and upper thirds of the predicted scale. RESULTS: Data from 283 AS and 274 nr-axSpA patients were analyzed. Predicting ASAS HI using ASQoL values, the best model was non-parametric local linear regression, with overall RMSE of 1.851. Predicting ASQoL using ASAS HI values, the best model also used non-parametric local-linear regression, with overall RMSE of 2.254. In predicting ASAS HI and ASQoL, models performed better in predicting lower values in the predicted scale (RMSE 1.597, 1.871, 2.871 across thirds for ASAS HI; and 1.719, 2.577, 3.140 for ASQoL). CONCLUSIONS: Results present a scoring algorithm for cross-walking the ASAS HI to the ASQoL and vice versa, with the approach enabling comparisons to be made across studies.

Complete chloroplast genome of the grain Chenopodium quinoa Willd., an important economical and dietary plant.

The grain Chenopodium quinoa Willd. is the main traditional food of Inca aboriginal, which was a native grain in South American Andes Mountains, the edible and cultivation history of which has been more than five thousand years. In this study, we sequenced the complete chloroplast genome of C. quinoa on the Illumina platform by shotgun genome skimming method. The complete chloroplast genome of C. quinoa was 152,087 bp in length with the GC content 37.2%, which was comprised of a large single copy (LSC) region of 83,570 bp, a small single copy (SSC) region of 18,107 bp, and a pair of inverted repeats (IRA/IRB) of 25,205 bp. The chloroplast genome encoded 133 genes including 88 protein-coding genes, 37 tRNA genes and eight rRNA genes. Phylogenetic analysis constructed using the maximum likelihood (ML) method strongly supported the monophyly of each genus in the family Chenopodiaceae, and the genus Chenopodium is sister to Spinacia as a cluster, which closely grouped to Dysphania.

Study of weak solutions for parabolic variational inequalities with nonstandard growth conditions.

In this paper, we study the degenerate parabolic variational inequality problem in a bounded domain. First, the weak solutions of the variational inequality are defined. Second, the existence and uniqueness of the solutions in the weak sense are proved by using the penalty method and the reduction method.

Toxicity assessment of the extractables from multi-layer coextrusion poly ethylene bags exposed to pH=5 solution containing 4% benzyl alcohol and 0.1 M sodium acetate.

A non-target analysis was developed for the analysis of extractables from multi-layer coextrusion bags exposed to 4% benzyl alcohol solution and 0.1 M sodium acetate at pH = 5 for defined periods (15 day, 45 day and 90 day) according to manufacturer instructions based on the ultra-performance liquid chromatography (UPLC) quadrupole-time of flight mass spectrometry (Q-TOF MS). In order to confirm the extractables, principal component analysis (PCA) was used to indicate the differences among samples of different periods. Then, the extractables were identified based on searching the self-built library or online searching. The total content of extractables of 90 day samples was 589.78 µg/L, and the content was in the range of acceptable levels for pharmaceutical manufacturers. The risk assessment of the extractables were evaluated by Toxtree and T.E.S.T. software to avoid the animals bioexperiment.

Caregivers' Experience of Decision-Making regarding Diagnostic Assessment following Cognitive Screening of Older Adults.

Targeted screening for dementia among older adults in primary healthcare has potential benefits such as better clinical outcomes and the opportunity to access services. Cognitive screening can be followed up by further diagnostic assessment to determine a diagnosis of dementia. Unfortunately, the rates of accepting further diagnostic assessment following cognitive screening are low. The objective of this study was to explore the caregivers' decision-making process regarding uptake of diagnostic assessment following positive screening results. A qualitative design was employed, and interpretative phenomenological analysis was used to analyze the data. Three major themes in caregiver decision-making were identified: gathering information, protecting the patient, and balancing obligation and convenience in caregiving. These findings suggest that the decision-making process involved effort to process information through observations of the patient and that caregivers emphasized quality of life.

[Assessment of pulpotomy in cariously exposed permanent teeth].

