This study uses a two-step approach to construct a multi-period double-difference model and introduces a quasi-natural experiment of the Broadband China pilot policy to investigate whether household financial market participation at the urban level is affected by the digital economy, which is significant for promoting Chinese households' shift from savings to investment and alleviating the long-standing problem of insufficient household financial market participation in China. In terms of direct impact, the digital economy increases the household financial market participation rate of urban residents by 3.26%, and increases the financial market participation rate of highly financially literate households by 2.14%; in terms of indirect impact, the development of the digital economy increases the total number of household smart Internet devices by 8.27%, and similarly increases the attention to household financial information by a significant 4.22%, which further positively influences the household financial market participation rate. This paper also evaluates the individual and regional differences of the digital economy on household financial market participation, and the estimated causal effect of the digital economy on household financial market participation is purer, which expands the scope of research on the digital economy and household financial market participation, and provides a certain reference basis and policy inspiration for the government to promote the construction of the digital economy. The advancement of the digital economy provides effective support for household participation in financial markets by broadening access to financial literacy and enhancing the convenience of financial investment for residents6. Aiming to analyse the implications of the digital economy for household participation in financial markets, scholars have quantified the digital economy in terms of both the level of Internet development and the level of digital financial development7. However, no uniform conclusions have been reached. Even though several scholars have discussed the effect of digital economy policies10, existing studies have ignored how these policies affect household financial market participation rates at the city level. As a result, the mechanism and heterogeneity analysis of the impact of the digital economy on household financial market participation rates needs to be further investigated. At the micro level, this paper is important for reducing household financial vulnerability, increasing household income diversity, and thus improving quality of life and welfare. At the macro level, guiding the transformation of residents' savings to the investment side, helping in expanding domestic demand, promoting the sound development of China's financial market, and achieving the strategic goal of a commonwealth is important for the government.The macroeconomic recovery in the post-epidemic era has caused a gradual shift in Chinese residents' asset allocation from risk-free broad asset classes to risky financial assets. Financial asset allocation is now entering an accelerated period and residents' effective participation in financial markets is crucial to the long-term sound appreciation of the family wealth11, and that broadband infrastructure is one of the key components of the digital economy12, and that broadband service policies can effectively penetrate in free economies throughout the world13, the aforementioned literature serves as the basis for the investigation in this paper.The latest edition of the China Household Finance Survey (CHFS) published in 2019 shows that Chinese households are not active in the financial market, with real estate assets accounting for 66.3% and financial assets  accounting for only 12.8%. In terms of broad asset allocation, real estate accounts for only 15% of U.S. households and 46% in Europe, compared to Chinese households' over-investment in real estate. In terms of financial asset allocation, the proportion of financial assets of American households is as high as 51%, and that of European households is 28%, while the proportion of financial asset allocation of Chinese households is at a relatively low level in the international arena. It is worth noting that in recent years, China's booming digital economy has become a possible means to address the mystery of "limited participation" in China's household financial market. Given that digital infrastructure has a positive impact on enhancing the financial literacy of the population14. This study explores the impact of the digital economy on the financial market participation rate of Chinese households by using the "Broadband China" pilot policy as a quasi-natural experiment as well as a two-step method to construct a multi-period double difference model based on Chinese household financial survey data. The following are the possible marginal contributions of our study: first, this paper introduces a quasi-natural experiment on the basis of the perspective of digital economy development to determine the causal effect of the digital economy on the household financial market participation rate. Second, this paper uses a two-step approach to construct a multi-period double-difference model that controls for individual-level characteristics without losing individual-level information and integrates information on household financial market participation at the prefecture level. The estimated household financial market participation rate at the city level is more statistically representative. Finally, this paper likewise assesses the regional differences and individual differences in household financial market participation rates that are affected by the digital economy while verifying the influence mechanism from two paths: information transmission and financial information concern, which broadens the scope of the study and deepens the paper’s policy connotation.On the one hand, the "Broadband China" policy aims to optimize and expand the construction of Internet infrastructure for broadband applications, and on the other hand, the "Broadband China" policy also includes the enhancement of residents' ability to use the Internet, the cultivation of digital consumption habits, and the promotion of the digital transformation of industries, therefore, the "Broadband China" policy is a good proxy for the development of the digital economy, and is mostly used in the literature to assess the impact of the digital economyThe following parts of this paper are organised as follows: the second part consists of the policy background; the introduction of data, variables, and models is covered in the third part; the fourth part discusses the main empirical results, robustness test, heterogeneity test, and mechanism discussion; the fifth part involves the research conclusion.The strategy implementation plan of "Broadband China" was released by the State Council in August 2013, and the Ministry of Industry and Information Technology and the National Development and Reform Commission released the list of 117 "Broadband China" demonstration cities (clusters) in three batches from 2014 to 2016. The objective is to optimize and upgrade broadband networks and reinforce the application of broadband networks.Since the implementation of the "Broadband China" strategy, China has made significant progress in digital infrastructure construction. According to the Ministry of Industry and Information Technology's 2021 Communications Industry Statistical Bulletin, by the end of 2021, the number of China's Internet broadband access ports reached 1.018 billion, up from fewer than 15 million at the start of the twenty-first century.16; at the firm level, the implementation of the "broadband China" policy aids in improving firm productivity and concentration18 and increasing the number of mergers and acquisitions19; at the level of green sustainable development, the implementation of "broadband China" policy further improves the effectiveness of green innovation in China through its impact on green technology innovation21; at the financial market level, the implementation of the "broadband China" policy has successfully mitigated the risk of stock price collapse22 and played a positive role in the spread of digital inclusive finance23. However, no scholars have evaluated the impact of the implementation of the "broadband China" policy at the level of household financial market participation.Several scholars have investigated various dimensions based on the quasi-natural experiment of the implementation of the Broadband China policy. At the consumption level, the implementation of the "broadband China" policy has a considerable positive impact on rural household consumption and electricity consumptionUnder the assumption of information asymmetry, investors lacking information have negative returns relative to the total market return, whereas investors with information can buy low and sell high to gain additional returns, which comes from information profit. An information-asymmetric market can make it difficult for households to engage in financial markets, which might cause some households to avoid using financial services. Through the development of network infrastructure and the optimisation of digital infrastructure, the "broadband China" policy's implementation reduces the obstacles to financial market participation caused by information asymmetries, giving the implementation of the "Broadband China" policy in the pilot cities an opportunity to explore the impact of the digital economy on household financial market participation.This paper examines the implementation of the Broadband China policy as a quasi-natural experiment by using data from the China Household Finance Survey (CHFS) for 2013, 2015, 2017, and 2019 to ascertain whether the digital economy can enhance the likelihood of household financial market participation in China. The "Broadband China" policy data were compiled from the list of selected "Broadband China" demonstration cities from 2014 to 2016 published by the Ministry of Industry and Information Technology of the People's Republic of China. The China Household Finance Survey data use modern sampling methods, a computer-assisted survey system (CAPI), along with other survey techniques and management tools to control sampling and non-sampling errors, and the data are representative and of high quality, which is the most extensively employed micro household finance data. The data of other prefecture-level cities used in this paper primarily comes from the China City Statistical Yearbook.24. In light of this, a two-step approach is used for the estimation in this paper25. In particular, this study first integrates data on household financial market participation to the prefecture-level controlling for individual characteristics and then performs double-difference estimation using prefecture-level data, in contrast to direct estimation with individual-level data, estimation with prefecture-level data allowing for intuitive interpretation of the estimated coefficients without losing individual-level information. Moreover, due to the fact that individual-level characteristics are controlled for in the first estimation step, the city-level household financial market participation estimated from this is more statistically representative. The model is estimated in the first step as:In this paper, the multi-period double difference method is used for estimation. If respondents' participation in financial markets is the explained variable, direct individual-level estimation encounters two major issues: first, Logit and Probit models, which are typically utilised for regressions on dichotomous variables, do not apply in double difference estimation, and marginal effects calculated based on regression coefficients are even less meaningful; Second, even switching to a linear probability model for estimation does not yield an intuitive explanation of the influence of a digital economy on household financial market participationIn the above equation, subscript mentclass2pt{minimThe city-level household financial market participation calculated in the first step is used in the second estimation step together with other data to create an unbalanced panel data and is regressed using a multi-period double difference model with the following estimated model:entclass1pt{minimaThe findings of descriptive statistics are depicted in Table Table As shown in Fig. p-values are above 0.1. The results indicate that the core findings of this paper are robust.This paper constructs a randomised experiment at both the pilot city and implementation time levels by randomly selecting the pilot cities of Broadband China and generating the implementation time of the policy at random. The randomisation process is repeated 500 times and the regression is performed 500 times. Figure The digital economy as suggested by the baseline results, significantly increases the financial market participation rate of Chinese households. However, so as to exclude confounding factors from the findings, further robustness tests are conducted in this paper. In this paper, we first consider that the explanatory variables increase simultaneously with the time trend; therefore, column (1) of Table 26.Although the previous results provide some evidence for the exogeneity of Broadband China's policies, this paper employs an instrumental variables approach to further validate the conclusions. We use historical postal and telecommunication data in 1984 for each city in China as the basis for constructing instrumental variables. On the one hand, the Internet is a continuation of the development of traditional communication technology, and the basic level of local historical communication facilities may affect whether a local area can be shortlisted as a pilot of the Broadband China policy; on the other hand, the impact of traditional communication tools, such as post offices and fixed-line telephones, on economic development diminishes with the decline in the frequency of use, which satisfies the exclusivity. It should be noted that the raw data of the instrumental variables selected are in cross-sectional form and cannot be directly used for the econometric analysis of panel data. In this paper, we introduce a time-varying variable to construct the panel instrumental variableSpecifically, the number of Internet users in the country in the previous year is constructed as an interaction term with the number of post offices and telephones per 10,000 people in each city in 1984 as an instrumental variable for the city's digital economy index in that year.Column (8) of Table From the objective investment environment, the level of development of the digital economy and the information environment in which China's urban and rural areas are located vary, and from the heterogeneity of households, the level of financial literacy also leads to different awareness of household investment, which affects household financial market participation rate. For examining the heterogeneous impact of the digital economy on the financial market participation rate of Chinese households, this paper takes two heterogeneous factors into account, urban–rural regional differences, and differences in household financial literacy, in further research so as to investigate whether there is heterogeneity in the impact of the digital economy on the financial market participation rate of Chinese households. This paper constructs financial literacy indicators from three dimensions: financial information, financial knowledge and financial capability, and calculates financial literacy scores using the iterative principal factor method. In this section, the paper uses the median score of financial literacy as a dividing line to delineate the high and low levels of financial literacy of households, Households with financial literacy scores greater than the median score are high financial literacy households, and households with financial literacy scores less than the median score are low financial literacy households.The results in columns (1) and (2) of Table The development of digital infrastructure and digital media represented by the Internet is the core element of the growth of the digital economy, which acts on household financial market investment decisions by altering residents' information search channels. The paths for promoting household financial market participation are as follows: first, the information transmission path where the digital social network information transmission function is strengthened, the amount and efficiency of information content that households obtain through the social network are greatly enhanced, affecting household financial market participation behaviour; second, the financial information concern path, where the massive amount of Internet information makes households intentionally or unintentionally exposed to increased financial and economic knowledge as well as wealth management awareness. As a result, this paper uses the same two-step method to determine the proportion of households participating in the financial market in different cities after controlling for individual characteristics, based on the data of whether the respondents have smart Internet devices and financial information concerns and then regresses the interaction term of the "Broadband China" policy pilot. Of which, the respondents have intelligent Internet access devices as 1, the respondents do not have intelligent Internet access devices as 0; the respondents on the financial information concern level is based on the questionnaire data to the respondents on the financial information concern level of no concern at all to very concerned about the division of 1–5.The regression results inTable The conclusion that the digital economy greatly enhances household financial market participation remains valid after several robustness tests. The digital economy can further promote the household financial market participation rate by increasing the proportion of households holding smart Internet devices as well as the attention paid to household financial information, while the digital economy has a greater effect on the financial market participation rate of urban households and the financial market participation rate of households with high financial literacy. Hence, the government should pay considerable heed to the investment in network infrastructure construction in rural areas in order to reduce the distance between households and financial services in backward areas. This will enable the residents in backward areas to better enjoy the dividends brought by the development of the digital economy. Simultaneously, financial institutions and financial management departments should strengthen the popularisation of financial knowledge and enhance household financial literacy with the high permeability of digital media, so as to raise investors' awareness of risk prevention.This paper highlights that the development of the digital economy may be a critical tool to solve the mystery of "limited participation" in the financial market of Chinese households, which is critical to effectively improve the financial welfare of Chinese households, raise the income of residents through multiple channels while enhancing people's sense of well-being.Supplementary Information.


