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To translate the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-ELD14 (EORTC QLQ-ELD14) into Chinese and validate its effectiveness in China.
Methods
The Chinese version was developed through a rigorous translation and back-translation process based on the Brislin model, followed by cross-cultural adaptation through expert consultation. A total of 260 elderly cancer patients from a tertiary hospital in Tianjin were recruited between June 2024 and February 2025 to evaluate the instrument’s reliability and validity.
Results
Among the 248 completed responses, the Chinese version of the EORTC QLQ-ELD14 demonstrated robust psychometric properties. The questionnaire comprises 7 dimensions (14 items), with item-level content validity indices ranging from 0.800 to 1.000 and a scale-level content validity index of 0.980. Exploratory factor analysis identified 7 underlying factors, accounting for 82.913% of the cumulative variance. Internal consistency was excellent, with a Cronbach’s α of 0.958 for the total scale and dimension alphas exceeding 0.800. Test–retest reliability was 0.849 for the total scale and ranged from 0.813 to 0.856 across dimension.
Significance of results
The Chinese version of the EORTC QLQ-ELD14 has good reliability and validity, which is suitable for evaluating the quality of life of elderly cancer patients within Chinese cultural contexts.
We propose a spatially resolved B-integral measurement method for high-power laser drivers based on off-axis aberration characterization. Theoretical analysis confirms the feasibility and high precision of this approach, in which coma-shaped intensity modulation is intentionally introduced into the laser system, imprinting nonlinear phase modulation with a corresponding aberration profile. The B-integral is then extracted by measuring the coma component of the output beam using a Shack–Hartmann sensor. The experimental results demonstrate a 5.8% deviation between the measured and simulated B-integral values for coma aberration, showing that the proposed method significantly outperforms the defocus-based measurement method (67.4% error) in terms of error reduction. This method does not require modifications to the laser setup, offers a single-shot measurement capability and achieves high accuracy and excellent repeatability. The direct quantification of wavefront phase distortions provides a practical solution for nonlinear phase modulation diagnostics in high-power laser systems.
To develop and assess interpretable machine-learning models for sarcopenia risk assessment among physically inactive middle-aged and older adults using two large population-based datasets from the UK and the US.
Background:
Physical inactivity represents a major modifiable risk factor for sarcopenia in aging populations, yet prediction models specifically targeting this high-risk subgroup remain limited. This study developed and evaluated interpretable machine-learning models for sarcopenia risk stratification in physically inactive middle-aged and older adults using large-scale UK and US population-based data.
Methods:
We analyzed physically inactive participants from the English Longitudinal Study of Ageing (ELSA, 2012; n = 1,146) and the US National Health and Nutrition Examination Survey (NHANES, 1999–2006 and 2011–2018; n = 2,733). Sarcopenia and physical inactivity were defined using cohort-specific measurements and cutoffs. Within each cohort, six machine-learning algorithms were trained using 70/30 training–testing splits, Synthetic Minority Oversampling Technique to address class imbalance, and five-fold cross-validation for hyperparameter optimization. Model performance was evaluated using area under the curve, accuracy, precision, recall, and F1 scores. Shapley Additive Explanations quantified predictor contributions, and stratified analyses explored heterogeneity by age and body-composition strata.
Findings:
Random forest demonstrated optimal performance across both cohorts (area under the curve: 0.817 and 0.801; accuracy: 83.8% and 83.1%). Shapley Additive Explanations analysis revealed waist-to-height ratio as the dominant predictor, followed by age, frailty score, and poverty-income ratio. Stratified analyses showed heterogeneous risk patterns across age groups and body-composition categories.
