Cumulative Ratio Research Articles

Long-term survival after on-pump coronary artery bypass grafting in patients with coronary artery disease in Taiwan

The study analyzed the long-term survival of 1,482 eligible patients with coronary artery disease who received on-pump coronary artery bypass grafting (ONCAB) between 1997 and 2003 in Taiwan. The cumulative all-cause death rate over 23 years was 21.9%, while the cumulative cardiovascular-specific death (CVD) rate was 2.09%. Patients aged ≥ 70 years had a significantly higher incidence rate ratio (IRR) (IRR, 2.183, 95% confidence interval [CI], 1.742–2.731), but the lower cumulative incidence rate ratio (CIRR) (CIRR, 0.634, 95% CI, 0.524–0.767) for all-cause deaths than those aged < 70 years. There was no significant difference for IRR and CIRR of CVD between 2 groups. Overall survival was influenced by hypertension (hazard ratio [HR], 1.412, 95% CI, 1.104–1.806), dyslipidemia (HR, 1.890, 95% CI, 1.506–2.372), and previous stroke (HR, 0.525, 95% CI, 0.391–0.705) in all patients. Our results suggest that ONCAB may be a viable option for older patients.

High ambient temperatures associations with children and young adult injury emergency department visits in NYC

Injury is a significant health burden for children and young adult and may be an increasing concern in a warming climate. Research reveals many impacts to children’s health associated with hot weather and heatwave events, including a growing literature on the association between high ambient temperature and injury, which may vary by intent such as injury resulting from violence. However, little is known about how this association varies across different types of injury and subgroups of young people. We examined relationships between warm season ambient temperature and intentional and unintentional injury among children and young adults in New York City (NYC). Within a case-crossover design, our study observed injury-related emergency department (ED) visits from the New York Statewide Planning and Research Cooperative System administrative dataset. Injuries were categorized as unintentional or intentional injuries during the warm season (May through September) in NYC from 2005 to 2011 among patients (0, 1–4, 5–9, 10–14, 15–19, 20–25 years old (y.o.)). Conditional logistic regression models with distributed lag non-linear functions were used to model the cumulative odds ratio (OR) injury-related ED visit over 0–5 lag days. Analyses were stratified by age group and sex to understand how associations vary across young people of different age and sex. There were a total of 572 535 injury-related ED visits. The largest effect of elevated temperature (daily minimum 77°F vs 48°F) was for unintentional injury among 5–9 y.o. (OR 1.32, 95% CI 1.23, 1.42) and for intentional injury among 20–25 y.o. (OR 1.54, 95% CI 1.28, 1.85). Further stratified analyses revealed that the highest risk of unintentional injury was among 5–9 y.o. males and 20–25 y.o. males for intentional injury. Our results suggest that high ambient temperatures are associated with higher odds of unintentional and intentional injuries among children. This work adds to a growing body of literature demonstrating the adverse impacts of heat on children, and suggests the need for messaging to parents and children about adopting adaptive strategies to prevent injuries when it is hot outside.

Association between use of the "health-supportive" roadside station and self-rated health: A three-wave longitudinal study

Objective Mutsuzawa town, Chiba Prefecture, relocated a "health-supportive" roadside station in 2019. The underlying hypothesis is that older people who use the roadside station will have better self-rated health than those who do not use it. We aimed to verify whether roadside station use was associated with a decrease in poor self-rated health.Method This was a longitudinal study that compared and evaluated the roadside station use and non-use groups using three-wave panel data before and after relocation of the roadside station in September 2019. To obtain three-wave panel data, self-administered questionnaires were mailed three times: in July 2018 (FY 2018) before the station was relocated and in November 2020 (FY 2020) and January 2022 (FY 2021) after the relocation in 2019. The dependent variable was poor self-rated health in FY 2021, and the independent variable was use of the roadside station as of FY 2020. Covariates included basic characteristics from FY 2018, as well as going out, social participation, and interacting on social networks in FY 2018 and FY 2020. A multivariate analysis was conducted using multiple imputation to complete missing values for the Crude model, which included the basic attributes of FY 2018 (Model 1); going out, social participation, and interacting on social networks in FY 2018 (Model 2); and going out, social participation, and interacting on social networks in FY 2020 (Model 3). The cumulative incidence rate ratio (CIRR), 95% confidence intervals, and P-values were calculated using a modified Poisson regression analysis for each model.Results Of the 576 participants, 344 (59.8%) were roadside station users. The multivariate analysis adjusted for basic attributes revealed that the number of people with poor self-rated health in the user group was significantly lower than that in the non-user group, with a CIRR of 0.67 (95% confidence interval: 0.45-0.99, P=0.043). However, the adjusted model showed a CIRR of 0.71 (95% confidence interval: 0.48-1.06, P=0.096) for going out, social participation, and interacting on social networks in FY2020 after the roadside station opened.Conclusion Findings of this study revealed that, after adjusting for confounding factors prior to relocation of the roadside station, the number of people with poor self-rated health decreased in the user group. Thus, such commercial facilities as roadside stations, which give users an opportunity to go out and meet people, can provide a "naturally healthy" environment.

