搜索结果：Journal of evolution equations

Our objective was to characterize nonarticular pain (NAP) at early rheumatoid arthritis (RA) diagnosis, the evolution over the first year of treatment, associations with active RA inflammation, and the impact on remission. This real-world, longitudinal multicenter cohort study observed participants with active early RA (symptoms <1 year and Clinical Disease Activity Index [CDAI] >2.8) enrolled between January 2017 and January 2022 who completed a body pain diagram over 1 year. Participants were grouped by prespecified definitions of NAP: (1) none, (2) regional, or (3) widespread. Rheumatologists performed joint counts. Descriptive statistics summarized the frequency and evolution of NAP patterns over 1 year. Chi-square tests compared the proportions of tender and/or swollen joints by the presence of pain in each NAP section. Multiadjusted generalized estimating equations regression models estimated associations of NAP patterns with remission outcomes. Participants (N = 392) were 70% female, with a mean &#xb1; SD age of 56 &#xb1; 14 years and mean &#xb1; SD symptoms duration of 5.1 &#xb1; 2.7 months. More than half reported NAP at baseline, with most (73%) presenting with regional NAP. Common patterns of regional NAP were axial (40%) and pain in upper quadrants (17%). A total of 43% of those with regional NAP persisted or worsened over 1 year, whereas 73% of those with widespread NAP resolved or improved. Joint inflammation was more frequently reported in areas with NAP versus areas without NAP. Regional and widespread NAP were associated with lower odds of reaching CDAI remission (adjusted odds ratio 0.42, 95% confidence interval 0.26-0.70 and adjusted odds ratio 0.30, 95% confidence interval 0.12-0.74), respectively. Regional NAP is common and persistent in early RA and impacts remission. RA activity may contribute to NAP. More attention to NAP in RA care is warranted.

The operational efficiency of the healthcare system is directly linked to the accessibility of health resources, the equitable distribution of health services across regions, and the sustainable functioning of the public health system. In the context of rapid population aging and growing medical demand, the persistent existence of interprovincial efficiency disparities may further intensify resource allocation imbalances and regional fragmentation in health service provision. Against this backdrop, this study examines the dynamic evolution and spatial interdependence of provincial healthcare system efficiency in China, systematically characterizing its transformation patterns and stratified structure. Using panel data from 31 Chinese provinces over the period 2001-2020, this study measures provincial healthcare system efficiency through an input-oriented Data Envelopment Analysis model under variable returns to scale. Pure technical efficiency is adopted as the core indicator, and efficiency states are categorized into low, medium, and high groups based on tercile thresholds. On this basis, Markov transition matrices and stationary distributions are constructed to capture efficiency mobility and long-term structural patterns. A spatial Markov framework is further employed to assess the influence of neighborhood efficiency contexts on state transitions. In addition, transition equations are estimated to identify structural factors associated with upward and downward efficiency movements. During the sample period, the mean pure technical efficiency across provinces was 0.884, indicating the presence of residual input redundancy under the existing resource allocation structure. The Markov transition results reveal strong state persistence and limited cross-level mobility, reflecting pronounced path dependence. The stationary distribution further confirms the long-term coexistence of low-, medium-, and high-efficiency "clubs," with corresponding steady-state probabilities of 44.91, 30.84, and 24.24%, respectively, suggesting no evidence of natural convergence. Spatial Markov analysis indicates that provinces located within high-efficiency neighborhoods are more likely to experience upward mobility, whereas clusters of low-efficiency regions tend to reinforce state persistence. China's provincial healthcare system efficiency exhibits structural stratification and spatial interdependence, and efficiency disparities do not diminish automatically over time. From a policy perspective, greater emphasis should be placed on cross-regional coordination and the optimization of resource allocation structures. By facilitating upward efficiency mobility and mitigating the persistence of low-efficiency states, policymakers can reduce the long-term risk of structural divergence.

