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Objective To develop a questionnaire on social media content production among adolescents and to test its reliability and validity. Methods This study was an empirical investigation that recruited middle school students from a secondary school in Tai’an City, Shandong Province, China. The preliminary questionnaire was developed based on a combination of semi-structured interviews and a comprehensive review of the relevant literature. A total of 672 adolescents served as the initial test subjects, with 336 questionnaires undergoing item analysis and exploratory factor analysis, and the remaining 336 questionnaires undergoing confirmatory factor analysis. A reliability test was conducted using a retest questionnaire administered to 62 adolescent retest subjects. Results The adolescent social media sports content production questionnaire comprises two dimensions—user-generated content (UGC) and professional-generated content (PGC)—and nine items. The results of the confirmatory factor analysis indicated that the questionnaire had good fit indices (CMIN/DF = 4.352, RMSEA = 0.031, RMR = 0.024, CFI = 0.994, TLI = 0.992); The internal consistency of the total questionnaire reached 0.883, with Cronbach’s Alpha coefficients for each dimension exceeding 0.7, and test-retest reliability at 0.792; validity analysis showed significant correlations between dimensions and between sub-dimensions and the total questionnaire. Conclusion The questionnaire developed in this study for assessing social media content production among adolescents demonstrates good reliability, validity, and discriminative power, and can serve as an evaluation tool for social media sports content production among adolescents.

This study investigates whether native Hmong speakers' first language (L1) lexical tone experience facilitates or interferes with their perception of Mandarin tones and whether training is effective for perceptual learning of second (L2) tones. In Experiment 1, 3 groups of beginning level learners of Mandarin with different L1 prosodic background (Hmong, Japanese, and English) took a perception test on Mandarin tones. Both the English and Japanese groups outperformed the Hmong group in perceptual accuracy of Mandarin tones. In Experiment 2, 18 learners with different L1 background received either perception training only or perception with production training on Mandarin tones for 6 hours within 3-4 weeks. Both training paradigms were effective for perceptual learning of Mandarin tone contrasts as the two training groups' perceptual accuracy improved significantly at posttest compared with a control group. Although Hmong speakers initially had more difficulties in perception of Mandarin tones than the other 2 groups, they are by no means disadvantaged by their L1 prosodic background as they gain L2 experience after intensive training. (Verlag).

This study examines 357 sports-related intangible cultural heritage (ICH) items in Shandong Province, employing an integrated methodology combining GIS spatial analysis, geodetector modeling, and comparative approaches to investigate their multi-tiered spatial distribution patterns. Through six analytical dimensions—natural ecological environment, sociodemographic conditions, economic development level, regional cultural foundations, transportation accessibility, and policy frameworks—the research systematically evaluates differential influences on spatial configuration. Key findings reveal: (1) Shandong possesses a substantial concentration of sports-related ICH resources with widespread municipal distribution. Among them, a series of results such as the geographic concentration index G = 28.56, Moran’s I 0.94, and Nearest neighbor ratio 0.1 indicate significant clustering characteristics; (2) Macroscale clustering occurs predominantly along the Yellow River Basin and Jiaodong Peninsula coastal zones. (3) Regional high-density clusters emerge in Jinan(1.48–2.03 cores/km 2 ), Heze(1.06–1.31 cores/km 2 ), Zibo(1.18–1.54 cores/km 2 ), and Tsingtao(1.07–1.48 cells/km 2 ), with medium-density clusters spanning Liaocheng, Jining, and Tai’an. (4) Multivariate analysis identifies economic development and sociodemographic factors as primary spatial determinants, with transportation networks and cultural foundations serving as significant contributors. Natural environmental factors and policy interventions exhibit comparatively limited explanatory power. The study proposes targeted recommendations for optimizing spatial distribution patterns and advancing preservation strategies for both Yellow River civilization and regional sports traditions.

