Comparing Digital Therapeutic Intervention with an Intensive Obesity Management Program: Randomized Controlled Trial

In this study, we evaluated whether the digital program Vitadio achieves comparable results to those of an intensive in-person lifestyle intervention in obesity management. This is a 12-month prospective, randomized controlled trial. Obese patients with insulin resistance, prediabetes or type 2 diabetes were included. The intervention group (IG) used Vitadio. The control group (CG) received a series of in-person consultations. Body weight and various metabolic parameters were observed and analyzed with ANOVA. The trial is ongoing and the presented findings are preliminary. Among 100 participants (29% men; mean age, 43 years; mean BMI, 40.1 kg/m²), 78 completed 3-month follow-up, and 51 have completed the 6-month follow-up so far. Participants significantly (p < 0.01) reduced body weight at 3 months (IG: −5.9 ± 5.0%; CG: −4.2 ± 5.0%) and 6 months (IG: −6.6±6.1%; CG: −7.1 ± 7.1%), and the difference between groups was not significant. The IG achieved favorable change in body composition; significant improvement in TAG (−0.6 ± 0.9 mmol/l, p < 0.01), HDL (0.1 ± 0.1%, p < 0.05), HbA1c (−0.2 ± 0.5%, p < 0.05) and FG (−0.5 ± 1.5 mmol/l, p < 0.05); and a superior (p = 0.02) HOMA-IR reduction (−2.5 ± 5.2, p < 0.01). The digital intervention achieved comparable results to those of the intensive obesity management program. The results suggest that Vitadio is an effective tool for supporting patients in obesity management and diabetes prevention.     

The Impact of Dense Breasts on the Stage of Breast Cancer at Diagnosis: A Review and Options for Supplemental Screening

The purpose of breast cancer screening is to find cancers early to reduce mortality and to allow successful treatment with less aggressive therapy. Mammography is the gold standard for breast cancer screening. Its efficacy in reducing mortality from breast cancer was proven in randomized controlled trials (RCTs) conducted from the early 1960s to the mid 1990s. Panels that recommend breast cancer screening guidelines have traditionally relied on the old RCTs, which did not include considerations of breast density, race/ethnicity, current hormone therapy, and other risk factors. Women do not all benefit equally from mammography. Mortality reduction is significantly lower in women with dense breasts because normal dense tissue can mask cancers on mammograms. Moreover, women with dense breasts are known to be at increased risk. To provide equity, breast cancer screening guidelines should be created with the goal of maximizing mortality reduction and allowing less aggressive therapy, which may include decreasing the interval between screening mammograms and recommending consideration of supplemental screening for women with dense breasts. This review will address the issue of dense breasts and the impact on the stage of breast cancer at the time of diagnosis, and discuss options for supplemental screening.     

Digital eye strain and its associated factors in children during the COVID-19 pandemic

Purpose:This study was undertaken to identify the prevalence of symptoms related to the use of display devices and contributing factors in children engaged in distance learning during the COVID-19 pandemic.Methods:An online electronic survey form was prepared using Google Forms (Alphabet Co., Mountain View, CA) and sent to parents of children under the age of 18 years engaged in distance learning during the COVID-19 pandemic. The types of display devices children use, how often such devices are used, the symptoms of digital eye strain, and the severity and frequency of the symptoms were recorded, and the associations between the factors were analyzed.Results:A total of 692 participants were included. The mean age of the children was 9.72 ± 3.02 years. The most common display devices used were personal computers (n = 435, 61.7%) for online classes and smartphones (n = 400, 57.8%) for nonacademic purposes. The mean duration of display device use was 71.1 ± 36.02 min without a break and 7.02 ± 4.55 h per day. The most common reported symptom was headache (n = 361, 52.2%). Of the participants, 48.2% (n = 332) reported experiencing 3 or more symptoms. The multivariate analysis detected that being male (P = 0.005) and older age (P = 0.001) were independent risk factors for experiencing 3 or more symptoms.Conclusion:The increasing use of digital devices by children is exacerbating the problem of digital eye strain in children as a side effect of online learning. Public awareness should be improved.     