PURPOSE: To observe the clinical effect of pulpotomy for cariously exposed permanent teeth with closed apices and provide guidance for clinical application. METHODS: Sixty-two cariously exposed permanent teeth with closed apices and vital pulps were included. Preoperative pulpal and periapical diagnosis was established. The teeth were divided into two groups, the experimental group was treated with pulpotomy(32 cases), and the control group was treated with one-visit root canal therapy (one-visit RCT) (30 cases). Clinical and radiographic evaluation was completed at 1 month, 3 months, 6 months, 12 months postoperatively. Statistical analysis was performed using SPSS 18.0 software package. RESULTS: After 1 year, the success rate of pulpotomy was 93.75%, and the success rate of root canal therapy was 93.10%. There was no significant difference between pulpotomy and root canal therapy(P=0.665). CONCLUSIONS: The advantages of pulpotomy are less invasive and less tooth destruction. It is a successful treatment option for cariously exposed pulps in mature permanent teeth.

Use of the 4Kscore test to predict the risk of aggressive prostate cancer prior to prostate biopsy: Overall cost savings and improved quality of care to the us healthcare system.

The 4Kscore® Test (BioReference Laboratories, Elmwood Park, NJ) is a blood test that accurately determines the risk of aggressive prostate cancer and significantly reduces prostate biopsies and associated overdiagnosis and overtreatment of indolent cancer. A budget impact model was developed to test the hypothesis that the 4Kscore Test can improve quality of care and deliver cost savings for patients who are suspected of having prostate cancer and would otherwise undergo prostate biopsy under the current standard of care (SOC) in the United States. The direct costs (diagnosis plus treatment) utilized in the model are based on Medicare payment data and were calculated over a 1-year time horizon. The model compares SOC, in which all patients have prostate biopsy, to a "4Kscore strategy," in which the 4Kscore Test is used to guide the decision to biopsy the prostate. A set of one-way sensitivity analyses was conducted to examine the robustness of the findings. Savings of more than $169 million (15.6% of total SOC costs) were realized in the 4Kscore strategy versus SOC ($917 M versus $1,086 M, respectively) in a cohort of 100,000 patients. Sensitivity analyses demonstrated that the findings are robust. Most cost savings for the 4Kscore strategy were realized in patients who, when managed by SOC, are found to have no prostate cancer or Gleason score 6 pathology. The patients with Gleason score 6 exhibited the greatest benefits from the 4Kscore strategy, avoiding both an unnecessary prostate biopsy and subsequent overtreatment. The 4Kscore Test was shown to significantly reduce costs to the healthcare system while improving patients' quality of care. Providers and their patients suspected of having prostate cancer should consider using the 4Kscore Test prior to proceeding with prostate biopsy.

Associations among Neighborhood, Race, and Sleep Apnea Severity in Children. A Six-City Analysis.

RATIONALE: Prior researchers found that individual-level environmental and social indicators did not explain the racial disparity in obstructive sleep apnea syndrome. Neighborhood socioeconomic variables, as well as risk factors for a range of adverse behavioral and health outcomes, may better explain this racial disparity and help identify modifiable intervention targets. OBJECTIVES: To evaluate the associations of neighborhood socioeconomic variables with obstructive sleep apnea severity and to assess whether the neighborhood variables explain the association between race and obstructive sleep apnea severity. METHODS: We performed a cross-sectional analysis of data of 774 children in six cities who participated in the Childhood Adenotonsillectomy Trial. The outcome variable was the apnea-hypopnea index (AHI). Neighborhood socioeconomic variables were obtained on the basis of the children's residential addresses and information in the American Community Survey. Regression models were used to assess the associations among neighborhood conditions, race, and AHI. MEASUREMENTS AND MAIN RESULTS: Higher poverty rate and percentage of single-female-headed households were associated with higher AHI (P = 0.008 and 0.002, respectively). African American race was associated with a 1.33 (1.08-1.64 95% confidence interval)-fold increase in AHI, adjusting for age and sex. After controlling for poverty rate or percentage of single-female-headed households with children, the association between race and AHI levels was no longer significant (P = 0.15 and 0.26, respectively), and the magnitude of race association decreased 34 or 55%, suggesting that the association between race and AHI levels was largely explained by poverty rate or percentage of single-female-headed households with children. CONCLUSIONS: Neighborhood socioeconomic variables in comparison with individual-level socioeconomic indicators provides better explanations for the racial disparity in pediatric obstructive sleep apnea syndrome. Further research aimed at identifying factors that aggregate in disadvantaged neighborhoods and increase sleep apnea risk may suggest modifiable intervention targets. Clinical trial registered with clinicaltrials.gov (NCT00560859).