The traditional method is capable of detecting and tracking stationary and slow-moving targets in a sea surface environment. However, the signal focusing capability of such a method could be greatly reduced especially for those variable-speed targets. To solve this problem, a novel tracking algorithm combining range envelope alignment and azimuth phase filtering is proposed. In this method, the motion of the airborne maritime surveillance radar platform is firstly compensated for target echoes. Secondly, range envelope alignment is performed to correct the unpredictable range migration of the target after pulse compression. The higher-order phase difference between the adjacent pulses is estimated and compensated. Ultimately, such pulse series are accumulated through azimuth Fourier transform. Traditional methods compensate only for platform motion, limiting their ability to handle variable-speed targets. The proposed algorithm addresses this limitation by compensating for both platform and target motion, significantly improving signal focusing and tracking accuracy. A detailed analysis shows that our algorithm can significantly increase the signal accumulating gain and improve the focusing effect. The simulation results are provided to demonstrate the effectiveness of the proposed algorithm.

Herbal medicines have gained recognition among physicians and patients due to their lower adverse effects compared to modern medicines. They are extensively used to treat various diseases, including cancer, cardiovascular issues, chronic inflammation, microbial contamination, diabetes, obesity, and hepatic disorders, among others. Unfortunately, the clinical application of herbal medicines is limited by their low solubility and inadequate bioavailability. Utilizing herbal medicines in the form of nanocrystals (herbal medicine nanocrystals) has shown potential in enhancing solubility and bioavailability by reducing the particle size, increasing the specific surface area, and modifying the absorption mechanisms. Multiple studies have demonstrated that these nanocrystals significantly improve drug efficacy by reducing toxicity and increasing bioavailability. This review comprehensively examines therapeutic approaches based on herbal medicine nanocrystals. It covers the preparation principles, key factors influencing nucleation and polymorphism control, applications, and limitations. The review underscores the importance of optimizing delivery systems for successful herbal medicine nanocrystal therapeutics. Furthermore, it discusses the main challenges and opportunities in developing herbal medicine nanocrystals for the purpose of treating conditions such as cancer, inflammatory diseases, cardiovascular disorders, mental and nervous diseases, and antimicrobial infections. In conclusion, we have deliberated regarding the hurdles and forthcoming outlook in the realm of nanotoxicity, in vivo kinetics, herbal ingredients as stabilizers of nanocrystals, and the potential for surmounting drug resistance through the utilization of nanocrystalline formulations in herbal medicine. We anticipate that this review will offer innovative insights into the development of herbal medicine nanocrystals as a promising and novel therapeutic strategy.

Introduction This study aims to evaluate the clinical efficacy and safety profiles of various cyclin-dependent kinase 4/6 inhibitors(CDK4/6i) when administered alongside endocrine therapy (ET) in individuals diagnosed with advanced or metastatic breast cancer characterized by hormone receptor-positive (HR +) and human epidermal growth factor receptor 2-negative (HER2-) status. A network meta-analysis approach was employed to systematically compare these therapeutic combinations. Methods A systematic literature search was executed across four biomedical databases (Web of Science, PubMed, Cochrane Library and Embase), followed by a Bayesian network meta-analysis implemented through R statistical software. Progression-free survival (PFS) served as the primary efficacy endpoint, with treatment effects expressed as hazard ratios (HR) and accompanying 95% confidence intervals (CI). Secondary endpoints encompassed overall survival (OS), objective response rate (ORR), and adverse events (AEs). Results The study included 24 articles, comprising 15,602 patients and involving 12 treatment options. There were significant differences in PFS among certain CDK4/6i + ET combinations. Notably, the most effective combination therapy in terms of PFS might be abemaciclib plus aromatase inhibitors(AI), showing significant differences relative to palbociclib plus fulvestrant (HR  =  2.01; 95% CI: 1.32–2.93) , abemaciclib plus fulvestrant (HR  =  2.68; 95% CI: 1.52–4.36) , ribociclib plus fulvestrant (HR  =  2.75; 95% CI: 1.54–4.83) , while ribociclib plus AI was second, showing significant differences relative to ribociclib plus fulvestrant (HR  =  0.38; 95% CI: 0.21–0.7) , abemaciclib plus fulvestrant (HR  =  0.39; 95% CI: 0.23–0.72) , palbociclib plus fulvestrant (HR  =  1.92; 95% CI: 1.20–2.92) . Meanwhile, the SUCRA ranking diagram indicated that abemaciclib plus AI and palbociclib plus AI regimens might show the most favorable results in PFS and OS. In terms of safety, there was no statistically significant difference in adverse events (AEs) among different CDK4/6i combinations. Conclusions The research results indicate that in the treatment of advanced or metastatic breast cancer with HR + /HER2- phenotype, CDK4/6 inhibitors combined with endocrine therapy is superior to endocrine monotherapy. Among the evaluated treatment options, abemaciclib plus aromatase inhibitors appear to be potentially recommended regimens. Therefore, clinical decision-making should be personalized based on comprehensive consideration of individual patient factors.

