Total Rate Research Articles

Experimental study of rotational relaxation for D2(1,12) in collisions with N2.

The rotational relaxation behavior of D2(1,12) in a D2-N2 mixture was investigated using coherent anti-Stokes Raman scattering (CARS) technique. The rovibrational level v = 1 and J = 12 of D2 was selectively excited through stimulated Raman pumping while monitoring the temporal evolution of population for D2(1, J ≤ 12) molecules using time-resolved CARS spectroscopy. The results demonstrate that the rotational relaxation processes of D2(1,12) encompass both multi-quantum relaxation and continuous single-quantum relaxation. When α, the molar ratio of N2, is less than 0.5, D2(1,12) predominantly undergoes a single quantum relaxation process transition. However, when α ≥ 0.5, the multi-quantum relaxation mechanism gradually predominates. The total rotational relaxation rate coefficients of D2(1,12) collisions with N2 and D2 at 295K were determined to be 3.974 × 10-14 and 1.179 × 10-14cm3s-1, respectively. The temperature dependence of rotational relaxation rate of D2(1,12) was investigated within the temperature range of 295-453K. With increasing temperature, the dominant relaxation process exhibited an accelerated behavior, while the minor relaxation process remained largely unaffected. The rotational temperature of the D2molecule at various N2 molar ratios was determined through the utilization of Boltzmann plots. The rotational temperature undergoes a rapid decline within 2 μs, corresponding to the near-resonant rotation-vibration relaxation process of D2(1,12) collisions with N2. The system reaches a quasi-equilibrium state when the delay time is 3 μs. The findings of this study can serve as a valuable empirical basis for further validation of the kinetic theory and simulation.

The collaborative approaches of the knowledge-based performance management system and lean six sigma to improve contractor productivity and safety performances

Purpose This paper aims to design a hybrid model of knowledge-based performance management system (KBPMS) for facilitating Lean Six-Sigma (L6s) application to increase contractor productivity without compromising human safety in Indonesian upstream oil field operations that manage ageing and life extension (ALE) facilities. Design/methodology/approach The research design applies a pragmatic paradigm by employing action research strategy with qualitative-quantitative methodology involving 385 of 1,533 workers. The KBPMS-L6s conceptual framework is developed and enriched with the Analytical Hierarchy Process (AHP) to prioritize fit-for-purpose Key Performance Indicators. The application of L6s with Human Performance Modes analysis is used to provide a statistical baseline approach for pre-assessment of the contractor’s organizational capabilities. A comprehensive literature review is given for the main pillars of the contextual framework. Findings The KBPMS-L6s concept has given an improved hierarchy for strategic and operational levels to achieve a performance benchmark to manage ALE facilities in Indonesian upstream oil field operations. To increase quality management practices in managing ALE facilities, the L6s application requires an assessment of the organizational capability of contractors and an analysis of Human Performance Modes (HPM) to identify levels of construction workers’ productivity based on human competency and safety awareness that have never been done in this field. Research limitations/implications The action research will only focus on the contractors’ productivity and safety performances that are managed by infrastructure maintenance programs for managing integrity of ALE facilities in Indonesian upstream of oil field operations. Future research could go toward validating this approach in other sectors. Practical implications This paper discusses the implications of developing the hybrid KBPMS- L6s enriched with AHP methodology and the application of HPM analysis to achieve a 14% reduction in inefficient working time, a 28% reduction in supervision costs, a 15% reduction in schedule completion delays, and a 78% reduction in safety incident rates of Total Recordable Incident Rate (TRIR), Days Away Restricted or Job Transfer (DART) and Motor Vehicle Crash (MVC), as evidence of achieving fit-for-purpose KPIs with safer, better, faster, and at lower costs. Social implications This paper does not discuss social implications Originality/value This paper successfully demonstrates a novel use of Knowledge-Based system with the integration AHP and HPM analysis to develop a hybrid KBPMS-L6s concept that successfully increases contractor productivity without compromising human safety performance while implementing ALE facility infrastructure maintenance program in upstream oil field operations.