The journal retracts the 2022 article cited above.Following publication, concerns were raised regarding the contributions of the authors of the article. Our investigation, conducted in accordance with Frontiers policies, confirmed a serious breach of our authorship policies and of publication ethics; the article is therefore retracted.This retraction was approved by the Chief Editors of Frontiers in Psychology and the Chief Executive Editor of Frontiers. The authors responded to the concerns raised, but did not provide a satisfactory explanation. The authors do not agree to this retraction.


The journal retracts the 2021 article cited above.Following publication, concerns were raised regarding the contributions of the authors of the article. Our investigation, conducted in accordance with Frontiers policies, confirmed a serious breach of our authorship policies and of publication ethics; the article is therefore retracted.This retraction was approved by the Chief Editors of Frontiers in Immunology and the Chief Executive Editor of Frontiers. The authors do not agree to this retraction.


The initiation, growth, and rupture of cerebral aneurysms are directly associated with Hemodynamic factors. This report tries to disclose effects of endovascular technique (coiling and stenting) on the quantitative intra-aneurysmal hemodynamic and the rupture of cerebral aneurysms. In this paper, Computational Fluid Dynamic are done to investigate and compare blood hemodynamic inside aneurysm under effects of deformation (due to stent) and coiling of aneurysm. The blood stream inside the sac of aneurysm as well as pressure and OSI distribution on the aneurysm wall are compared in nine cases and results of two distinctive cases are compared and reported. Obtained results specifies that the mean WSS is reduced up to 20% via coiling of the aneurysm while the deformation of the aneurysm (applying stent) could reduce the mean WSS up to 71%. In addition, comparison of the blood hemodynamic shows that the blood bifurcation occurs in the dome of aneurysm when endovascular technique for the treatment is not applied. It is found that the bifurcation occurs at ostium section when ICA aneurysm is deformed by the application of stent. The impacts of coiling are mainly limited since the blood flow entrance is not limited in this technique and WSS is not reduced substantial. However, usage of stent deforms the aneurysm angle with the orientation of parent vessel and this reduces blood velocity at entrance of the ostium and consequently, WSS is decreased when deformation of the aneurysm fully occurs. These qualitative procedures provide a preliminary idea for more profound quantitative examination intended for assigning aneurysm risk of upcoming rupture. Although risk of rupture is moderately low in unruptured cerebral aneurysms, protective interventions are frequently considered owing to the poor diagnosis of intracranial haemorrhage8. Existing treatments of intracranial aneurysms convey a small but momentous risk that could surpass the natural risk of aneurysm rupture, and this augments the importance of performance of different endovascular techniques for reduction of the rupture risk of cerebral aneurysms for clinicians14. Pre-interventional analysis of the aneurysm is mainly related to size of aneurysm in which rupture risk of larger aneurysm is higher than lower ones19. Although this logic seems reasonable, some reports indicates rupture of small aneurysm is not ignorable. Hence, the importance of hemodynamic analysis and related factors for the evaluation of the aneurysm rupture is raised23. Previous reports and articles confirmed that the mechanisms of aneurysm growth and rupture are related to hemodynamic factors29. Besides, hemodynamic factors also present valuable measure for the estimation of aneurysm rupture. A few geometric measures, for example shape descriptors and aspect ratio, are considered in former studies as substitutes for hemodynamic information34. Although these factors could be suitable for refining risk evaluation, the underlying mechanisms are difficult to connect rarely disclosed via these values38.The precise evaluation of the endovascular techniques is crucial for the selection of efficient treatment for saccular aneurysms44. This study tries to investigate the effects of these two techniques on hemodynamic factors. CFD technique is used for modeling of the pulsatile blood flow and achieve hemodynamic factors (i.e. OSI and WSS) for estimation of the aneurysm rupture.These methods have their own cons and pros and comparison of these techniques are seldom reported for ICA aneurysms45.It is confirming that all methods were carried out in accordance with relevant guidelines and regulations. Besides, all experimental protocols were approved by of the Ca' Granda Niguarda Hospital and it is confirmed that informed consent was obtained from all subjects and/or their legal guardian(s). All study are approved by Ca' Granda Niguarda Hospital ethics committeeNine different patients with intracranial aneurysms are investigated in present study. Due to similarity between the hemodynamic of some of these aneurysms, results of two most distinctive models are presented in this paper. For the selection of the aneurysm, the chosen aneurysms have high angles with parent vessel orientation. Besides, the sac Neck Vessel angle is almost identical in these two chosen models. Selected cases of 34 and 06 are related to women and man, respectively. Hence, HCT value of the female and male cases are 0.4 and 0.45, respectively. Details of chosen aneurysms are presented in Table 45 which offer full shape of the ICA aneurysm with case number of CO34 and C006. The surface of chosen aneurysm is produced by ICEM software. Then, sac section is split for the implementation of the porous as coiling technique. Deformation is also applied according to angle of the parent vessel angle with normal vector of ostium surface. The main concept for the deformation is to preserve the straight angle of the main parent vessel to reduce the blood entrance in to sac section area. Details of ICA ostium and neck vessel angles are presented in Table The geometry (.stl) of selected aneurysm is obtained from Aneurisk Website48. One-way FSI model is used for the modeling the blood interactions with aneurysm wall. Casson model is developed for the calculation of the viscosity term in the main governing equations. For modeling of coiling, sac section is assumed to fill with porous material with specific details associated with size of aneurysm55. Applied porosity for the chosen aneurysms are presented in Table In this work, Navier–Stokes equations are solved for computational modeling of the blood stream. It is assumed that the blood stream is non-Newtonian, incompressible and transient31. There are four distinctive stage in the figure for the comparison of the results. To ensure about the archived data, results of 3rd blood cycle is presented in this work and reported OSI value is for last time step (step = 3000). Maximum blood velocity occurs in the peak systolic and this condition is evaluated as wore case scenario. This study tried to investigate the rheology aspects of blood stream60.Figure To investigate the impacts of coiling, Table Comparison of the WSS in the sac of the aneurysm at peak systolic stage are demonstrated in Fig. Figure As explained earlier, one of side effects of the stent is to change the angle of blood inflow with normal vector of ostium area. Figure The impacts of the deformation are clearly observed on the distribution of the WSS as shown in Fig. In this work, computational fluid dynamic is used for the modeling of the blood stream inside cerebral ICA aneurysms. The impacts of endovascular coiling on blood hemodynamic are investigated by applying porosity inside the sac. Also, the deformation of the aneurysm by the effects of stent is also studied in two different stages. WSS, pressure and OSI value of selected aneurysm are compared in different stages of blood cycles. Obtained results indicates that the mean WSS is reduced up to 20% via coiling of the aneurysm while the deformation of the aneurysm (applying stent) could reduce the mean WSS up to 71%. In fact, the impacts of limiting blood stream by deformation is more than coiling on protection and control of aneurysm growth and probable rupture.