Children and adolescents with type 1 diabetes (T1D) experience persistent impacts on quality of life (QoL). While most previous studies have relied on cross-sectional designs, this prospective cohort study intended to: (1) assess longitudinal changes in patient-reported QoL over a three-year period; (2) identify distinct QoL trajectory subgroups; and (3) examine demographic, physiological, psychological, and clinical determinants associated with trajectory membership and multidimensional QoL outcomes. Two hundred children and adolescents with T1D from China were followed for three years in a longitudinal cohort study. QoL was measured using the Quality of Life Scale for Children and Adolescents (QLSCA) at baseline from June 2019 to May 2020, with follow-up visits at years 1, 2, and 3 thereafter. Trajectories of QoL and associations with determinants were identified via iterative estimations of group-based trajectory models and multivariable multinomial logistic regression, respectively. The specific impacts of the determinants on QoL were revealed using multiple linear regressions. Changes in QoL dimensions over time were examined using linear mixed models, while changes in determinants were analyzed using both linear mixed models and generalized estimating equations. Four QoL trajectory groups were identified (N&#x2009;=&#x2009;200): poor (19.5%), moderate (27.5%), improving (17.5%), and good (35.5%) QoL. Improved QoL was associated with higher paternal education, greater height, lower glycosylated hemoglobin (HbA1c), fewer hypoglycemic episodes, and reduced depression levels. Furthermore, the frequency of self-monitoring of blood glucose (SMBG), Self-Management of Type 1 Diabetes for Adolescents (SMOD-A) scores, and higher parental education were positively correlated with improvements in various QoL dimensions. In contrast, higher State-Trait Anxiety Inventory-Trait (STAI-T) and Children's Depression Inventory (CDI) scores were negatively correlated with relationship between teacher and pupil, negative emotions, and other QoL aspects. Throughout the study, a significant increase in the use of continuous glucose monitoring (CGM) and insulin pumps was observed, along with improvements in SMBG and self-management ability. Notably, a reduction in the monthly frequency of hypoglycemic episodes and anxiety levels was also observed. Statistically significant improvements were found across several QoL dimensions, including companionship, self-esteem, physical feeling, activity opportunity, and physical activity ability, with the most pronounced improvement seen in physical activity ability. This study identified the dynamic trajectories of QoL changes in a cohort of children and adolescents with T1D and screened potential determinants that enhance QoL. These insights are valuable for developing tailored, individualized diabetes management strategies aimed at improving long-term outcomes for T1D patients. Type 1 diabetes (T1D) is highly prevalent among children and adolescents and significantly affects their long-term quality of life (QoL). Understanding how QoL evolves in this population remains limited. This study tracked a cohort of young T1D patients at the Type 1 Diabetes Comprehensive Management Clinic and assessed changes in their QoL after three years of regular follow-up. The findings revealed variable QoL outcomes within this group, characterized overall as moderate. An analysis of the subgroup that showed significant improvements identified key determinants influencing QoL and documented the evolution of these factors over time. These results underscore the necessity for more long-term follow-up care and tailored interventions to increase the QoL young T1D patients.

Personalized medicine for patients receiving radiation therapy remains an elusive goal due, in part, to the limits in our understanding of the underlying mechanisms governing tumor response to radiation. The purpose of this study was to develop a kinetic model, in the context of locally advanced lung cancer, connecting cancer cell subpopulations with tumor volumes measured during the course of radiation treatment for understanding treatment outcome for individual patients. The kinetic model consists of three cell compartments: cancer stem-like cells (CSCs), non-stem tumor cells (TCs) and dead cells (DCs). A set of ordinary differential equations were developed to describe the time evolution of each compartment, and the analytic solution of these equations was iterated to be aligned with the day-to-day tumor volume changes during the course of radiation treatment. A least squares fitting method was used to estimate the parameters of the model that include the proportion of CSCs and their radio-sensitivities. This model was applied to five patients with stage III lung cancer, and tumor volumes were measured from 33 cone-beam computed tomography (CBCT) images for each of these patients. The analytical solution of these differential equations was compared with numerically simulated results. For the five patients with late stage lung cancer, the derived proportions of CSCs are 0.3 on average, the average probability of the symmetry division is 0.057 and the average surviving fractions of CSCs is 0.967, respectively. The derived parameters are comparable to the results from literature and our experiments. The preliminary results suggest that the CSC self-renewal rate is relatively small, compared to the proportion of CSCs for locally advanced lung cancers. A novel mathematical model has been developed to connect the population of cancer stem-like cells with tumor volumes measured from a sequence of CBCT images. This model may help improve our understanding of tumor response to radiation therapy, and is valuable for development of new treatment regimens for patients with locally advanced lung cancer.