To find out the effect of different oral anticoagulation therapies (OAC) on mortality rate in patients with acute kidney injury (AKI) and atrial fibrillation (AF). A retrospective study. This study was conducted in the Medical Information Mart for Intensive Care IV database. A total of 19 672 patients diagnosed with AKI. Patients were categorised into three groups: (1) AF; (2) AKI and AF, OAC-; (3) AKI and AF, OAC+. The primary endpoint was 30-day mortality. Secondary endpoints were the length of stay (LOS) in the intensive care unit (ICU) and hospital. Propensity score matching (PSM) and Cox proportional hazards model adjusted confounding factors. Linear regression was applied to assess the associations between OAC treatment and LOS. After PSM, 2042 pairs of AKI and AF patients were matched between the patients who received OAC and those without anticoagulant treatment. Cox regression analysis showed that, OAC significantly reduce 30-day mortality compared with non-OAC (HR 0.30; 95% CI 0.25 to 0.35; p<0.001). Linear regression analysis revealed that OAC prolong LOS in hospital (11.3 days vs 10.0 days; p=0.013) and ICU (4.9 days vs 4.4 days; p<0.001). OAC did not improve survival in patients with haemorrhage (HR 0.67; 95% CI 0.34 to 1.29; p=0.23). Novel OAC did not reduce mortality in acute-on-chronic renal injury (HR 2.03; 95% CI 1.09 to 3.78; p=0.025) patients compared with warfarin. OAC administration was associated with improved short-term survival in AKI patients concomitant with AF.

Unlike uniform motion, when an object moves underwater with variable speed, it experiences additional resistance from the water, commonly referred to as added mass force. At present, several methods exist to solve this force, including theoretical, experimental, and simulation approaches. This paper addresses the challenge of determining the added mass force for irregularly shaped small objects undergoing variable speed motion underwater, proposing a method to obtain the added mass force through numerical simulation. It employs regression analysis and parameter separation analysis to solve the added mass force, added mass, viscous drag coefficient, and pressure drag coefficient. The results indicate that an added mass force exists during both the acceleration and deceleration of the object, with little difference between them. Under the same velocity conditions, significant differences exist in pressure drag forces, while differences in viscous drag forces are not significant. This suggests that the primary source of added mass force is pressure drag, with viscous drag having little effect on it. During acceleration, the surrounding fluid accelerates with the object, increasing the pressure drag with a high-pressure area concentrating at the object’s front, forming an added mass force that is directed backward. By contrast, during deceleration, the fluid at the object’s front tends to detach, and the fluid at the rear rushes forward, leading to a smaller high-pressure area at the front and a larger one at the rear, reducing the pressure drag and forming an added mass force that is directed forward. By comparing the added mass of a standard ellipsoid obtained from numerical simulation with theoretical values, the regression analysis method is proven to be highly accurate and entirely applicable for solving the added mass of underwater vehicles.