Risks of lower third molar surgery like the inferior alveolar nerve injury may result in permanent consequences. Risk assessment is important prior to the surgery and forms part of the informed consent process. Traditionally, plain radiographs like orthopantomogram have been used routinely for this purpose. Cone beam computed tomography (CBCT) has offered more information from the 3D images in the lower third molar surgery assessment. The proximity of the tooth root to the inferior alveolar canal, which harbours the inferior alveolar nerve, can be clearly identified on CBCT. It also allows the assessment of potential root resorption of the adjacent second molar as well as the bone loss at its distal aspect as a consequence of the third molar. This review summarized the application of CBCT in the risk assessment of lower third molar surgery and discussed how it could aid in the decision-making of high-risk cases to improve safety and treatment outcomes.  Third molar surgery is known to be the most common oral surgical procedure . Lower tOne major indication of lower third molar surgery is to preserve the adjacent second molar, which could be affected by the third molar impaction because of persistent food trapping and recurrent infection . There iOrthopantomogram (OPG) has been the most useful imaging for the assessment of IAN injury risk of lower third molar surgery ,16. OPG Dental CBCT machines were developed and commercialised in the late 1990s. Since then, CBCT has been popularized, and it is used extensively in the field of dentistry. Its utilization was largely advanced by the development of dental implantology . With CBIn third molar surgery, CBCT offers a thorough understanding of the 3D relation between the third molar and the IAC . The bonCBCT undoubtedly offers a better visual of the relationship between the tooth root and the IAC as an imaging modality. Yet, does the difference lead to clinical relevance? The query was raised by several researchers who argued the absolute need for routine CBCT as a pre-operative assessment imaging tool. Matzen et al. prospectively evaluated 186 lower third molar surgery and found that only 12% of the cases had changed the treatment plan as an influence by the CBCT . Manor eCompared to OPG, CBCT carries a larger radiation dose. For this reason, the European Academy of Dento-Maxillo-Facial Radiology stated that CBCT should not be used in a routine manner for the assessment of lower third molar surgery and should be prescribed when plain radiography could not provide sufficient diagnostic information . Cost an2 could clearly exhibit the IAC at the mesial root of the third molar [2 for OPG could be fulfilled with well-designed clinical studies [One of the major drawbacks of CBCT is its radiation exposure and the related potential health hazards . Althougrd molar . However studies ,64. The Apart from pathologies like caries or pericoronitis, the impaction of third molars may result in external root resorption (ERR) of the adjacent second molars. It was found that 20–47.7% of the impacted lower third molars are associated with ERR of adjacent second molar ,66,67,68The clinical decision to prophylactically remove the impacted lower third molar to prevent ERR relies on the position of the third molar to the adjacent second molar. Traditionally, OPG is used to assess if there is a risk of ERR of the second molar when the third molar is impacted. However, it was found that the accuracy of OPG in diagnosing ERR was low because of the overlapping 2D images. The use of CBCT to assess ERR of the second molar as a consequence of impacted lower third molar is found to be more accurate. Oenning et al. found that for the same sample of patients with impacted third molars, OPG only found about 23% of the ERR of adjacent second molars that were diagnosed by CBCT . With anWith the presence of an ERR of the adjacent second molar, patients should be notified of the risk of the pulpal pathology of the second molar after the removal of the impacted third molar. Fortunately, the majority of adjacent second molars with ERR by the lower third molar appeared to be unaffected after the lower third molar removal. A classic paper by Nitzan et al. found that in most cases, the damaged periodontium of the second molar as a consequence of ERR was completely re-established one year after the third molar surgery . HoweverIt is known that third molar impaction affects the periodontal health of the adjacent second molar and leads to periodontal attachment loss of the tooth . It is cLingual plate fracture during lower third molar surgery is uncommon but potentially may lead to other severe complications like lingual nerve injury, bleeding, or displacement of fractured root or tooth into the sublingual space ,83. The Despite the potential benefits of CBCT in assessing the risks of lower third molar surgery, the imaging modality is not without its limitations. Apart from the higher radiation dosage, it is known that CBCT is more expensive in the equipment and maintenance costs, which may not be affordable for some patients. Routine screening of third molars using CBCT is costly and may be considered unnecessary. It is of note that the interpretation of the images of CBCT needs the proficiency and experience of the clinicians, which forms the most critical part of the risk assessment process. Wrong interpretation may put the patients at risk of potentially irreversible damages like IAN injury.Radiographic imaging has been the most useful tool for risk assessment of lower third molar surgery. CBCT is useful in understanding the 3D relationship between the third molar and the relevant adjacent structures, in particular, the IAC and the adjacent second molar. CBCT has been proven to be sensitive to identifying the true proximity of the tooth root and the IAC, yet it might not reduce the risk of IAN injury if the third molar is to be removed in a conventional manner. Since coronectomy of the lower third molar is proven to be safe in the long term, it offers a treatment alternative if a third molar carries a high IAN injury risk. CBCT may be useful in the decision-making of whether coronectomy or total removal of the lower third molar shall be performed by considering the proximity of the tooth and the IAC. There are also efforts to reduce the radiation dosage of CBCT to acquire a diagnostically acceptable image to improve the safety of the imaging modality. CBCT is also used to assess the risk of second molar root resorption or bone loss as a consequence of the third molar impaction. CBCT may also identify risky cases of lingual plate fracture when the lingual plate is very thin, or the tooth root perforates the lingual plate. The development and research of CBCT have increased its popularity as part of the risk assessment and informed consent procedure for lower third molar surgery. Further research on low-dose CBCT to acquire similar diagnostic-value images is ongoing to improve patients’ safety.