Type 2 diabetes is a highly heterogeneous disease for which new subgroups ('clusters') have been proposed based on disease severity: moderate age-related diabetes (MARD), moderate obesity-related diabetes (MOD), severe insulin-deficient diabetes (SIDD) and severe insulin-resistant diabetes (SIRD). It is unknown how disease severity is reflected in terms of quality of life in these clusters. Therefore, we aimed to investigate the cluster characteristics and cluster-wise evolution of quality of life in the previously defined clusters of type 2 diabetes. We included individuals with type 2 diabetes from the Maastricht Study, who were allocated to clusters based on a nearest centroid approach. We used logistic regression to evaluate the cluster-wise association with diabetes-related complications. We plotted the evolution of HbA1c levels over time and used Kaplan-Meier curves and Cox regression to evaluate the cluster-wise time to reach adequate glycaemic control. Quality of life based on the Short Form 36 (SF-36) was also plotted over time and adjusted for age and sex using generalised estimating equations. The follow-up time was 7 years. Analyses were performed separately for people with newly diagnosed and already diagnosed type 2 diabetes. We included 127 newly diagnosed and 585 already diagnosed individuals. Already diagnosed people in the SIDD cluster were less likely to reach glycaemic control than people in the other clusters, with an HR compared with MARD of 0.31 (95% CI 0.22, 0.43). There were few differences in the mental component score of the SF-36 in both newly and already diagnosed individuals. In both groups, the MARD cluster had a higher physical component score of the SF-36 than the other clusters, and the MOD cluster scored similarly to the SIDD and SIRD clusters. Disease severity suggested by the clusters of type 2 diabetes is not entirely reflected in quality of life. In particular, the MOD cluster does not appear to be moderate in terms of quality of life. Use of the suggested cluster names in practice should be carefully considered, as the non-neutral nomenclature may affect disease perception in individuals with type 2 diabetes and their healthcare providers.

Generalized Feller theory provides an important analog to Feller theory beyond locally compact metric state spaces. This is very useful for solutions of certain stochastic partial differential equations, Markovian lifts of fractional processes, or infinite-dimensional affine and polynomial processes which appear prominently in the theory of signature stochastic differential equations. We extend several folklore results related to generalized Feller processes, in particular on their construction and path properties, and provide the often quite sophisticated proofs in full detail. We also introduce the new concept of extended Feller processes and compare them with classical and generalized ones as well as with Doob's h-transform. A key example relates generalized Feller semigroups of algebra homomorphisms via the method of characteristics to transport equations and continuous semiflows on weighted spaces, i.e.,&#xa0;a remarkably generic way to treat differential equations on weighted spaces. We also provide a counterexample, which shows that no condition of the basic definition of generalized Feller semigroups can be dropped.

Chemotaxis phenomena govern the directed movement of microorganisms in response to chemical stimuli. In this paper, we investigate two Keller-Segel systems of reaction-advection-diffusion equations modeling chemotaxis on thin networks. The distinction between two systems is driven by the rate of diffusion of the chemo-attractant. The intermediate rate of diffusion is modeled by a coupled pair of parabolic equations, while the rapid rate is described by a parabolic equation coupled with an elliptic one. Assuming the polynomial rate of growth of the chemotaxis sensitivity coefficient, we prove local well-posedness of both systems on compact metric graphs, and, in particular, prove existence of unique classical solutions. This is achieved by constructing sufficiently regular mild solutions via analytic semigroup methods and combinatorial description of the heat kernel on metric graphs. The regularity of mild solutions is shown by applying abstract semigroup results to semi-linear parabolic equations on compact graphs. In addition, for logistic-type Keller-Segel systems we prove global well-posedness and, in some special cases, global uniform boundedness of solutions.