A meta-analysis comparing treatment of benign prostatic hyperplasia with holmium laser enucleation and photoselective greenlight vaporization

Abstract Background We compared the safety and efficacy of treating benign prostatic hyperplasia with photoselective greenlight vaporization (PVP) versus holmium laser enucleation of the prostate (HoLEP). Methods Databases (PubMed, Embase, Cochrane Library, Chinese CBM, and CNKI) were searched for eligible studies evaluating HoLEP or PVP outcomes, published until May 2022. We analyzed the incidence of relative complications and postoperative outcomes, including the international prostate symptom score, maximum flow rate (Qmax), postvoid residual urine volume, quality of life index, and prostate-specific antigen levels. Results Eleven studies involving 4763 patients were included in this meta-analysis. The significant differences in postoperative Qmax at 1 month (mean difference [MD], 3.31, 95% confidence interval [CI], 0.45–6.16, p = 0.02, I 2 = 92%), 3 months (MD, 2.78, 95% CI, 0.53 to 5.02, p = 0.02, I 2 = 89%), 6 months (MD, 2.13, 95% CI, 1.11 to 3.15, p < 0.0001, I 2 = 87%), and 12 months (MD, 3.98, 95% CI, 2.06 to 5.89, p < 0.0001, I 2 = 58%) further confirmed unique advantage of HoLEP over PVP. We used forest plots to determine significant differences in the severe complication rates among patients in the PVP and HoLEP groups (odds ratio, 0.05, 95% CI, 0.01 to 0.28, p = 0.0005). Conclusions Holmium laser enucleation of the prostate and PVP showed comparable international prostate symptom scores, quality of life index, postvoid residual urine volumes, prostate-specific antigen levels, perioperative factors, and total complication rates. Compared with PVP, HoLEP had a greater Qmax 1 year postoperatively, decreased energy expenditure, and fewer high-grade complications. These results need to be verified in long-term follow-up studies with well-structured randomized controlled trials.

Curative effect of motherwort combined with ethinylestradiol-cyproterone acetate on dysfunctional uterine bleeding

ABSTRACT Objective Thisstudy aimed to investigate the curative effect of motherwort combinedwith ethinylestradiol-cyproterone acetate (EE/CPA) on dysfunctionaluterine bleeding (DUB). Methods Atotal of 68 patients with DUB were divided into a single medicationgroup (treated with EE/CPA) and a combination medication group(treated with motherwort and EE/CPA). The clinical efficacy, uterinehemodynamic parameters, sex hormone levels, coagulation index levels,blood routine test levels, and adverse reactions of patients wereevaluated. Results Afterthree months of treatment, total treatment response rate of thecombination medication group was significantly higher than that ofthe single medication group. Decreased uterine volume, endometrialthickness and resistance index (RI), increased pulsatility index(PI), average flow rate, and uterine artery blood flow, as well asreduced follicle-stimulating hormone (FSH), luteinizing hormone (LH),estradiol (E2), progesterone (P), activated partial thromboplastintime (aPTT), prothrombin time (PT), fibrinogen (FIB), thrombin time(TT), platelet count (PLT), red blood cell (RBC), and hemoglobin (Hb)levels were witnessed in patients of the two groups. In thecombination medication group, there exhibited reduced uterine volume,endometrial thickness and RI, elevated PI, average flow rate, anduterine artery blood flow, reduced P, E2, FSH, LH, aPTT, PT, FIB, TT,PLT, RBC, and Hb levels in comparison to the single medication group. Conclusion Thecombination of motherwort and EE/CPA is clinically effective in thetreatment of DUB.