基才网络环境的远程数字人体中医脉诊智能诊断系统

本文主要阐述了中医学脉诊原理,分析了脉诊数字化的可行性,描述了数字脉诊诊断系统的设计方案及进行家庭远程诊断的设想,并对该系统的应用前景作了展望。     

中医药工程领域研究的新进展

本文对中医药工程学科近期研究的状况作了概要的介绍。对数字中医药体系的新构想、中医数字人体工程、中医临床诊疗技术研究中的四诊客观化的脉象研究和舌象研究的内容作了较细的介绍；而对中医经络研究、中药细胞级粉碎的微粉技术研究、中医专家诊疗系统研究、中医药古籍整理研究、亚健康医学研究及中医药工程教育和学科人才培养等内容作了一般介绍。此外也对引发的思考和学科宗旨、任务略作阐述。     

108例支气管哮喘患者舌脉象特征分析

目的：探讨对支气管哮喘临床辨证有意义的舌脉象客观指标,以辅助临床诊断。方法：应用TP—I型中医舌脉象数字化分析仪检测108例患者舌脉象参数,分析支气管哮喘发作期与缓解期的舌脉象特征。结果：108例支气管哮喘患者的舌象中,舌色以淡红舌、淡紫舌多见,舌苔以白苔、黄苔、薄苔为多见;脉象以弦脉、滑脉、弦滑脉为多见;舌脉象参数中舌色指数、苔色指数、厚苔指数、胖瘦指数在哮喘发作期各证型中有显著性差异（P〈0．05）;RPSR1、RPSR3、RPSR4、RBF、RLMS2、PLMP2、RLMS3、RLMP3在哮喘发作期与缓解期有显著性差异（P〈0．05）。结论：支气管哮喘患者的脉象参数、舌色指数、苔色指数、厚苔指数、胖瘦指数、RPSR1、RPSR3、RPSR4、RBF、RLMS2、PLMP2、RLMS3、RLMP3对其辨证分型有重要参考价值。     

Papers Please - Predictive Factors of National and International Attitudes Toward Immunity and Vaccination Passports: Online Representative Surveys

BackgroundIn response to the COVID-19 pandemic, countries are introducing digital passports that allow citizens to return to normal activities if they were previously infected with (immunity passport) or vaccinated against (vaccination passport) SARS-CoV-2. To be effective, policy decision-makers must know whether these passports will be widely accepted by the public and under what conditions. This study focuses attention on immunity passports, as these may prove useful in countries both with and without an existing COVID-19 vaccination program; however, our general findings also extend to vaccination passports.ObjectiveWe aimed to assess attitudes toward the introduction of immunity passports in six countries, and determine what social, personal, and contextual factors predicted their support.MethodsWe collected 13,678 participants through online representative sampling across six countries—Australia, Japan, Taiwan, Germany, Spain, and the United Kingdom—during April to May of the 2020 COVID-19 pandemic, and assessed attitudes and support for the introduction of immunity passports.ResultsImmunity passport support was moderate to low, being the highest in Germany (775/1507 participants, 51.43%) and the United Kingdom (759/1484, 51.15%); followed by Taiwan (2841/5989, 47.44%), Australia (963/2086, 46.16%), and Spain (693/1491, 46.48%); and was the lowest in Japan (241/1081, 22.94%). Bayesian generalized linear mixed effects modeling was used to assess predictive factors for immunity passport support across countries. International results showed neoliberal worldviews (odds ratio [OR] 1.17, 95% CI 1.13-1.22), personal concern (OR 1.07, 95% CI 1.00-1.16), perceived virus severity (OR 1.07, 95% CI 1.01-1.14), the fairness of immunity passports (OR 2.51, 95% CI 2.36-2.66), liking immunity passports (OR 2.77, 95% CI 2.61-2.94), and a willingness to become infected to gain an immunity passport (OR 1.6, 95% CI 1.51-1.68) were all predictive factors of immunity passport support. By contrast, gender (woman; OR 0.9, 95% CI 0.82-0.98), immunity passport concern (OR 0.61, 95% CI 0.57-0.65), and risk of harm to society (OR 0.71, 95% CI 0.67-0.76) predicted a decrease in support for immunity passports. Minor differences in predictive factors were found between countries and results were modeled separately to provide national accounts of these data.ConclusionsOur research suggests that support for immunity passports is predicted by the personal benefits and societal risks they confer. These findings generalized across six countries and may also prove informative for the introduction of vaccination passports, helping policymakers to introduce effective COVID-19 passport policies in these six countries and around the world.     