Environmental protection talents training (EPTT) is recognized as a key prerequisite for maintaining environmental sustainability, and in order to study the influence of each player on EPTT. This paper innovatively constructs a tripartite evolutionary game model of government, university and enterprise. The equilibrium points and evolutionary stabilization strategies of each participant are solved by replicating the dynamic equations, and the behaviors of each subject in EPTT are analyzed so as to clarify the behavioral characteristics and optimal strategies of the government's participation in EPTT. The results show that enterprises occupy a more important position in influencing government decisions. The government should reduce the financial incentives for enterprises and replace them with greater policy support. Meanwhile, the government should actively promote the cultivation mechanism that integrates universities and enterprises. The results of the study can provide a decision-making basis for the government to promote the sustainable development of EPTT.

Alzheimer's disease (AD) is a major public health concern, and there is an urgent need to better understand its complex biology and develop effective therapies. AD progression can be tracked in patients through validated imaging and spinal fluid biomarkers of pathology and neuronal loss. We still, however, lack a coherent quantitative model that explains how these biomarkers interact and evolve over time. Such a model could potentially help identify the major drivers of disease in individual patients and simulate response to therapy prior to entry in clinical trials. A current theory of AD biomarker progression, known as the dynamic biomarker cascade model, hypothesizes AD biomarkers evolve in a sequential but temporally overlapping manner. A computational model incorporating assumptions about the underlying biology of this theory and its variations would be useful to test and refine its accuracy with longitudinal biomarker data from clinical trials. We implemented a causal model to simulate time-dependent biomarker data under the descriptive assumptions of the dynamic biomarker cascade theory. We modeled pathologic biomarkers (beta-amyloid and tau), neuronal loss biomarkers, and cognitive impairment as nonlinear first-order ordinary differential equations (ODEs) to include amyloid-dependent and nondependent neurodegenerative cascades. We tested the feasibility of the model by adjusting its parameters to simulate three specific natural history scenarios in early-onset autosomal dominant AD and late-onset AD and determine whether computed biomarker trajectories agreed with current assumptions of AD biomarker progression. We also simulated the effects of antiamyloid therapy in late-onset AD. The computational model of early-onset AD demonstrated the initial appearance of amyloid, followed by biomarkers of tau and neurodegeneration and the onset of cognitive decline based on cognitive reserve, as predicted by the prior literature. Similarly, the late-onset AD computational models demonstrated the first appearance of amyloid or nonamyloid-related tauopathy, depending on the magnitude of comorbid pathology, and also closely matched the biomarker cascades predicted by the prior literature. Forward simulation of antiamyloid therapy in symptomatic late-onset AD failed to demonstrate any slowing in progression of cognitive decline, consistent with prior failed clinical trials in symptomatic patients. We have developed and computationally implemented a mathematical causal model of the dynamic biomarker cascade theory in AD. We demonstrate the feasibility of this model by simulating biomarker evolution and cognitive decline in early- and late-onset natural history scenarios, as well as in a treatment scenario targeted at core AD pathology. Models resulting from this causal approach can be further developed and refined using patient data from longitudinal biomarker studies and may in the future play a key role in personalizing approaches to treatment.

The aging population in the United States is increasingly diverse, particularly among community-dwelling individuals with disabilities. Black and Hispanic older adults experience greater reliance on assistance with daily activities (e.g., bathing, shopping, banking) than White adults. Assistance is often provided by multiple caregivers helping with the same tasks ("role-sharing"). We describe patterns of shared care by examining racial and ethnic differences in role-sharing in 2015 and 2022. We use weighted, repeated cross-sectional data from the 2015 and 2022 National Health and Aging Trends Study, focusing on Black, White, and Hispanic community-dwelling care recipients (n&#x2009;=&#x2009;3,050 in 2015; n&#x2009;=&#x2009;2,318 in 2022) who receive assistance with household (e.g., shopping), self-care (e.g., bathing, dressing), mobility (e.g., getting around indoors), or medical activities (e.g., medication management) due to health or functioning limitations. Logistic regression models using generalized estimating equations assessed race differences in experiencing role-sharing, adjusting for older adult characteristics and survey year. Role-sharing was most common in the household assistance domain, with approximately 30% of all groups reporting role-sharing in both years. In fully adjusted models, Hispanic recipients experienced lower odds of role-sharing for household tasks (OR: 0.72, 95% CI: 0.57-0.91) compared to White care recipients. Racial and ethnic differences were not observed in other care domains, and role-sharing prevalence was consistent in 2015 and 2022. Findings underscore the complexity of caregiving networks and inform strategies to improve collaboration and reduce role ambiguity among role-sharing caregivers.