Background Significant disparities in breast cancer screening coverage existed between high-income and low-income regions. This study aims to assess the implementation, effectiveness, and sustainability of a breast cancer screening program in China to provide insights into developing an effective implementation strategy suitable for rural areas with limited health resources. Methods This study employed the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework to assess the implementation, effectiveness, and sustainability of a breast cancer screening program in Ordos, Inner Mongolia, China. An explanatory mixed methods design was applied, in which qualitative data were used to explain unexpected quantitative findings. The quantitative study, conducted from 2016 to 2020, analyzed screening records and survey data from 177,107 women aged 35–64. The qualitative study, conducted in 2024, collected data through semi-structured interviews with nine health workers and analyzed the transcripts using thematic analysis. The qualitative themes and quantitative findings were matched within the RE-AIM framework. Results The screening program covered 52.24% of the women by the end of 2020, with a total of 177,107 women receiving screening. The cancer detection rate was 0.56/1000, ranging from 0.09/1000 in women aged 35–39 to 1.58/1000 in those aged 60–64. The Positive Prediction Value (PPV) for biopsy was over 64.9%, but few patients who were referred for further examinations (mammography and biopsy) completed the procedure. Key facilitators included strong patient-provider communication, staff involvement, adequate funding and training, and strict supervision, while barriers involved geographical distance, lack of multi-sector support, limited service capacity, and low health awareness. The “rural outreach” model (where MCHHs conduct screenings by visiting rural villages and setting up temporary clinics at local village health centers), along with routine hospital screening, was seen as the most effective solution for reaching dispersed populations with low health awareness and literacy. Increased awareness from prior screenings improved participation and compliance in subsequent programs. A key challenge in program maintenance was the reduction in quality control, supervision, and training efforts. Conclusion To improve cancer detection in rural areas, it is essential to strengthen both the screening capacity of primary healthcare facilities and the patient referral system for timely diagnosis. “Rural outreach” is an effective way to reduce health inequity in marginalized women and increase their awareness at the same time. Further research is needed to assess long-term outcomes and develop customized implementation strategies for overcoming the identified barriers.

Irrational use of antimicrobial agents for gastrointestinal diseases deserves attention, but corresponding antimicrobial stewardship programs (ASPs) are generally not a priority for managers. We conducted this study to evaluate the effectiveness of multifaceted pharmacist-led (MPL) interventions in the gastroenterology ward (GW) to provide evidence for the efficacy of ASPs in a non-priority department. This was an interventional, retrospective study implemented in China. The MPL intervention lasting 1.5 years involved daily ward rounds with physicians, regular review of medical orders, monthly indicator feedback, frequent physician training, and necessary patient education. Data on all hospitalized adults receiving antibiotics was extracted from the hospital information system over a 36-month period from January 2016 to December 2018. Segmented regression analysis of interrupted time series was performed to evaluate the effect of the MPL interventions (started in July 2017) on antibiotic use and length of hospital stay, which was calculated monthly as analytical units. A total of 1763 patients receiving antibiotics were enrolled. Segmented regression models showed descending trends from the baseline in the intensity of antibiotic consumption (coefficient = -0.88, = 0.01), including a significant decline in the level of change of the proportion of patients receiving combined antibiotics (coefficient = -9.91, = 0.03) and average length of hospital stay (coefficient = -1.79, = 0.00), after MPL interventions. The MPL interventions led to a temporary increase in the proportion of patients receiving antibiotics (coefficient = 4.95, = 0.038), but this was part of a declining secular trend (coefficient = -0.45, = 0.05). The MPL interventions led a statistically significant decline in the number of patients receiving antibiotics, the antibiotic consumption, and the average hospital stay post-intervention compared to the pre-intervention phase of the study. Health policymakers should actively practice MPL interventions by clinical pharmacists in ASPs in those departments that are not included in priority management.