Assessment of Metal Toxicity in Marine Ecosystems: Comparative Toxicity Potentials for Nine Cationic Metals in Coastal Seawater.

This study is a first attempt to develop globally applicable and spatially differentiated marine comparative toxicity potentials (CTPs) or ecotoxicity characterization factors for metals in coastal seawater for use in life cycle assessment. The toxicity potentials are based exclusively on marine ecotoxicity data and take account of metal speciation and bioavailability. CTPs were developed for nine cationic metals (Cd, Cr(III), Co, Cu(II), Fe(III), Mn, Ni, Pb, and Zn) in 64 large marine ecosystems (LMEs) covering all coastal waters in the world. The results showed that the CTP of a specific metal varies 3-4 orders of magnitude across LMEs, largely due to different seawater residence times. Therefore, the highest toxicity potential for metals was found in the LMEs with the longest seawater residence times. Across metals, the highest CTPs were observed for Cd, Pb, and Zn. At the concentration levels occurring in coastal seawaters, Fe acts not as a toxic agent but as an essential nutrient and thus has CTPs of zero.

[Characteristics of Elements and Potential Ecological Risk Assessment of Heavy Metals in PM2.5 at the Southwest Suburb of Chengdu in Spring].

PM2.5 samples were collected at the southwest suburb of Chengdu in spring (in May 2012 and 2014). The mass concentrations of PM2.5 were determined by the weight method, and 24 chemical elements in PM2.5 were analyzed by XRF. To study the pollution characteristics and sources of chemical elements, and the potential ecological risk of heavy metals in PM2.5, the Geo-accumulation Index, Enrichment Factor, and Potential Ecological Risk Index methods were applied, respectively. The results indicated that the mass concentrations of PM2.5 in spring at the southwest suburb of Chengdu were very high, compared with American EPA's Standard and National Standard level-Ⅱ. The detection of chemical element composition in PM2.5 showed that K and S were the main elements, whereas the contents of Ga, Cs, Co, Cd, and V were the lowest. The differences of elemental concentrations in PM2.5 showed relatively large differences, when compared with domestic and foreign representative cities. Se, Cd, As, Br, S, Pb, Cl and Zn were present at an extremely high level of geo-accumulation degree, which revealed that the pollution coming from human activities was serious. The analysis results of enrichment factor showed that Se, Cd, As, Br, Cl, Pb, Zn and S elements were highly enriched or hyper accumulated, Cu, Cs, Ni, Ga and Co elements were moderately enriched, and they were mainly from human activities rather than soil dust. Cr, Mn, Ca and V elements were mildly enriched, and they were from both natural sources and human activities. Na, Ti, Al, Si and Mg elements were scarcely enriched, and they were mainly from natural sources. The ecological risk assessment of heavy metals showed that the order of potential ecological risk inedx of heavy metals in PM2.5 was Cd > As > Pb > Cu > Zn > Ni > Co > Cr > Mn > V > Ti, while the ecological harm degree of Cd was extremely strong, and the whole potential ecological risk degree was very strong.

Assessment of Aerial Agrichemical Spraying Effect Using Moderate-Resolution Satellite Imagery.