Testicular Cancer Incidence among Obstructive Sleep Apnea (OSA) Patients: South Korean National Health Insurance Data.

Obstructive sleep apnea (OSA) has been linked to an increased risk of acquiring many types of cancer. No data on the prevalence of testicular cancer in OSA patients have been reported in the literature. The goal of the present investigation is to find out the impact of OSA on the incidence of testicular cancer based on the Korea National Health Insurance Service (KNHIS) dataset. A cohort of adult male patients newly registered with OSA in the KNHIS data from 2007 to 2014 who had no history of any previous cancer diagnosis was included. The main outcome measure was newly diagnosed testicular cancer in the National Medical Expenses Support Program. The control group was set at five times larger than the OSA group, and it was matched with age and sex. The cumulative incidence and hazard ratio (HR) for the development of testicular cancer were compared between the OSA and control groups. Further subgroup analysis was conducted in the three different age groups. In the study period, a total of 152,801 male adult patients newly diagnosed with OSA were included, whereas 764,005 individuals were recruited as the control group. The HR of OSA for developing testicular cancer was 1.58 (95% confidence interval [CI]: 0.92-2.60), showing no significant HR regardless of confounding adjustment. However, the subgroup analysis revealed a significantly increased HR to develop testicular cancer of 3.39 (95% CI: 1.08-10.06) in groups aged more than 65, whereas the age ranges of 20-40 and 40-64 showed no significance (1.19 (0.44-2.75) and 1.27 (0.50-2.80), respectively). OSA may not influence the incidence of testicular cancer in the general adult population. However, compared to younger males, males over 65 may be more susceptible to OSA when it comes to developing testicular cancer.

Accurate SARC-F Score in Patients with Liver Disease.

SARC-F is a well-accepted screening tool for sarcopenia. A SARC-F value of 1 point is reported to be more discriminating in identifying sarcopenia than 4 points (recommended cutoff point). The prognostic impact of the SARC-F score was investigated in patients with liver disease (LD, n = 269, median age = 71 years, 96 hepatocellular carcinoma (HCC) cases). Factors associated with SARC-F ≥ 4 points and SARC-F ≥ 1 point were also examined. In the multivariate analysis, age (p = 0.048), and Geriatric Nutritional Risk Index (GNRI) score (p = 0.0365) were significant factors linked to SARC-F ≥ 1 point. In our patients with LD, the SARC-F score is well correlated with the GNRI score. The 1-year cumulative overall survival ratio in patients with SARC-F ≥ 1 (n = 159) and SARC-F 0 (n = 110) was 78.3% and 90.1% (p = 0.0181). After excluding 96 HCC cases, similar tendencies were found (p = 0.0289). In the receiver operating curve (ROC) analysis based on the prognosis for the SARC-F score, the area under the ROC was 0.60. The sensitivity was 0.57, the specificity was 0.62, and the optimal cutoff point of the SARC-F score was 1. In conclusion, sarcopenia in LDs can be affected by nutritional conditions. A SARC-F score of ≥1 is more useful than a score of 4 in predicting the prognosis of patients with LD.

Association of public health insurance with cancer-specific mortality risk among patients with nasopharyngeal carcinoma: a prospective cohort study in China.