The performance of a fluid bed granulator was investigated through experimental and numerical study to develop a stand-alone fluid bed granulation model. The single-compartment model proposed in part I (for agglomeration modeling) was extended to account for i) evaporation of freely-flowing droplets, and ii) particle drying. This model enables us to predict the granule liquid content and temperature besides the granule size. Accurately, the equations of heat and mass conservation were solved in parallel to the population balance calculation of the agglomeration. In the same manner as for the agglomeration model, the model parameters associated with the drying model were estimated and correlated to the relevant quantities. The analysis of the experimental results revealed the significant contribution of the system "degree of wetness" to the bed performance, i.e., granule size and loss on drying (LoD). As the agglomeration model parameters were partially correlated to LoD in Part I, the presented model was revisited by inclusion of the degree of wetness. The reliability of the developed model in predicting the temporal evolution of granule size, liquid content, and temperature was proven through comparing the bed performance between simulation and experiment. Subsequently, to lowering the costs associated with experimental run, an approach was proposed based on the degree of wetness, aimed at reducing the number of experiments required for the design of experiment (DoE). The results of our simulation using reduced experiments demonstrated that the degree of wetness can be a promising indicator for the performance of the fluid bed granulator as well as for more efficient design of experiment.

We study the Cauchy problem for the advection-diffusion equation &#x2202;tu+div(ub)=&#x394;u associated with a merely integrable divergence-free vector field b defined on the torus. We discuss existence, regularity and uniqueness results for distributional and parabolic solutions, in different regimes of integrability both for the vector field and for the initial datum. We offer an up-to-date picture of the available results scattered in the literature, and we include some original proofs. We also propose some open problems, motivated by very recent results which show ill-posedness of the equation in certain regimes of integrability via convex integration schemes.

Glomerular filtration rate (GFR) is the best index for kidney function and estimated GFR (eGFR) calculated from endogenous filtration markers like serum creatinine and cystatin C is widely used in clinical practice for chronic kidney disease diagnosis and prognostication. We sought to review the evolution of GFR estimating equations, nuances of eGFR interpretation, and utility of eGFR in drug dosing. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) serum creatinine eGFR equation was recently updated to exclude the race variable and the CKD-EPI creatinine-cystatin C equation demonstrated the highest reliability. Although calculated creatinine clearance by Cockcroft Gault has been traditionally used for drug dosing, the use of eGFR is slowly being adapted by the Food and Drug Administration for pharmacokinetic studies. However, the individual-level accuracy of eGFR using the CKD-EPI 2021 equations remained low, with the distribution of measured GFR at a given eGFR value spanning several CKD stages. Although current methods of estimating GFR have improved in population measures of reliability, all have significant individual-level inaccuracies that can be an issue when clinical decision-making is contingent on the actual level of GFR. Modern methods of GFR measurements should be made widely available to enhance individualized patient decision-making.

In Crohn's disease (CD), a composite therapeutic target was recently recommended, including both objective measurement (endoscopic remission) and Patient-Reported Outcomes (resolution of abdominal pain and normalization of bowel function). All dimensions of health-related quality of life (HRQoL) are impacted: not only bowel symptoms but also systemic symptoms, emotional wellbeing and social function. Thus, understanding the predictors of each HRQoL dimension would improve patient management. However, analysis of these factors has only been found in a few publications, with some limitations. Therefore, this study aimed to explore the evolution of the HRQoL of CD patients during six months after initiation of anti-TNF and to identify its predictors. We analyzed data of 56 patients included in a multicenter prospective cohort study (COQC-PIT). HRQoL measures (using IBDQ-32) and data related to patient, disease and treatment characteristics were collected every two months. Generalized estimating equations were used. Overall HRQoL was significantly improved 2&#x2009;months after anti-TNF initiation, and then stagnated. Patient, disease, and treatment characteristics have differentiated impacts on the overall score and on each dimension of quality of life. Subcutaneous anti-TNF had no significant effect on overall HRQoL, improving only emotional function and bowel symptoms. Concomitant use of corticosteroids and/or immunomodulators impaired almost all dimensions. Having children or working altered bowel symptoms. Disease duration and active smoking negatively impact emotional function and systemic symptoms. Each HRQoL dimension, not only bowel symptoms, and their influencing factors should therefore be considered in medical decision-making, especially in months following the initiation of a new treatment such as anti-TNF.