Translation plays a consequential role in how states govern, manage multilingual affairs, and project influence, yet this role is rarely examined through a comparative, state-centred framework. This Element introduces the State Translation Programme (STP) to analyse translation as state-organised action. Comparing China with Japan, Türkiye, the United States, South Korea, Canada, and Poland, it identifies three strategic modes: Architects build national capacity and identity, Influencers project soft power and shape external narratives, and Administrators manage internal coordination and multilingual governance. China stands out in comparative perspective in seeking to combine all three modes, a pattern this Element terms 'sovereign maximalism'. Tracing these governance functions from imperial dynasties to the contemporary People's Republic, the Element offers a framework for comparative analysis across translation studies and political science.
This work presents an integrated modelling study of fast-proton distributions generated by ion cyclotron range of frequency (ICRF) minority heating in the Experimental Advanced Superconducting Tokamak (EAST). Using a series of high-confinement (H-mode) discharges with increasing ICRF power levels from 0.8 to 2.4 MW, fast protons were produced via minority heating mechanisms and analysed through simulations using the ASCOT code. The results reveal that the fast protons are primarily concentrated near the fundamental cyclotron resonance layer and exhibit strong power-dependent behaviour in both real-space (R–Z) distribution and velocity space, where R is the major radius and Z is the vertical coordinate. As the ICRF power increases, the energetic proton population shows significant spatial broadening and energy enhancement, reaching up to 1 MeV. The fast-ion pitch-angle distribution becomes increasingly anisotropic, with high-energy ions concentrated around $|\textit{v}_{\|}/\textit{v}| \lt 0.5$, where $\nu$ is the magnitude (speed) of the full velocity vector of the particle. Furthermore, the energy density of fast ions aligns well with the ICRF power deposition profile, confirming efficient central-core heating. These findings, which provide insight into fast-ion behaviour and ICRF heating characteristics in EAST plasmas, also support future fast-ion diagnostics and performance control strategies in EAST and similar experimental conditions.
Thomas’s account suggests that infants are limited to reasoning about interpersonal relationships. We argue that this account fails to do justice to infants’ sociomoral reasoning. We describe an alternative account that grants infants expectations of harm avoidance, ingroup support, authority, fairness, and reciprocity. We highlight differences between the two accounts and suggest research directions for moving beyond these differences.
Metabolic dysfunction-associated steatotic liver disease (MASLD) was very common worldwide and was associated with metabolic syndrome, modifiable lifestyle factors and socio-economic status (SES). Although provitamin A carotenoid-rich foods have shown potential protective effects against MASLD, there was limited population-based evidence in this regard, and the mediating role of healthy lifestyle and SES in the association of carotenoids induced MASLD was still unclear. This study aimed to assess the association of provitamin A carotenoid-rich foods intake with MASLD risk and the mediating effects of healthy lifestyle and SES. Provitamin A carotenoid-rich foods intake was assessed using a 24-h recall data from the National Health and Nutrition Examination Survey. The USA Fatty Liver Index value ≥ 30 was used to define the MASLD status. SES (education/income) and healthy lifestyle (smoking/drinking/physical activity) were categorised via latent class analysis. Multivariable logistic regression and mediation analysis were used for analyses. A total of 6613 participants (mean (sd) age 50·8 (17·7) years; 53·6 % female) were included. Provitamin A carotenoid-rich foods intake was inversely associated with MASLD risk (adjusted OR, 0·684; 95 % CI: 0·532, 0·879). SES (mediation proportion, 12·92 %) and healthy lifestyle (16·84 %) exerted significant mediating effects. Subgroup analyses showed stronger associations in females (OR, 0·572; 95 % CI: 0·406, 0·805) and adults aged < 45 years (OR, 0·519; 95 % CI: 0·367, 0·734). Higher provitamin A carotenoid-rich foods intake was associated with lower MASLD risk, partially mediated by SES and healthy lifestyle. This provided a feasible dietary strategy for MASLD prevention, especially in females and younger adults.