Prevalence of hypertension and related risk factors in older Chinese population: a meta-analysis

ObjectiveHypertension is the most challenging public health problem worldwide and seriously affects human health. To date, there are no epidemiological studies on the prevalence of and risk factors for hypertension among older people in mainland China.MethodsWe conducted a meta-analysis of the prevalence and risk factors of hypertension among the older population in mainland China. We searched Chinese and English databases for Chinese and English literature on hypertension epidemiology published between 2000 and 2022, and hypertension data among the older population were extracted from the included literature. A meta-analysis was performed using a random-effects model (I2 > 50%) with 95% confidence intervals for the forest plots. Data were processed using RevMan 5.3. Forty-nine publications (with data from 84,429 samples) met the evaluation criteria and were included in this study.ResultsWe found that the total prevalence of hypertension was 47%. The total prevalence rate of the older population in China from 2000 to 2010 was 50%, and the prevalence rate from 2011 to 2021 was 45%, with no significant differences. The total prevalence in Central China was the highest (59%). There was no significant correlation between the prevalence rate of the older population, sex, and urban or rural areas.ConclusionHypertension is common among the older population in China, and its control rate is low. Therefore, effective prevention and treatment measures, as well as education, should be formulated to improve the diagnosis and treatment of hypertension in the older population.

Japanese survey of perioperative complications and ureteral stricture after ureteroscopy with laser lithotripsy for upper urinary tract stones in multicenter collaborative study.

This study aimed to investigate perioperative complications and the details of postoperative ureteral stricture after ureteroscopy with laser lithotripsy (URS-L) for upper urinary tract stones in Japan. Patient data on intra- and postoperative complications after ureteroscopy using URS-L were retrospectively collected from multiple centers in Japan between April 2017 and March 2020 with the cooperation of the Japanese Society of Endourology and Robotics. Data included the number of patients undergoing URS-L, number and type of intra- and postoperative complications, and detailed characteristics of postoperative ureteral stricture. In total, 14 125 patients underwent URS-L over 3 years at 82 institutions. Annual URS-L numbers gradually increased from 4419 in 2017, to 4760 in 2018, and 4946 in 2019. The total complication rate was 10.5%, which was divided into intra-operative complications in 1.40% and postoperative complications in 9.18%. The annual incidences of intra- and postoperative complications were not significantly different from year to year (p = 0.314 and p = 0.112). Ureteral perforation, ureteral avulsion, and the intra-operative conversion rate were 1.35%, 0.03%, and 0.02%, respectively. Fever >38°C, septic shock, blood transfusion, and postoperative mortality were 7.44%, 0.81%, 0.07%, and 0.04%, respectively. Ureteral stricture occurred in 0.8% of cases. The median length of stricture site was 10.0 mm and the success rate of stricture treatment was 54.6%. Although URS-L utilization has increased in Japan, the annual complication rate has remained steady. Although URS-L is a useful and less invasive procedure, devastating complications can still occur.

A reassessment of trends and rural–urban/regional differences in the total fertility rate in China, 2000–2020: analyses of the 2020 national census data

The decline in the total fertility rate (TFR) is a key driver of population change and has important implications for population health and social development. However, China’s TFR has been a considerable controversy due to a lack of high-quality data. Therefore, this study used the 2020 national population census of China (NPCC) data and reverse survival method to reassess temporal trends in the TFRs and to reexamine rural–urban differences and regional variations in TFRs from 2000 to 2020 in China. Overall, there were significant gaps between the estimated and reported TFRs before 2020, and the estimated TFRs based on the 2020 NPCC data remained higher than the reported TFRs from government statistics. Although TFRs rebounded shortly in the years after the two-child policy, they have shown a wavelike decline since 2010. Additionally, the estimated TFRs fluctuated below 1.5 children per woman in urban areas compared to above 1.8 in rural areas, but the rural–urban differences continued to decrease. Regarding geographic regional variations, the estimated TFRs in all regions displayed a declining trend during 2010–2020, especially in rural areas. Large decreases of over 25% in TFRs occurred in the north, east, central, and northwest regions. In addition to changing the birth policy, the government and society should adopt comprehensive strategies, including reducing the costs of marriage, childbearing, and child education, as well as promoting work-family balance, to encourage and increase fertility levels.