The forensic investigation of asphyxia deaths still poses a challenge due to the need to demonstrate vital exposure to hypoxic insult according to high levels of evidence. The pulmonary effects of hypoxia are complex and the understanding of the mechanisms underlying the acute pneumotoxicity induced by hypoxia is still incomplete. Redox imbalance has been suggested as the protagonist of the main acute changes in pulmonary function in the hypoxic context. The development of knowledge in biochemistry and molecular biology has allowed research in forensic pathology to identify some markers useful in immunohistochemical diagnostics of asphyxia deaths. Several studies have highlighted the diagnostic potential of markers belonging to the HIF-1α and NF-kB pathways. The central role of some highly specific microRNAs has recently been recognized in the complex molecular mechanisms involved in the hypoxia response; thus, several research activities are currently aimed at identifying miRNAs involved in the regulation of oxygen homeostasis (hypoxamiR). The aim of the manuscript is to identify, the miRNAs involved in the early stages of the cellular response to hypoxia, in order to characterize the possible implications in the forensic field of the determination of expression profiles. At present, more than 60 miRNAs involved in the hypoxia response with different expression profiles (upregulation and downregulation) have been identified. Despite the multiple and different effects on reprogramming following the hypoxic insult, the evaluation of the diagnostic implications of hypoxamiRs in the forensic field presupposes a specific treatment of the influences on HIF-1α regulation, cell cycle progression, DNA repair, and apoptosis. The forensic investigation of asphyxia deaths still poses a challenge due to the need to prove vital exposure to hypoxic insult according to high levels of evidence. Historically, the study of pulmonary histomorphological changes resulting from asphyxia has been considered of great importance for diagnostic purposes. However, the correlation of histopathological findings with the diagnosis of asphyxia death requires an accurate assessment of any concomitant conditions such as alterations in the relationship between ventilation and perfusion attributable to age, comorbidities, and exposure to smoke. Therefore, over the years, constant research has been aimed at studying the molecular response to the decrease in oxygen tension.Hypoxia represents a fundamental physiological stimulus capable of triggering adaptive and maladaptive responses in a wide variety of pathophysiologically relevant situations. The effects of hypoxia at the pulmonary level are complex and the understanding of the mechanisms underlying the acute pneumotoxicity induced by the hypoxic insult is still incomplete. Redox imbalance has been suggested as the protagonist of the main acute changes in lung function in the hypoxic context, in particular as regards hypoxic vasoconstriction, endothelial dysfunction, edema, and lung inflammation. Growing evidence suggests that hypoxia is capable of causing severe mitochondrial oxidative stress in the lungs by increasing the production of ROS in complexes I and III of the electron transport chain The development of knowledge in the field of biochemistry and molecular biology has enabled research in forensic pathology to identify some molecular markers of response to hypoxic insult useful in immunohistochemical diagnostics of asphyxia deaths. Precisely, several scientific contributions have highlighted the diagnostic potential of markers belonging to the molecular pathways of HIF-1α and NF-κB.The central role of some highly specific microRNAs (miRNAs) in the context of the complex molecular mechanisms involved in the response to hypoxia has recently been recognized. In parallel, a role of miRNAs as emerging diagnostic biomarkers of the cellular response to low oxygen tensions has been established, so much so that several research activities are currently aimed at identifying the miRNAs involved in the regulation of oxygen homeostasis (hypoxamiRs) Despite the evidence generated, currently, the molecular biology of the pulmonary response to hypoxic insult requires further investigation aimed at clarifying - among other things - the actual diagnostic usefulness in the forensic field. The majority of the studies carried out so far have been conducted on animal models and have been specifically directed to the evaluation of the expression profiles of hypoxamiRs in different pathological conditions such as pulmonary hypertension, myocardial infarction, hypoxic-ischemic encephalopathy, skin ischemic lesions, and neoplastic progression.The main objective of the present study is the identification of a miRNA panel, whose expression in the lungs is induced by an acute hypoxic insult, to evaluate the actual possibility of using hypoxamiRs in the diagnosis of asphyxia deaths.To this purpose, a literature search was carried out aimed at identifying the markers currently supported by scientific evidence. In the selection process, the molecular pathways currently studied in post-mortem diagnostics were also considered with the aim of conferring objectivity and facilitating efficacy evaluations.The term "asphyxia" in its etymological meaning indicates the absence of the pulse, the cessation of the heartbeat, and therefore, by extension, the absence of respiratory acts or peripheral pulses with consequent respiratory block The main issues of interest in the diagnosis of asphyxia deaths concern the diagnosis of death, the comparative study of cadaveric phenomena for the estimation of the post-mortem interval (PMI), and the chronological diagnosis of the lesions as well as the differential diagnosis between vital phenomena and post-mortem. The medico-legal investigation of the chronology and vitality of the lesions requires the integration of different techniques and produces results that can be difficult to interpret, especially in cases of advanced decomposition and poor representation of the signs of the vital reaction.At present, the integration of macroscopic evidence and microscopic data obtained from histological and immunohistochemical investigations allows in most cases the chronological and vitality diagnosis of the lesions.The macroscopic diagnosis of mechanical asphyxia is based on the generic signs of asphyxia death and the presence of traumatic injury related to the application of injurious means The histopathological study of asphyxia deaths, as well as the autopsy one, is aimed at evaluating signs of asphyxia , as well as traumatic lesions . For a long time, immunohistochemical techniques have been of great importance in the study of the vitality of lesions, since death is very rapid, affecting the tissue with alterations included in the early stages of the inflammatory response At present, the diagnosis of mechanical asphyxia still presents difficulties due to the poor specificity of the macroscopic signs and the limited expression of vitality related to the rapidity of death. Such a condition requires a reflection on the need to identify additional diagnostic means to be used in a complementary or, in some cases, substitute way. For this purpose, a joint evaluation of the inflammatory response, especially through the immunohistochemical markers just proposed, and of the hypoxic insult response through the study of the molecular pathway of HIF-1α could be useful. Undoubtedly, in addition to the methods outlined, a fundamental contribution to post-mortem investigations can be made by molecular biology through the study of miRNA expression profiles.The synthesis of mature miRNAs represents a complex multiphasic process capable of undergoing the influence of low oxygen concentrations at practically all levels. While causing a reduction of about 50% in the levels of target proteins HypoxamiRs are involved in the stereotyped rapid adaptive response to oxygen deprivation, even transient; precisely, miRNAs act rapidly at the post-transcriptional level to organize the response to environmental stress. Furthermore, such molecules coordinate a dynamic biological response based on gene regulation and - in particular - on transcription. Such a complex regulatory system is supported by significant molecular crosstalk aimed at effective communication between hypoxic signaling mechanisms and miRNAs (biogenesis and function).Despite currently acquired knowledge, the precise mechanisms by which miRNAs carry out their multiple regulatory effects remain largely undefined. Further insights will derive from future research aimed at defining the complexity of hypoxic adaptive processes. In particular, the study activity will have to continue in the current direction toward the better characterization of the role of HIF and redox reactions in the regulation of miRNA biogenesis.At present, more than 60 miRNAs involved in the hypoxia response with different expression profiles (upregulation and downregulation) have been identified. Despite the multiple and different effects on reprogramming following the hypoxic insult, the evaluation of the diagnostic implications of hypoxamiRs in the forensic field presupposes a specific treatment of the influences on HIF-1α regulation, cell cycle progression, DNA repair, and apoptosis  samples allows the study of wide retrospective cases Given the defined diagnostic implications, it is essential to carry out further studies aimed at improving the knowledge in the field of miRNA biology and of the modalities of expression regulation in response to hypoxia


The renin-angiotensin aldosterone system (RAAS) is a hormonal cascade that functions in the homeostatic control of arterial pressure, tissue perfusion, and extracellular volume. Dysregulation of the RAAS plays an important role in the pathogenesis of cardiovascular and renal disorders.To review the role of the RAAS in the development of hypertensive cardiovascular disease and related conditions and provide an overview of the classes of pharmacologic agents that inhibit this system.The RAAS is initiated by the regulated secretion of renin, the rate-limiting enzyme that catalyzes the hydrolysis of angiotensin (Ang) I from the N-terminus of angiotensinogen. Ang I is in turn hydrolyzed by angiotensin-converting enzyme (ACE ) to form Ang II, a potent vasoconstrictor and the primary active product of the RAAS. Recent evidence has suggested that other metabolites of Ang I and II may have biological activity, particularly in tissues. Development of agents that block the RAAS  began as a therapeutic strategy to treat hypertension. Preclinical and clinical studies have indicated important additional cardiovascular and renal therapeutic benefits of ACE Is and ARBs. However, blockade of the RAAS with these agents is incomplete.Therapeutic approaches that target more complete inhibition of the RAAS may offer additional clinical benefits for patients with cardiovascular and renal disorders. These approaches may include dual blockade using ACE Is and ARBs in combination, or new therapeutic modalities such as direct renin inhibition with aliskiren, recently approved for the treatment of hypertension.


The journal retracts the 2022 article cited above.Following publication, concerns were raised regarding the contributions of the authors of the article. Our investigation, conducted in accordance with Frontiers policies, confirmed a serious breach of our authorship policies and of publication ethics; the article is therefore retracted.This retraction was approved by the Chief Editors of Frontiers in Chemistry and the Chief Executive Editor of Frontiers. The authors have not responded to correspondence regarding this retraction.


