Health Literacy Needs of Acute Pancreatitis Patients During the Diagnosis and Treatment Process Under the Lens of the Timing It Right Theory: A Qualitative Study.

Background: The incidence and recurrence rate of acute pancreatitis (AP) continues to increase worldwide. The risk of AP attack and recurrence is closely related to the patient's health literacy. Previous studies have shown that AP patients had low levels of health literacy. Understanding patients' experience in AP's diagnosis and treatment process and their health literacy needs might significantly improve their health status. Objective: This study aims to understand the experience of acute pancreatitis (AP) patients in the diagnostic and treatment process and explore their health literacy needs at various phases of this process. Methods: This study utilized a qualitative approach based on Timing It Right theory. A purposive sampling strategy was employed to select 31 participants diagnosed with AP at various phases of the diagnosis and treatment process. These patients were selected from the Pancreatitis Treatment Centers of two tertiary hospitals in Eastern China. Subsequently, semi-structured in-depth interviews were conducted with the selected participants. The qualitative data was analyzed using the Colaizzi's method. Results: The themes of AP patients' experiences and health literacy needs at various phases of the diagnosis and treatment process were presented as follows. 1. Diagnosis phase: inability to obtain disease information, psychological support seeking, and change unhealthy lifestyle; 2. Hospitalization phase: disease treatment information needs and medical professionals' healthcare. 3. Discharge Preparation phase: fear of recurrence, individualized healthy lifestyle instruction. 4. Home Recovery phase: self-management, continuous healthcare needs, and family support. Conclusion: AP patients' HL needs and health-related problems vary during the diagnosis and treatment process. Medical professionals should comprehend AP patients' changing needs and individual differences, provide continuous healthcare, and involve families in patient management. These factors support patients' long-term self-management and preserve their overall health.

Assessment of green technology innovation on energy-environmental efficiency in China under the influence of environmental regulation considering spatial effects.

Enhancing energy-environmental efficiency (EEE) is crucial for achieving energy conservation and emission reduction goals. Investigating the mechanism through which green technology innovation (GTI) affects EEE and understanding the role of environmental regulation (ER) in this process provides a theoretical basis for efficient utilization of GTI and ER. This study employs a Dynamic Spatial Durbin Model and utilizes panel data from 2003 to 2017 for 30 Chinese provinces to examine the impact of GTI on EEE in the presence of ER. The empirical results reveal: (1) GTI has a U-shaped impact on EEE, primarily driven by SubGI. (2) GTI's influence on EEE is predominantly reflected in PTE, also stemming from SubGI. (3) The interaction term between ER and GTI is 0.0022, while the GTI coefficient is - 0.0741, and the GTI quadratic term coefficient is 0.0007, all statistically significant. This implies that ER mitigates the negative impact of GTI on EEE while strengthening its positive effect. These findings provide empirical evidence and policy insights for more effectively utilizing GTI and ER to enhance EEE and achieve energy conservation and emissions reduction goals.

Development of the mirror-image sensitivity for different object categories-Evidence from the mirror costs of object images in children and adults.

Object recognition relies on a multitude of factors, including size, orientation, and so on. Mirrored orientation, particularly due to children's mirror confusion in reading, holds special significance among various object orientations. Brain imaging studies suggest that the visual ventral and dorsal streams exhibit distinct orientation sensitivity across diverse object categories. Yet, it remains unclear whether mirror orientation sensitivity also varies among these categories during development at the behavioral level. Here, we explored the mirror sensitivity of children and adults across five distinct categories, which encompass tools that activate both the visual ventral stream for function information and the dorsal stream for manipulation information, and animals and faces that mainly activate the ventral stream. Two types of symbols, letters and Chinese characters, were also included. Mirror sensitivity was assessed through mirror costs-that is, the additional reaction time or error rate in the mirrored versus the same orientation condition when judging the identity of object pairs. The mirror costs in reaction times and error rates consistently revealed that children exhibited null mirror costs for tools, and the mirror costs for tools in adults were minimal, if any, and were smaller than those for letters and characters. The mirror costs reflected in absolute reaction time and error rate were similar across adults and children, but when the overall difference in reaction times was considered, adults showed a larger mirror cost than children. Overall, our investigation unveils categorical distinctions and development in mirror sensitivity of object recognition across the ventral and dorsal streams.

Regional Differences, Dynamic Evolution and Convergence of Public Health Level in China.