Performance and harmonic detection algorithm of phase locked Loop for parallel APF

As the boost of power electronics technology, the harmonic problem in the power system is becoming increasingly prominent. Fourier decomposition is performed on the load current in the power system, and components with a frequency that is an integer multiple of the fundamental wave are referred to as harmonic components. Harmonic control is essential to establish a safe and reliable power grid environment and provide high-quality and clean electricity to power users. The study focused on parallel active power filters, proposed a specific harmonic detection method on the grounds of synchronous harmonic rotating coordinate system, and developed a phase-locked loop design on the grounds of order generalized integrator. Meanwhile, a compensation current control method on the grounds of space vector pulse width modulation was introduced. The results showed that in the full compensation simulation experiment, the compensated A-phase grid side current waveform was significantly improved and presented a sinusoidal shape. After 0.05 s, the actual output compensation current closely followed the command current. Meanwhile, after compensation, the total harmonic distortion rate decreased from 26.58 to 3.06%. In specific harmonic compensation simulation experiments, when the sum of 5th, 7th, and 11th harmonic components was used as the command current for compensation, the distortion of the current waveform was improved after the load undergoes a sudden change. After compensation, the 5th, 7th, and 11th harmonic content significantly decreased, and the total harmonic distortion rate decreased to 4.08%. This indicated that the proposed phase-locked loop design and harmonic detection method for active power filters had high stability and effectiveness. The study’s primary contribution is to enhance the utilization efficiency of DC voltage and improve the dynamic response ability of current. Additionally, it offers a new method for reducing the impact of harmonics on the power grid and improving power quality. It provided an effective method reference for technological progress in related fields such as power electronics and control engineering.

Social Determinants of Health and Patient-reported Outcomes Following Autologous Breast Reconstruction, Using Insurance as a Proxy.

Insurance type can serve as a surrogate marker for social determinants of health and can influence many aspects of the breast reconstruction experience. We aimed to examine the impact of insurance coverage on patients reported outcomes with the BREAST-Q (patient reported outcome measure for breast reconstruction patients, in patients receiving) in patients receiving deep inferior epigastric artery perforator (DIEP) flap breast reconstruction. We retrospectively examined patients who received DIEP flaps at our institution from 2010 to 2019. Patients were divided into categories by insurance: commercial, Medicaid, or Medicare. Demographic factors, surgical factors, and complication data were recorded. Descriptive statistics, Fisher's exact, Kruskal-Wallis rank sum tests, and generalized estimating equations were performed to identify associations between insurance status and five domains of the BREAST-Q Reconstructive module. A total of 1,285 patients were included, of which 1,011 (78.7%) had commercial, 89 (6.9%) had Medicaid, and 185 (14.4%) had Medicare insurances. Total flap loss rates were significantly higher in the Medicare and Medicaid patients as compared to commercial patients; however, commercial patients had a higher rate of wound dehiscence as compared to Medicare patients. With all other factors controlled for, patients with Medicare had lower Physical Well-being of the Chest (PWBC) than patients with commercial insurance (β = - 3.1, 95% confidence interval (CI): -5.0, -1.2, p = 0.002). There were no significant associations between insurance classification and other domains of the BREAST-Q. Patients with government-issued insurance had lower success rates of autologous breast reconstruction. Further, patients with Medicare had lower PWBC than patients with commercial insurance regardless of other factors, while other BREAST-Q metrics did not differ. Further investigation as to the causes of such variation is warranted in larger, more diverse cohorts.

Trends and risk factors for drug-resistant tuberculosis among children in Sichuan, China: A 10-year retrospective analysis, 2013-2022.