Health insurance programs are effective in preventing financial hardship in patients with cancer. However, not much is known about how health insurance policies, especially in Southwest China with a high incidence of nasopharyngeal carcinoma (NPC), influence patients' prognosis. Here, we investigated the association of NPC-specific mortality with health insurance types and self-paying rate, and the joint effect of insurance types and self-paying rate. This prospective cohort study was conducted at a regional medical center for cancer in Southwest China and included 1,635 patients with pathologically confirmed NPC from 2017 to 2019. All patients were followed up until May 31, 2022. We determine the cumulative hazard ratio of all-cause and NPC-specific mortality in the groups of various insurance kinds and the self-paying rate using Cox proportional hazard. During a median follow-up period of 3.7 years, 249 deaths were recorded, of which 195 deaths were due to NPC. Higher self-paying rate were associated with a 46.6% reduced risk of NPC-specific mortality compared to patients with insufficient self-paying rate (HR: 0.534, 95% CI: 0.339-0.839, p = 0.007). For patients covered by Urban and Rural Residents Basic Medical Insurance (URRMBI), and for patients covered by Urban Employee Basic Medical Insurance, each 10% increase in the self-paying rate reduced the probability of NPC-specific death by 28.3 and 25%, respectively (UEBMI). Results of this study showed that, despite China's medical security administration improved health insurance coverage, NPC patients need to afford the high out-of-pocket medical costs in order to prolong their survival time.

Directions of change in intrinsic case severity across successive SARS-CoV-2 variant waves have been inconsistent

To determine how the intrinsic severity of successively dominant SARS-CoV-2 variants changed over the course of the pandemic. A retrospective cohort analysis in the NHS Greater Glasgow and Clyde (NHS GGC) Health Board. All sequenced non-nosocomial adult COVID-19 cases in NHS GGC with relevant SARS-CoV-2 lineages (B.1.177/Alpha, Alpha/Delta, AY.4.2 Delta/non-AY.4.2 Delta, non-AY.4.2 Delta/Omicron, and BA.1 Omicron/BA.2 Omicron) during analysis periods were included. Outcome measures were hospital admission, ICU admission, or death within 28 days of positive COVID-19 test. We report the cumulative odds ratio; the ratio of the odds that an individual experiences a severity event of a given level vs all lower severity levels for the resident and the replacement variant after adjustment. After adjustment for covariates, the cumulative odds ratio was 1.51 (95% CI: 1.08-2.11) for Alpha versus B.1.177, 2.09 (95% CI: 1.42-3.08) for Delta versus Alpha, 0.99 (95% CI: 0.76-1.27) for AY.4.2 Delta versus non-AY.4.2 Delta, 0.49 (95% CI: 0.22-1.06) for Omicron versus non-AY.4.2 Delta, and 0.86 (95% CI: 0.68-1.09) for BA.2 Omicron versus BA.1 Omicron. The direction of change in intrinsic severity between successively emerging SARS-CoV-2 variants was inconsistent, reminding us that the intrinsic severity of future SARS-CoV-2 variants remains uncertain.

Clinical Characteristics, Outcomes, and Risk Factors of Patients Hospitalized for COVID-19 across the Latest Pandemic Waves: Has Something Changed?

Despite the availability of vaccines and antivirals and the biological evolution of SARS-CoV-2, the rate of hospitalizations and deaths from COVID-19 remains high in Italy. It is crucial to understand whether and how the clinical characteristics of patients hospitalized for COVID-19 have changed over 2021–2022 and which risk factors are currently associated with adverse outcomes to develop targeted interventions. In this study, we present and compare the characteristics and outcomes of 310 patients with COVID-19 who were hospitalized between 1 August and 9 December 2021, when the Delta SARS-CoV-2 variant was prevalent (Group A), and between 3 January and 30 June 2022, when the Omicron variant was predominant (Group B). Using Survival Analysis, we estimated the cumulative 28-day hazard ratio (H.R.) of Intensive Care Unit (ICU) admission/death of patients in Group B vs. A. We built uni- and multivariate Cox regression models for the overall population and each group to identify risk factors for ICU admission/death among patient features. We found that Group B had a comparable risk of ICU admission/death (HR 1.60, 95% Confidence Interval, C.I. 1.00–2.58, p = 0.05) but a higher prevalence of elderly and co-morbid subjects than Group A. Non-invasive ventilation requirement was associated with adverse outcomes in both Group A (HR 21.03, 95% C.I. 5.34–82.80, p &lt; 0.001) and Group B (HR 4.53, 95% C.I. 2.39–8.59, p &lt; 0.001), as well as in the overall population (HR 3.88, 95% C.I. 2.49–6.06, p &lt; 0.001). During the Omicron wave, elderly and co-morbid subjects had the highest risk of hospitalization and poor outcomes.