Since the outbreak of the COVID-19 pandemic, Fangcang shelter hospitals have been built and operated in several cities, and have played a huge role in epidemic prevention and control. How to use medical resources effectively in order to maximize epidemic prevention and control is a big challenge that the government should address. In this paper, a two-stage infectious disease model was developed to analyze the role of Fangcang shelter hospitals in epidemic prevention and control, and examine the impact of medical resources allocation on epidemic prevention and control. Our model suggested that the Fangcang shelter hospital could effectively control the rapid spread of the epidemic, and for a very large city with a population of about 10 million and a relative shortage of medical resources, the model predicted that the final number of confirmed cases could be only 3.4% of the total population in the best case scenario. The paper further discusses the optimal solutions regarding medical resource allocation when medical resources are either limited or abundant. The results show that the optimal allocation ratio of resources between designated hospitals and Fangcang shelter hospitals varies with the amount of additional resources. When resources are relatively sufficient, the upper limit of the proportion of makeshift hospitals is about 91%, while the lower limit decreases with the increase in resources. Meanwhile, there is a negative correlation between the intensity of medical work and the proportion of distribution. Our work deepens our understanding of the role of Fangcang shelter hospitals in the pandemic and provides a reference for feasible strategies by which to contain the pandemic. Plagues such as the Spanish flu, Ebola and COVID-19 have had a huge impact on human economic production and daily life . FangcanInfectious disease dynamics models are frequently used to quantify the effect of control strategies on transmission control . They tyThe propagation of infectious diseases is highly stochastic, according to past experience. Scholars have developed a range of infectious illness models to capture this stochastic process, such as adapting the infectious disease dynamics model to the random network ,14 or inThere are three areas of relevant research regarding Fangcang shelter hospitals. The first area focuses on introducing the basic situation of the cabin hospital ,4,20. ThTo quantitatively answer this question, an infectious disease model with two stages based on the SEIR model was created in order to simulate the various scenarios of the epidemic prevention process . WhetherIn this model, both mildly and severely affected patients seek treatment at the designated hospital in the first stage as the Fangcang shelter hospital is not yet operational. The severe patients have priority access to the designated hospital, and both mild and severe patients are constrained by the limited amount of accommodation. Equation (1) shows the number of mild and severe patients who enter the designated hospital each day in the initial phase and are admitted in various compartments. The second stage involves the opening of the Fangcang shelter hospital, where mild patients who are already being treated at the designated hospital are transferred; meanwhile, only severe patients are treated at the designated hospital, each with their own upper limitations. The number of mild patients entering various pods in the second stage is shown in Equation (2). D. The patient division and SEIR model were combined to create the final state transfer process, which is shown in The estimate of the maximum capacity of the designated hospital and the Fangcang shelter hospital with new medical resources is shown in Equation (3). Three categories of model parameters are employed in this study. Disease parameters, which are taken from traditional infectious disease transmission models and reflect the fundamental features of the disease, make up the first group ,41,42. TWe presented a one-stage simple model that significantly simplifies the two-stage model to aid in the analytical analysis. The transfer procedure of the model is shown in The requirement that must be met denotes the extent to which the number of patients increases with the number of susceptible patients at a given level of prevalence; this can be obtained by setting the derivative of the number of confirmed patients. When this requirement is met, the epidemic hits an inflection point and the number of current patients stops growing. This requirement can be expressed as We conduct simulations to determine the effectiveness and size of the role of Fangcang shelter hospitals in epidemic prevention and control with different allocations and efficiencies. These simulations will be used to determine the number of uninfected individuals who remain after the Fangcang shelter hospitals are put into use.(i): The Fangcang shelter hospitals’ efficacy. The effectiveness of the medical resources invested in the Fangcang shelter hospitals in order to prevent the epidemic’s spread is examined in this section. In addition, the connection between the quantity of emergency resources built and the epidemic’s spread when those resources are used to build Fangcang shelter hospitals are also examined. Specifically, we set (ii): Impact of the use and distribution of medical resources. This section investigates whether changing medical resource allocation and use have an effect on stopping the epidemic’s spread. Specifically, we set (iii): Optimal conversion rate and allocation ratio combinations. When the additional medical resources are constant, this section investigates the effects of various combinations of allocation ratios and conversion rates on containing the epidemic’s spread. We specifically set We first tested the model’s ability to demonstrate the usefulness of allocating medical resources to Fangcang shelter hospitals to stop the epidemic by varying the number of infections under various Fangcang shelter constructions. The development of infections under various medical resource addition rates and using real-time patient data in Wuhan from 29 January is shown in research  that proWe then immediately conducted an examination of how various conversion rates and allocation ratios contributed to the outbreak’s control. The role of increasing the conversion rate under various additional medical resources is shown in It can be seen that with fixed resources, increasing the conversion rate can raise the maximum carrying capacity of Fangcang shelter hospitals, which is consistent with our prediction. Although there is theoretically no upper limit to the conversion rate, in practice, the work intensity and energy of health care workers are limited, and the conversion rate cannot be increased indefinitely. Increasing the conversion rate can have the effect of alleviating the lack of resources when resources are relatively scarce. If resources are available in sufficient quantities, excessively raising the conversion rate will not improve the preventative outcomes due to the fact that the Fangcang shelter hospital has enough space to accommodate all of the patients with a mild illness; indeed, adding more beds would only result in excess and increase the workload of the medical personnel.The effect of increasing the allocation ratio of new medical resources is shown in As the allocation ratio rises, The allocation ratio with the highest proportion of susceptible populations under scenarios with different quantities of total new medical resources is identified via the comparison of the proportion of susceptible populations. s depicts the epidemic’s spread under the scenario of fixed medical support with various allocation ratios and conversion rates. Overall, when the conversion rate and allocation ratio are both higher, the proportion of susceptible population is larger and epidemic prevention is more effective. With the same level of epidemic prevention, there is a specific inverse proportional relationship between the distribution ratio and conversion rate. If the conversion rate and distribution ratio reach a certain level, the proportion of the susceptible population no longer rises, and the epidemic prevention effect in this region is the same.The combined impact of the conversion rate and allocation ratio on the efficiency of epidemic prevention was then simulated as shown in As can be seen, the upper bound of the allocation ratio does not change as the conversion rate increases. The lower bound of the allocation ratio under the optimal parameters decreases and exhibits a certain inverse relationship with the increase in the conversion rate, which is consistent with our prediction. The best epidemic prevention can only be achieved at a given resource quantity when the minimum combination of Fangcang shelter hospital and a designated number of hospital beds is met. To meet this demand, a minimum conversion rate needs to be attained in order to ensure that a sufficient number of Fangcang shelter hospital beds can be provided. As the conversion rate increases, the selected interval of the allocation ratio gradually increases, but the maximum cannot be exceeded.We further confirmed the change in the number of deaths, with the lowest number of deaths occurring in the same parameter domain as when the number of infections was lowest, demonstrating that excessive medical resource consumption does not result in better epidemic prevention. The differences between the scenarios of absolutely insufficient resources (A two-stage infectious disease model was constructed in this paper. The model takes into account the limited medical resources based on the conventional SEIR model, adds the maximum capacity of the designated hospitals and the Fangcang shelter hospitals, as well as various admission strategies that denote the two stages. In the first stage, all patients were admitted to the designated hospital, and in the second stage, patients were triaged; thus, mild patients entered the Fangcang shelter hospital first, and severe patients entered the designated hospital, and the transition between the two stages was marked by the operation of the Fangcang shelter hospital. Furthermore, we defined an allocation ratio in order to represent the method used to allocate healthcare resources, and also defined a medical resource conversion rate in order to demonstrate the advantages of Fangcang shelter hospital regarding their admission of minorly affected patients. Using these two parameters, we investigated the role of health care resource allocation strategies in stopping the spread of the epidemic.In order to examine the effects of medical resource allocation on epidemic prevention and control, we analyzed the function of Fangcang shelter hospitals and their impact on epidemic prevention and control, as well as the influence of medical resource allocation. Our analysis demonstrates, firstly, that Fangcang shelter hospitals can successfully slow the spread of epidemics, which is consistent with previous research. Second, when medical resources are scarce, increasing the conversion rate and the proportion of input to Fangcang shelter hospitals can help stop the spread of the epidemic rapidly; however, when medical resources are abundant, excessively increasing either the conversion rate or the proportion of input to Fangcang shelter hospitals is detrimental to the overall prevention and control of epidemics. This may be explained by the fact that when medical resources are insufficient, putting resources into Fangcang shelter hospitals can minimize the potential transmission among the public by admitting as many minorly affected patients as possible; meanwhile, when there is a certain amount of spare medical resources, over-investing in Fangcang shelter hospitals can produce a wasteful excess of resources and designated hospitals require investment in order to save seriously affected patients.This paper develops a two-stage model of infectious disease to examine the role of Fangcang shelter hospitals in outbreak prevention and control, and examines the impact of healthcare resource allocation on outbreak prevention and control. Our findings demonstrate that Fangcang shelter hospitals can effectively control the rapid spread of epidemics, which is consistent with previous research. Furthermore, we further discuss what the optimal medical resource allocation solutions are when medical resources are either limited or abundant. The results show that the optimal allocation ratio of resources between designated hospitals and Fangcang shelter hospitals varies with the amount of additional resources.The results of our study’s analysis of allocation ratios and conversion rates may inform further developments in healthcare resourcing policy. Firstly, the early diagnosis and elimination of an epidemic are the cornerstones of prevention strategies. More medical resources are helpful during epidemic prevention and control if the disease has already spread to a given area, but excessive resource investment will lead to resource redundancy and ineffectiveness. Secondly, the government should allocate as many medical resources as possible to large-scale isolation measures, such as Fangcang shelter hospitals, if medical resources are insufficient. Meanwhile, it also needs to guarantee a certain number of beds for serious illnesses in designated hospitals. To prevent medical staff from becoming overwhelmed, the use of medical resources should be organized intelligently. However, overwhelmed medical staff will not result in a greater contribution to the prevention of epidemics. Finally, in order to achieve the best epidemic prevention and control objectives, the government’s medical resource allocation policy might consider both minorly and seriously affected patients, isolation admission and medical treatment, and flexible disposal within a reasonable interval, combined with the actual situation.Our work is not without limitations. Firstly, we did not consider the social and economic costs in our model. Indeed, from an economic perspective, future research could also examine the long-term effects of short-term investments in Fangcang shelter hospitals and designated hospitals. This is because allocating medical resources to either the designated hospitals or Fangcang shelter hospitals requires the consideration of whether to renovate the existing site or build a new one, as well as the long-term future operations. Secondly, the parameters of our model are static, which may not be the case in the real world. Although we set key parameters using some realistic scenarios, these parameters remain constant. Future research could focus on the dynamics of infectious disease models with multiple thresholds. Further research using realistic and feasible optimization scenarios and employing operational research methods could contribute from an optimization perspective.Finally, our paper offers guidelines regarding the allocation of resources in such Fangcang shelter hospitals. The effects of the rational governmental allocation of health care resources vary during epidemics. Combined with reality, healthcare resources are flexibly allocated and deployed in order to adjust and therefore maximize the benefits of these measures. Our work exploring the impact of Fangcang shelter hospitals on epidemic prevention and control has improved our understanding of the impact of healthcare resource allocation on infectious disease prevention and control, and will inform future disease prevention and control responses.