To investigate the status of the drug-resistant tuberculosis (DR-TB) among children in Sichuan, and to find out the risk factors and high-risk population related to drug resistance among children. The clinical data of tuberculosis patients ≤14 years old with culture-confirmed tuberculosis hospitalized in Chengdu Public Health Clinical Center from January 2013 through December 2022 were collected. Clinical data such as gender, age, ethnicity, history of anti-TB treatment, history of exposure to tuberculosis, nutritional status, and specific drug resistance of the children were collected and recorded. The drug resistance of children in different age groups (0-4 years old, 5-9 years old, 10-14 years old) and different periods (2013-2017 and 2018-2022) were grouped and compared. Logistic regression analysis was to analyze analysis of risk factors of drug resistance in children. A total of 438 children with culture-confirmed tuberculosis were screened. Among them, 26.19% (11/42) were 0 to 4 years old, 33.33% (22/66) were 5 to 9 years old, and 36.67% (121/330) were 10 to 14 years old among the resistant children. There was no statistically significant difference in the resistance rate among the 3 groups (P = .385). The proportions of DR-TB, monoresistant tuberculosis, polydrug-resistant tuberculosis were decreased during 2019 to 2022 compared with 2013 to 2017 (P < .0001). The resistance rates of drug resistant, monoresistant, polydrug-resistant, isoniazid-resistant, and rifampicin resistant during 2018 to 2022 were decreased compared with those from 2013 to 2017 (P < .05), but the multi-drug resistance rate was not decreased (P = .131, without statistical difference). The results of logistic regression analysis showed that male gender OR = 1.566 (95% CI 1.035-2.369), a history of antituberculosis therapy OR = 4.049 (95% CI 1.442-11.367), and pulmonary and extrapulmonary tuberculosis OR = 7.335 (95% CI 1.401-38.392) were risk factors for the development of drug resistance; but fever OR = 0.581 (95% CI 0.355-0.950) was Protective factor. The total drug resistance rate of children in Sichuan showed a downward trend, but the rate of multi-drug-resistant tuberculosis was still at a high level, and the form of drug resistance was still severe. Absence of fever, male, retreatment, and pulmonary concurrent with extrapulmonary tuberculosis are risk factors for DR-TB in children.

Uncovering Chemical Interactions between Danshen and Danggui Using Liquid Chromatography–Mass Spectrometry and Network Pharmacology-Based Research on Stroke

Abstract Objective: The objective of this study was to decipher chemical interactions between Danshen and Danggui using liquid chromatography–mass spectrometry (LC-MS) and explore the mechanisms of Danshen–Danggui against stroke using network pharmacology and molecular docking. Materials and Methods: First, the chemical compounds of Danshen–Danggui were profiled using ultra-high-performance liquid chromatography (HPLC)-quadrupole time-of-flight MS. Accurately characterized compounds in various proportions of Danshen–Danggui were quantified using HPLC combined with triple quadrupole electrospray tandem MS. Network pharmacology was used to uncover the essential mechanisms of action of Danshen–Danggui against stroke. Discovery Studio Software was used for the molecular docking verification of key active chemicals and stroke-related targets. Results: A total of 53 compounds were characterized, and 22 accurately identified constituents (10 phenolic acids, 8 phthalides, and 4 tanshinones) were quantified in 15 proportions of Danshen–Danggui. The quantification results showed that Danggui significantly increased the dissolution of most phenolic acids (compounds from Danshen), whereas Danshen promoted the dissolution of most phthalides (compounds from Danggui). Overall, the combination of Danshen and Danggui at a 1:1 ratio resulted in the maximum total dissolution rate. Further network pharmacology and molecular docking results indicated that Danshen–Danggui exerted anti-stroke effects mainly by regulating inflammation-related (tumor necrosis factor, hypoxia-inducible factor, and toll-like receptor) signaling pathways, which ranked among the top three pathways based on Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. Conclusion: The chemical compounds in Danshen–Danggui could interact with each other to increase the dissolution of the most active compounds, which could provide a solid basis for uncovering the compatibility mechanisms of Danshen–Danggui and Danshen–Danggui-based formulae.

