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To enhance the cost-effectiveness of vascular robotic systems in clinical settings, this study constructs an integrated forecasting-optimization framework for long-term resource planning. A weekly demand forecasting model is developed using the SARIMA approach, with model order selection guided by stationarity testing and ACF and PACF analysis. Forecast accuracy is validated to ensure reliable downstream optimization. Based on the predicted 112-week demand, a nonlinear procurement scheduling model is formulated, incorporating Poisson-distributed scrap rates and two types of acquisition strategies: conventional and emergency-use procurement. To solve the mixed-integer nonlinear programming problem under constraints such as maintenance cycles, training limits, and resource coupling, a continuous relaxation method is adopted along with a penalty-based cost function. The problem is then optimized using an Adaptive Sparrow Search Algorithm (ASSA), enhanced with Levy flights and adaptive producer ratios. Extensive sensitivity and interaction analyses are conducted on parameters including scrap rate, training limits, and initial inventory levels. The results not only demonstrate the robustness of the proposed approach but also offer valuable insights into strategic procurement under dynamic clinical demand, providing a novel data-driven paradigm for hospital resource allocation.

Objective To investigate the risk factors associated with aggression in patients with schizophrenia. Methods Patient clinical, behavioural, and demographic information was collected and reported online to the Beijing Mental Health Information Management System by psychiatrists. We used chi-square tests to analyse information between 2011 and 2015 to determine the prevalence and incidence of schizophrenia and the rate of aggression. We used univariate and binary logistic regression to analyse risk factors of aggressive behaviours. Results The prevalence and incidence of schizophrenia, and the proportion of cases displaying aggressive behaviour, increased considerably from 2011 to 2015. Risk of aggression was associated with non-adherence to medication (odds ratio [OR]: 2.92; 95% confidence intervals [CI]: 2.08–4.11), being unmarried (OR: 1.62; 95% CI: 1.03–2.55), having physical disease (OR: 3.26; 95% CI: 2.28–4.66), and higher positive symptom scores (OR: 2.01; 95% CI: 1.06–3.81). Physical disease was a risk factor associated with committing more than one type of aggression. Conclusion We confirmed that demographic factors, treatment-related factors, and clinical symptoms were associated with aggression in patients with schizophrenia in Beijing. A focus on improving controllable factors, including medication adherence and physical health status, might help to prevent aggressive behaviour.

As the effects of anthropogenic climate change become more severe, several approaches for deliberate climate intervention to reduce or stabilize Earth’s surface temperature have been proposed. Solar radiation modification (SRM) is one potential approach to partially counteract anthropogenic warming by reflecting a small proportion of the incoming solar radiation to increase Earth’s albedo. While climate science research has focused on the predicted climate effects of SRM, almost no studies have investigated the impacts that SRM would have on ecological systems. The impacts and risks posed by SRM would vary by implementation scenario, anthropogenic climate effects, geographic region, and by ecosystem, community, population, and organism. Complex interactions among Earth’s climate system and living systems would further affect SRM impacts and risks. We focus here on stratospheric aerosol intervention (SAI), a well-studied and relatively feasible SRM scheme that is likely to have a large impact on Earth’s surface temperature. We outline current gaps in knowledge about both helpful and harmful predicted effects of SAI on ecological systems. Desired ecological outcomes might also inform development of future SAI implementation scenarios. In addition to filling these knowledge gaps, increased collaboration between ecologists and climate scientists would identify a common set of SAI research goals and improve the communication about potential SAI impacts and risks with the public. Without this collaboration, forecasts of SAI impacts will overlook potential effects on biodiversity and ecosystem services for humanity.

A regional nuclear war between India and Pakistan with a 5 Tg black carbon injection into the upper troposphere would produce significant climate changes for a decade, including cooling, reduction of solar radiation, and reduction of precipitation, which are all important factors controlling agricultural productivity. We used the Decision Support System for Agrotechnology Transfer agricultural simulation model to simulate regional nuclear war impacts on rice yield in 24 provinces in China. We first evaluated the model by forcing it with daily weather data and management practices for the period 1980–2008 for 24 provinces in China, and compared the results to observations of rice yields in China. Then we perturbed observed weather data using climate anomalies for a 10-year period from a nuclear war simulation. We perturbed each year of the 30-year climate record with anomalies from each year of the 10-year nuclear war simulations for different regions in China. We found that rice production would decline by an average of 21 % for the first 4 years after soot injection, and would slowly recover in the following years. For the next 6 years, the reduction in rice production was about 10 %. Different regions responded differently to climate changes from nuclear war. Rice production in northern China was damaged severely, while regions along the south and east coasts showed a positive response to regional nuclear war. Although we might try to adapt to a perturbed climate by enhancing rice planting activity in southern and eastern China or increasing fertilizer usage, both methods have severe limitations. The best solution to avoid nuclear war impacts on agriculture is to avoid nuclear war, and this can only be guaranteed with a nuclear-weapon-free world.