Evaluation of the fracturing fluid flowback based on perforation clusters for horizontal shale gas wells using data-mining methods

Multi-stage hydraulic fracturing is a crucial technique in the development of horizontal shale gas wells. After fracturing and shut-in for several days, the well would be opened and the fracturing fluid injected into the gas formation would flow back to the ground along with extracted gas. Field experts suggest fracturing fluid flowback plays a key role in the production of shale gas and hope to find the relationship between flowback and production. However, the flowback and production data we collected from 161 wells in one shale gas field in China illustrate that there is no general relationship between flowback and production. The main reason we deduce is that the commonly-used cumulative flowback amount is not a good indicator to represent shale gas wells’ flowback situation. Therefore, we propose a new flowback indicator based on filed data and a shale gas flow model. The proposed indicator is the cumulative flowback ratio per fracturing cluster calculated on production days, where production day is a newly proposed time measurement substituting the calendar day. Further study illustrates that the proposed indicator can be easily predicted using a random forest model with engineering parameters, geological parameters, and well operation parameters. Besides, fracturing scale parameters and brittle mineral proportion are identified as the most important controlling factors of the proposed indicator. With the help of the newly proposed flowback indicator, field experts can have a new way to comprehend each well’s flowback characteristics and make better development plans.

Permanent single-chamber atrial pacing: an obsolete or viable alternative to dual-chamber pacing in selected patients with sinus node disease?

Single atrial stimulation (AAI) has been commonly used for permanent pacing in sick sinus syndrome and significant bradycardia. The study aimed to evaluate long‑term AAI pacing and to identify timing and reasons for pacing mode change. Retrospectively, we included 207 patients (60% women) with initial AAI pacing, who were followed‑up for an average of 12 years. At the time of death or loss to follow‑up, 71 patients (34.3%) had unchanged AAI pacing mode. The reason for an upgrade of the pacing system was development of atrial fibrillation (AF) in 43 patients (20.78%) and atrioventricular block (AVB) in 34 patients (16.4%). The cumulative ratio for a pacemaker upgrade reoperation reached 2.77 per 100 patient‑years of the follow‑up. Cumulative ventricular pacing below 10% after an upgrade to dual‑chamber pacemaker was observed in 28.6% of the patients. Younger age at implant was the leading independent predictor of the change to dual‑chamber simulation (hazard ratio, 1.98; 95% CI, 1.976-1.988; P = 0.001). There were 11 (5%) lead malfunctions that required reoperation. Subclavian vein occlusion was noted in 9 upgrade procedures (11%). One cardiac device-related infection was observed. The reliability of AAI pacing decreases with each year of observation due to development of AF and AVB. However, in the current era of effective AF treatment, the advantages of AAI pacemakers, such as lower incidence of lead malfunction, venous occlusion, and infection, as compared with dual-chamber pacemakers, may make AAI pacemakers a viable option.

High-Strength, High-Water-Retention Hemicellulose-Based Hydrogel and Its Application in Urea Slow Release.