Phenological and life-history responses of a tropical cladoceran Moina micrura to multiple environmental drivers

Context Climate change and global warming has led to changes in water-quality parameters, which in turn have negative consequences for zooplankton. Aims To investigate the effects of various environmental stressors (pH, temperature, photoperiod, and food concentration) on the tropical freshwater microcrustacean Moina micrura. Methods The study examined the effects of these stressors on survival (lifespan), reproduction (days to first brood, number of broods, and total offspring), growth (individual size and total moulting), physiology (heart rate), and sex-switching effects (total male offspring). Key results Significant (P &lt; 0.05) reductions in the total offspring, individual size, and heart rate of M. micrura were observed when exposed to acidic (pH 5) and alkaline (pH 9) conditions. Conversely, higher water temperatures (31°C) and longer light exposure (20 h) were found to increase total offspring and heart rate in M. micrura. Furthermore, male offspring were produced only under conditions of food scarcity (no food supply and 1 × 102 cells mL−1). Conclusions Climate change has a significant effect on the life-history traits of M. micrura, a tropical cladoceran species. Implications Vital insights that can guide policymakers and practitioners in developing more effective strategies to safeguard and preserve tropical freshwater aquatic habitats, especially those of zooplankton species.

Temporal evolution of traffic accident mortality rates in the State of São Paulo, Brazil, in the period 2009-2019

Introduction: external causes are considered a public health problem in the world, associated with socioeconomic, political, and cultural diversities. Among them, traffic accidents stand out.&#x0D; Objective: to assess the trend in traffic accident mortality for each sex in the state of São Paulo, Brazil.&#x0D; Methods: ecological study of time series analyses. Secondary data referring to deaths from traffic accidents by place of residence in the state of São Paulo, Brazil, in the period 2009 - 2019 were used.&#x0D; Results: the total mortality rate in 2019 for females is 39.80 and for males, 185.85, with a reduction of 4.96% per year for both sexes. The trends in mortality from traffic accidents for females proved to be stationary for motorcyclists, motorized tricycle, pickup truck, heavy transport vehicle, and bus occupants at the end of the study period. For males, the same pattern was observed, but only for truck, heavy transport vehicle, and bus occupants. In the rest of the vehicles, the mortality rate showed decreasing trends.&#x0D; Conclusion: the highest number of deaths occurred among males (81.38%), aged between 20 and 49 years (58.70%), single (49.12%), on public roads (46.73%) and hospitals (45.64%). Females have more stationary trends than males.

Assessment of Lung Nodule Detection and Lung CT Screening Reporting and Data System Classification Using Zero Echo Time Pulmonary MRI.

The detection rate of lung nodules has increased considerably with CT as the primary method of examination, and the repeated CT examinations at 3 months, 6 months or annually, based on nodule characteristics, have increased the radiation exposure of patients. So, it is urgent to explore a radiation-free MRI examination method that can effectively address the challenges posed by low proton density and magnetic field inhomogeneities. To evaluate the potential of zero echo time (ZTE) MRI in lung nodule detection and lung CT screening reporting and data system (lung-RADS) classification, and to explore the value of ZTE-MRI in the assessment of lung nodules. Prospective. 54 patients, including 21 men and 33 women. Chest CT using a 16-slice scanner and ZTE-MRI at 3.0T based on fast gradient echo. Nodule type (ground-glass nodules, part-solid nodules, and solid nodules), lung-RADS classification, and nodule diameter (manual measurement) on CT and ZTE-MRI images were recorded. The percent of concordant cases, Kappa value, intraclass correlation coefficient (ICC), Wilcoxon signed-rank test, Spearman's correlation, and Bland-Altman. The p-value <0.05 is considered significant. A total of 54 patients (age, 54.8 ± 11.9 years; 21 men) with 63 nodules were enrolled. Compared with CT, the total nodule detection rate of ZTE-MRI was 85.7%. The intermodality agreement of ZTE-MRI and CT lung nodules type evaluation was substantial (Kappa = 0.761), and the intermodality agreement of ZTE-MRI and CT lung-RADS classification was moderate (Kappa = 0.592). The diameter measurements between ZTE-MRI and CT showed no significant difference and demonstrated a high degree of interobserver (ICC = 0.997-0.999) and intermodality (ICC = 0.956-0.985) agreements. The measurement of nodule diameter by pulmonary ZTE-MRI is similar to that by CT, but the ability of lung-RADS to classify nodes from MRI images still requires further research. 2 TECHNICAL EFFICACY: Stage 2.