To evaluate the evolution of interhemispheric coherences (ICo) in background and spindle frequency bands during childhood and use it to identify individuals with corpus callosum dysgenesis (CCd). A monocentric cohort of children aged from 0.25 to 15 years old, consisting of 13 children with CCd and 164 without, was analyzed. The ICo of background activity (ICOBckgrdA), sleep spindles (ICOspindles), and their sum (sICO) were calculated. The impact of age, gender, and CC status on the ICo was evaluated, and the sICO was used to discriminate children with or without CCd. ICOBckgrdA, ICOspindles and sICO increased significantly with age without any effect of gender (p < 10-4), in both groups. The regression equations of the different ICo were stronger, with adjusted R2 values of 0.54, 0.35, and 0.57, respectively. The ICo was lower in children with CCd compared to those without CCd (p < 10-4 for all comparisons). The area under the precision recall curves for predicting CCd using sICO was 0.992 with 98.9 % sensitivity and 87.5 % specificity. ICo of spindles and background activity evolve in parallel to brain maturation and depends on the integrity of the corpus callosum. sICO could be an effective diagnostic biomarker for screening children with interhemispheric dysfunction.

Punctate white matter injury on brain magnetic resonance imaging (MRI) is described in very preterm infants (<&#x2009;32&#xa0;weeks' gestation) and is predictive of poorer developmental outcomes. The reliability of scoring and the incidence and evolution of white matter injury in moderate-late preterm infants is unknown. To assess inter-observer variability in white matter injury using a published scoring system (UCSF system), and to describe changes over time in moderate-late preterm infants. Infants born between 32&#x2009;+&#x2009;0 and 36&#x2009;+&#x2009;6&#xa0;weeks' gestation in the Auckland region underwent MRI scans as soon as clinically feasible after birth and again at term-equivalent age. De-identified scans were scored independently by two observers. White matter injury was graded as minimal (<&#x2009;3 lesions measuring&#x2009;<&#x2009;2&#xa0;mm), moderate (>&#x2009;3 lesions or lesions&#x2009;>&#x2009;2&#xa0;mm), or severe (>&#x2009;5% hemispheric involvement). Scores were compared between reviewers using weighted and unweighted kappa statistics interpreted using Cohen's criteria. Incidences were compared between scans using generalised estimating equations. Scans of 101 infants were assessed. Inter-observer agreement was near perfect for the presence of white matter injury (k&#x2009;=&#x2009;0.88 and 0.81 for the first and second scan respectively), and for the severity of white matter injury was near perfect at the first scan (k&#x2009;=&#x2009;0.85) and substantial at the second scan (k&#x2009;=&#x2009;0.80). The incidence of white matter injury detected by the two observers decreased between the first and second scans (30% to 22% and 29% to 19%), and severity also decreased. This scoring system can be reliably applied in moderate-late preterm infants. White matter injury is common in moderate-late preterm infants but may be underestimated when MRI is performed close to term-equivalent age.