People's health is a necessary condition for the country's prosperity. Under the background of the COVID-19 pandemic and frequent natural disasters, exploring the spatial and temporal distribution, regional differences and convergence of China's provincial public health level is of great significance to promoting the coordinated development of China's regional public health and achieving the strategic goal of a "healthy China". Based on China's provincial panel data from 2009 to 2020, this paper constructs an evaluation index system for China's public health level from five dimensions: the popularization of a healthy life, optimization of health services, improvement of health insurance, construction of a healthy environment, and development of a health industry. In this paper, the entropy method, Dagum Gini coefficient, Kernel density function and spatial econometric model are used to analyze the spatiotemporal distribution, regional differences, dynamic evolution and convergence of China's public health level since the new medical reform. The study found that, first, China's public health level is generally low, structural contradictions are prominent and the construction of a healthy environment has become a shortcoming hindering the improvement of China's public health level since the new medical reform. The public health level of the four major regions showed a spatial distribution pattern of "high in the eastern, low in the northeastern, central and western" areas. Second, the overall Gini coefficient of China's public health level showed a "V-shaped" trend of first decreasing and then rising, but the overall decrease was greater than the increase, among which the regional difference was the main source of regional differences in China's public health level, but its contribution rate showed a downward trend. Third, except for the basic maintenance of a healthy environment, the Kernel density curves of China's public health level and its sub-dimensions have shifted to the right to a certain extent, and there is no polarization phenomenon. Finally, the level of public health in China has a significant spatial correlation. Except for the northeast region, the growth rate of low-level public health provinces in China and the other three major regions is higher than that of high-level public health provinces, showing a certain convergence trend. In addition, the impact of economic development, financial pressure, and urbanization on the convergence of public health levels in the four major regions is significantly heterogeneous.

Finite-Time Event-Triggered Stabilization for Discrete-Time Fuzzy Markov Jump Singularly Perturbed Systems.

The finite-time event-triggered stabilization is studied for a class of discrete-time nonlinear Markov jump singularly perturbed models with partially unknown transition probabilities (TPs). T-S fuzzy strategy is adopted to characterize the related nonlinear Markov jump singularly perturbed models. The control objective is to make sure that the system states remain within a bounded domain during a fixed-time interval. First, a mode-dependent event-triggered scheme is constructed to reduce the communication burden and save the network bandwidth. On that basis, by using a new Lyapunov function, a developed finite-time stability criterion is derived for the corresponding system to avoid an ill-conditioned issue due to a small singular perturbation parameter. Moreover, the mode-dependent fuzzy controller gain and the event-triggered parameter are co-designed under the framework of partially unknown TPs. Finally, the feasibility of the main results is provided to verify the finite-time event-triggered control strategy.

The Spatiotemporal Evolution and Influencing Factors of the Chinese Cities' Ecological Welfare Performance.

In the "full world" where natural capital is scarce, within the limits of the ecological environment, the improvement of welfare is a fundamental requirement for sustainable development. The ecological wellbeing performance (EWP) of 284 cities in China from 2007 to 2020 was measured by the superefficient SBM-DEA model, considering undesirable output, and analyzing the evolutionary trends of overall comprehensive technical efficiency, pure technical efficiency, and scale efficiency. The Theil index was used to explore the source and distribution of the Chinese cities' EWP differences. Exploratory spatial data analysis (ESDA) and the spatial Durbin model (SDM) were applied to analyze the spatial distribution characteristics and driving factors of cities' EWP. The results showed the following: (1) Regarding spatial and temporal distribution, the EWP of Chinese cities showed a fluctuating upward trend, in which pure technical efficiency > scale efficiency. (2) Considering regional differences, the differences in cities' EWP were mainly intraregional rather than interregional. The contribution rates of distinct regions to the differences in EWP varied, i.e., western region > eastern region > central region > northeastern region. (3) In terms of spatial correlation, China's EWP showed positive spatial correlation, i.e., high-high agglomeration and low-low agglomeration. (4) Concerning influencing factors, the level of financial development, the structure of secondary industries, the level of opening-up, and the degree of urbanization significantly improved EWP. Decentralization of fiscal revenue significantly inhibited improvement of EWP. Decentralization of fiscal expenditure and technological progress had no significant impact on the EWP. In the future, to improve cities' EWP, China should focus on reducing differences in intraregional EWP, overcoming administrative regional limitations, encouraging regions with similar locations to formulate coordinated development plans, promoting economic growth, reducing levels of environmental pollution, and paying attention to the improvement of social welfare.

