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关键词： All-cause mortality   Cardiovascular disease mortality   Depressive symptoms   Multimorbidity   Prospective cohort study  

摘要： Objective To explore the association between depressive symptoms and all-cause mortality and cardiovascular disease mortality in patients with chronic comorbidity. Methods Single-factor analysis was performed using chi-square test, and the relationship between PHQ-9 scores, depressive symptoms, and all-cause mortality as well as cardiovascular disease mortality in patients of multimorbidity were analyzed using COX proportional hazards regression model. Results The results of the multivariable COX regression showed that as compared to those without depressive symptoms, patients of multimorbidity with depressive symptoms had HR=1.665 (95%CI: 1.135-2.444) for all-cause mortality and HR=2.090 (95%CI: 1.216-3.594) for cardiovascular mortality. With an increase in PHQ-9 score, the risks of all-cause mortality (HR=1.060, 95%CI: 1.014-1.107) (P_trend <0.010) and cardiovascular mortality (HR=1.072, 95%CI: 1.005-1.144) (P_trend <0.010) gradually increased. Subgroup analysis by urban and rural areas showed that there was an interaction between different urban and rural depressive symptoms on the risk of all-cause mortality in patients of multimorbidity (P interaction <0.05). In rural areas, patients of multimorbidity with depressive symptoms had 2.637 times (95%CI: 1.639-4.243) higher risk of all-cause mortality and 3.207 times (95%CI: 1.686-6.101) higher risk of cardiovascular mortality compared to those without depressive symptoms. With an increase in PHQ-9 score, the risks of all-cause mortality (P_trend<0.001) and cardiovascular mortality (P_trend<0.001) also increased. However, these associations were not significant in urban areas. Conclusion Depressive symptoms is a risk factor for all-cause mortality and cardiovascular disease mortality in patients of multimorbidity, and more attention should be paid to psychological interventions for patients of multimorbidity in rural areas to reduce the risk of mortality in patients of multimo

摘要： 学生社团是校园文化建设的重要载体，是学生第二课堂的引领者。社团活动的有效开展可为卫生类高职院校学生的职业发展提供良好平台，为学校的全方位育人及校园文化建设添砖加瓦。然而，卫校学生专业课程任务重，课余时间少，如何有效利用好社团活动实现育人功能，达到育人目的，是高职校社团工作者值得探讨的问题。本文以某卫生高职校为例，着重分析目前卫生类高职院校社团活动的开展价值、工作现状、所遇困境及优化策略。

关键词： 知识图谱   AI技术   课程建设  

摘要： 在教育数字化转型的时代浪潮下,市场调查类课程作为市场营销专业的核心课程,其教学模式创新与优化迫在眉睫.本研究通过对教师教学与学生学习的深度调研,精准剖析了市场调查课程在教学方法、资源利用、内容更新及个性化教学等维度的现实困境.与此同时,系统梳理知识图谱与AI技术在教育领域的应用现状与发展趋势,深度挖掘其在市场调查类课程中的应用潜力.构建了基于超星平台、AI技术的市场调查类课程知识谱图,并创新性地打造了"三阶段四维度"的教学模式.此教学模式充分释放知识图谱与AI技术的优势效能,全方位满足学生多样化的学习诉求,有力推动学生的全面发展.

关键词： 广义互模糊函数   积分旁瓣电平   最大块改进   连续凸近似   交替方向惩罚法  

摘要： 具有良好相关特性的正交波形集可以提高多输入多输出(MIMO)雷达系统的目标检测性能和抗干扰能力。为此，该文提出主瓣增益和动态范围约束下最小化广义互模糊函数积分旁瓣(ISL)的发射序列集和接收滤波器组联合设计方法。该方法采用最大块改进算法(MBI)将非凸优化问题分解为多个子问题，再利用连续凸近似方法(SCA)迭代求解子问题。为了进一步降低运算量，该文还提出了具有并行实现潜力的交替方向惩罚法(ADPM)求解SCA的子问题。最后，通过仿真实验从收敛速度、积分旁瓣电平等方面验证了该方法的有效性。

摘要： BACKGROUND:Coronary artery calcification is common among patients undergoing percutaneous coronary intervention (PCI), and severe coronary artery lesion calcification is associated with increased procedural complexity, stent under-expansion, and high rates of intraprocedural complications and out-of-hospital adverse events. Whether calcium ablation before stent implantation can mitigate these adverse events is not currently established. We aimed to prospectively compare orbital atherectomy with a balloon angioplasty-based strategy before stent implantation for the treatment of severely calcified coronary lesions. METHODS:In this multicentre, open-label, randomised controlled trial conducted at 104 medical centres in the USA, patients (aged ≥18 years) with severely calcified coronary lesions were randomly assigned (1:1) to orbital atherectomy or balloon angioplasty before PCI with drug-eluting stents using a web-based system (block sizes of four and six) and stratified by intended treatment of single versus multiple lesions and enrolling site. Randomly assigned lesions were deemed by operators to be eligible for both treatment strategies. Operators and patients were not masked to treatment. The two powered coprimary study endpoints were target vessel failure at 1 year (a composite of cardiac death, target vessel myocardial infarction, or ischaemia-driven target vessel revascularisation) and post-procedural minimal stent area at the site of maximal calcification, as assessed by intravascular optical coherence tomography in an imaging patient cohort. Primary analyses were by intention-to-treat. The trial is registered at ***03108456, and 2-year follow-up is ongoing. FINDINGS:From March 27, 2017, to April 13, 2023, 2005 patients with 2492 lesions were randomly assigned to lesion preparation with orbital atherectomy (1008 patients with 1250 lesions) or balloon angioplasty (997 with 1242 lesions) before stent implantation. Median patient age was 70·0 yea

关键词： Esthetic evaluation   Esthetics, Dental   Lip prominence   Midface   Questionnaires  

摘要： To evaluate the influence of midface (nasal base and zygomatic bone) morphological changes on the overall perception of lip prominence from different perspectives. From February to March 2024, 212 volunteers were recruited in Fujian Province as study subjects and divided into three groups: orthodontists [65 participants, 28 males and 37 females, aged (31.3±6.9) years], orthodontic patients [72 participants, 24 males and 48 females, aged (27.6±5.7) years], and healthy adults [75 participants, 37 males and 38 females, aged (25.6±4.4) years]. Three-dimensional facial modeling software was used to generate facial models, which were sculpted using three-dimensional model sculpting software to simulate different nasal base, zygomatic bone, and upper lip prominence conditions. A total of 15 facial models were generated, divided into five groups (three models per group): Group A (normal nasolabial angle, normal nasal base, normal upper lip); Group B (increased nasolabial angle, normal nasal base, flattened upper lip); Group C (decreased nasolabial angle, normal nasal base, protruded upper lip); Group D (increased nasolabial angle, protruded nasal base, normal upper lip); Group E (decreased nasolabial angle, recessed nasal base, normal upper lip). Models 1, 2, and 3 in each group had normal, protruded, and flattened zygomatic bones, respectively (with Model 1 in Group A as the initial model). Forty-five-degree and ninety-degree profile images of the models were captured (30 images in total) and compiled into a questionnaire. Participants in the three study groups were selected as the most attractive and least attractive facial appearances based on the questionnaire and ratings of the lip prominence of the 45° and 90° profile images (0-10 points, where 0=very flat, 5=normal, and 10=very prominent). A one-sample t-test was used to compare the difference between model ratings and the median score of 5. Among the 30 images, the proportion of lip prominence ratings deviating fr