In the Calculating epidemiologically adjusted Ct values subsection of the Methods, there are a number of formatting errors in the sixth and ninth equations. Please view the complete, correct sixth equation here:In the Investigating variables associated with within-host viral burden subsection of the Results, there is an error on the third line of the second paragraph referencing


The presence of an upper subscapular nerve branching from the posterior division of the superior trunk, and it being accompanied by an accessory subscapular artery, is of both clinical and surgical significance. During routine dissection of the root of the neck in a 75-year-old male cadaver, an unusual branch from the third part of the right subclavian artery was observed lateral to the dorsal scapular artery. Continued dissection revealed that this artery traveled between the anterior divisions of the superior and middle trunks of the brachial plexus before traveling alongside a nerve from the posterior division of the superior trunk of the brachial plexus. This artery and nerve descended on the anterior aspect of the subscapularis muscle before piercing into its muscle belly. We believe this to be a previously unreported unique variation of the upper subscapular nerve that is accompanied by an accessory subscapular artery on its course to the subscapularis muscle. Knowledge of anatomical variations like this may lead to decreased complications in nerve blocks and surgical procedures related to the shoulder. The brachial plexus is a network of nerves that provides both somatic motor and sensory innervation to the upper extremity, including the rotator cuff. As the brachial plexus travels through the posterior triangle of the neck and then into the axilla, arm, forearm, and hand, it contains various regions that are named according to how the plexus is formed . The mosTypically, the upper subscapular nerve emerges from the posterior cord along with the lower subscapular nerve to innervate the subscapularis muscle, one of the four muscles making up the rotator cuff, which collectively assist in producing a wide range of shoulder movement while maintaining the stability of the glenohumeral joint ,4.The vascular supply to the rotator cuff muscles typically arises from multiple arteries, including the subscapular artery, posterior circumflex humeral artery, dorsal scapular artery, and suprascapular artery ,5. Both The variation described in this case is a novel finding of unique neurovascular branching of the posterior division of the superior trunk and the third part of the subclavian artery, both of which terminate in the subscapularis muscle. The relations of the brachial plexus to surrounding muscles or blood vessels are very complex, and this complexity must be comprehensively understood by physicians engaged in surgical intervention in this region . AwareneA 75-year-old male donor was received through the Saint Louis University (SLU) Gift of Body Program of the Center for Anatomical Science and Education (CASE) with signed informed consent from the donor. The donor’s self-reported medical history included Alzheimer’s disease and Parkinson’s disease. Every effort was made to follow all local and international ethical guidelines and laws that pertain to the use of human cadaveric donors in anatomical research . The CASUpon dissection of the root of the neck, two arteries were observed branching from the third part of the right subclavian artery before coursing between components of the brachial plexus. The dorsal scapular artery meandered between the superior and middle trunks of the brachial plexus on its path to supply the levator scapulae and rhomboid muscles. The other branch, identified as an accessory subscapular artery, emerged from the subclavian artery 0.8 cm lateral to the dorsal scapular artery, though medial to the first rib, before traveling between the anterior divisions of the superior and middle trunks Figures , 2.This accessory subscapular artery was present in addition to the subscapular artery, posterior circumflex humeral artery, suprascapular artery, and dorsal scapular artery, all of which demonstrated typical branching patterns to supply the rotator cuff. Further dissection of the accessory subscapular artery revealed that it traveled with the upper subscapular nerve after emerging from the posterior division of the superior trunk of the brachial plexus Figure . This arAnatomical variations of the brachial plexus in human infant and adult cadavers are well documented. Kerr lists 29 different forms of the brachial plexus among 175 cadaver specimens dissected between 1895 and 1910 ,12. TherIn another case report by Deshmukh et al. 2016), the upper subscapular nerve was reported to originate in a triplet fashion resulting in accessory upper subscapular nerves. Of these accessory nerves, one originated directly from the posterior cord, the other from the lower subscapular nerve, and the remaining third midway between the other two . Emamhad, the uppThe presence of multiple branches from the third part of the subclavian artery is a unique finding by itself. The dorsal scapular artery has been found to branch from the third part of the subclavian artery 67-75% of the time with the thyrocervical trunk being the second most common origin . As the The literature is ripe with reports of arterial branching pattern variations supplying the rotator cuff muscles. For example, the subscapular artery typically arises from the third part of the axillary artery; however, it has also been reported to arise from the second part of the axillary artery or be completely absent with thoracodorsal and circumflex scapular arteries arising separately from the axillary artery . The supExplanations for these variations in branching from the subclavian artery and the subsequent relationship of those branches with the brachial plexus may be the result of embryologic developmental differences . An initKnowledge of this atypical relationship between the upper subscapular nerve and the accessory subscapular artery is important for anatomists, radiologists, surgeons, and anesthesiologists due to its clinical and surgical implications. Neurovascular variations must be kept in mind whenever surgical access is needed to repair vascular or neurological lesions in the axilla, scapular region, or posterior triangle. The location of this anomalous artery could also create difficulty in placing a supraclavicular block because it increases the risk of damage to the blood vessel. Atypical relationships between nerves and arteries could increase the chances of impingement of vessels leading to ischemia and loss of function .During routine dissection of the root of the neck, a unique variation involving an accessory subscapular artery from the third part of the subclavian was observed. After reviewing the literature, we found this to be a novel variation as there have been no reported cases of this anomaly. As this unique vessel passed between the anterior divisions of the superior and middle trunks of the brachial plexus, it was accompanied by an unusual branch from the posterior division of the superior trunk as it traveled to the subscapularis muscle. To the best of our knowledge, there have been no documented cases of the coexistence of these neurovascular variations. This cadaveric study improves the knowledge of variations in the anatomy of the brachial plexus and branches of the subclavian artery, which is significant to anatomists, radiologists, anesthesiologists, and surgeons.


Experiences and practices addressing ethical conflicts and malpractice from the personal perspective of health care workers in these settingsIdentification and engagement with violenceMeasures for the reduction of restraints and coercion (violation of the autonomy of patients)The code of ethics of the EPA intends to guide the ethical practice of psychiatry by offering a comprehensive approach to the ethical challenges in the field. It highlights universal ethical principles and considers their application to the specific practice of psychiatry. Ethical questions in psychiatric practice are manifold: tensions between respect for autonomy versus care and protection from harm, problems with coercive therapy and capacity for judgement etc. To receive more information, the Committee on Ethical Issues conducted a survey on “Ethics in psychiatric practice” to collect information from inpatient treatment settings of individual wards in psychiatric hospitals Europe-wide on following topics:In this talk, the preliminary results of this survey will be presented and discussed.None Declared


For children, receiving adequate nutrition in their first 1000 days of life is vital to ensuring their appropriate growth and preventing the future development of diseases .Breastfeeding and complementary feeding play important roles in determining future health. Breast milk is rich in components that stimulate a baby’s immune system positively from the day it is born, so breast milk is beneficial and should be recommended at least in the first six months of life . The AmeChildren is to highlight recent data in the context of child nutrition. This Special Issue publishes a study by Natalie R. JaBaay et al. in a Michigan cohort (USA) of children aged 1–3 whose diet meets basic nutritional recommendations. Breastfeeding rates, fruit and vegetable intake, and the avoidance of added sugars in infancy were all beneficial eating behaviors for the children in the study population, but behaviors related to the restriction of nutrient-poor foods and added sugars in early childhood were not observed. The authors summarize that the area of infant nutrition requires additional public attention and education [The goal of this Special Issue of ducation .Improper diet and a low level of physical activity are the main determinants of the development of the obesity epidemic among children. Nutrition in early childhood, including breastfeeding and complementary feeding, also has a significant impact on the development of obesity . A rapidProper nutrition is needed to halt these negative trends. Establishing healthy dietary patterns in infancy through preschool age may prevent the development of negative health effects in the future and promote a higher quality of life.I believe this Special Issue contributes to the enhancement of further studies on child nutrition.


The journal retracts the 2022 article cited above.Following publication, concerns were raised regarding the contributions of the authors of the article. Our investigation, conducted in accordance with Frontiers policies, confirmed a serious breach of our authorship policies and of publication ethics; the article is therefore retracted.This retraction was approved by the Chief Editors of Frontiers in Psychology and the Chief Executive Editor of Frontiers. The authors have not responded to correspondence regarding this retraction.