The use of fertilizer is closely related to crop growth and environmental protection in agricultural production. It is of great significance to develop environmentally friendly and biodegradable bio-based slow-release fertilizers. In this work, porous hemicellulose-based hydrogels were created, which had excellent mechanical properties, water retention properties (the water retention ratio in soil was 93.8% after 5 d), antioxidant properties (76.76%), and UV resistance (92.2%). This improves the efficiency and potential of its application in soil. In addition, electrostatic interaction and coating with sodium alginate produced a stable core-shell structure. The slow release of urea was realized. The cumulative release ratio of urea after 12 h was 27.42% and 11.38%, and the release kinetic constants were 0.0973 and 0.0288, in aqueous solution and soil, respectively. The sustained release results demonstrated that urea diffusion in aqueous solution followed the Korsmeyer-Peppas model, indicating the Fick diffusion mechanism, whereas diffusion in soil adhered to the Higuchi model. The outcomes show that urea release ratio may be successfully slowed down by hemicellulose hydrogels with high water retention ability. This provides a new method for the application of lignocellulosic biomass in agricultural slow-release fertilizer.

Research on the influence of panel zone on dynamic damage of multi-story steel structure

As the most important component of steel structure, the panel zone has done a lot of research. In this article, the influence of the thickness of the panel zone on the performance of the multi-story steel frame is studied through the dynamic elastic-plastic time-history analysis of the panel zone models with different thickness. Then the appropriate thickness of the panel zone is summarised. The research conclusions are as follows: The displacement of each story is uniform and the displacement of the first story decreases after considering the influence of panel zone. While the residual deformation increases. When the thickness of panel zone is increased by three or four times, the residual deformation decreases significantly. The inter-layer displacement, plastic deformation energy, velocity conversion, maximum ductility ratio and maximum cumulative ductility ratio are closer to those of the frame model which is not consider the influence of panel zone when the panel zone is increased by three times. It concluded that the influence of panel zone should be considered, and the thickness of panel zone needs to be thickened by three or four times according to the model in this article.

Association of high ambient temperature with daily hospitalization for cardiorespiratory diseases in Brazil: A national time-series study between 2008 and 2018

Further research is needed to examine the nationwide impact of temperature on health in Brazil, a region with particular challenges related to climate conditions, environmental characteristics, and health equity. To address this gap, in this study, we looked at the relationship between high ambient temperature and hospital admissions for circulatory and respiratory diseases in 5572 Brazilian municipalities between 2008 and 2018. We used an extension of the two-stage design with a case time series to assess this relationship. In the first stage, we applied a distributed lag non-linear modeling framework to create a cross-basis function. We next applied quasi-Poisson regression models adjusted by PM2.5, O3, relative humidity, and time-varying confounders. We estimated relative risks (RRs) of the association of heat (percentile 99th) with hospitalization for circulatory and respiratory diseases by sex, age group, and Brazilian regions. In the second stage, we applied meta-analysis with random effects to estimate the national RR. Our study population includes 23,791,093 hospital admissions for cardiorespiratory diseases in Brazil between 2008 and 2018. Among those, 53.1% are respiratory diseases, and 46.9% are circulatory diseases. The robustness of the RR and the effect size varied significantly by region, sex, age group, and health outcome. Overall, our findings suggest that i) respiratory admissions had the highest RR, while circulatory admissions had inconsistent or null RR in several subgroup analyses; ii) there was a large difference in the cumulative risk ratio across regions; and iii) overall, women and the elderly population experienced the greatest impact from heat exposure. The pooled national results for the whole population (all ages and sex) suggest a relative risk of 1.29 (95% CI: 1.26; 1.32) associated with respiratory admissions. In contrast, national meta-analysis for circulatory admissions suggested robust positive associations only for people aged 15–45, 46–65, >65 years old; for men aged 15–45 years old; and women aged 15–45 and 46–65 years old. Our findings are essential for the body of scientific evidence that has assisted policymakers to promote health equity and to create adaptive measures and mitigations.

A Real-World Prognosis in Idiopathic Pulmonary Fibrosis: A Special Reference to the Role of Antifibrotic Agents for the Elderly.