Vector Flow Mapping Application in Local Cardiac Function in Hypertension Assessment.

OBJECTIVE: This study aims to investigate the clinical significance of vector flow mapping (VFM) by observing and quantifying energy loss (EL) during different phases and in different left ventricle (LV) segments. METHODS: 42 healthy physical examination subjects and 89 patients with hypertension (HTN) were enrolled in the present study. The patients with HTN were divided into two groups: the left ventricular hypertrophy group (LVH) (n = 51) and the non-left ventricular hypertrophy group (NLVH) (n = 38), while the healthy patients were control group. VFM analysis software DSA-RS1 was used to calculate EL during the rapid filling phase (P1), slow filling phase (P2), atrial contraction phase (P3), and rapid ejection phase (P4). The energy loss of basal segment (EL-B), middle segment (EL-M) and apical segment (EL-A) of left ventricle in different phases was calculated and compared among the three groups. RESULTS: In controls, segmental EL showed a gradual increase from the apex to the base during diastole; however, the regularity was not found in the HTN patients. During both P1 and P2 EL-B, EL-M and EL-A were significantly higher in the NLVH group and the LVH group compared with the control group (P < 0.05). EL in LVH group was the highest among the three groups (P < 0.05). During P3, EL-B, EL-M and EL-A were increased in the NLVH group and LVH group compared with the control group. However, EL-M and EL-A in LVH group were significantly lower than the NLVH group (P < 0.05). During P4, EL of all segments was significantly higher in the NLVH group and LVH group compared with the control group (P < 0.05). CONCLUSION: VFM can visually quantify hydrodynamic LV changes in healthy subjects. The EL levels in the different LV segments during different phases were significantly higher in the patients with HTN compared with the healthy subjects.

An image-based approach for quantitative assessment of uniformity in particle distribution of noise reduction material.

Under the background of noise pollution caused by railway development, noise reduction material is worthy of in-depth study. A uniform distribution of particles in the material has an important influence on sound absorption property. In this article, the relevant image processing technology is applied to get structure information to quantify the uniformity. The main contributions of this study are: (a) In the preprocessing stage, SEM cross-sectional image of material is processed by mean filter and histogram equalization. Therefore, the grayscale and the contrast between target and background are enhanced, and a low-quality image is transformed into a high-quality one. (b) In the locating stage, local details of the image are considered to discriminate each particle from the whole image. When a global threshold is combined with the local iteration threshold, an improved Otsu algorithm is designed to binarize the image. Through morphology transforming, area filtering, and hole filling, the connected domain of target can be found and particles are located. (c) In the assessing stage, area index, number index and local distance index are established for assessing the uniformity of pore distribution. The experimental results indicate that statistical analysis is consistent with human visual observation. The smaller the porosity is, the better the uniformity is. Compared with some important methods, the effectiveness and efficiency of the proposed approach could be illustrated.

Burden of acute gastroenteritis caused by norovirus in China: A systematic review.

BACKGROUND: To understand the epidemiology and disease burden of norovirus (NoVs) gastroenteritis in China, a systematic review was conducted. METHODS: Studies on acute gastroenteritis (AGE) caused by NoVs from mainland China, published before 2017 were searched. All retrieved articles were screened and reviewed by a standardized algorithm. NoVs detection rates as well as strain variations by ages, seasonal variations and geographic locations were analyzed using random-effects model. RESULTS: A total of 225 articles were included in the final analysis. Similar detection rates at 21.0% and 19.8% were obtained from the North and the South, respectively. NoVs infection occurred year round, with a peak between October and January in the North and between August and November in the South. High detection rates (∼29%) of NoVs were found in adults and the elderly and in children aged 6-35 months (∼22%). The predominant strains were GII.4 (70.4%), followed by GII.3 (13.5%). CONCLUSION: NoVs cause significant disease burden in China which warrants development of vaccines against NoVs, particularly for children and the elderly who are vulnerable to gastroenteritis diseases. To achieve a broad protection, continual monitoring NoV epidemics and strain variations for selection of proper vaccine strains is critical.

Rapid removal of bacterial endotoxin and natural organic matter in water by dielectric barrier discharge plasma: Efficiency and toxicity assessment.