Solar geoengineering is receiving increased policy attention as a potential tool to offset climate warming. While climate responses to geoengineering have been studied in detail, the potential biodiversity consequences are largely unknown. To avoid extinction, species must either adapt or move to track shifting climates. Here, we assess the effects of the rapid implementation, continuation and sudden termination of geoengineering on climate velocities—the speeds and directions that species would need to move to track changes in climate. Compared to a moderate climate change scenario (RCP4.5), rapid geoengineering implementation reduces temperature velocities towards zero in terrestrial biodiversity hotspots. In contrast, sudden termination increases both ocean and land temperature velocities to unprecedented speeds (global medians >10 km yr −1 ) that are more than double the temperature velocities for recent and future climate change in global biodiversity hotspots. Furthermore, as climate velocities more than double in speed, rapid climate fragmentation occurs in biomes such as temperate grasslands and forests where temperature and precipitation velocity vectors diverge spatially by >90°. Rapid geoengineering termination would significantly increase the threats to biodiversity from climate change. Geoengineering is a potential strategy to offset the effects of climate change. Using climate velocities to predict the effects on biodiversity shows particular risk from the abrupt termination of geoengineering.

Overcoming apoptosis resistance is necessary to ensure an effective cancer treatment; however, it is currently very difficult to achieve. A desirable alternative for cancer treatment is the targeted activation of pyroptosis, a unique type of programmed cell death. However, the pyroptosis inducers that are efficient for cancer therapy are limited. This work reports the engineering of 2D NiCoOx nanosheets as inducers of the production of harmful reactive oxygen species (ROS), which promote intense cell pyroptosis, and that can be applied to ultrasound (US)‐augmented catalytic tumor nanotherapy. The main therapeutic task is carried out by the 2D NiCoOx nanosheets, which have four multienzyme‐mimicking activities: peroxidase‐ (POD), oxidase‐ (OXD), glutathione peroxidase‐ (GPx), and catalase‐ (CAT) mimicking activities. These activities induce the reversal of the hypoxic microenvironment, endogenous glutathione depletion, and a continuous ROS output. The ROS‐induced pyroptosis process is carried out via the ROS‐NLRP3‐GSDMD pathway, and the exogenous US activation boosts the multienzyme‐mimicking activities and favors the incremental ROS generation, thus inducing mitochondrial dysfunction. The anti‐cancer experimental results support the dominance of NiCoOx nanosheet‐induced pyroptosis. This work expands on the biomedical applications of engineering 2D materials for US‐augmented catalytic breast cancer nanotherapy and deepens the understanding of the multienzyme activities of nanomaterials. The 2D multienzyme‐mimicking NiCoOx nanosheets as proptosis inducers have been developed to increase the rate of deleterious reactive oxygen species generation for the ultrasound‐augmented catalytic nanotherapy of breast cancer.

A range of solar radiation management (SRM) techniques has been proposed to counter anthropogenic climate change. Here, we examine the potential effects of stratospheric sulfate aerosols and solar insolation reduction on tropospheric ozone and ozone at Earth's surface. Ozone is a key air pollutant, which can produce respiratory diseases and crop damage. Using a version of the Community Earth System Model from the National Center for Atmospheric Research that includes comprehensive tropospheric and stratospheric chemistry, we model both stratospheric sulfur injection and solar irradiance reduction schemes, with the aim of achieving equal levels of surface cooling relative to the Representative Concentration Pathway 6.0 scenario. This allows us to compare the impacts of sulfate aerosols and solar dimming on atmospheric ozone concentrations. Despite nearly identical global mean surface temperatures for the two SRM approaches, solar insolation reduction increases global average surface ozone concentrations, while sulfate injection decreases it. A fundamental difference between the two geoengineering schemes is the importance of heterogeneous reactions in the photochemical ozone balance with larger stratospheric sulfate abundance, resulting in increased ozone depletion in mid- and high latitudes. This reduces the net transport of stratospheric ozone into the troposphere and thus is a key driver of the overall decrease in surface ozone. At the same time, the change in stratospheric ozone alters the tropospheric photochemical environment due to enhanced ultraviolet radiation. A shared factor among both SRM scenarios is decreased chemical ozone loss due to reduced tropospheric humidity. Under insolation reduction, this is the dominant factor giving rise to the global surface ozone increase. Regionally, both surface ozone increases and decreases are found for both scenarios; that is, SRM would affect regions of the world differently in terms of air pollution. In conclusion, surface ozone and tropospheric chemistry would likely be affected by SRM, but the overall effect is strongly dependent on the SRM scheme. Due to the health and economic impacts of surface ozone, all these impacts should be taken into account in evaluations of possible consequences of SRM.