Idiopathic pulmonary fibrosis (IPF) is the most common and severe form of idiopathic interstitial pneumonia, and its prevalence increases with age. In the era of pre-antifibrotic agents, the median survival time of Japanese patients with IPF is 35 months, with a 5-year survival rate in western countries ranging from 20% to 40%. The prevalence of IPF is highest in elderly patients aged ≥75 years; however, the efficacy and safety of long-term use of pirfenidone and/or nintedanib are not fully understood. This study aimed to determine the efficacy and safety of the sole use of antifibrotic agents (pirfenidone or nintendanib) for IPF in the elderly. We retrospectively reviewed patients with IPF who were diagnosed and treated with either pirfenidone or nintedanib in our hospital between 2008 and 2019. We excluded patients with the subsequent use of both antifibrotic agents. We examined the survival probability and frequency of acute exacerbation, with focus on long-term use (≥1 year), elderly patients (≥75 years of age), and disease severity. We identified 91 patients with IPF (male to female ratio: 63 to 28, age 42 to 90 years). The numbers of patients with disease severity classified by JRS (I/II/III/IV) and GAP stage (I/II/III) were (38/6/17/20) and (39/36/6), respectively. The survival probabilities were comparable between the elderly (n = 46) and non-elderly groups (n = 45, p = 0.877). After the initiation of antifibrotic agents, the cumulative incidence ratio of acute exacerbation of IPF was significantly lower in the early stage (GAP stage I, n = 20) than in the progressive stage of disease (GAP stages II and III, n = 20, p = 0.028). A similar trend was noted in the JRS disease severity classification (I, II vs. III, IV) (n = 27 vs. n = 13, p = 0.072). In the long-term treatment (≥1 year) group (n = 40), the survival probabilities at 2 and 5 years after treatment initiation were 89.0% and 52.4%, respectively, which did not reach the median survival rate. Even in elderly patients (≥75 years of age), antifibrotic agents demonstrated positive effects on survival probability and the frequency of acute exacerbation. These positive effects would be improved for earlier JRS/GAP stages or long-term use.

Single-Dose Rifapentine in Household Contacts of Patients with Leprosy

BackgroundPrevious studies have suggested that a single dose of rifampin has protective effects against leprosy in close contacts of patients with the disease. Rifapentine was shown to have greater bactericidal activity against Mycobacterium leprae than rifampin in murine models of leprosy, but data regarding its effectiveness in preventing leprosy are lacking.MethodsWe conducted a cluster-randomized, controlled trial to investigate whether single-dose rifapentine is effective in preventing leprosy in household contacts of patients with leprosy. The clusters (counties or districts in Southwest China) were assigned to one of three trial groups: single-dose rifapentine, single-dose rifampin, or control (no intervention). The primary outcome was the 4-year cumulative incidence of leprosy among household contacts.ResultsA total of 207 clusters comprising 7450 household contacts underwent randomization; 68 clusters (2331 household contacts) were assigned to the rifapentine group, 71 (2760) to the rifampin group, and 68 (2359) to the control group. A total of 24 new cases of leprosy occurred over the 4-year follow-up, for a cumulative incidence of 0.09% (95% confidence interval [CI], 0.02 to 0.34) with rifapentine (2 cases), 0.33% (95% CI, 0.17 to 0.63) with rifampin (9 cases), and 0.55% (95% CI, 0.32 to 0.95) with no intervention (13 cases). In an intention-to-treat analysis, the cumulative incidence in the rifapentine group was 84% lower than that in the control group (cumulative incidence ratio, 0.16; multiplicity-adjusted 95% CI, 0.03 to 0.87; P=0.02); the cumulative incidence did not differ significantly between the rifampin group and the control group (cumulative incidence ratio, 0.59; multiplicity-adjusted 95% CI, 0.22 to 1.57; P=0.23). In a per-protocol analysis, the cumulative incidence was 0.05% with rifapentine, 0.19% with rifampin, and 0.63% with no intervention. No severe adverse events were observed.ConclusionsThe incidence of leprosy among household contacts over 4 years was lower with single-dose rifapentine than with no intervention. (Funded by the Ministry of Health of China and the Chinese Academy of Medical Sciences; Chinese Clinical Trial Registry number, ChiCTR-IPR-15007075.)