A new model of the mean temperature profiles within incompressible wall-bounded turbulence is developed based on a relationship between the momentum and thermal eddy diffusivities for a wide range of Prandtl numbers ($ \textit{Pr}$). Flow media with $ \textit{Pr}$ and Schmidt numbers ($ \textit{Sc}$) other than unity are of great engineering importance, and the proposed model for passive scalar mean profiles is able to suitably account for $ \textit{Pr}$ and $ \textit{Sc}$ variations and their effects. Existing models have a higher degree of error at the lower $ \textit{Pr}$ ranges due to significant inaccuracies of the modelled thermal eddy diffusivity in this region. Considering incompressible wall-bounded turbulence at $0.007 \leqslant \textit{Pr} \leqslant 10$, the proposed methodology reduces the average error to just around $4\,\%$ across all cases considered, lower than previously proposed models due to its ability to capture low $ \textit{Pr}$ behaviour, showcasing a new temperature–velocity relationship that can account for variations in $ \textit{Pr}$ for all the cases considered.
The relationship between frailty, self-efficacy, and advance care planning (ACP) remains unclear in Asia. This study examined how frailty status relates to decisional self-efficacy, ACP engagement, and advance directive completion among older adults receiving home healthcare in Taiwan.
Methods
A cross-sectional analysis was conducted using baseline data from a nationwide cohort in Taiwan. Participants (N = 358) were categorized by Clinical Frailty Scale (CFS): mildly frail (CFS 4–5, n = 60), moderately frail (CFS 6, n = 83), severely frail (CFS 7, n = 147), and very severely frail (CFS 8–9, n = 68). ACP engagement and decision-making self-efficacy were assessed using Likert scales.
Results
Patients with greater frailty had lower odds of high decisional self-efficacy (CFS: 8–9: odds ratio [OR] = 0.38, 95% confidence interval [CI] = 0.14–1.07) but higher odds of ACP engagement (CFS: 6: OR = 3.38, 95% CI = 1.40–8.17; CFS: 7: OR = 2.52, 95% CI = 1.08–5.89) compared with mildly frail individuals. However, this increase did not extend linearly to the very severely frail group. Advance directive completion remained low across all frailty levels (4.8–10.0%) and was not significantly associated with frailty status.
Conclusions
Frailty was associated with lower decisional self-efficacy but higher readiness for ACP, revealing a divergence between perceived confidence and planning motivation. Despite greater engagement, advance directive completion remained low. Stage-sensitive, values-based approaches may help bridge the gap between intention and documentation across the frailty spectrum.
This study systematically investigated the effects of Lactiplantibacillus plantarum (Lp), cellulase (CE), and their combination (CELp) on the fermentation quality, fiber degradation, and microbial community in rapeseed straw silage. This research was carried out with a completely randomized design, and rapeseed straw was inoculated with L. plantarum (1.0 × 10⁶ colony-forming units [CFU]/g), CE (50,000 U/g), or CELp and fermented in vacuum-sealed bags at 25°C for 60 days. Results demonstrated that the CELp co-treatment yielded superior outcomes, significantly increasing lactic acid content, accelerating acidification, and effectively degrading neutral detergent fiber, acid detergent fiber, and hemicellulose compared to individual treatments. Microbial community analysis demonstrated that the CELp co-treatment effectively enriched functional bacterial treatments represented by Lactobacillus and Xanthomonas while significantly enhancing the activities of core enzymes, including L-lactate dehydrogenase, xylanase, and β-glucosidase. The CELp co-treatment intensified homolactic fermentation and structural carbohydrate decomposition, with correlation analysis revealing tight links among microbial composition, enzyme activities, and silage quality. In conclusion, the microbial–enzyme synergistic approach effectively improved the fermentation quality of rapeseed straw silage by directionally modulating the microbial community structure and enhancing core enzyme activities. These findings provide a novel theoretical basis for the efficient utilization of lignocellulosic agricultural by-products.