Flame retardant polyurethane microbubble elastomer based on ionic liquid/ammonium polyphosphate/aluminum hypophosphite ternary flame retardant system

AbstractTo develop a highly efficient flame retardant system for polyurethane microbubble elastomer (PME), a phosphate‐based ionic liquid (IL) 1‐methyl‐3‐(dioxyphosphoryl)‐propyl imidazole bromide was synthesized, and then combined with ammonium polyphosphate (APP) and aluminum hypophosphate (ALHP) to form a ternary flame retardant system, which shows excellent synergistic flame retardancy and plays an important role in both gas phase and condensed phase flame retardancy. Compared with pure PME, the limiting oxygen index of flame retardant PME with 6 wt% IL and 15 wt% APP/ALHP increased from 20.25% to 29.25%, the char yields is increased by 13 times, and the heat release rate, total heat release rate, mass loss rate, and smoke production rate are reduced by 74%, 19%, 67%, and 22%, respectively. Ignition time increased from 9 s to 19 s, and extinguishing time increased from 295 s to 573 s. At the same time, the addition of IL promoted the dispersion and compatibility of APP/ALHP in the PME matrix and improved the mechanical properties. In addition, IL also shows potential in antistatic modification, providing the possibility for materials to meet both flame retardant and antistatic requirements.

At any cost: a paradigm shift in the culture of caesarean section rate monitoring in the United Kingdom

Recent reviews into maternity safety in the United Kingdom (UK) have led to a paradigm shift in culture and policy around caesarean section (CS) rate monitoring. CS rates in the UK have risen considerably over the last few decades and, in this time, there has been national effort at the level of government to kerb such rises due to concerns about the associated morbidity, and the medicalisation of birth. However, recent findings from two landmark reviews raise concerns that the pursuit of low CS rates may have caused harm to patients in some instances, and this has led the UK government to recommend cessation of the use of total CS rates as performance metric for maternity services. Instead, it is proposed that such data be collected with use of the Robson classification. Ongoing appraisal of maternity safety will be required to evaluate the effect of these changes in future.

The projected increase of vertebral osteomyelitis in Germany implies a demanding challenge for future healthcare management of aging populations.

Since an increase in the occurrence of native vertebral osteomyelitis (VO) is expected and reliable projections are missing, it is urgent to provide a reliable forecast model and make it a part of future health care considerations. Comprehensive nationwide data provided by the Federal Statistical Office of Germany were used to forecast total numbers and incidence rates (IR) of VO as a function of age and gender until 2040. Projections were done using autoregressive integrated moving average model on historical data from 2005 to 2019 in relation to official population projections from 2020 to 2040. The IR of VO is expected to increase from 12.4 in 2019 to 21.5 per 100,000 inhabitants [95% CI 20.9-22.1] in 2040. The highest increase is predicted in patients over 75years of age for both men and women leading to a steep increase in absolute numbers, which is fourfold higher compared to patients younger than 75years. While the IR per age group will not increase any further after 2035, the subsequent increase is due to a higher number of individuals aged 75years or older. Our data suggest that increasing IR of VO will seriously challenge healthcare systems, particularly due to demographic change and increasing proportions of populations turning 75years and older. With respect to globally fast aging populations, future health care policies need to address this burden by anticipating limitations in financial and human resources and developing high-level evidence-based guidelines for prevention and interdisciplinary treatment.

Identification of system parameters of a large‐scale dynamic multiaxial testing facility