To examine longitudinal changes in health belief trajectories regarding colonoscopy screening across generations among first-degree relatives (FDRs) of colorectal cancer (CRC) patients and to inform tailored intervention strategies. An explanatory sequential mixed-methods design was conducted. In the quantitative phase, 200 FDRs of CRC inpatients were recruited from a tertiary hospital in Wuhan (April-November 2025) using convenience sampling. Health beliefs were measured using the Chinese version of the Colorectal Cancer Screening Health Belief Scale at hospitalization, 3 months, and 6 months post-discharge. Of these, 184 participants completed all assessments. Generalized estimating equations were used to analyze temporal and intergenerational effects. In the qualitative phase, 17 participants were selected via maximum variation sampling and underwent semi-structured interviews. Thematic analysis was performed to explain and complement quantitative findings. Quantitative analysis revealed significant temporal changes in overall health beliefs (Wald &#x3c7;&#xb2; = 66.37, P&#x202f;<&#x202f;0.001) and a significant group-by-time interaction (Wald &#x3c7;&#xb2; = 130.97, P&#x202f;<&#x202f;0.001). Generation A (born 1950-1969, aged 56-75) exhibited a rise-then-fall pattern. Generation B (born 1970-1989, aged 36-55) remained relatively stable. Generation C (born 1990-2009, aged 16-35) showed a continuous decline. All groups demonstrated the lowest health belief scores at 6 months post-discharge. Qualitative analysis identified two major themes: dynamic evolution of screening health beliefs (three generational patterns) and intergenerational difference factors (role positioning, information access, emotional support, and health awareness). The perceived illness warning effect gradually weakened over time, with generation-specific influencing mechanisms. Intergenerational differences in health belief trajectories highlight the need for stage-specific and generation-tailored interventions to improve CRC screening adherence among FDRs. Healthcare providers should enhance risk perception and screening guidance during hospitalization. Post-discharge, personalized multi-channel reminders are recommended: emotional support for Generation A, practical assistance for Generation B, and new media-based risk communication for Generation C.

This work proposes a method for the simultaneous estimation of the exchange-dependent relaxation rate R e x $$ {R}_{ex} $$ and the longitudinal relaxation time T 1 $$ {T}_1 $$ from a single acquisition. A novel acquisition scheme was developed that combines CEST saturation with an inversion pulse and a Look-Locker readout to capture the magnetization evolution starting from the inverse transient Z-spectrum. The corresponding signal model, derived from the Bloch-McConnell equations, describes both the transient Z-spectrum and the Look-Locker dynamics. A model-based reconstruction approach is employed to jointly estimate R e x $$ {R}_{ex} $$ and T 1 $$ {T}_1 $$ . The proposed method was validated using a numerical phantom and benchmarked against conventional CEST and Look-Locker T 1 $$ {T}_1 $$ mapping in a phantom and in vivo on a clinical 3T scanner. The joint estimation approach demonstrated strong agreement with ground truth and conventional methods across a wide range of T 1 $$ {T}_1 $$ and CEST parameters. The acquisition time was reduced by 20%-30% compared to standard CEST protocols, while providing a higher signal-to-noise ratio (SNR) in parameter maps. The proposed technique enables robust and efficient simultaneous quantification of CEST R e x $$ {R}_{ex} $$ and T 1 $$ {T}_1 $$ in a single acquisition. It improves parameter map quality and reduces scan time, making it suitable for both phantom and in vivo imaging across a wide range of physiological conditions.

Ray tracing software systems are commonly used to analyze the optics of solar energy devices, since they allow to predict the energy gains of devices in real conditions, and also to compare them with other systems constantly emerging in the market. However, the available open-source packages apply excessive simplifications to the model of light-matter interaction, making that the optical behaviour of the systems can not be properly characterized, which in turn implies disagreements between physical experiments and computer simulations. We present here the open source python package OTSun, which applies the Fresnel equations in their most general form, without further simplifications, and is suitable for the simulation of both solar-thermal and photovoltaic systems. The geometrical objects used in this package are created using the parametric 3D modeler FreeCAD, which is also a free and open source program and allows for the construction of arbitrary geometries that can be analyzed with OTSun. These, and other software capabilities, make OTSun extremely flexible and accurate for the optical analysis of solar devices with arbitrary geometry. Additionally, OTSun has a companion webtool, OTSunWebApp, that allows for the usage of certain features of the package without the need to install anything locally. We also show here two numerical experiments that we performed in order to validate the model and implementation: The analysis of the optical efficiency of a Linear Fresnel Reflector (with moving objects), and of a second surface mirror (with variable wavelengths). In each case, the numerical computations had deviations of less than 0.25% from reference models (either computed with another program or with exact formulas).