The inner–outer interaction model (IOIM), first proposed by Marusic et al. (Science, 2010, vol. 329, pp. 193–196), has proven to be an effective turbulence model for canonical and non-canonical wall-bounded flows, where a reference velocity signal from the logarithmic region acts as the input for predicting near-wall velocity fluctuations. Its most recent iteration by Baars et al. (Phys. Rev. Fluids, 2016, vol. 1, p. 054406) further proposes a user-independent scale separation point, refining model parameters. In this study, we compared the long-perceived universal IOIM’s parameters, including the linear transfer kernel, amplitude modulation coefficients and the universal signal for a range of Reynolds and Mach numbers, where mathematical relationships between the parameters are proposed. We observed that while the universal signals exhibit a high degree of similarity, particularly near the wall, the amplitude modulation coefficients and linear transfer kernels display Reynolds and Mach number effects, where varying the reference location also causes them to exhibit significant changes. We have found transformations to collapse amplitude modulation coefficients for incompressible flows and differing reference locations, improving modelling via the IOIM across flow parameters. Despite this, compressibility effects cannot be suitably accounted for currently and remain a future challenge for the IOIM framework.
The explosive dispersal of granular media, exemplified by the rapid radial expansion of a dense particle ring driven by internal pressurised gases, serves as a paradigmatic system for investigating multiphase blast dynamics. Despite the ubiquity of jetting and clustering phenomena in explosive dispersal scenarios, their governing mechanisms remain poorly resolved. In this work, we combine compressible computational fluid dynamics–discrete parcel method simulations, and theoretical modelling to elucidate the multiscale physics underlying explosion-induced particle jetting. We reveal a hierarchy of jetting structures, comprising non-jetting, suppressed jetting and prominent jetting, which are governed by the interplay between microscale particle force-chain evolution, mesoscale gas–particle coupling and macroscale ring dynamics. Jetting initiation emerges from the transient competition between shock-induced particle compaction and gas filtration during the early expansion phase, whereas sustained jet development requires subsequent ring implosion driven by adverse pressure gradients. By unifying this multiscale dynamics, we reduce the system’s complexity into two dimensionless parameters: one characterising mesoscale gas–particle interactions and another quantifying macroscale implosion intensity. A phase diagram for jetting morphology under weak-shock conditions is established in this dimensionless parameter space, delineating two necessary criteria for jet formation. Systems failing either criterion exhibit no jetting, resolving long-standing ambiguities in the prediction of explosive dispersal structures.
Using different techniques to derive dietary patterns (DP) could evaluate real-world diet behaviours and provide DP recommendations. Therefore, we identified DP using hybrid methodologies and examined the associations of DP with all-cause and CVD mortality among older Chinese. Using data from the Guangzhou Biobank Cohort Study, dietary intake was assessed using a validated FFQ. DP were derived using hybrid methods including reduced rank regression (RRR) and partial least squares (PLS), focusing on nutrients commonly insufficient in Asian diets. Associations of the DP with mortality and CVD risk factors were examined using Cox regression and generalised linear models, respectively. Of 19 598 participants with an average follow-up of 15·8 years, 4966 deaths occurred. Two DP were derived based on the riboflavin-density, K:Na ratio and vitamin C-density. The DP derived from both RRR and PLS featured high intakes of green vegetables, yellow/orange fruits and whole grains and low intakes of refined grains and plant oils, with additional high intakes of fish identified by RRR and milk by PLS. These DP were associated with lower all-cause and CVD mortality risks. Compared with the lowest quartile, the highest quartiles showed lower risks of all-cause (hazard ratio (HR): 0·89–0·91, all P < 0·01) and CVD mortality (HR: 0·79–0·82, all P < 0·01). Moreover, both DP were associated with favourable cardiometabolic profiles, including lower systolic blood pressure, TAG and high-sensitivity C-reactive protein levels, and higher HDL-cholesterol levels. These findings suggest that nutrient-rich DP using hybrid methods may support the development of dietary recommendations to reduce mortality among older Chinese.