Remote sensing technique can be used to examine the effects of agrichemical application on the performance of field crops at a large scale in an effort to develop precision agricultural aerial spraying technology. In this study, an airplane M-18B at the 4-m flight height was used to spray a mix of agrichemicals (a fungicide and a plant growth regulator) to control rice leaf blast disease and improve the growth vigor of rice plants in the field. After the aerial spraying, satellite imagery of tested area was acquired and processed to calculate vegetation indices (VIs). Ground agrichemical concentration data were also collected. The relationships between droplets deposition and VIs were analyzed. The results indicated that the highest correlation coefficient between single phase spectral feature (NDVI) and droplets deposition points density (DDPD, points·cm-2) was 0.315 with P-value of 0.035 while the highest correlation coefficient between temporal change characteristic (MSAVI) and droplets deposition volume density (DDVD, µL·cm-2) was 0.312 with P-value of 0.038). Rice plants with the greatest growth vigor were all detected within the spraying swath, with a gradual decrease in the vigor of rice plants with the increase of droplets drift distance. There were similar trend patterns in the changes of the spraying effects based on the spatial interpolation maps of droplets deposition data and spectral characteristics. Therefore, vegetation indexes, NDVI and MSAVI calculated from satellite imagery can be used to determine the aerial spraying effects in the field on a large scale.

Defining the Value of Future Research to Identify the Preferred Treatment of Meniscal Tear in the Presence of Knee Osteoarthritis.

BACKGROUND: Arthroscopic partial meniscectomy (APM) is extensively used to relieve pain in patients with symptomatic meniscal tear (MT) and knee osteoarthritis (OA). Recent studies have failed to show the superiority of APM compared to other treatments. We aim to examine whether existing evidence is sufficient to reject use of APM as a cost-effective treatment for MT+OA. METHODS: We built a patient-level microsimulation using Monte Carlo methods and evaluated three strategies: Physical therapy ('PT') alone; PT followed by APM if subjects continued to experience pain ('Delayed APM'); and 'Immediate APM'. Our subject population was US adults with symptomatic MT and knee OA over a 10 year time horizon. We assessed treatment outcomes using societal costs, quality-adjusted life years (QALYs), and calculated incremental cost-effectiveness ratios (ICERs), incorporating productivity costs as a sensitivity analysis. We also conducted a value-of-information analysis using probabilistic sensitivity analyses. RESULTS: Calculated ICERs were estimated to be $12,900/QALY for Delayed APM as compared to PT and $103,200/QALY for Immediate APM as compared to Delayed APM. In sensitivity analyses, inclusion of time costs made Delayed APM cost-saving as compared to PT. Improving efficacy of Delayed APM led to higher incremental costs and lower incremental effectiveness of Immediate APM in comparison to Delayed APM. Probabilistic sensitivity analyses indicated that PT had 3.0% probability of being cost-effective at a willingness-to-pay (WTP) threshold of $50,000/QALY. Delayed APM was cost effective 57.7% of the time at WTP = $50,000/QALY and 50.2% at WTP = $100,000/QALY. The probability of Immediate APM being cost-effective did not exceed 50% unless WTP exceeded $103,000/QALY. CONCLUSIONS: We conclude that current cost-effectiveness evidence does not support unqualified rejection of either Immediate or Delayed APM for the treatment of MT+OA. The amount to which society would be willing to pay for additional information on treatment outcomes greatly exceeds the cost of conducting another randomized controlled trial on APM.

Association between socioeconomic status and pain, function and pain catastrophizing at presentation for total knee arthroplasty.

BACKGROUND: Patients with higher socioeconomic status (SES) are shown to have better total knee arthroplasty (TKA) outcomes compared to those with lower SES. The relationship between SES and factors that influence TKA use is understudied. We examined the association between SES and pain, function and pain catastrophizing at presentation for TKA. METHODS: In patients undergoing TKA at an academic center, we obtained preoperative pain and functional status (WOMAC Index 0-100, 100 worst), pain catastrophizing (PCS, ≥ 16 high), and mental health (MHI-5, <68 poor). We described individual-level SES using education as a proxy, and area-level SES using a validated composite index linking geocoded addresses to U.S. Census data. We measured associations between these indicators and pain, function and pain catastrophizing, adjusting for age, sex and BMI. RESULTS: Among 316 patients, mean age was 65.9 (SD 8.7), 59% were female, and 88% were Caucasian; 17% achieved less than college education and 62% were college graduates. The median area SES index score was 59 (U.S. median 51). Bivariable analyses demonstrated associations between higher individual- and area-level SES and lower pain, higher function and less pain catastrophizing (all p<0.05). Adjusted analyses demonstrated statistically significant associations between higher individual- and area-level SES and better function and less pain. CONCLUSION: In this cohort, patients with higher individual- and area-level SES had lower pain and higher function at the time of TKA than lower SES patients. Further research is needed to assess what constitutes appropriate levels of pain and function to undergo TKA in these higher SES groups.