The degree of success and effectiveness of the child’s socialization largely depends on the timely formation of social emotions, the ability to understand the emotional states of the participants in the interaction and manage their emotions.studying the features of understanding the emotional states of peers and adults by children of preschool age with special educational needs.The study involved 227 children aged 5-7 attending educational institutions: 95 children without developmental disorders; 73 children with severe speech disorders; 9 children with motor disorders; 25 children with visual impairment ; 15 children with hearing impairment ; 10 children with autism spectrum disorder. The “Emotional Faces” method (Semago) and the method of studying the child’s understanding of tasks in situations of interaction (Veraksa) were used.Tasks for the categorization of emotional states cause difficulties in children with speech disorders, since they require a certain mastery of vocabulary for the designation of emotional states. As a result of limited communication in children, there is a lack of understanding of the meaning, causes and motives of the actions of other people, as well as the consequences of their actions, their impact on others.Preschool children with motor disabilities are inferior to peers without developmental disabilities in accurate verbalization of emotional states, manifested in a primitive description of emotions.Visually impaired preschool children do not have sufficiently clear ideas about socially acceptable actions in communication situations, about ways of expressing relationships with peers and adults.Children with hearing impairment better understand the emotional states of their peers than the states of adults, but they do not know how to show their attitude towards their peers. Difficulties in verbalizing emotions are observed.Children with autism spectrum disorder experience significant difficulties in recognizing various situations of interaction, isolating tasks and requirements set by adults in these situations; children practically did not try to depict an emotion, having difficulty in differentiating it.The research confirmed the assumption that children with disabilities have significant difficulties in differentiating similar emotions, they do not accurately determine the emotional state of their peers and people around them. This paper has been supported by the Kazan Federal University Strategic Academic Leadership Program.None Declared


The cognitive health of older adults has become an increasingly important topic as the world's population continues to age. This symposium discusses the latest research and best practices for promoting and maintaining cognitive health in older adults, with an emphasis on the role of physical activity. Four expert presentations will delve into various aspects of this complex topic.The first presentation will provide a bibliometric analysis of the scientific literature about the link between lifestyle and cognition.The second presentation will present cross-sectional findings on the relationship between 24-hour movement behaviours and cognition in adults aged 55 years and above.The third presentation will present the effects and process evaluation of a cognitively enriched walking program for older adults, focusing on the challenges of research in real-life settings.The final presentation will highlight the impact of a combined physical and cognitive activity program on executive function and walking speed in adults aged 70-85 years.The bibliometric analysis and cross-sectional findings will provide a broad overview of the current state of research in this area, while the intervention studies will offer practical insights into the design and implementation of physical activity programs that target cognitive health in older adults. This symposium is a valuable opportunity for researchers, practitioners, and policy makers to learn about the latest developments in this field and discuss the future direction of research and policy.


Steel–concrete continuous composite beams are widely used in buildings and bridges and have many economic benefits. Slip has always existed in composite beams and will reduce the stiffness of composite beams. The effect of creep under a long-term load will also be harmful. Many scholars ignore the combined effects of slip and creep. In order to more accurately study the mechanical properties of steel–concrete continuous composite beams under long-term loads, this paper will consider the combined actions of slip and creep. By combining the elastic theory and the age-adjusted effective modulus method, the differential equation of the composite beam is derived via the energy variational method. The analytical solutions of axial force, deflection and slip under a uniform load are obtained by substituting the relevant boundary conditions. The creep equation is used to simulate the behavior of concrete with time in ANSYS. The analytical solution is verified by establishing a finite element model of continuous composite beams considering slip and creep. The results suggest the following: the analytical solution is consistent with the finite element simulation results, which verifies the correctness of the analytical solution. Considering the slip and creep effects will increase the deflection of the composite beam and the bending moment of the steel beam, reduce the bending moment of the concrete slab and have a significant impact on the structural performance of the continuous composite beam. The research results considering the coupling effect of slip and creep on continuous composite beams can provide a theoretical basis for related problems. The steel–concrete composite structure can not only give full play to the performances of the materials themselves  but also to the overall superiority of the materials after combination , so it is widely used in the construction industry and in bridge engineering ,2. In stMost of the studies on slip and creep effects were carried out in simply supported composite beams, and there are few studies on continuous composite beams. Dezi et al. proposed a viscoelastic analysis method and a parametric analysis of continuous composite beams with flexible shear connectors, considering the effects of creep in composite beams ,8. UsingBan et al. studied the time-dependent behaviors of simply supported composite beams with blind plate bolts under sustained loads. The results showed that the use of blind plate bolts in composite beams is beneficial to the time-dependent response . Nguyen Slip and creep have been considered in most composite beam research, but their combined effects can lead to inaccurate solutions under long-term loading. Compared with simply supported composite beams, the analytical problem of a continuous composite beam under the combined actions of slip and creep is difficult to solve. At present, there is no analytical solution in the literature for the internal force and deformation of a continuous composite beams under the coupling effect of slip and creep. This analytical solution is obtained in this paper. In order to accurately and conveniently calculate the coupling effect of slip and creep on steel–concrete continuous composite beams, this paper studies the mechanical properties of continuous composite beams under long-term uniform loads and establishes a governing differential equation for an axial force function for continuous composite beams via the energy variational principle. By introducing the relevant boundary conditions, the analytical solutions for the axial force, deflection and slip of a continuous composite beam under a uniform load are solved. Finally, the correctness and applicability of the obtained formulae are verified via ANSYS examples. At the same time, the effects of three kinds of shear stiffness on the slip and deflection of continuous composite beams are calculated. It is hoped that this research can provide a theoretical basis for the practical engineering calculation of continuous composite beams under the influence of a long-term load.In this section, based on the elastic theory and the age-adjusted effective modulus method, the basic assumptions of continuous composite beams are established, and the related theories of the slip and creep of continuous composite beams are described. Using the energy variational principle, the strain energy equation of the composite beam considering the effects of slip and creep is established, and the control differential equation and boundary conditions are obtained via the variational method and the partial integral method.Without considering the influence of transverse shear deformation in the composite beam, the curvatures of the steel beam and the concrete flange plate are completely consistent, and the vertical lifting phenomenon at the interface of the steel–concrete composite beam is ignored.The cross-sections of the concrete slab and the steel beam meet the plane section assumption, respectively, and the stud connector conforms to the elastic sandwich setting.The stress–strain relationship between the steel beam and the concrete is linear throughout the stressing phase, and the concrete is not cracked or spalled.The shear connectors are evenly distributed along the length direction of the composite beam, and the shear force of each shear connector is linearly related to the slip.In the coupled analysis of the slip and creep effects of continuous steel–concrete composite beams, the calculation is based on the following basic assumptions ,24:WithoV are the axial force, bending moment and shear force of the composite beam; The section and element force diagram of the composite beam is shown in From the diagram of the forces on the unit and the equilibrium relationship, it is known that:From the bending moment equilibrium condition, In Equation (2), The shear connector of the composite beam is similar to the assumption that the spring conforms to the elastic interlayer. The displacement diagram of the interlayer slip is shown in ectively .According to the relationship between the axial strain and the displacement of the composite beam, On the basis of considering the influence of the interface slip of the composite beam, the age-adjusted effective modulus method (AEMM) is used to consider the creep effect of the composite beam concrete. This method uses the integral mean value theorem to transform the integral equation into an algebraic equation. At the same time, the influence of the aging properties of the concrete is considered, which simplifies the calculation and meets the needs of calculation accuracy. It is suitable for finite element analysis. The algebraic constitutive relation is ,27:(6)εct; Through the effective modulus of age adjustment, considering the influence of the aging coefficient on the creep coefficient, we can rewrite Equation (6) as:The range of the aging coefficient H. Torst  recommenH. Torst  combinedH. Torst  considerThe standard loading age of concrete is 7~14 days, and most concrete creep is completed within 1~2 years. The creep coefficient curves of concrete are different under different initial loading times. When the loading time of concrete is the same, the earlier the initial loading age, the greater the creep coefficient of the concrete will be . The calAccording to the principle of minimum potential energy, the composite beam maintains an equilibrium state when subjected to external forces. Therefore, this paper will establish the strain energy equations of the flange and steel beam of the steel–concrete composite beam.The strain energy of the concrete slab:The strain energy of steel beam:The elastic interlayer slip’s strain energy:The external load potential energy:K is the single shear connector connection stiffness and e is the shear connector spacing.The total potential energy of the combined beam is According to the principle of minimum potential energy, the first-order variation of the total potential energy is divided into zero, that is, The governing differential equations and boundary conditions can be obtained by Equation (15):According to the internal force balance relationship of the composite beam, In Equation (18), According to the relationship between the bending moment and curvature:Substituting Equation (19) into Equation (18), we can obtain:Simplifying Equation (20) by After simplifying the first derivative of Equation (16), we obtain:After substituting Equation (20) into Equation (22) and calculating the first derivative, we obtain:Substituting the first term of Equation (16) into Equation (23), the slip differential equation is obtained:Simplifying Equation (20) by In the case of determining the structural form and load, arrange the integral using the boundary conditions and axial force control differential equations to obtain the expression of the deflection function:In this section, according to the differential equations of the axial force, slip and deflection solved above, an analytical calculation of continuous composite beams under the combined actions of slip and creep is carried out. By substituting different boundary conditions, the analytical solution for a continuous composite beam under a uniform load is obtained.A two-span continuous beam subjected to uniform load q is selected as the research object, as shown in The bending moment function of the continuous composite beam is shown in Equation (27):The bending moment function (27) of the composite beam is substituted into the differential Equation (21) of the axial force function. Then, with the boundary conditions The first derivative of the bending moment function (27) of the composite beam is substituted into the differential equation of the slip function (21). Then, through the boundary conditions According to the deflection function expression in Equation (32), the bending moment function in Equation (33) under the uniform load of the composite beam and the analytical solution of the axial force, shown in Equations (28) and (29), are introduced, and then through the boundary conditions There are two creep analysis methods in ANSYS: explicit and implicit time integration methods. At the same time, the equation of the creep strain rate, t in Equation (34), we obtain:After the first derivative of the variable Substituting the relationship Creep should have a linear relationship with the strain rate of concrete. Take t and the creep coefficient. The time at the ith moment is According to the expression, we can see the relationship between For the calculation of the creep coefficient 2, the Poisson’s ratio value is 2 and the Poisson’s ratio value is The section size of the steel–concrete continuous composite beam selected in this paper is shown in A sketch of the continuous composite beam model under a uniform load is shown in The ANSYS finite element composite beam model was built for structural analysis. The upper and lower flanges of both the concrete slab and the steel beam were simulated using the solid unit Solid45, and the web of the steel beam was simulated using the Plane42 unit; the studs between the concrete slab and the steel beam were simulated using the Combin39 spring element. Combin39 can define the load–slip curve with an axial or torsional function and can provide good simulations of studs in composite beams. By controlling the meshing and nodes of the steel beam and the concrete slab, the steel beam and the concrete node (two overlapping nodes) were selected at the position at which the studs were arranged, and the spring element Combine39 element was established. The spring element node, the concrete node and the steel beam node were connected by the degree of freedom coupling. The constraint arrangement was a fixed hinge support at the left end of the continuous beam and movable hinge supports at the mid-span and right end. The finite element model of the continuous composite beam is shown in The results of the comparison between the theoretical and FEM calculated axial forces at the mid-span position of the left span of the continuous composite beam are shown in As can be seen from As can be seen in The comparative results of deflection and slip at the mid-span position of the left span of the continuous composite beam are shown in As can be seen from As can be seen in The shear stiffness of the shear connector was taken as the research variable, and the remaining parameters were the same as in the previous example. Three kinds of shear stiffness, namely, The maximum axial forces of the composite beam at the initial time and the final time of creep under the three shear stiffnesses are compared, as shown in According to the data in In the case of different shear stiffnesses, the maximum deflection and slip values of the composite beam on the 14th and 728th days are compared, as shown in According to According to A comparison between the concrete bending moment of the composite beam and the bending moment of the steel beam at the initial moment and at the final moment of creep is shown in According to In this paper, the energy variational method is used to establish the control differential equation, considering the combined actions of slip and creep. The theoretical analytical solutions for the slip, deflection and axial forces of continuous composite beams under uniform loads are derived. The correctness of the analytical solution is verified by establishing a finite element composite beam model.For a composite beam under a long-term load, creep will increase the deflection of the composite beam and the steel beam bending moment, reducing the concrete bending moment. The deflection of the composite beam increases by 14% under the influence of creep, the bending moment of the steel beam increases by 12% and the bending moment of the concrete decreases by 49%. Creep has little effect on the slip and axial force of a composite beam, increasing by about 2%.The analytical solution obtained in this paper is suitable for the calculation and analysis of any equal-span continuous composite beam under a uniform load and can calculate any shear stiffness, which can quickly and intuitively reflect changes in the deflection, slip and axial force under a long-term load. The increase in the shear stiffnesses of shear connectors will increase the axial forces of composite beams and reduce slip, deflection and bending moments. The increase in shear stiffness will reduce the influence of creep on the axial forces and slip of composite beams and increase the influence of creep on deflection.In this paper, the slip, deflection and axial force of steel–concrete continuous composite beams under the coupling of slip and creep effects are analyzed and studied. The conclusions are as follows:In this paper, mechanical properties under the coupling actions of slip and creep are studied. Future work will carry out experimental research on continuous composite beams. The changes in the internal forces in the negative moment zones of composite beams under coupling and the stress caused by concrete cracking affected by creep must be further studied.