This experimental study aims to clarify how and when a weak centrifugal force affects the turbulent rotating thermal convection system. For the bulk flow, the weak centrifugal effect is significant on long-time averaged flow fields, contrasting sharply with its negligible effect on the instantaneous fields. As for the sidewall flow, it is found that properties of the boundary zonal flow are influenced by the weak centrifugal force appreciably. The onset Froude number $\textit{Fr}_c^{\textit{local}}$, signalling when the weak centrifugal effects start to set in, is found to scale with Rayleigh number $Ra$ as $\textit{Fr}_c^{\textit{local}}\sim Ra^{0.55}$ over approximately two and a half decades of $Ra$. The underlying mechanism for this robust scaling is captured by the mechanism of local force balance, which involves three unknown local scales. With the help of both a viscous–Archimedean–Coriolis argument and the experimental data, these local scales are successfully resolved to reveal a consistent result with this 0.55 scaling.
Biomphalaria straminea (Gastropoda: Planorbidae) and Physa acuta (Gastropoda: Physidae), both invasive species in southern China, are important vectors for zoonotic diseases. However, the lack of information on the infection dynamics of Angiostrongylus cantonensis in these snails leaves gaps in understanding the compatibility mechanisms between the snails and the parasite. This study aims to reveal differences in A. cantonensis infection between B. straminea and P. acuta from Guangdong, southern China, and to investigate the potential interaction mechanisms between A. cantonensis and P. acuta. We found that both phenotypic color variants of B. straminea snails were highly susceptible to A. cantonensis (100%). The load of the L3 larvae ranged from 243 to 765 per snail, and it was positively correlated with the infection dosage. Based on the comparison of third-stage larvae quantities, B. straminea is more suitable than P. acuta for establishing the life cycle of A. cantonensis in the laboratory. In contrast, geographic isolates of P. acuta exhibited variable susceptibility (13–91%) and markedly lower parasite loads, with 6–32 third-stage larvae per snail. Diverse strains of P. acuta exhibit distinct immune responses to A. cantonensis, characterized by varied expression patterns of immune-related genes such as TEP1, HSP70, FREP2, Cu-Zn_SOD1, Fe-Mn_SOD2, MIF and Galectin. Our findings establish B. straminea as both a high-risk vector and a laboratory model for studying the life cycle of A. cantonensis, while highlighting P. acuta as a model for investigating parasite-snail interactions, thereby enhancing our understanding of snail-parasite dynamics in southern China.
Alterations in hypothalamic–pituitary–adrenal axis function may underlie the relation between childhood maltreatment and nonsuicidal self-injury (NSSI) behaviors. This study examined how co-occurring patterns of maltreatment types influenced adolescent NSSI behaviors and the mediating role of diurnal cortisol, using a longitudinal design. The sample included 295 Chinese adolescents (Mage = 10.79 years, SD = 0.84 years; 67.1% boys). The study employed latent profile analysis to identify childhood maltreatment patterns and conducted path analysis to examine the mediating mechanism. Four maltreatment patterns were identified: Low Maltreatment (67.8%), High Neglect (15.6%), Moderate Maltreatment (10.2%), and High Abuse with Moderate Neglect (6.4%). Furthermore, compared to the Low Maltreatment profile, adolescents in the High Neglect profile were at increased risk for later NSSI behaviors through higher waking cortisol levels, while those in the High Abuse with Moderate Neglect profile were at increased risk through a steeper diurnal slope. Disturbances in diurnal cortisol rhythm serve as a pathway through which childhood maltreatment “gets under the skin” to lead to adolescent NSSI behaviors. These findings offer promise for identifying maltreated youth at risk for NSSI behaviors and informing targeted prevention strategies.