Prospective Clinical Split-Mouth Study of Two-Wing–Retained Resin-Bonded Anterior Fixed Dental Prostheses with Metallic and Ceramic Frameworks: 5-year Results

To analyze the clinical performance of two-wing–retained resin-bonded fixed dental prostheses (RBFDPs) after 5 years of clinical use with respect to technical and biologic complications, as well as survival and success rates. RBFDPs were fabricated from 3Y-TZP zirconia layered by hand (Lava Frame veneered with Lava Ceram; 3M ESPE) or metal (Remanium Star, Dentaurum; layered with Reflex, Wieland). The primary endpoints were debonding and fracture. The secondary endpoints (marginal integrity, marginal discoloration, abrasion of antagonist dentition, patient satisfaction, Gingival Index, and side effects) were evaluated at baseline and after 5 years. Survival and success rates were calculated using the Kaplan-Meier method. Log-rank test was used to compare the survival and success rates of the different materials. The mean observation time was 6 years and 10 months. The estimated cumulative success rate after 5 years was 88.9% ± 10% for metal-supported and 33% ± 16% for all-ceramic two-wing RBFDPs. After conversion into one-wing RBFDPs, the survival rate was 100% in both groups. Debonding of one of the two wings was the major complication. One zirconia framework fracture occurred. Metal-based two-wing RBFDPs showed a significantly higher success rate, but lower esthetic evaluation. Due to a reduction in technical complication rate and less invasiveness, one-wing RBFDPs should be preferred over two-wing RBFDPs whenever possible.

Research on rock mass strength parameter perception based on multi-feature fusion of vibration response while drilling

To accurately and reliably perceive the strength parameters of rock mass, a perception method based on the combination of multi-feature fusion of vibration response while drilling and BP neural network is proposed. Firstly, the feasibility of using vibration response while drilling to reverse rock mass strength parameters is discussed by the Ls-Dyna. Afterwards, the concept of the window function is introduced, and the hybrid domain features of different sequences are extracted. The experimental results show that the fluctuation degree of the vibration signal is positively correlated with the strength of rock mass. Also, the kernel principal component analysis is used to extract the principal component with a cumulative contribution ratio greater than 85% to construct the fusion feature vector. Finally, the fusion feature vector was input into the BP neural network optimized by the Bat algorithm to identify the rock mass strength. The results show that the perception accuracy is 93.75%. Compared with other input features, the accuracy of perception through multi-feature fusion is at least 3.125% higher.

Potassium assisted pyrolysis of Chinese Baijiu distillers' grains to prepare biochar as controlled-release K fertilizer

A novel K-loaded biochar as controlled-release K fertilizer was prepared through K assisted pyrolysis of distillers' grains (DGs, typical solid-byproducts of Chinese Baijiu) under different atmospheres (N2 and CO2) and temperatures (400 and 800 °C). The fabricated DGs-based biochar exhibited high K loading (200.20–232.33 mg/g), and the release kinetics and column leaching experiments suggested that K-loaded biochar exhibited excellent controlled release performance in a long term. Compared with other biochar, the K-loaded biochar prepared at CO2 and 400 °C has lower cumulative release ratio of 82.35 %, and could retain the durative K release at ~0.5 % for 25 d. The release kinetics suggested that the K release behavior was dominated by dissolution, electrostatic attraction, adsorption, confinement effect, and chemical interaction. Furthermore, pot experiments revealed that K-loaded biochar could promote the growth of Komatsuna, in which the fresh weight and chlorophyll relative content of Komatsuna cultivated with biochar prepared at CO2 and 400 °C reached 0.146 g and 41.95 after 25 d growth, respectively. The above results suggested that the K-loaded biochar exhibited excellent utilization potential as a controlled-release K fertilizer, facilitating the sustainable development and resource valorization of Baijiu industry.

Spectrum of PRSS1, SPINK1, CTRC, CFTR, and CPA1 Gene Variants in Chronic Pancreatitis Patients in Russia.