Low-temperature plasma was used to control bacteria, endotoxins and natural organic matter (NOM) in water by a dielectric barrier discharge (DBD) device. Results indicate that DBD plasma has an obvious inactivation effect on various bacteria in water. The degree of inactivation from difficult to easy is as follows: Bacillus subtilis>Escherichia coli>Staphylococcus aureus. Activated ultrapure water treated using DBD plasma exhibited a sustained sterilization effect, but this sterilization effect decreased gradually after 1h. The total-endotoxin (free-endotoxin and bound-endotoxin) released by Escherichia coli during inactivation, as well as artificially simulated endotoxin in a control solution, was significantly controlled by DBD plasma. Both the metabolites that appeared after inactivation of microorganisms by plasma treatment, and the NOM in filtration effluent of a water treatment plant were well removed by DBD plasma if the treatment duration was sufficiently long. However, the acute toxicity increased significantly, and persisted for at least 2h, indicating that some long-life active substances were generated during the DBD process. Therefore, the removal of bacteria, endotoxins or NOM does not mean a safe water is produced. It is also important to eliminate the toxicity and byproducts produced during water treatment for the continuous promotion and industrial application of DBD plasma.

Resistance Assessment for Oxathiapiprolin in Phytophthora capsici and the Detection of a Point Mutation (G769W) in PcORP1 that Confers Resistance.

The potential for oxathiapiprolin resistance in Phytophthora capsici was evaluated. The baseline sensitivities of 175 isolates to oxathiapiprolin were initially determinated and found to conform to a unimodal curve with a mean EC50 value of 5.61 × 10(-4) µg/ml. Twelve stable oxathiapiprolin-resistant mutants were generated by fungicide adaptation in two sensitive isolates, LP3 and HNJZ10. The fitness of the LP3-mutants was found to be similar to or better than that of the parental isolate LP3, while the HNJZ10-mutants were found to have lost the capacity to produce zoospores. Taken together these results suggest that the risk of P. capsici developing resistance to oxathiapiprolin is moderate. Comparison of the PcORP1 genes in the LP3-mutants and wild-type parental isolate, which encode the target protein of oxathiapiprolin, revealed that a heterozygous mutation caused the amino acid substitution G769W. Transformation and expression of the mutated PcORP1-769W allele in the sensitive wild-type isolate BYA5 confirmed that the mutation in PcORP1 was responsible for the observed oxathiapiprolin resistance. Finally diagnostic tests including As-PCR and CAPs were developed to detect the oxathiapiprolin resistance resulting from the G769W point mutation in field populations of P. capsici.

[Development of the general module of the system of quality of life instruments for cancer patients: responsiveness analysis].

BACKGROUND & OBJECTIVE: The general module of the system of quality of life instruments for cancer patients, QLICP-GM, has been developed and its reliability and validity has been evaluated by us. This study was to analyze its responsiveness. METHODS: The quality of life of 600 patients with 5 kinds of cancer was measured using QLICP-GM before and after treatment. Traditional significance tests with some indices, such as effect size, standardized response mean and equivalence, were applied to evaluate responsiveness. RESULTS: The quality of life score changed significantly after treatment on 3 domains: physical function, psychologic function, and general symptoms and side effects. The standardized response mean of the overall instrument ranged from 0.16 to 0.67. Equivalence test showed no equivalence on quality of life score changes of these domains and the overall instrument. CONCLUSION: QLICP-GM possesses reasonable responsiveness and can be used in clinical measurement of quality of life for cancer patients.

[Development of the general module of the system of quality of life instruments for cancer patients: item selection and structure of the general module].

BACKGROUND & OBJECTIVE: The researches on quality of life (QOL) of cancer patients are concerned worldwide. Two QOL instrument systems for cancer patients, Functional Assessment of Cancer Therapy (FACT) and Quality of Life Questionnaires (QLQ), have been developed and used widely in the US and Europe, but no one has been developed in China. This study was to develop the general module of the system of quality of life instruments for cancer patients (QLICP-GM) used in China. METHODS: The structured group (nominal group and focus group) methods and the qualitative combined quantitative theory and methodology was used to develop rating scales. The items were preliminarily screened, evaluated, and modified. The QOL data of 448 cancer patients were analyzed by the methods of coefficient of variation, factor analysis, clustering analysis, and correlation analysis. RESULTS: QLICP-GM was developed and evaluated. The module, including 32 items, was consisted of 4 domains: physical function, psychologic function, social function, and general symptoms and side effects. CONCLUSION: QLICP-GM possesses a reasonable content validity because it reflects the WHO definition and connotation of QOL, and common issues of cancer patients as well.