As a highly aggressive tumour of the digestive tract, pancreatic cancer has a high mortality rate and poor treatment outcomes. The five-year survival rate for patients with pancreatic cancer is distressingly low, and the recurrence chance remains unacceptably high even with successful treatment. Surgical procedures and chemotherapy are the main treatments of pancreatic cancer, and surgical procedures are the only effective treatment at present. However, these cancer cells can easily develop resistance to chemotherapy agents, which leads to low treatment efficacy and high mortality in pancreatic cancer. Additionally, early diagnosis of pancreatic cancer is challenging due to the absence of obvious symptoms, making surgical intervention unattainable in early stages. However, pancreatic cancer cells show unique changes at genetic and cellular levels, which makes them sensitive to metalrelated cell death or exhibit some characteristics related to metalrelated cell death. These changes and characteristics could be utilized for treatment and diagnosis in pancreatic cancer.
Method
Therefore, our motivation is to explain the potential of metalrelated cell death in treating this aggressive cancer. This review begins by analysing the types of metal-related cell death: ferroptosis, cuproptosis and lysozincrosis. Each form is evaluated based on its unique features and related metabolic pathways.
Results
By examining the key characteristics of metal-related cell death modalities, their primary metabolic patterns and their interactions with pancreatic cancer, our aim is to point the direction to identify potential therapies and treatments.
Conclusions
Our review expands the possibilities for utilizing metal-related cell death and instils hope for its future potential in pancreatic cancer treatment.
This paper presents the first demonstration of a mid-infrared (MIR) Fe:ZnSe laser gain-switched by a non-critical phase-matched potassium titanyl arsenate optical parametric oscillator and amplifier at 3.47 μm. A novel improvement in slope efficiency was achieved by this new pump source, which significantly promoted the quantum efficiency compared to the conventional pump wavelength near 2.9 μm. The slope efficiency of 70.7% is a new record for Fe:ZnSe lasers with an output energy of 86 mJ and pulse width of 6.7 ns at 10 Hz. The output wavelength was tunable from 3.9 to 4.5 μm by changing the crystal’s temperature from 80 to 300 K. The influence of the pump beam size on transverse parasitic oscillation and crystal damage was investigated considering the dynamic absorption effect in Fe:ZnSe. This unique design provides an advancing and promising method of high-energy and short-pulse-width MIR lasers for extreme applications requiring both high-energy density and high-peak-power intensity.
This study aimed to update the incidence of device-associated healthcare-associated infections (DA-HAIs), and to characterize pathogen distribution and carbapenem-resistant Enterobacteriaceae (CRE) detection among ICU patients in Shanghai, China.
Methods:
Prospective surveillance in 223 ICUs using standardized International Nosocomial Infection Control Consortium methodology (INICC) protocols collected patient-level data on demographics, microbiology, device use, and DA-HAIs. Trends, annual percent change (APC) and average annual percent change (AAPC) were estimated using Joinpoint regression models.
Results:
The overall DA-HAIs incidence density in ICUs was 1.67 per 1000 catheter-days for catheter-associated urinary tract infection (CAUTI) (95% CI: 1.62–1.73), 0.59 per 1000 central line-days for central line-associated bloodstream infection (CLABSI) (95% CI: 0.56–0.63), and 4.63 per 1000 ventilator-days for ventilator-associated pneumonia (VAP) (95% CI: 4.51–4.76). Significant reductions were observed in VAP (AAPC: −15.36%; P < 0.001) and CLABSI (AAPC: −11.23%; P < 0.001). Pathogen distributions varied by infection type, with Enterococcus faecium (17.22%) and Klebsiella pneumoniae (16.63%) predominating in CAUTI patients, Klebsiella pneumoniae (26.87%) in CLABSI patients, and Acinetobacter baumannii (37.60%) in VAP patients. The overall CRE detection rate was 33.67% in CAUTI patients, 37.56% in CLABSI patients, and 35.24% in VAP patients.
Conclusions:
Although DA-HAI rates showed significant declines, the persistently high CRE prevalence underscores substantial antimicrobial resistance challenges in Chinese ICUs.