[Assessment of chlorophyll content using a new vegetation index based on multi-angular hyperspectral image data].

The fast estimation of chlorophyll content is significant for understanding the crops growth, monitoring the disease and insect, and assessing the yield of crops. This study gets the hyperspectral imagery data by using a self-developed multi-angular acquisition system during the different maize growth period, the reflectance of maize canopy was extracted accurately from the hyperspectral images under different view angles in the principal plane. The hot-dark-spot index (HDS) of red waveband was calculated through the analysis of simulated values by ACRM model and measured values, then this index was used to modify the vegetation index (TCARI), thus a new vegetation index (HD-TCARI) based on the multi-angular observation was proposed. Finally, the multi-angular hyperspectral imagery data was used to validate the vegetation indexes. The result showed that HD-TCARI could effectively reduce the LAI effects on the assessment of chlorophyll content. When the chlorophyll content was greater than 30 µg x cm(-2), the correlation (R2) between HD-TCARI and LAI was only 26.88%-28.72%. In addition, the HD-TCARI could resist the saturation of vegetation index during the assessment of high chlorophyll content. When the LAI varled from 1 to 6, the linear relation between HD-TCARI and chlorophyll content could be improved by 9% compared with TCARI. The ground validation of HD-TCARI by multi-angular hyperspectral image showed that the linear relation between HD-TCARI and chlorophyll content (R2 = 66.74%) was better than the TCARI (R2 = 39.92%), which indicated that HD-TCARI has good potentials for estimating the chlorophyll content.

Patients' willingness to contribute to cost of novel implants in total joint arthroplasty.

As health care organizations adapt to more accountable financial models, it is increasingly important to assess how patients value new technologies, and their willingness to contribute to their cost. A questionnaire described features of a 'standard' implant including its longevity and risk of complications. We asked if participants would be willing to contribute to the cost of 3 novel implants with differing longevity and risk of complications. Our cohort included 195 patients, 45% were willing to add a co-pay to increase the longevity. Willingness to pay decreased to 26% with increased risk of complications, and 29% were willing to pay for a decreased risk of complications. Patients with higher education level, private insurance and males were more willing to contribute for a novel prosthesis. This study demonstrated that 26%-45% of patients are willing to share costs of a novel prosthesis. Willingness to pay was associated with the proposed implant benefits and with patient characteristics.

[Study on the best detector-distance of noninvasive biochemical examination by Monte Carlo simulation].

The present paper studies the best detector-distance to improve the near-infrared spectrum signal intensity of the dermis layer and eliminate the interference of the epidermis and subcutaneous layer. First, we analyzed the organizational structure of the skin and calculated the tissue optical parameters of different layers. And we established the Monte Carlo model with the example of glucose absorption peak at 2 270 nm. Then, we used the Monte Carlo method to simulate the light transmission rules in the skin, obtaining the average path length, the average visit depth and the fractions of absorbed energy at each layer with the change in critical angle and detector-distance. The results show that when the photons are incident at an angle less than 45 degrees, you can ignore the effect of the incident angle on photon transmission path, and when the detector-distance is 1 mm, the fraction of absorbed photon energy by the dermis layer is the largest, while it can ensure more energy received by detector. We determined that the best detector-distance is 1mm, which successfully avoids the interference of the epidermis spectral information and obtains large amounts of blood in the dermis layer, which is conducive to the near-infrared non-invasive measurement of biochemical components and the subsequent experiments.