The study group included 105 patients with CP, with the age of the disease onset under 40 years old (the average age of onset was 26.9 years). The control group consisted of 76 persons without clinical signs of pancreatitis. The diagnosis of chronic pancreatitis in patients was made on the basis of clinical manifestations and the results of laboratory and instrumental investigations. Genetic examination of patients was conducted using the next-generation sequencing (NGS) technology and included targeted sequencing of all exons and exon-intron boundaries of the PRSS1, SPINK1, CTRC, CFTR, and CPA1 genes. The genotyping of the rs61734659 locus of the PRSS2 gene was also conducted. Genetic risk factors of the CP development were found in 61% of patients. Pathogenic and likely-pathogenic variants associated with the risk of CP development were identified in the following genes: CTRC (37.1% of patients), CFTR (18.1%), SPINK1 (8.6%), PRSS1 (8.6%), and CPA1 (6.7%). The frequent gene variants in Russian patients with CP were as follows: CTRC gene - c.180C>T (rs497078), c.760C>T (rs121909293), c.738_761del24 (rs746224507); cumulative odds ratio (OR) for all risk alleles was 1.848 (95% CI: 1.054-3.243); CFTR gene - c.3485G>T (rs1800120), c.1521_1523delCTT (p.Phe508del, rs113993960), and c.650A>G (rs121909046); OR=2.432 (95% CI: 1.066-5.553). In the SPINK1, PRSS1, and CPA1 genes, pathogenic variants were found only in the group of patients with CP. The frequent variants of the SPINK1 gene include c.101A>G (p.Asn34Ser, rs17107315) and c.194+2T>C (rs148954387); of the PRSS1 gene - c.86A>T (p.Asn29Ile, rs111033566); of the CPA1 gene - c.586-30C>T (rs782335525) and c.696+23_696+24delGG. The OR for the CP development for the c.180TT genotype (rs497078) CTRC according to the recessive model (TT vs. CT+CC) was 7.05 (95% CI: 0.86-263, p=0.011). In the CTRC gene, the variant c.493+49G>C (rs6679763) appeared to be benign, the c.493+51C>A (rs10803384) variant was frequently detected among both the diseased and healthy persons and did not demonstrate a protective effect. The protective factor c.571G>A (p.Gly191Arg, rs61734659) of the PRSS2 gene was detected only in the group of healthy individuals and confirmed its protective role. 12.4% of the patients with CP had risk factors in 2 or 3 genes. Sequencing of the coding regions of the PRSS1, SPINK1, CTRC, CFTR, and CPA1 genes allowed to identify genetic risk factors of the CP development in 61% of cases. Determining the genetic cause of CP helps to predict the disease course, perform preventive measures in the proband's relatives, and facilitate a personalized treatment of the patient in future.

Changes in the neighborhood food environment and walking time among older adults: A longitudinal Japan Gerontological Evaluation Study (JAGES) between 2016 and 2019

Objective Maintaining or increasing walking provides several health benefits to older adults. However, the mid-term evaluation of Health Japan 21 [second term] showed that older adults' daily steps did not meet the goal. Therefore, this study emphasized primordial prevention, which is different from previous preventive approaches and focuses on the relationship between the built environment and physical activities, including daily steps. This study investigated the relationship between changes in the number of food stores and walking time.Methods This longitudinal study utilized the self-administered mail survey data between 2016 and 2019 from the Japan Gerontological Evaluation Study (JAGES). Older adults aged ≥65 years and residing in 27 independent municipalities were recruited. The dependent variable was a change in the walking time at two-time points (increase or not). Our explanatory variable was the change in the number of food stores at two-time points, reported on a 5-point scale, including no store (reference), increased stores, store available, decreased stores, and I don't know. Equivalently, it was defined as the self-reported change in the number of food stores (stores that sell meats, fish, fruits, and vegetables) within the walking distance of participants' homes (within ～1 km) from 2016 to 2019. The covariates included demographic factors, health behavior factors, environmental factors, and health factors in 2016. We used Poisson regression analysis (5% significance level) to calculate the cumulative incidence rate ratio (CIRR) and 95% confidence interval (CI) for an increase in walking time compared to no increase in walking time. The multivariate normal imputation method supplemented missing data of the dependent variable, explanatory variable, and covariates. Additionally, respondents' answer of "other" for the covariates was supplemented.Results Three years later, 13,400 (20.4%) respondents had increased their walking time. Older adults who reported increased number of stores (5,311, 8.1%) had more walking time than those who reported no stores (6,577, 10.0%) (CIRR=1.12; 95% CI: 1.03-1.21).Conclusion Participants who reported an increase in the number of fresh food stores within the walking distance had 12% more walking time three years later. A built environment might be used to measure primordial prevention that increases the amount of walking in daily life. Our results may provide evidence for policymakers and stakeholders to consider healthy urban planning.