The prognosis of advanced stage cervical cancer is poorer due to cancer invasion and metastasis. Exploring new factors and signalling pathways associated with invasiveness and metastasis would help to identify new therapeutic targets for advanced cervical cancer. We searched the cancer microarray database, Oncomine, and found elevated calponin 3 (CNN3) mRNA expression in cervical cancer tissues. QRT-PCR verified the increased CNN3 expression in cervical cancer compared to para-cancer tissues. Proliferation, migration and invasion assays showed that overexpressed CNN3 promoted the viability and motility of cervical cancer cells, the opposite was observed in CNN3-knockdown cells. In addition, xenografted tumours, established from SiHa cells with CNN3 knockdown, displayed decreased growth and metastasis in vivo . Furthermore, RNA-sequencing showed that ribosomal protein lateral stalk subunit P1 (RPLP1) was a potential downstream gene. Gene function experiments revealed that RPLP1 had the same biological effects as CNN3 did. Rescue experiments demonstrated that the phenotypes inhibited by CNN3 silencing were partly or completely reversed by RPLP1 overexpression. In conclusion, we verified that CNN3 acts as an oncogene to promote the viability and motility of cervical cancer cells in vitro and accelerate the growth and metastasis of xenografted tumours in vivo , by affecting RPLP1 expression.

Net primary productivity (NPP) can indicate vegetation ecosystem services ability and reflect variation response to climate change and human activities. This study applied MODIS-1 km NPP products to investigate the NPP variation from 2001 to 2006, a fast urban expansion and adjustment period in Guangzhou, China, and quantify the impacts of weather and land use/land cover (LULC) changes, respectively. The results showed that the NPP mean value increased at a rate of 11.6 g∙C∙m−2∙yr−1 during the initial three years and decreased at an accelerated rate of 31.0 g∙C∙m−2∙yr−1 during the final three years, resulting in a total NPP loss of approximately 167 × 106 g∙C. The spatiotemporal of NPP varied obviously in the central area, suburb and exurb of Guangzhou driven by three patterns of weather and LULC changes. By the interactive effects and the weather variation dominated effects, NPP of most areas changed slightly with dynamic index less than 5% of NPP mean value in the central area and the suburb. The LULC change dominated effects caused obvious NPP reduction, by more than 15% of the NPP mean value, which occurred in some areas of the suburb and extended to the exurb with the outward urban sprawl. Importantly, conversion from wood grassland, shrublands and even forests to croplands occupied by urban landscapes proved to be a main process in the conversion from high-NPP coverage to low-NPP coverage, thereby leading to the rapid degradation of urban carbon stock capacity in urban fringe areas. It is helpful for government to monitor urban ecological health and safety and make relevant policies.

Objectives To study the factors that influence the 6-minute walking distance (6MWD) among older patients with chronic heart failure. Methods This was a single-center, retrospective, observational study. A total of 123 patients from the First Affiliated Hospital of Nanjing Medical University was selected. The factors associated with the 6MWD were analyzed using Pearson correlation analysis and multivariate linear regression. Results The 6MWD of older patients was negatively correlated with age, fall risk, nutritional score, frailty, and depression but was positively correlated with educational level, fall efficacy, self-care ability, and plasma albumin. The results of independent variable multiple linear regression analysis showed that age (β = −0.098), fall risk (β = −0.262), fall efficacy (β = 0.011), self-care ability (β = −0.021), nutrition (β = −0.405), frailty (β = −0.653), and plasma albumin (β = 0.127) influenced the 6MWD. Conclusions The 6MWD of older patients with chronic heart failure was related to age, self-care ability, fall risk, nutrition, frailty, and depression.