AbstractLarge‐scale multiaxial testing facilities mainly serve to experimentally examine the horizontal behavior of full‐scale critical structural members, such as columns and seismic isolation bearings, on which a large vertical compression load is exerted as they simultaneously undergo horizontal deformation. The system friction and inertia force play an important role in obtaining sufficiently reliable test results, and it is not easy to comprehensively grasp all the issues involved. To understand the system friction and inertia force of the Bi‐Axial Dynamic Testing System (BATS) at the National Center for Research on Earthquake Engineering Tainan laboratory and to avoid complexity caused by specimens as much as possible, a lubricated flat sliding bearing is chosen as the specimen to be tested under horizontal triangular and sinusoidal reversed loading together with a constant vertical compression load. When no specimens are installed, that is, without vertical compression loading, the system friction of BATS generated by the various sliding surfaces can be identified and mathematically characterized using the horizontal triangular reversed loading test results; then, the effective mass of BATS can be estimated using the horizontal sinusoidal reversal loading test results to solve the inertia force problem. When applying a vertical compression load, it is assumed that the system friction of BATS and the shear force of the specimen are simply related to the applied total normal force (or vertical compression load) and horizontal excitation rate. An iteration methodology is proposed to identify and mathematically describe the dependency of the friction performance of BATS and the specimen on total normal forces (or vertical compression loads) and horizontal excitation rates by iterating the horizontal triangular and sinusoidal reversed loading test results. Finally, a lead‐rubber bearing and a direct force measurement system are connected in series such that the measurement system precludes the system friction and inertia force and a series of tests are conducted. The reliability of the proposed mathematical model for BATS and the feasibility of the proposed direct force measurement strategy are further demonstrated by comparing the calibrated force response with the directly measured response.

Pelagic fish spared from ocean catch by integrating Black Soldier Fly Larvae in U.S. aquaculture production

The sustainability challenges associated with utilizing forage fish sourced from ocean catch as fish meal and fish oil in the aquaculture industry has increased the demand for alternative feeds. Previous research indicates that Black Soldier Fly Larvae (BSFL; Hermetia illucens) can partially replace fish meal and/or fish oil in the diets of farmed aquaculture species without compromising fish growth or efficiency. The objective of our study was to identify the amount of pelagic fish from ocean catch that could be spared from fish meal and fish oil production by integrating BSFL in the diets of three aquaculture species, Atlantic Salmon (Salmo salar), Rainbow Trout (Oncorhynchus mykiss), and Whiteleg Shrimp (Litopenaeus vannamei) in the United States. Annual output for these aquaculture species was collected for 2017–2019. For each specie, we calculated the total metric tons (MT) of spared pelagic fish, by taxa, from fish meal and fish oil production based on total lifetime food intake and dietary replacement rates of fish meal and fish oil by BSFL as established in previous literature. At the highest level of dietary BSFL substitution for fish meal and/or fish oil that did not sacrifice performance of the three aquaculture species, 40,843 MT of pelagic fish could be spared from ocean catch in the U.S. per year. Therefore, integrating BSFL in the diets of aquaculture species could reduce the demand for pelagic fish sourced from ocean catch and positively contribute to the sustainability of aquaculture production.

Design and Experiment of Plate Taking Control System of Edible Sunflower (Edulis helianthus catino L.) Harvester

This study aims at the problems of high labor intensity, high cost and high loss rate of mechanical picking of seeds, low mechanization level and difficulty to guarantee the quality of picking plates in the process of picking edible sunflower. Based on the principle of manual plate taking, a plate taking control system for a sunflower harvesting table was designed. The principle of taking the plate of the edible sunflower harvesting table was analyzed. According to the actual operation requirements, the overall scheme of the sunflower plate control system is determined, and the control strategy of imitating artificial low-loss harvesting is designed. To reduce the grain loss in the process of taking the plate and improve the control accuracy of the system on the movement speed and displacement of the key components in the process of taking the plate, a trapezoidal acceleration and deceleration control algorithm is designed as the control algorithm of taking the plate. The working performance of the plate control system was verified with the absolute error, relative error and total loss rate of the harvest as objectives. Bench and field verification experiments were both carried out. The bench experiment showed that the speed error of the plate parts was not more than 0.028 m/s. In the bench experiments of the device, the maximum positioning error was 1.25 mm, the average relative error was only 0.94% and the grain loss rate was not more than 2.26%. Its result showed that the system algorithm was reliable, the positioning accuracy was high and the plate taking operation can be completed well. The field verification experiment showed that the forward speed of the unit was in the range of 0.4~0.8 m/s, and the total loss rate of harvest was less than 5%. When the forward speed is 0.6 m/s, the minimum harvest loss rate is 2.32%, which indicated the control system meets the requirements of sunflower harvesting operation.