Semiconductor chips on a substrate have a wide range of applications in electronic devices. However, environmental temperature changes may cause mechanical buckling of the chips, resulting in an urgent demand to develop analytical models to study this issue with high efficiency and accuracy such that safety designs can be sought. In this paper, the thermal buckling of chips on a substrate is considered as that of plates on a Winkler elastic foundation and is studied by the symplectic superposition method (SSM) within the symplectic space-based Hamiltonian system. The solution procedure starts by converting the original problem into two subproblems, which are solved by using the separation of variables and the symplectic eigenvector expansion. Through the equivalence between the original problem and the superposition of subproblems, the final analytical thermal buckling solutions are obtained. The SSM does not require any assumptions of solution forms, which is a distinctive advantage compared with traditional analytical methods. Comprehensive numerical results by the SSM for both buckling temperatures and mode shapes are presented and are well validated through comparison with those using the finite element method. With the solutions obtained, the effects of the moduli of elastic foundations and geometric parameters on critical buckling temperatures and buckling mode shapes are investigated. Semiconductor chips have garnered significant scholarly attention due to their indispensable engineering applications in stretchable electronics , flexiblA variety of numerical and approximate methods can be employed to address the above issue. Raju and Rao  investigAlthough numerical methods can effectively solve a variety of engineering problems within an acceptable margin of error, analytical methods are still vital since they not only provide benchmark solutions but also are helpful for rapid parameter analysis. Bouazza et al.  conducteIt is noted that most existing analytical methods are limited to yield only Lévy-type (including Navier-type) solutions for plates with simply supported BCs, leading to an urgent demand for the exploration of new analytical solutions for non-Lévy-type plates. The symplectic superposition method (SSM), incorporating the symplectic approach pioneered by Yao et al.  and the In this paper, with the SSM, the thermal buckling of a semiconductor chip on a substrate, which is treated as a thin plate on a Winkler foundation, is studied. The rest of the paper is organized as follows: The governing equation for the thermal buckling of the thin plate in the Hamiltonian system is introduced in As shown in The governing equations for the thermal buckling of the thin plate areBy introducing the thermal buckling problem of the plate into the Hamiltonian system, the governing equation is obtained as (4)∂Z∂y=In this section, the thermal buckling problem of a fully clamped rectangular thin plate is explained in detail. Firstly, the original problem is divided into two fundamental subproblems, each of which is based on a plate with simply supported BCs. Secondly, each subproblem is deduced without any assumptions of the solution forms by the techniques of separating variables and symplectic eigenvector expansion. Finally, the analytical solution of the original problem is obtained through the superposition of subproblems’ solutions.The original problem a is diviFor the first subproblem, the separation of variables is implemented in the symplectic space such thatSubstituting Equation (5) into Equation (4) we obtain the eigenvalue problemThe eigenvalue problem is solved according to the BCs in the The eigenvalues areAccording to the symplectic eigenvector expansion , the staThe final solution of the governing equations expressed in terms of the undetermined coefficients For the second subproblem, the coordinate transformation is used to replace To make the superposition of the two subproblems equivalent to the original problem, the superposition of the subproblems’ solutions must fulfill the actual BCs. For the original problem, the BCs areFor Therefore, we obtain an infinite system of linear equations regarding the coefficients To ensure accurate and reliable benchmarks for subsequent structural designs, the analytical thermal buckling results of semiconductor chips are presented using the SSM and verified with the FEM. All the present numerical and graphical results based on the SSM were achieved through programming in the Mathematica software Version 12.0, and the FEM-based numerical solutions were obtained via the ABAQUS software  where thFirstly, the convergence study for the buckling temperatures of the plates with different aspect ratios, Additionally, the first five buckling temperatures of CCCC plates with aspect ratios With the analytical solutions, the effects of the moduli of the Winkler foundation and geometric parameters on the critical buckling temperature This study gives an analytical model to solve the problem of thermal buckling of semiconductor chips on a substrate within the framework of the Hamiltonian system. The SSM is used to transform the original problem into two subproblems, and the separation of variables and symplectic eigenvector expansion are utilized to solve each subproblem. The buckling temperatures and corresponding mode shapes are determined by the requirement of the equivalence between the original problem and the superposition of the two subproblems. After the fast convergence of the method is verified, comprehensive numerical examples are provided, which can serve as benchmarks. With the analytical solutions, the effects of the moduli of the Winkler foundations and geometric parameters are quantitatively studied. Specifically, it is observed that with the increase in the foundation parameter, both the critical buckling temperature and the half wave number of thermal buckling mode shape increase. Additionally, the critical buckling temperatures of plates continuously decline with an increase in aspect ratio. From the perspective of ensuring safety, a larger foundation modulus is favored and the shape of the semiconductor chips is recommended to be square to protect semiconductor chips from thermal buckling. While recognizing the inherent merits of the current approach in terms of its versatility and accuracy, it is important to acknowledge that, like any other solution method, it has certain limitations. The SSM is primarily tailored for addressing linear partial differential equation problems, posing limitations when encountering nonlinear partial differential equations. To tackle complex issues involving plastic behavior or substantial deformations, it becomes necessary to complement the method with perturbation techniques to effectively linearize the nonlinear equations and subsequently address them as a combination of linear equations. Although this paper focuses on thermal buckling problems of plates on elastic foundations, it is also necessary to mention that the SSM holds the potential for broader applications in the analysis of bending, vibration, and buckling problems associated with similar structures.