顺行指掌侧固有动脉推进皮瓣修复指端组织缺损的临床疗效观察

目的 探讨顺行指掌侧固有动脉推进皮瓣应用于指端组织缺损患者的疗效。方法 77例指端组织缺损患者随机分为两组,对照组行指动脉逆行岛状皮瓣修复术,实验组行顺行指掌侧固有动脉推进皮瓣修复术,比较两组的疗效、术后患指功能以及并发症。结果 实验组的治疗优良率和术后患指功能评分均显著高于对照组（P <0.05）;两组的术后并发症发生率无统计学差异（P>0.05）。结论 顺行指掌侧固有动脉推进皮瓣在指端组织缺损患者中应用效果显著,可促进术后患指功能恢复,安全性高。     

颈动脉体瘤的影像学诊断

目的:探讨比较颈动脉体瘤的超声、CT、MRI、DSA的影像学表现,提高术前诊断水平。方法:回顾性分析手术病理证实的14例颈动脉体瘤的各种影像学表现及特征。结果:各种检查均可显示肿瘤部位、大小及形态,颈动脉体瘤的彩色多普勒特点为中等偏低实质回声,境界清楚,大于3.0cm的肿瘤可见管道结构,但肿瘤上缘观察欠清,14例行彩色多普勒超声其中9例可显示瘤内网状血管,有1例神经鞘瘤误诊为颈动脉体瘤,诊断符合率为93%(14/15)。14例均行CT平扫加增强,CT增强显示为富血管肿瘤,其中12例肿瘤均匀强化,2例呈明显不均匀强化,CT值150～180HU,颈内、外动脉密度与瘤体等同难以分辨,术前CT诊断符合率为100%(14/14)。11例患者行MRI及MRA检查,MRI平扫特点为瘤内见流空的血管影像,明确显示颈内、外动脉分离和紧贴或镶嵌在肿瘤后外缘及前外缘,MRA能良好显示肿瘤与颈总动脉及其分叉的关系,术前MRI诊断符合率为100%(11/11)。其中8例同时行DSA血管造影,除能明确诊断和显示供血动脉外,DSA能清晰显示其血供及与颈内、外动脉的关系,术前DSA诊断符合率为100%(8/8)。结论:彩色多普勒超声、CT和MRI对颈动脉体瘤均有很高的诊断价值,差异无显著性意义。     

Digital Image Correlation Characterization and Formability Analysis of Aluminum Alloy TWB during Forming

The formability of aluminum alloy 5754-O tailor-welded blanks prepared by friction stir welding was studied experimentally. The strain evolution and deformation during limiting dome height experiments were studied using digital image correlation and the ARAMIS software. The influence of the sheet thickness of the base materials on the punch loading, fracture strain and formability were investigated experimentally. It was found that the punch loading, fracture strain and limiting dome height values increase with the increasing sheet thickness of the base materials. A linear relationship between the limiting dome height value and the sheet thickness was demonstrated. An increase of 16.8% in the fracture strain of aluminum tailor-welded blanks was observed for an increase of 36% in sheet thickness. This paper provides a methodology for experimentally determining the forming limits of aluminum alloy tailor-welded blanks accurately.